Court Opinion

ID: 9891167
Source: CourtListenerOpinion
Date Created: 2023-10-17 18:03:21.032767+00
Date Added: 2024-06-11T13:39:26.710020
License: Public Domain

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  UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL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

         BODEGA LATINA CORPORATION, Petitioner Employer,

    SAFETY NATIONAL CASUALTY CO, Petitioner Insurance Carrier,

                                         v.

      THE INDUSTRIAL COMMISSION OF ARIZONA, Respondent,

                   ADELA ZUBIATE, Respondent Employee.

                              No. 1 CA-IC 23-0001
                               FILED 10-17-2023

                Special Action - Industrial Commission
                      ICA Claim No. 20210530703
                     Carrier Claim No. 036-001238
         The Honorable Jeanne Steiner, Administrative Law Judge

                             AWARD SET ASIDE

                                    COUNSEL

Jardine, Baker, Hickman & Houston, P.L.L.C., Phoenix
By Stephen C. Baker
Counsel for Petitioner Employer and Insurance Carrier

Industrial Commission of Arizona, Phoenix
By Gaetano J. Testini
Counsel for Respondent

Rios Law Firm, PLLC, Phoenix
By Crystal Rios Ramos
Counsel for Respondent Employee
                   BODEGA/NATIONAL v. ZUBIATE
                        Decision of the Court

                      MEMORANDUM DECISION

Judge Brian Y. Furuya delivered the decision of the Court, in which
Presiding Judge James B. Morse Jr., and Judge Cynthia J. Bailey joined.

F U R U Y A, Judge:

¶1            Employer Bodega Latina Corporation and its insurance
carrier Safety National Casualty Co. appeal an award entered by an
Industrial Commission of Arizona (“ICA”) Administrative Law Judge
(“ALJ”) in favor of employee Adela Zubiate. For the reasons explained
below, we set aside the award.

                FACTS AND PROCEDURAL HISTORY

¶2           We consider the evidence in the light most favorable to
sustaining the award. Snyder v. Indus. Comm’n, 96 Ariz. 81, 83 (1964). In
January 2021, Adela Zubiate worked in a bakery for her employer, Bodega.
She had a history of low back injuries in 2017, 2018, and 2020, and chronic
low back pain. According to her supervisor, Zubiate often complained of
low back pain at work.

¶3             On January 7, 2021, Zubiate reported to her employer she had
hurt her back at work several days earlier. No other worker observed this
injury. That same day she went to urgent care, where she reported she had
injured her back lifting boxes at work. The urgent care physician, Dr.
Jacquelyn Island, noted Zubiate had a “lumbar strain” and prescribed pain
medications, cold/heat therapy, and physical therapy. Dr. Island also
recommended a modified work schedule (half days) with restrictions that
included no lifting over 10 pounds, no bending, and no twisting at the
waist. Zubiate continued to work full-time until one day in March, when
she went to the emergency room due to back pain and an inability to move
her left leg. She had lower back surgery three months later.

¶4            In the meantime, Zubiate filed a workers’ compensation claim
in February 2021. Bodega and Safety denied the claim, and Zubiate
protested. At the hearing that followed, the ALJ heard testimony from Dr.
David Jackson, an orthopedic spine surgeon who performed the June 2021
surgery on Zubiate, and Dr. Lyle Young, a spinal surgeon who conducted
an independent medical examination of Zubiate in July 2021.

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                    BODEGA/NATIONAL v. ZUBIATE
                         Decision of the Court

¶5             Dr. Jackson evaluated Zubiate’s condition in April 2021, three
months after the reported work injury at issue here. Zubiate reported lower
back pain going back several years, specifically mentioning a work-related
back injury from 2017. She did not relate her pain to the January 2021 work
injury. Dr. Jackson’s examination found a “disc extrusion at L4-5” and
“fluid in the facet . . . that can certainly correlate with a lifting injury.” He
treated her for a degenerative condition based on her documented medical
history and the symptoms she reported. Although Zubiate noticed and
called Dr. Jackson as her expert witness, he declined to offer an opinion on
the cause of her symptoms at the hearing.

¶6            Dr. Young testified he found no medical evidence of a work
injury in January 2021, either in his examination or his review of the medical
records, which included Dr. Island’s notes.

¶7             The ALJ’s award acknowledged that neither testifying doctor
attributed the January 2021 injury as the medical cause of her back
problems. The ALJ also noted that medical records documented Zubiate’s
chronic low back pain before January 2021. However, the ALJ found Dr.
Island’s clinical notes conflicted with Dr. Young’s expert testimony and
credited the notes as medical causation evidence sufficient to support the
claim:

       Notably, the evidence established that Jacquelyn Island, M.D.
       opined [that Zubiate] sustained an acute lumbar strain as a
       result of lifting at work on January 3, 2021. . . .

       Dr. Island opined [that Zubiate] sustained a work-related
       lumbar strain on January 3, 2021. . . . [T]he opinions and
       conclusions of Dr. Island are adopted herein as being most
       probably correct and well-founded.

¶8            Upon administrative review, the ALJ affirmed the award. The
ALJ specified that she based her decision on the “medical report from
January 7, 2021, that shows Jacquelyn Island, M.D. examined [Zubiate] and
opined [that Zubiate] sustained an acute lumbar strain as a result of lifting
at work on January 3, 2021.” Bodega and Safety filed this statutory special
action, arguing Dr. Island’s clinical treatment notes alone cannot sustain the
award. Based on the specific facts of this record, we agree.

