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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ6766189
Regular
Jul 03, 2012

MIRNA CERRATO AGUILAR vs. BEVERLY PAVILION ASSOCIATES, FIRSTCOMP OMAHA

This case involves a petition for reconsideration filed by Anna Montes, a hearing representative, regarding a $1,500 sanction imposed by the WCJ. Montes was sanctioned for her "insolent, obstructive, disrespectful and frivolous" conduct during a workers' compensation trial involving her client, Dr. Anguizola. The Appeals Board denied Montes' petition, adopting the WCJ's report which detailed how her behavior caused unnecessary delay and wasted Board resources. The Board reiterated that representatives must conduct themselves professionally and ethically, adhering to rules against bad faith tactics that cause delay.

Workers' Compensation Appeals BoardSanctionsPetition for ReconsiderationIndustrial InjuryRoom AttendantLien ClaimantMedical TreatmentPenaltyInterestInsolent Conduct
References
Case No. MON 0325089 MON 0325090
Regular
Oct 05, 2007

NORA MEDEARIS vs. COUNTY OF LOS ANGELES

This case concerns the denial of an applicant's petition for reconsideration of a workers' compensation award. The applicant sought further temporary disability benefits beyond the 104-week limit imposed by Labor Code § 4656(c)(1). The Workers' Compensation Appeals Board denied the petition, finding the applicant failed to prove equitable estoppel against the defendant's application of the statutory limit, despite the defendant's initial refusal to authorize shoulder surgery. The Board adopted the WCJ's reasoning that the applicant did not demonstrate reliance on any conduct by the defendant that prevented her from timely pursuing authorization for the surgery.

Workers' Compensation Appeals BoardNora MedearisCounty of Los AngelesPermissibly Self-InsuredMON 0325089MON 0325090Opinion and Order Denying Petition for ReconsiderationInterim Joint Findings and AwardCentral Services TechnicianIndustrial Injury
References
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
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
Case No. ADJ7553654, ADJ7550664
Regular
May 16, 2016

JOSE REYES vs. WESTERN LIGHTWAVE, AIG

The Workers' Compensation Appeals Board (WCAB) denied a petition for disqualification filed in the case of Jose Reyes v. Western Lightwave; AIG. The Board adopted the findings of the workers' compensation administrative law judge (WCJ) in its decision. While the WCAB denied the disqualification, it noted with concern allegations of unprofessional conduct by the applicant's former attorney and reminded all participants of their duty to act professionally.

Petition for DisqualificationWCJ ReportUnprofessional ConductUncivil ConductApplicant's AttorneyDuty to Act ProfessionallyCourteous ConductWorkers' Compensation Appeals BoardAdministrative Law JudgeDenied Order
References
Case No. ADJ1132942 (LAO 0875472)
Regular
Aug 20, 2009

James Lewis vs. COMPTON UNIFIED SCHOOL DISTRICT, HAZELRIGG RISK MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied James Lewis's petition for reconsideration of its prior decision that his injury arose from an altercation where he was the initial physical aggressor. The Board found applicant initiated a confrontation with a co-worker over a parking space, culminating in physical contact with the co-worker while attempting to move a truck. Applicant's arguments regarding evidence review and the Board exceeding its powers were rejected, as the Board can independently reweigh evidence and found applicant's conduct barred his claim under Labor Code section 3600(a)(7).

Initial physical aggressorLabor Code section 3600(a)(7)Petition for reconsiderationWorkers' Compensation Appeals BoardOpinion and OrderGranting ReconsiderationDecision After ReconsiderationFindings of FactAdministrative law judgeReconsideration of evidence
References
Case No. ADJ7118771
Regular
Mar 13, 2012

CHARLES THOMAS vs. LOS ANGELES COUNTY METROPOLITAN TRANSIT AUTHORITY

This case involves a bus driver injured during an altercation with a passenger. The Appeals Board reversed the initial ruling, finding the injury compensable because the applicant was not the initial physical aggressor. While the applicant's actions were unauthorized, they occurred in the course of employment as they stemmed from his duties dealing with the passenger. The Board also found sufficient evidence of injury beyond the applicant's testimony. The case is returned for further proceedings on all remaining issues.

Workers' Compensation Appeals Boardindustrial injurybus driveraltercationinitial physical aggressorLabor Code section 3600(a)(7)course of employmentunauthorized conductCode of Conductcitizen's arrest
References
Case No. ADJ563768 (SBR 0331684), ADJ2410618 (SBR 0338943)
Regular
Mar 22, 2010

JORGE GONZALEZ vs. TOYO TIRE USA, TOKO MARINE PASADENA

Lien claimant Access Health Medical Group seeks full reimbursement for services, arguing the WCJ erred by disallowing most of its lien based on anti-referral laws (Labor Code §§ 139.3, 139.31). Access contends these laws do not apply to in-house referrals for chiropractic, acupuncture, or "work conditioning" services, as these are not "physical therapy." The Appeals Board granted reconsideration, finding the WCJ applied an overly broad definition of physical therapy. The case is returned for further proceedings to determine if the billed services were distinct from physical therapy, or if "work conditioning" constitutes physical therapy under the statute.

Labor Code §§ 139.3Labor Code § 139.31anti-referral lawsin-office referralsphysical therapychiropracticacupuncturework conditioninglien claimantFindings and Order
References
Case No. ADJ9365063
Regular
Dec 30, 2016

SABRINA RICCIO vs. STATE COMPENSATION INSURANCE FUND, legally uninsured, adjusted by, THE HARTFORD

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued that the applicant's psyche injury was not predominantly caused by actual employment events and that her internal injuries were not compensable as they were caused by stress. The Board affirmed the WCJ's findings, clarifying that the physical injury (heart attack) caused the psychiatric injury, making the heart attack compensable as a physical injury. The Board also distinguished this case from situations where a physical condition is solely the result of a non-compensable psychiatric injury.

AOE/COEpsychiatric injuryphysical injurystresscausation of injurycausation of disabilityapportionmentcompensable consequencemental-physical injuryLabor Code § 3208.3
References
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