Public safety claim not decided in 75 days? What the presumption does

Seventy-five days, in the statute’s words

The ordinary rule, and the shorter one written into it.

The 75-day rule is a shorter version of a rule every California claim already has. Section 5402(b)(1) reads: “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.”

The shorter rule. SB 1127 (Statutes of 2022, chapter 835) added a second paragraph to that subdivision, effective January 1, 2023. For injuries and illnesses covered by the public safety presumptions, the period is 75 days. If liability is not rejected within 75 days after the claim form is filed, the injury is presumed compensable, and the presumption can be rebutted only by evidence discovered after the 75 days.

What it asks of you. Nothing beyond the claim form. Rejecting liability, which means deciding the claim is not covered, is the claims administrator’s act: the insurer, or whoever handles claims for your employer. Silence past the deadline is the trigger. Compensable means covered: the injury arose out of and in the course of the job, so benefits are owed for it.

Fifteen days is not a rounding error. Claims operations run on the 90-day number, in diary systems and form letters. A presumption claim handled like every other claim, and decided at day 80, has already run out of time the office did not know it was spending. Fifteen days separate a claim decided on time from a claim the law presumes is covered.

Public safety presumptions, condition by condition Workers’ comp claim denied? From the letter to the judge

Why the range is written in two pieces

Three sections left out on purpose, and what that changed.

The new paragraph, (b)(2), does not list conditions. It names the sections of the Labor Code that create the public safety presumptions, and it names them this way: “Sections 3212 to 3212.85, inclusive, and Sections 3212.9 to 3213.2, inclusive.”

That is two ranges with a gap between them, and the gap is not a drafting slip. It steps around the three COVID-19 presumptions, numbered 3212.86 to 3212.88, which set shorter rejection deadlines of their own: 30 days, or 45 for the one tied to workplace outbreaks. All three were written to “remain in effect only until January 1, 2024, and as of that date is repealed,” and they were repealed on that date.

The penalty enacted with it is written differently. SB 1127 also added a penalty for unreasonably rejecting these claims, explained below. Its text opens with the words “Notwithstanding Section 5814” and reaches “Sections 3212 to 3213.2, inclusive.” One range, no gap. The two provisions came from the same bill, they do not cover the same sections, and the difference is on the face of the statute.

So a COVID-19 claim had a combination no other claim had: its own 30 or 45 days to decide it, outside the 75-day rule, and the five-times penalty for an unreasonable rejection. Since the repeal, that reaches only a claim still open from that window. If you have one, it is worth raising. Today the gap is mostly a check: any summary that prints the 75-day rule against one unbroken run of sections is wrong on its face.

Which claims get the 75 days

The condition and the job, together.

The 75 days belong to the claim, not to the uniform. What puts a claim on the shorter clock is that the injury or illness falls within one of the presumption sections, and each of those turns on the condition, your classification, your employer and sometimes your years of service. A presumption, here, means the law treats the condition as caused by the job unless the employer proves otherwise. In brief:

• Heart trouble, hernia and pneumonia. Police, sheriffs, the Highway Patrol, fire departments, CAL FIRE and a run of other classes, from corrections staff with custodial duties to University of California police. Some require five years in the job.
• Cancer, including leukemia. Active firefighting members, peace officers primarily engaged in active law enforcement, and the other classes the cancer presumption lists, once exposure to a known carcinogen is shown.
• Tuberculosis and meningitis. Police, sheriffs, the Highway Patrol and fire departments, and in some sections prison and jail staff and probation officers.
• Blood-borne infectious disease, MRSA skin infection and biochemical exposure. Sheriff’s offices, police, fire departments and peace officers, and CAL FIRE for the first two.
• Skin cancer, Lyme disease and the lower back. Lifeguards employed more than three consecutive months in a calendar year; peace officers and California Conservation Corps members; and officers required to wear a duty belt for at least five years.
• Post-traumatic stress. Six classes, firefighters and peace officers among them, after six months of employment unless the cause was a sudden and extraordinary employment condition. It is set to expire on January 1, 2029.

What changed on January 1, 2026. Two bills widened the list for injuries from that date. SB 230 (Statutes of 2025, chapter 404) extended the cancer and post-traumatic stress presumptions to active firefighting members of fire departments that protect a commercial airport. AB 1125 (Statutes of 2025, chapter 291) extended the heart trouble presumption to peace officers employed by the Department of State Hospitals. A claim within either is on the 75-day clock.

Outside the list, 90 days. A claim outside the presumption sections keeps the ordinary 90 days, whatever the job. A firefighter’s knee torn in a fall is a claim like any other. So is a dispatcher’s post-traumatic stress claim: when this site last checked, in August 2026, no enacted statute extended the presumption to dispatchers, so that claim runs on 90 days and the ordinary psychiatric rules. Same department, same call, a different clock.

Firefighters Police, deputies and correctional officers

After you leave the job

Three months for each full year of service.