                                DISCUSSION

¶9           In reviewing ICA awards, we do not disturb the ALJ’s
findings unless the conclusions cannot be “supported on any reasonable

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                    BODEGA/NATIONAL v. ZUBIATE
                         Decision of the Court

theory of evidence.” Phelps v. Indus. Comm’n, 155 Ariz. 501, 506 (1987). We
will not disturb the ALJ’s resolution of conflicts in the evidence. Perry v.
Indus. Comm’n, 112 Ariz. 397, 398–99 (1975). When reasonable evidence
exists to support an ALJ’s factual determinations, we will not overturn
them. Kaibab Indus. v. Indus. Comm’n, 196 Ariz. 601, 609 ¶ 25 (App. 2000).
Neither will we re-weigh the evidence. Id. at 608 ¶ 21. Where the evidence
conflicts or when two different inferences may be drawn from the evidence,
the ALJ may resolve those conflicts; a reviewing court will not disturb that
choice unless it is wholly unreasonable. Waller v. Indus. Comm’n, 99 Ariz. 15,
18 (1965).

¶10            A work-related incident is not compensable unless it results
in an injury. Arizona Revised Statutes § 23-1021; see Yates v. Indus. Comm’n,
116 Ariz. 125, 127 (App. 1977) (explaining an injury is not synonymous with
an incident). But while establishing an injury is necessary to assert a
compensable worker’s compensation claim, it is not sufficient. An injury
must be accompanied by some loss or expense to be cognizable under
worker’s compensation law. Yates, 116 Ariz. at 128. And when the nature of
the injury is not readily apparent to a layperson, a claimant must provide
expert medical testimony. W. Bonded Prods. v. Indus. Comm’n, 132 Ariz. 526,
527 (App. 1982). Further, although we defer to an ALJ’s resolution of
conflicts in the evidence, “[e]quivocal or speculative medical testimony is
insufficient to support an award or to create a conflict in the evidence.”
Hackworth v. Indus. Comm’n, 229 Ariz. 339, 343 ¶ 10 (App. 2012).

¶11            As the ALJ acknowledged, neither Dr. Young nor Dr. Jackson
provided any expert medical evidence establishing that Zubiate’s January
2021 work injury caused her lower back condition. Instead, the ALJ based
her medical causation finding exclusively on Dr. Island’s January 7, 2021
medical notes. Because this finding was based solely on documentary
evidence, we are not bound by it. In re Lagunowicz, 21 Ariz. App. 442, 443
(1974). Nevertheless, we “should not disturb the findings of [a] trial court if
they are based on reasonable inferences drawn from the documentary
evidence.” Id. Thus, our inquiry here is whether the ALJ’s medical causation
inferences were reasonable. We conclude they were not, especially in light
of Zubiate’s history of back injuries and chronic lower back pain at the time
of the injury.

¶12           The ALJ infers Dr. Island opined Zubiate’s symptoms were
caused by the January 2021 work injury. But without more, the clinical notes
themselves are at best equivocal as to causation and therefore ambiguous.
For instance, the ALJ relied on Dr. Island’s notes to find Zubiate had an
“acute lumbar strain.” But more precisely, Dr. Island’s notes state only that

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                   BODEGA/NATIONAL v. ZUBIATE
                        Decision of the Court

Zubiate had “lumbar strain.” They do not designate whether it was an acute
or chronic problem. Without more clarity from Dr. Island, the import of this
diagnosis is too speculative to support a causation determination of acute
injury.

¶13           Further, Dr. Island’s notes do not make clear whether the
statements associating Zubiate’s injury with her lifting heavy boxes at work
are Dr. Island’s medical opinion that the injury being treated was acute and
caused by that activity, or if those statements merely document what
Zubiate self-reported. And as we have previously held, a claimant’s self-
reporting of the nature and cause of their injury—even if repeated by a
medical professional—is insufficient to constitute competent expert
medical testimony of causation to support an award without a definitive
and independent medical opinion verifying that causation. See Compunnel
Software Grp./Cont’l Ins. Co. v. Indus. Comm’n, 1 CA-IC 21-0037, 2022 WL
872282, at *2 ¶ 9 (App. Mar. 24, 2022).

¶14            The equivocal nature of Dr. Island’s notes precludes exclusive
reliance on them to establish medical causation. Hackworth, 229 Ariz. at 343
¶ 10. And neither the notes themselves, nor any other evidence in this
record provides the necessary foundation to resolve the ambiguity one way
or the other. Thus, the ALJ’s inference that Dr. Island expressed a causation
opinion in her clinical notes is speculative and insufficient to support an
award, id., and therefore unreasonable, In re Lagunowicz, 21 Ariz. App. at
443.

                              CONCLUSION

¶15           Because Dr. Island’s January 2021 report is ambiguous, it is
insufficient by itself to support a finding of medical causation as to
Zubiate’s claim. Therefore, the ALJ’s award in Zubiate’s favor was entered
in error. The award is set aside.

                           AMY M. WOOD • Clerk of the Court
                           FILED:    JT

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