Court Opinion

ID: 9590549
Source: CourtListenerOpinion
Date Created: 2023-08-21 23:55:59.403718+00
Date Added: 2024-06-11T09:34:16.962118
License: Public Domain

*392FELDMAN, Justice,
specially concurring.
I concur in the result. I write separately because I am unable to agree with the limited basis for that result. The court states today that medical benefits are not available for surgery not recommended or offered at the time the claim was closed, even though the evidence is uncontroverted that the surgery has now become appropriate for treatment of the industrial injury. It is not as if the court refuses to interpret an otherwise clear statute. To reach this result, the court is compelled to interpret the statute by inserting the word “physical” before the word “condition,” restricting the grounds for reopening to those situations where there has been a change in “physical” condition. The court states, therefore, that need for new medical or surgical treatment is not a “new, additional, or previously undiscovered ... condition” and medical benefits for payment of the treatment are not available. (At 277.)
In my view, by so restricting the words of the statute, the court fails to give sufficient deference to either the constitutional objectives of the Workmen’s Compensation Act or the legislative objective in enacting the statute. The statute is part of a system intended by the constitution to replace employees’ common law rights with a system of workmen’s compensation designed “to assure and make certain a just and humane compensation law ... for the relief and protection of such workmen ... from the burdensome, expensive and litigious remedies for injuries ... now existing in the State of Arizona, and producing uncertain and unequal compensation____” Arizona Constitution, art. 18, § 8.
The issue with which we deal is basically a question of the application of res judicata in a no-fault system designed to provide compensation on a continuing basis. See Note, Res Judicata and Reopening Worker’s Compensation Claims in Arizona, 23 Ariz.L.Rev. 1103, 1103-05 (1981). Res judicata as a “principle of judicial economy” applies in workmen’s compensation cases to bar relitigation of issues which have been determined in the proceeding, including those “which could have been decided” in the proceeding. Id. at 1106. However, the doctrine of res judicata does not apply in workmen’s compensation matters as it does in ordinary tort actions because the objectives of the workmen’s compensation system
are best accomplished if the commission can increase, decrease, revive, or terminate payments to correspond to claimant’s changed condition. Theoretically, then, commissions ought to exercise perpetual and unlimited jurisdiction to reopen cases as often as necessary to make benefits meet current conditions.
3 A. Larson, The Law of Workmen’s Compensation § 81.10 at 15-528 (1983). Also, in a workmen’s compensation matter, unlike the typical tort case, it is neither possible nor useful to submit evidence of the probability of need for future medical treatment. The concept of res judicata does not serve the purposes of the system; it applies in workmen’s compensation simply because administrative considerations and practical problems involved in continuing jurisdiction require limitations on the power to open and modify awards. Id.
This tension between administrative necessity and the desire to effectuate the purposes of the workmen’s compensation legislation has not escaped the attention of this court. We first adverted to the problem in Zager v. Industrial Commission, 40 Ariz. 479, 14 P.2d 472 (1932). We stated that only questions which were “existing and known” at the time of an award were concluded by the final decision on that award through the doctrine of res judicata. We then stated:
But it is common knowledge that the results of physical injuries are often not determinable at the time they are received, and to require that they be then stated is to demand the performance of the impossible----
The Workmen’s Compensation Law does not specifically confer on the commission a continuing power over its awards, as is the case in compensation *393laws generally, but we think such power is impliedly conferred____ Without a continuing power to alter, amend, or rescind its awards ... the commission would certainly be greatly hampered in its efforts to carry out the spirit of the law____ The spirit of the act is that every employee injured ... in an accident arising out of and in the course of his employment, shall be indemnified therefor in the manner and amounts provided by the act____ To effectuate this wholly laudable and desirable end, the commission must possess and exercise a continuing power to alter, amend or rescind the award if the facts justify it.
Id. at 486-88, 14 P.2d 472. In Zager, we held, therefore, that the Commission had power to reserve jurisdiction to alter, rescind or amend awards for good cause. The statute which the court construes today was not enacted as a boon granting some limited exceptions to res judicata in favor of injured workers; it is a codification, and some limitation, of the Zager rule which recognized a broad exception to res judicata in workmen’s compensation matters. That exception is today construed more narrowly than is either required by the words of the statute or permitted by the philosophy of the Act as recognized in Zager.
In my view, the proper test should not be based upon whether there has been a change in physical condition as distinguished from a change in medical condition, nor upon whether there has been a change in pain as subjectively reported by the patient. The proper rule would be to permit reopening upon comparative evidence showing that the claimant’s current condition is “different or more aggravated than his condition existing at the time of the original hearing.” Note, supra, at 1119. Res judicata would apply and conclude those issues which were or could have been litigated at the time of the award, even if incorrectly decided. Id. at 1117; see also, id. at 1109 n. 37.
Thus, reopening and medical benefits would be permitted for changes in any or all of the following circumstances: physical condition, mental condition, pain, toleration of pain, improvements of medical science which make further treatment advisable, recommendations of new treatment, or discovery of injury previously unknown. Reopening for new benefits would not be allowed where there is no change in condition or circumstance, but merely a discovery that the original award incorrectly decided some issue which was or could have been litigated. Adopting such a comparative rule would save us from deciding reopening questions on subtle shadings such as whether the pain has worsened slightly, thus supporting a finding that physical condition has changed a bit. Such distinctions give no solace to employers, since the most unscrupulous claimant is the most likely to experience increased pain. Reopening would be permitted where something has occurred different from what was, or could have been, decided at the time the award became final. This would satisfy the objectives of the Workmen’s Compensation Act. It would not violate the statute, because A.R.S. § 23-1061(H) does not forbid reopening on such a basis. The majority opinion indicates (at 277) that no authority for such a theory has been cited,1 but it is also true that no authority has been cited which has considered and rejected such a theory. This court need but take one small step forward, interpreting the statute in accordance with, and not contrary to, constitutional objectives, and there will then be authority which will bring logic and common sense to the reopening question.
The language used today applies the doctrine of res judicata to preclude the payment of benefits for surgery needed today, when the need for that surgery was neither adjudicated nor susceptible of adjudication at the time the award was made. If tomor*394row a totally new type of surgery is devised, offering the prospect of completely curing or rehabilitating the injured worker, the doctrine of res judicata will be applied so that the worker will be unable to obtain benefits necessary to procure such treatment.2 Thus, no matter what the advances in medical science, the injured worker today becomes the captive of a legal system that eschews the reality of scientific progress. In my view, it is neither good law nor good policy to give such a construction to a statute which was presumably passed to effectuate the remedial purposes of the constitution.

. This is not quite correct. See intimations in Zager v. Industrial Commission, supra; Garrote v. Industrial Commission, 121 Ariz. 223, 224, 589 P.2d 466, 467 (App.1978); Capitol Foundry v. Industrial Commission, 27 Ariz.App. 79, 82, 551 P.2d 69 (1976); Moccia v. Eclipse Pioneer Division of Bendix Aviation, 57 N.J.Super. 470, 155 A.2d 129 (1959).

. Presumably, if the worker obtains such treatment and pays for it himself, therefore improving his physical condition, the employer will be able to move to reopen and decrease disability benefits on the basis of a changed and improved physical condition. In light of this, the logic of requiring the employee to pay for his own surgery is, at best, tenuous. We should encourage, rather than discourage, rehabilitation.