WCPanelIQ
PanelQMEMed-legalGranted

Assefa, Tersit

TERSIT ASSEFA, Applicant vs. YOSEMITE FALLS CAFÉ, INC.; ILLINOIS MIDWEST INSURANCE AGENCY, LLC on behalf of PROCENTURY INSURANCE COMPANY, Defendants

ADJ number
ADJ19310869
Decision date
Dec 14, 2025
District office
Fresno
WCJ
—
Claim administrator
Illinois Midwest Insurance Agency, LLC on behalf of ProCentury Insurance Company
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PAUL F. KELLY, COMMISSIONER

Injury / body parts: psyche, body systems, circulatory system, stress

LC §5909LC §5900LC §3208.3CCR §10600

Summary

Applicant Tersit Assefa, a wait server employed by Yosemite Falls Café for approximately 16 years, claimed a cumulative trauma psychiatric injury (and injuries to body systems, circulatory system, and stress) due to alleged harassment and mistreatment by co-workers and management, including age-related comments, racial slurs, and a banana-throwing incident. The WCJ found applicant failed to meet her burden of proving an industrial psychiatric injury, found the defendant's witnesses more credible than applicant, found Dr. Hoffman's PQME reports were not substantial medical evidence, and ordered applicant take nothing. The WCAB granted reconsideration, finding the WCJ never addressed whether the workplace incidents were 'actual events of employment' under the Rolda analysis, that Dr. Hoffman's reports were deficient because they failed to consider employer testimony, lumped all causal factors together without percentage breakdown, and that no medical evidence was developed on the claimed physical injuries. The Board rescinded the F&O and remanded for further proceedings and development of the record.

Issues

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Holding

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Analysis

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Defense takeaway

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Provider takeaway

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