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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ10762593
Regular
Feb 06, 2023

NICHOLAS KOBE vs. CITY OF LOS ANGELES, AIMS

The Workers' Compensation Appeals Board denied the City of Los Angeles' petition for reconsideration, upholding the finding that firefighter Nicholas Kobe's TMJ/myofascial pain injury was compensable. The Board adopted the judge's report, which determined that the applicant was not the initial physical aggressor in an altercation with a fellow firefighter, as the initial physical contact was initiated by the other firefighter. Therefore, Labor Code §3600(a)(7) did not bar the claim, and the applicant was awarded temporary and permanent disability benefits. The defense exclusively argued the initial physical aggressor defense, which the Board found inapplicable based on the facts.

Initial physical aggressor defenseLabor Code §3600(a)(7)TMJ/myofascial painPanel Qualified Medical EvaluatorNina Nattiv DDSfirefighter injurytemporary disabilitypermanent disabilitywage calculationattorney fees
References
11
Case No. ADJ7806856
Regular
Aug 01, 2013

MICHAEL WEINBERG vs. SUTTON AGRICULTURAL ENTERPRISES, INSURANCE COMPANY OF THE WEST PLEASANTON

This case involved an employee's claim for a psyche industrial injury. The defendant sought reconsideration of a prior ruling that denied the "initial physical aggressor" defense, arguing the applicant was the aggressor. The Workers' Compensation Appeals Board denied reconsideration, agreeing that the applicant was not the initial physical aggressor because the co-worker physically pushed him first. The Board affirmed that the applicant's claim was not barred by Labor Code section 3600(a)(7), deferring other issues.

Initial physical aggressor defenseLabor Code section 3208.3Verga v. Workers' Comp. Appeals Bd.AOE/COEweldersaltercationsphysical conductreasonable fear of bodily harmanimosityhostile words
References
8
Case No. ADJ8633613
Regular
Apr 01, 2014

BYRON MATTAS vs. SHOKER TRADING CORPORATION dba TRIPLE S. CHEVRON, HANOVER INSURANCE COMPANY

This case concerns a workers' compensation claim where the applicant sustained injuries during an altercation with a customer. The defendant argued the claim was barred by specific Labor Code sections, including being the initial physical aggressor. The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for removal and denied reconsideration, upholding the judge's finding that the applicant was not the initial aggressor, based largely on surveillance video. A dissenting commissioner argued that the applicant was indeed the initial physical aggressor by throwing soup, thus barring the claim.

Workers Compensation Appeals BoardByron MattasShoker Trading CorporationTriple S. ChevronHanover Insurance CompanyADJ8633613Findings and Orderindustrial injuryheadneck
References
3
Case No. ADJ7345520
Regular
Sep 07, 2011

ANTONIO NAVARRO vs. CBS FASTENERS, INC., CYPRESS INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case involves applicant Antonio Navarro's petition for reconsideration of a denial of workers' compensation benefits. The administrative law judge found applicant was the initial aggressor in an altercation with a co-worker on December 4, 2008, rendering his injury non-compensable under Labor Code § 3600(a)(7). Applicant argued the defendant failed to prove initial aggressor status and that he reasonably felt threatened, but his petition misrepresented the record and contradicted his own trial testimony where he denied initiating the physical contact. The Appeals Board denied reconsideration, adopting the judge's report and finding overwhelming evidence, including witness testimony and a police report, that applicant was the initial aggressor.

initial aggressoraltercationsLab. Code § 3600(a)(7)Mathews v. Workmen's Comp. Appeals Bd.credibility determinationwitness testimonypolice reportWCJ credibilityPetition for ReconsiderationReport and Recommendation
References
3
Case No. ADJ9653109
Regular
Sep 06, 2016

William Morales vs. Bonsal American Oldcastle, Inc., Liberty Mutual Insurance Company

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought review of a decision that denied his injury claim because he was the initial physical aggressor in a workplace altercation. The Board deferred to the administrative law judge's credibility findings, which found the applicant less credible than defense witnesses and a video recording that was inconclusive. Therefore, the Board affirmed the original finding that the applicant was the initial physical aggressor and is barred from compensation.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderInitial Physical AggressorLabor Code Section 3600(a)(7)Credibility DeterminationsVideo FootageOccupational InjuryMachine OperatorPhysical Altercation
References
7
Case No. ADJ10903154
Regular
Apr 01, 2020

JEHUDA KNOBLER vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a teacher claiming workers' compensation for PTSD after a student altercation. The Board overturned the initial finding, now recognizing the PTSD as arising out of and occurring in the course of employment. However, they affirmed the finding that the applicant was the initial physical aggressor under Labor Code section 3600(a)(7). This disqualifies him from receiving compensation benefits due to his role in initiating the physical confrontation.