Most of these presumptions do not end on your last shift. They extend three calendar months for each full year of service in the covered job, counted from your last day actually worked, up to 60 months. The cancer presumption runs up to 120 months, ten years. Twenty years of service produces the full 60 months; the cancer maximum of 120 takes forty.

An illustrative retiree. A fire captain retires after 24 years and is diagnosed with cancer five and a half years later, which is 66 months. Under a presumption capped at 60 months, that is too late: 24 years reaches the cap, and the diagnosis came after it. For cancer, 24 years is 72 months, so the diagnosis falls inside. A claim filed then is a presumption claim, and the administrator has 75 days to reject it.

What the extension does not change. The count still starts when the claim form is filed, not on the day of the diagnosis.

The count starts with the claim form

Filing starts it. Knowing does not.

The 75 days run from the day the DWC-1 claim form is filed, not from the day your department learned you were hurt or sick. The California Supreme Court settled that for the 90-day rule in 2005, in Honeywell v. WCABWCAB Workers’ Compensation Appeals Board. The court system that decides these cases. 23 district offices statewide. (Wagner). The employer heard in October that the worker had been hospitalized for work stress, sent no claim form until January and rejected the claim in March. Counted from what it knew, that was past 90 days; counted from the filing, it was inside them, and the Court counted from the filing. A captain who knows about the diagnosis, a coordinator holding the records, an injury log with your name in it: none of it starts the count.

The form, and proof of the day. Your employer has to give you a claim form within one working day after learning of the injury. Filing means personal delivery to your employer, or receipt by first-class or certified mail. Hand it over and keep a copy with the date stamped on it, or send it certified and keep the receipt. The presumption turns on that one date, and a filing date you cannot prove is a presumption that is hard to claim.

The Application for AdjudicationApplication for Adjudication Opens your case at the Appeals Board. One year. does not start it. That form opens a case at the Appeals Board; the 75 days run from the DWC-1 alone. If no claim form was ever filed, nothing is running: file one now.

The same filing starts treatment. Within one working day after the claim form is filed, the employer has to authorize the treatment the medical guidelines call for, up to $10,000 until liability is accepted or rejected. Providing it creates no presumption of liability. If you were told to use your own health insurance meanwhile, ask for the authorization in writing.

The count, worked. Take an illustrative claim form filed on June 1. The 29 remaining days of June, the 31 of July and 15 of August make 75, so a presumption claim’s window closes on August 15. An ordinary claim runs 15 more days, to August 30.

Most disputes about a late rejection come down to exactly this: two dates and a subtraction.

Run your own dates The first 30 days after a work injury

What has to happen by day 75

A decision, not a letter, and never a delay notice.

The decision is what counts. In Rodriguez v. WCAB, decided in 1994, the court held a rejection timely even though its letter, mailed on day 89, reached the worker on day 96: “it is the rejection which must occur within the 90-day period, not the receipt of notice of that rejection.” That case was decided under the 90-day rule. The 75-day rule is built the same way, so a letter that reaches you after day 75 does not, by itself, prove a late rejection.

But the administrator has to prove when it decided. It carries that burden, and a regulation sets the outer edge of the paperwork: a notice denying liability has to be sent no later than 14 days after the decision to deny. It has to give the reasons and, where the denial rests on a medical report, include a copy, with a narrow exception for some psychiatric reports. An administrator that claims a day-70 decision on the strength of a letter dated day 110 has a gap in its own file to explain.

A delay notice is not a rejection. It says the administrator has not decided. It may send more than one, each no later than the date the last one gave. None of them stops the count. The law contains no tolling provision of any kind, meaning nothing pauses it: not a delay letter, not a records request, not an evaluation still to come. If day 75 passed with no rejection, the presumption attached on the statute’s own terms.

What can still overcome the presumption

Evidence that could not have been found in time, and nothing else.

Once the 75 days pass without a rejection, the presumption can be rebutted only by evidence discovered after the period, and courts read that strictly. The records the department already held, the statement it could have taken, the medical opinion it could have asked for in time: none of it comes in late.

A police sergeant’s claim shows how far that reaches. In Williams v. WCAB, decided in 1999, the employer accepted a sergeant’s psychiatric claim, paid it for nearly two years, then denied it on what it called new evidence. The presumption held. The court found no good-faith exception, and held that evidence the employer could have obtained with reasonable diligence inside the window cannot rebut it. In the court’s words, “Accepting a claim and paying benefits does not permit employers to place the claim on the back burner.” That case, too, was decided under the 90-day rule; the 75-day rule is built the same way, so the same test should apply.

Two bars, not one. Late evidence has to clear both. It has to be evidence that could not have been found inside the window with reasonable diligence, and it has to be substantial evidenceSubstantial evidence The standard a medical opinion must meet to support a finding. in its own right, meaning evidence a judge can reasonably rely on. Attacking the second is often easier than the first.

