NOTICE: NOT FOR OFFICIAL PUBLICATION.

UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL

AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

IN THE

ARIZONA COURT OF APPEALS

DIVISION ONE

ANN MARTIN, 

Petitioner,

v.

THE INDUSTRIAL COMMISSION OF ARIZONA,

Respondent,

CAMP VERDE UNIFIED SCHOOL DISTRICT,

Respondent Employer, 

ARIZONA SCHOOL ALLIANCE,

Respondent Carrier.

No. 1 CA-IC 16-0059

Special Action - Industrial Commission

ICA No. 20143-170460

INSCA No. 2014001288A

The Honorable Gaetano J. Testini, Administrative Law Judge

AWARD AFFIRMED

COUNSEL

Ann Martin, Camp Verde

Petitioner
2

Industrial Commission of Arizona, Phoenix

By Jason M. Porter

Counsel for Respondent ICA

Jardine, Baker, Hickman & Houston, PLLC, Phoenix

By K. Casey Kurth

Counsel for Respondent Employer/Carrier

MEMORANDUM DECISION

Presiding Judge Diane M. Johnsen delivered the decision of the Court, in 

which Judge Patricia K. Norris and Judge Jennifer B. Campbell joined.

J O H N S E N, Judge:

¶1 This is a special action review of an Industrial Commission of 

Arizona ("ICA") award concerning a compensable injury. The claimant, 

Ann Martin, argues the administrative law judge ("ALJ") erred by finding 

her physical condition is stationary without permanent impairment. For 

the reasons that follow, we affirm the award.

FACTS AND PROCEDURAL BACKGROUND

¶2 On October 15, 2014, Martin, a paraprofessional and printroom coordinator at Camp Verde Elementary School, slipped as she 

stepped off a sidewalk on her way to recess duty.

1 Although Martin did 

not fall, she "tweaked" her back in her effort to maintain her balance. The 

following morning, Martin woke with pain in her lower back, left hip and 

left buttock.

¶3 On October 21, 2014, her symptoms worsening, Martin visited 

urgent care. There, Martin was diagnosed with "[l]ow back pain" and

referred to physical therapy for treatment. The same day, Martin filed a 

claim for industrial injury, and later she began receiving benefits from the 

school's insurance carrier.

¶4 Despite physical therapy, the pain persisted. On December 

15, 2014, Martin made a trip to the emergency room, where she underwent 

an x-ray on her lumbosacral spine. The x-ray, however, revealed no 

 

1 We consider the evidence in the light most favorable to upholding 

the award. Lovitch v. Indus. Comm'n, 202 Ariz. 102, 105, ¶ 16 (App. 2002).
MARTIN v. CAMP VERDE USD/ARIZONA

Decision of the Court

3

obvious defects. Accordingly, Martin was prescribed medicine for her pain 

and told to follow up with her primary care provider.

¶5 On January 23, 2015, Martin met with Dr. Kyle Norris, who 

specializes in physical medicine and rehabilitation with a subspecialty in 

pain medicine. Norris performed a physical exam of Martin and reviewed 

the results of an MRI from earlier in the month. Although Norris believed

the MRI revealed a "mild" disc bulge, he recommended "continued 

conservative management," including additional physical therapy, given 

the "relatively unremarkable physical examination." Over the next few 

months, Martin continued to follow-up with Norris, and on April 6, 2015,

after physical therapy and three epidural steroid injections failed to

alleviate Martin's pain, Norris referred Martin to Dr. Donald Hales, an 

orthopedic surgeon.

¶6 On June 2, 2015, Martin met with Hales. Hales performed a 

physical exam of Martin's lumbar spine and reviewed the results of Martin's 

January 2015 MRI. After concluding the MRI was "normal," Hales opined 

that Martin might have injured her left sacroiliac joint. According to Hales, 

several tests he performed on Martin during the physical exam indicated as 

much, including the "FABER" test.

2 Hales suggested Martin undergo a 

diagnostic sacroiliac joint injection in her left side; he believed that if that 

injection provided greater pain relief than her earlier epidural injections, it 

would tend to show that the left sacroiliac joint was the pain source and 

would confirm his initial diagnosis of "Sacroiliac joint dysfunction."