AOE/COEinitial physical aggressorLabor Code section 3600(a)(7)posttraumatic stress disorderphysical altercationPQME reportstudent altercationwitness statementsadministrative leavetrier of fact
References
0
Case No. ADJ15544152
Regular
May 02, 2025

TALIBAH COFFEE vs. COUNTY OF LOS ANGELES, SEDGWICK

Applicant, Talibah Coffee, sought reconsideration of a finding that her claimed industrial injury was non-compensable due to her being the initial physical aggressor in an altercation. The Workers' Compensation Appeals Board reviewed the applicant's petition, the defendant's answer, and the WCJ's report. The Board concurred with the WCJ's analysis, which found that the applicant's act of physically touching and moving a cameraman's equipment constituted the initial physical aggression, thereby barring compensation under Labor Code section 3600(a)(7). Consequently, the Petition for Reconsideration was denied.

Initial physical aggressorLabor Code section 3600(a)(7)Deputy Probation Officer IIaltercationphysical conductreal and present threat of bodily harmPetition for ReconsiderationWCJReport and Recommendationinjury AOE/COE
References
3
Case No. 2016-198 Q C
Regular Panel Decision
Jun 01, 2018

Comprehensive Care Physical Therapy, P.C. v. Allstate Ins. Co.

This case concerns a provider, Comprehensive Care Physical Therapy, P.C., seeking no-fault benefits from Allstate Insurance Company. The Civil Court initially denied the plaintiff's summary judgment motion and granted the defendant's cross-motion, dismissing the complaint based on the assignor's failure to appear for independent medical examinations (IMEs) and claims exceeding the fee schedule. On appeal, the Appellate Term modified this order, finding that Allstate failed to provide sufficient proof of timely denial form mailing, thereby precluding its defenses regarding IMEs and the fee schedule. Consequently, Allstate's cross-motion for summary judgment was denied, reversing that part of the lower court's decision. However, the Appellate Term affirmed the denial of the plaintiff's summary judgment motion, as the plaintiff also failed to establish their claims.

no-fault insurancesummary judgmentindependent medical examinationstimely denialinsurance defenseappellate reviewmedical billingassignee rightsprocedural requirementsfee schedule
References
5
Case No. ADJ1132942
Regular
Jun 04, 2009

James Lewis vs. Compton Unified School District, Hazelrigg Risk Management Services

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior finding that James Lewis was not the initial physical aggressor in an altercation. The Board found that Lewis's actions, including throwing tools at a co-worker and attempting to move the co-worker's truck, initiated the physical confrontation. Consequently, Lewis's claim for injury benefits is barred under Labor Code section 3600(a)(7).

Workers' Compensation Appeals BoardInitial Physical AggressorLabor Code section 3600(a)(7)AltercationFindings of FactReconsiderationOpinion and OrderAffirmative DefensesEmploymentInjury
References
0
Case No. ADJ4513629 (SAL 0120784)
Regular
Feb 18, 2010

RICHARD GALINDO vs. MV TRANSPORTATION, INC.; BROADSPIRE, a CRAWFORD COMPANY

This case concerns a bus driver who sustained a back injury after an altercation with a passenger. The employer denied the claim, asserting the employee was the initial physical aggressor, which would bar compensation. The Board reviewed videotape evidence and affirmed the WCJ's finding that the passenger's spitting and verbal threats constituted the initial physical aggression. Therefore, the employer failed to establish the exclusion under Labor Code section 3600(a)(7), and the injury is compensable.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONINDUSTRIAL INJURYBUS DRIVERCOMPENSABILITYINITIAL PHYSICAL AGGRESSORLABOR CODE SECTION 3600(a)(7)ALTERCATIONVIDEOTAPE EVIDENCETHREAT OF BODILY HARM
References
2
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