CDCR | File Multiple Work Comp Claims or One?

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When handling CDCR workers’ compensation claims, you run into officers who have multiple incidents over a period of time. Some of them are bandaid form situations and others require that a workers’ compensation claim form be filed with the employer.

When you file a claim, you need to be careful in understanding the long-term impact of each claim when you file multiple claims for multiple issues.

For instance, I had an officer contact me who had filed two claims, because Return To Work (I don’t believe out of any wrong doing) told him to file two claims.  First, his back and neck had been bothering him in his day to day work and it got worse and worse until he could not take it anymore.  Second, his heart was becoming an issue, so a claim was filed for that.  Because they are two different conditions, Return To Work felt he needed to file two claims.  

The problem is that the problem with the back and neck was caused by years of “wear and tear” of the job as an officer, and the heart caused by the chronic stress of the job (which is why officers have the heart presumption).

Since both claims were “wear and tear” and both happened at the same time in the same job duties, the cause of the injury and disability was the same.  One claim should be filed.

When you read this, you might ask “Why does it matter?”

The reason it matters is because if have one case that is a 10% disability and the another that is a 10% disability, you are compensated for both disabilities.  You will get compensated whether you file two or one. However, getting compensated for 10% and 10% isn’t the same as one that is 20%.  So, if the facts support one claim, you are being compensated less.

I have seen the agency argue there are two claims that *should* have been filed instead of one (even when only one was properly filed), because they want that discounted compensation.  

This occurs most often when cases rate over 70%.  In those cases, all injured workers get a “life pension” in addition to permanent disability compensation.  The agency will often argue that the conditions should be split.  For example, an orthopedic problem is 20% and the heart is 50%.  Two payouts (20% and 50%) is WAY less than the proper 70% depending on the age of the person.  In most cases, 70% is worth more.

CDCR has appealed this issue many times over the last five to seven years and has lost every time to my knowledge.  The reason is that you cannot have two overlapping cumulative trauma (wear and tear injury) periods which is what you are trying to do.  Further, from an evidence point of view, how can a doctor separate out the two different disabilities over different employment duties?  It’s impossible.  I would argue all officer duties on the essential job functions cause wear or tear on the entire body.  In most cases, the spine (back and neck), feet, knees, hips and heart are common.  You also see upper extremity problems from the constant use of keys and heavy doors.  The stress of the job is involved in every physical part of the job. 

The point of this article is that when you file a claim (even if it is a specific event), you should speak with an attorney before you do it.  What you do with a claim matters in the long-term.