A police officer engaged in a gunfight in May 2013. Afterward, he had problems such as difficulty sleeping, anxiety, and social withdrawal. The problems worsened over time. In December 2015, he visited a primary care doctor to get sleep medication, and the doctor noted “[p]robable PTSD.” In January 2016, he saw a trauma psychologist, who diagnosed PTSD.
In October 2016, the officer filed a worker’s compensation claim. An administrative law judge (“ALJ”) held a hearing, considered testimony from the officer and his fiancée, and found the claim untimely under A.R.S. § 23-1061(A).
On special action review, the Court of Appeals set aside the ALJ’s finding for lack of evidence. Under A.R.S. § 23-1061(A), a worker’s compensation claim must be filed within one year of “when the injury becomes manifest or when the claimant knows or in the exercise of reasonable diligence should know that the claimant has sustained a compensable injury.” A party asserting untimeliness must raise the issue as an affirmative defense and bears the burden of production.
Here, the parties asserting untimeliness (the employer and the insurance carrier) failed to submit evidence that the officer’s injury became “manifest” or that he should have known he sustained a “compensable injury” prior to one year before he filed his claim. PTSD is difficult to diagnose because its symptoms are varied and often delayed. The only formal diagnosis in this case was made in the same year the claim was filed. The record does not show that, before that diagnosis, the officer’s symptoms had progressed to the point that a diagnosis would have been possible. Expert testimony is generally required to make such a showing, and no experts testified here.
Judge Campbell delivered the opinion; Judges McMurdie and Cattani joined.
Posted by: Josh Whitaker