ADJ9023911 · April 8, 2025

The Appeals Board found that defendant did not meet its burden to prove applicant was the initial physical aggressor, and that applicant sustained injury arising out of and in the course of employment.

From the decision · page 1Defendant American Zurich Insurance Company seeks reconsideration of the January 3, 2025 Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration (O&O), wherein we rescinded the June 19, 2019 Findings and Order (F&O) issued by the Workers' Compensation Administrative Law Judge (WCJ) that found that applicant was an initial physical aggressor in a confrontation that resulted in industrial injury and therefore his claim for benefits is barred by Labor Code section 3600(a)(7). Our O&O substituted new Findings of Fact that found that: 1)applicant sustained injury arising out of and in the course of employment to his low back/tailbone and to the right elbow and deferred the issue of injury to any other body parts; 2) applicant was not the initial physical aggressor and defendant did not meet its burden to show that applicant's claim for benefits is barred under section 3600(a)(7); and, 3) applicant is entitled to medical treatment.

Applicant was not the initial physical aggressor in the altercation resulting in injury.

Favours Applicant prevailed

This fact led the Appeals Board to rescind the WCJ's finding that barred applicant's claim under Labor Code section 3600(a)(7).

From the decision · page 1Defendant American Zurich Insurance Company seeks reconsideration of the January 3, 2025 Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration (O&O), wherein we rescinded the June 19, 2019 Findings and Order (F&O) issued by the Workers' Compensation Administrative Law Judge (WCJ) that found that applicant was an initial physical aggressor in a confrontation that resulted in industrial injury and therefore his claim for benefits is barred by Labor Code section 3600(a)(7). Our O&O substituted new Findings of Fact that found that: 1)applicant sustained injury arising out of and in the course of employment to his low back/tailbone and to the right elbow and deferred the issue of injury to any other body parts; 2) applicant was not the initial physical aggressor and defendant did not meet its burden to show that applicant's claim for benefits is barred under section 3600(a)(7); and, 3) applicant is entitled to medical treatment.

Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 319

The Appeals Board may exercise independent judgment to reject WCJ findings if evidence does not meet the required legal elements, even if WCJ credibility findings are given great weight.

The Appeals Board found the evidence relied on by the WCJ lacking and exercised independent judgment to rescind the WCJ's findings.

From the decision · page 4III. Defendant contends in its Petition that the Appeals Board could not rescind the WCJ's June 19, 2019 F&O unless "evidence of considerable substantiality" existed to reject the WCJ's credibility determinations. We emphasize here that the board in its January 3, 2025 O&O determined that defendant failed to satisfy its burden of proving that applicant was the initial physical aggressor. We also reiterate that while we accord great weight to WCJs' findings on the credibility of witnesses, if they are supported by "ample, credible evidence" or "substantial evidence," we exercise independent judgment as to whether the evidence satisfies the required elements of the applicable law. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 319 [35 Cal.Comp.Cases 500].) As detailed in the O&O, we found the evidence relied on by the WCJ that applicant was the initial physical aggressor lacking. Specifically, the Appeals Board found that the police report and the victim's statements contained therein do not serve as substantial evidence that applicant acted as the initial physical aggressor. Defendant's petition fails to address the shortcomings in the record that would support an argument that defendant satisfied their burden of proof that applicant was the initial physical aggressor.

The police report and victim's statements did not constitute substantial evidence that applicant was the initial physical aggressor.

From the decision · page 4III. Defendant contends in its Petition that the Appeals Board could not rescind the WCJ's June 19, 2019 F&O unless "evidence of considerable substantiality" existed to reject the WCJ's credibility determinations. We emphasize here that the board in its January 3, 2025 O&O determined that defendant failed to satisfy its burden of proving that applicant was the initial physical aggressor. We also reiterate that while we accord great weight to WCJs' findings on the credibility of witnesses, if they are supported by "ample, credible evidence" or "substantial evidence," we exercise independent judgment as to whether the evidence satisfies the required elements of the applicable law. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 319 [35 Cal.Comp.Cases 500].) As detailed in the O&O, we found the evidence relied on by the WCJ that applicant was the initial physical aggressor lacking. Specifically, the Appeals Board found that the police report and the victim's statements contained therein do not serve as substantial evidence that applicant acted as the initial physical aggressor. Defendant's petition fails to address the shortcomings in the record that would support an argument that defendant satisfied their burden of proof that applicant was the initial physical aggressor.