¶7 On June 9, 2015, before Martin received a sacroiliac joint 

injection, she met with Dr. John Beghin for an independent medical 

examination. In addition to reviewing Martin's x-rays and her January 2015

MRI, Beghin performed a physical examination. After noting Martin's xrays and MRI were "normal," Beghin reported that the results of his own 

FABER test were negative for a left sacroiliac injury. Accordingly, Beghin 

diagnosed Martin with a "[p]robable lumbar sprain/strain with aberrant 

pain response" and concluded Martin's condition was stable without 

permanent impairment. As a result, Martin's claim was closed without 

permanent impairment effective June 9, 2015.

 

2 According to the evidence, the FABER test is the "standard" method 

for applying stress to the sacroiliac joint. A positive FABER test is one that

reproduces a patient's symptoms upon applying stress to the sacroiliac 

joint.
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Decision of the Court

4

¶8 While Martin protested the termination of her benefits and 

awaited a hearing, she continued to seek medical treatment for her pain. 

She received her first sacroiliac joint injection on August 18, 2015, and a

second on November 5, 2015. As a result, on January 8, 2016, Beghin

performed a second independent medical examination. After Beghin 

reviewed Martin's relevant medical history and performed a second FABER 

test, his conclusions remained unchanged.

¶9 The ALJ's hearing on Martin's protest began on January 29, 

2016 and concluded after three days of testimony, ending June 10, 2016. In 

the meantime, on February 25, 2016, Hales recommended Martin undergo 

left sacroiliac joint fusion surgery, and in May, Hales performed the 

surgery.

¶10 The ALJ issued a Decision Upon Hearing on July 5, 2016, in 

which he found Martin's condition was stationary without permanent 

physical impairment as of June 9, 2015. Martin requested review and the 

ALJ affirmed the decision. This timely special action followed.

¶11 This court has jurisdiction pursuant to Arizona Revised 

Statutes ("A.R.S.") sections 12-120.21(A)(2) (2017), 23-951 (2017) and 

Arizona Rule of Procedure for Special Actions 10.3

DISCUSSION

¶12 In reviewing the ICA's awards and findings, we defer to the 

ALJ's factual findings and review questions of law de novo. Young v. Indus. 

Comm'n, 204 Ariz. 267, 270, ¶ 14 (App. 2003). The ALJ has discretion to 

resolve any conflicts in the evidence, see Perry v. Indus. Comm'n, 112 Ariz. 

397, 398 (1975), and is the sole judge of witness credibility, Henderson-Jones 

v. Indus. Comm'n, 233 Ariz. 188, 191, ¶ 9 (App. 2013). As long as the ALJ's 

findings are not unreasonable, this court will not disturb them. Hackworth 

v. Indus. Comm'n, 229 Ariz. 339, 343, ¶ 9 (App. 2012).

¶13 To be compensable, an injury must arise out of and in the 

course of employment. A.R.S. § 23-1021 (2017). The claimant has the 

burden to prove the elements of the claim by a preponderance of the 

evidence. Brooks v. Indus. Comm'n, 24 Ariz. App. 395, 399 (1975). Unless the 

causal relationship between the industrial incident and the resulting injury 

 

3 Absent material revision after the relevant date, we cite a statute's 

current version.
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Decision of the Court

5

is apparent, it must be proved by expert medical testimony. Raymer v. 

Indus. Comm'n, 18 Ariz. App. 184, 186 (1972).

¶14 On appeal, Martin challenges the ALJ's finding that her 

medical condition was stationary without permanent impairment as of June 

9, 2015. To that end, Martin argues first that the ALJ was obligated to accept 

Hales's opinion that Martin suffered from left sacroiliac joint dysfunction.

¶15 Although Martin's medical records, which were in evidence,

indicate that Hales diagnosed her with left sacroiliac joint dysfunction,

Hales was not called to testify at Martin's hearing. Even if he had testified, 

the ALJ received Beghin's two independent medical examination reports

outlining his conclusion that Martin's physical condition was stationary 

without permanent impairment as of June 9, 2015, and Beghin also testified

in support of that conclusion at Martin's hearing. Accordingly, the ALJ was 

within his discretion in determining which of the competing diagnoses of 

Martin's condition was more probably correct. See Perry, 112 Ariz. at 398

("[I]t is [the ALJ's] privilege to determine which of the conflicting testimony 

is more probably correct.").