An open question, honestly. Whether a medical opinion obtained after the window, resting on facts available before it closed, can rebut the presumption is being litigated, and Appeals Board panels have gone both ways.

Denied and delayed claims My claim is delayed

What the presumption decides, and what it does not

Coverage, settled. Disability and value, still to be built.

It decides coverage. The presumption shifts the burden on compensability: whether the injury arose out of and in the course of employment. It leaves open how disabled you are, how much of the disability belongs to other causes, and what the claim is worth. Those are built afterward on medical evidence, through the same medical-legal process as any other claim.

It sits on top of another presumption. A public safety claim can carry two at once. The condition presumption, the one that puts the claim on the 75-day clock, already treats the condition as caused by the job once you show you are in the covered class and meet any service requirement. Most of those sections add that the condition “shall in no case be attributed to any disease existing prior to that development or manifestation,” which closes off a common defense. The 75-day presumption is a separate layer about timing.

Cancer has a narrower rebuttal. Most presumptions in the series can be controverted by other evidence. The cancer presumption can be rebutted only by evidence that the primary site of the cancer has been established and that the carcinogen you were exposed to is not reasonably linked to it. Both, not either. What you have to show first is exposure, while in service, to a carcinogen known to the International Agency for Research on Cancer.

The penalty enacted with it

Five times the delayed benefits, up to $50,000.

SB 1127 did more than shorten the clock. For a cancer covered by the cancer presumption, with a date of injuryDate of injury For a cumulative or occupational disease claim, the law sets it as when you first suffered disability and knew or should have known it was work-related — not when the wear began. Almost every deadline runs off this. on or after January 1, 2023, it let temporary disabilityTD / TTD / TPD Temporary Disability, Total or Partial. Wage replacement while recovering. Two-thirds of average weekly earnings; 2026 maximum $1,764.11/week. run to 240 weeks instead of 104, without the ordinary five-year limit. And it added a penalty that takes the place of the ordinary one. Where liability on a claim within the presumption sections is unreasonably rejected, the penalty is five times the benefits unreasonably delayed, up to $50,000, and the Appeals Board decides whether the rejection was reasonable. The Legislative Counsel’s digest of the bill says the penalty applies whatever the date of injury, before or after the bill took effect.

The ordinary penalty, for comparison. On any other claim, compensation that is unreasonably delayed or refused is increased by up to 25% or up to $10,000, whichever is less. At small amounts the difference is a multiple. At large amounts, the caps decide it.

Late is not the same as unreasonable. Lateness triggers the presumption. The penalty needs more: a finding that the rejection was unreasonable. In Kerley v. WCAB, decided in 1971, the California Supreme Court held that delay is not unreasonable where the employer had genuine doubt from a medical or legal standpoint. The strong cases look alike: a rejection after day 75, with no investigation or medical opinion behind it.

What the pair changes is the cost of mishandling. An administrator that lets a presumption claim drift past day 75 and then rejects it without a real reason faces exposure of a different order. That is worth saying plainly in a negotiation.

Late payments and penalties Public employees and public safety workers

When day 75 has passed

Two dates, a subtraction and a letter.

If the claim has sat past day 75, or a rejection came close to it, take these steps in order.

1. Find the filed claim form and its date. Not the incident report or the injury log: the DWC-1, the day it was filed, and whatever proves that day.
2. Check that it is a presumption claim. The condition, your classification, any service requirement and, if you have left the job, the extension. If it is not, the count is 90.
3. Count. Day 75 from the filing, on a calendar.
4. Sort the letters. Delay or denial, each with its envelope.
5. Put it in writing. A dated letter to the claims administrator: the filing date, day 75, the date of any rejection or the absence of one, and that the claim falls within a public safety presumption. The file already shows the dates; your letter shows you know them.
6. Ask for the treatment authorization in writing, if treatment is not already authorized.
7. If the rejection came late and looks unconsidered, raise the penalty, with the claim file in hand.

When you may not need a lawyer for this. If the claim was accepted inside the 75 days and benefits are being paid, the count has done its work. Every district office of the Division of Workers’ Compensation has a free Information & Assistance officer who helps unrepresented workers with notices and forms. A review is worth having for a rejection near or after day 75, a denial resting on a report you doubt, or a claim tied up with a disability retirement application. A consultation with this office costs nothing, and if there is nothing worth doing, we will tell you that.

A file to keep on a presumption claim

One folder, started the day the form goes in.

• The DWC-1, with proof of the day it was filed — The date-stamped copy, the certified-mail receipt, or who took it.
• Day 75, written down — The filing date and the date 75 days later, on the folder’s cover.
• Every letter, with its envelope — Delay notices and any denial, each marked with the day it arrived.
• The diagnosis — The date, the doctor, and the report that names the condition.
• Your service record — Classification, employer and years of service, and your last day worked if you have left.
• Your written request for treatment — And any answer.
• Your dated letter about day 75 — And any reply.
• Names and dates — Everyone who told you anything about the claim, what they said, and when.