¶16 Next, Martin argues that an asserted inconsistency in Beghin's 

two reports "shed doubt on whether [Beghin's] opinion is truly 

independent" and therefore credible. At issue is the following sentence, 

which was in the discussion of Martin's x-rays in Beghin's first report but 

not his second: "Limited projection of the hips reveals probable normal hip 

joint space but the study is inadequate for a thorough evaluation of the 

hips." At the hearing, Beghin testified that his evaluation of Martin's hip 

joints was irrelevant to her left sacroiliac joint. Because the ALJ is the sole 

judge of witness credibility, we cannot conclude the ALJ erred in relying on 

either of Beghin's independent medical examinations or his testimony at 

Martin's hearing.

¶17 Additionally, Martin asserts she submitted supplemental 

evidence showing that Beghin misrepresented statements Martin made 

during her second independent medical examination. The evidence Martin 

submitted was an audio recording of her second independent medical 

examination, which she argues contradicts Beghin's account of the pain 

relief she obtained immediately after her second sacroiliac joint injection. 

We have reviewed the transcript of that recording and identify no clear 

contradictions. Moreover, the ALJ is the sole judge of witness credibility. 

Henderson-Jones v. Indus. Comm'n, 233 Ariz. 188, 191, ¶ 9 (App. 2013).
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¶18 Finally, Martin argues that the medical treatment she received 

after June 9, 2015 demonstrates that the ALJ erred in concluding her 

condition was stationary without permanent impairment as of that date. 

Indeed, Martin argues the surgical fusion of her left sacroiliac joint in May 

2016 "is leading . . . to the stationary status desired by the worker's 

compensation system."

¶19 At the hearing, Beghin explained that there are two types of 

"sacroiliac diagnoses." The first, known as sacroiliitis, is diagnosed based 

on the presence of objective findings that typically appear on "plain film." 

Additionally, an individual suffering from sacroiliitis should experience 

symptoms with stress of the sacroiliac joint, such as that applied during a 

FABER test. Because Martin's x-rays and MRI appeared normal, and 

because she did not experience symptoms during either FABER test Beghin 

performed, Beghin concluded she did not suffer from sacroiliitis. Indeed, 

when Beghin performed the FABER test during his second independent 

medical examination, Martin reported that it made her symptoms feel 

better.

¶20 According to Beghin, the second sacroiliac diagnosis is 

known as sacroiliac joint dysfunction. At the outset of Beghin's testimony, 

he noted that sacroiliac joint dysfunction is controversial because it is not 

diagnosed based on objective findings, such as imaging studies, MRIs, bone 

scans and plain films. Rather, he testified that diagnoses are made based 

on sacroiliac stress tests, such as the FABER test, none of which had been 

validated as scientifically reliable diagnostic methods. And, as mentioned 

above, Martin tested negative for a sacroiliac injury in each of the FABER 

tests Beghin performed.

¶21 Moreover, contrary to Martin's assertion on appeal, Beghin 

testified that neither sacroiliac joint injection she received could be 

considered diagnostic for sacroiliac joint dysfunction in this case. 

Specifically, he said, if either injection was to be considered diagnostic, 

there should have been "immediate" pain relief following the injection.

4 

According to Martin's "daily pain diary," however, her symptoms were

"worse" in the two days following the first injection. Although the diary 

showed that Martin's pain decreased on the day of her second injection

from a "five" pre-injection to a "three" post-injection on a scale from one to 

 

4 The anesthetic in the injection immediately numbs the sacroiliac 

joint. It follows that, if the sacroiliac joint was the pain source, then Martin 

would have experienced immediate relief.
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Decision of the Court

7

ten, her symptoms remained unchanged in the four days that followed. For 

these reasons, Beghin testified that neither injection supported a diagnosis 

of sacroiliac joint dysfunction.

¶22 On appeal, Martin cites Hales's records, which indicated that 

he believed Martin's pain was the result of left sacroiliac joint dysfunction. 

According to a report dated February 25, 2016, Hales found support for this 

diagnosis in Martin's response to the sacroiliac joint injections—on the day

of his report, Martin said 95% of her symptoms disappeared immediately 

upon receiving the injections—and several positive physical tests for 

sacroiliac joint pain, including a FABER test on June 2, 2015. As noted, 

however, we cannot conclude the ALJ erred in adopting Beghin's contrary 

opinion or that the ALJ was unreasonable in finding Martin's condition was 

stationary as of June 9, 2015.

CONCLUSION

¶23 For the foregoing reasons, we affirm the award.