Court Opinion

ID: 9960552
Source: CourtListenerOpinion
Date Created: 2024-04-16 16:01:50.205071+00
Date Added: 2024-06-11T08:19:36.772302
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  UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL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

                     LISA DOUGLAS, Petitioner Employee,

                                         v.

      THE INDUSTRIAL COMMISSION OF ARIZONA, Respondent,

LOVES TRAVEL STOPS AND COUNTRY STORES, Respondent Employer,

          ACE AMERICAN INSURANCE CO., Respondent Carrier.

                              No. 1 CA-IC 23-0016
                               FILED 4-16-2024

                Special Action - Industrial Commission
                      ICA Claim No. 20210080100
                   Carrier Claim No. 189418826-001
        The Honorable Colleen Marmor, Administrative Law Judge

                             AWARD AFFIRMED

                                    COUNSEL

Taylor & Associates, P.L.L.C., Phoenix
By Nicholas C. Whitley
Counsel for Petitioner Employee

Industrial Commission of Arizona, Phoenix
By Afshan Peimani
Counsel for Respondent
Lundmark, Barberich, La Mont & Puig P.C., Phoenix
By R. Todd Lundmark, David T. Lundmark
Counsel for Respondent Employer and Carrier

                      MEMORANDUM DECISION

Judge D. Steven Williams delivered the Court’s decision in which Presiding
Judge Daniel J. Kiley and Judge Kent E. Cattani joined.

W I L L I A M S, Judge:

¶1             The Industrial Commission of Arizona (“ICA”) issued an
initial award concluding that Lisa Douglas, an injured worker, was not
medically stationary and needed further active medical care. Upon
reconsideration of that award, the ICA Administrative Law Judge (“ALJ”)
reversed, concluding that Douglas’s work-related injury was stationary
through October 17, 2021. Douglas challenges the ALJ’s decision upon
review as insufficient and unsupported by evidence. While we agree that
the initial award makes no findings of fact and merely chooses one expert
opinion over others without meaningful explanation, we conclude that the
decision upon review provides a legally sufficient basis for resolving the
conflict in expert medical opinion evidence. Accordingly, we affirm.

                 FACTS AND PROCEDURAL HISTORY

¶2             While working in late 2020 for Loves Travel Stops and
Country Stores (“the Employer”), Douglas hurt her back pushing a heavy
laundry basket. She was diagnosed with an insufficiency fracture to the
sacrum. Initially, she experienced pain on the right side of her lower back.
Later, her right-side pain resolved but she developed pain on the left side
of her lower back. She sought further treatment, but Ace American
Insurance Co., the Employer’s insurance carrier, issued a notice of claim
status closing the claim as of October 17, 2021, with no permanent disability.
Douglas requested a hearing, claiming that she continued to require active
medical treatment and, in the alternative, that she sustained a permanent
disability. Although the hearing addressed whether Douglas was medically
stationary, the primary issue at the hearing was whether the opposite (left)
side pain was causally related to the work accident.

¶3         At the hearing, three medical experts testified. Dr. Eamonn
Mahoney, board-certified in orthopedics, began treating Douglas in
December 2020, just after her accident at work. He testified that Douglas

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                        DOUGLAS v. LOVES/ACE
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sustained a work-related fracture on the right side of the sacrum, which had
healed by October 2021. He also diagnosed a lytic spondylolisthesis
(“slipped vertebrae”) at L5-S1, however, a pre-existing condition in which
a defect in Douglas’s bone caused the vertebrae at L5 to slip forward on the
S1 vertebrae, causing Douglas’s pain on the left side. Dr. Mahoney focused
his treatment attention on the slipped vertebrae rather than the fracture, but
a flare-up of Douglas’s lupus hindered her treatment. Although he testified
that Douglas’s pain on the left side was not directly caused by the fracture,
he explained that the fracture could have made the slipped vertebrae worse
or symptomatic. Neither side asked Dr. Mahoney to opine whether Douglas
suffered a permanent impairment from the work injury.

¶4             Two experts testified for the Employer and its insurance
carrier. Dr. Gary Dilla, board-certified in physical medicine and
rehabilitation, conducted an independent medical examination (“IME”) on
Douglas in February 2022. He opined that Douglas suffered the
insufficiency fracture described by Dr. Mahoney and a lumbar sprain, both
of which resolved by October 2021. He also opined that Douglas did not
show evidence of any sacroiliac joint injury that would account for her
left-side pain. He concluded that Douglas’s work injury had resolved, and
she sustained no permanent impairment.

¶5            Dr. Michael S. Chang, a board-certified orthopedic surgeon,
also conducted an IME of Douglas in April 2021, with an update in
September 2021. He agreed that Douglas suffered an acute insufficiency
fracture from the work accident but opined that her slipped vertebrae were
caused by an old stress fracture that had “been going on for decades” and
was thus a degenerative condition. He found no evidence of acute injury to
the vertebrae and concluded that the slipped vertebrae were unrelated to
the work accident, expressly disagreeing with Dr. Mahoney’s opinion that
the work accident may have exacerbated the slipped vertebrae. He did not
find that Douglas suffered any permanent impairment because of the
accident.

¶6            The ALJ issued an award that summarized the testimony of
the witnesses, described the law relevant to challenging the closure of a
claim, and concluded that Douglas had proven that she needed further
active care and was entitled to further benefits until she became medically
stationary. The award made no findings of fact and concluded, without
explanation, that Dr. Mahoney’s opinion was “most probably correct and
well-founded.”

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                        DOUGLAS v. LOVES/ACE
                          Decision of the Court

¶7            The Employer and its insurance carrier moved for
reconsideration, arguing that Dr. Mahoney opined only that the work
injury may have aggravated Douglas’s slipped vertebrae, not that it, in fact,
did so. The ALJ reconsidered the evidence and concluded that “Dr.
Mahoney’s testimony was more speculative than certain with regard to
what caused [Douglas’s] ongoing left-sided symptoms.” The decision upon
review provides no factual findings nor a conclusion about whether
Douglas suffered a permanent impairment. Instead, it notes the conflicting
medical opinion evidence presented, adopts the opinions of Dr. Dilla and
Dr. Chang “as being most probably correct and well-founded,” and
concludes that Douglas failed to establish “by a reasonable preponderance
of the credible evidence that she needs further active medical care.”
Douglas filed this statutory special action challenging the conclusion that
she does not require further active medical care.1

                               DISCUSSION

¶8             An injured worker bears the burden of proving that her
condition has not become stationary and she is entitled to continuing
benefits. Stephens v. Indus. Comm’n, 114 Ariz. 92, 94 (App. 1977). “[T]he term
‘stationary’ refers to that time when the physical condition of the employee
resulting from the industrial injury has reached a relatively stable status so
that nothing further in the way of medical treatment is indicated to improve
that condition.” Aragon v. Indus. Comm’n, 14 Ariz. App. 175, 176 (1971).
When an issue is peculiarly within the knowledge of medical doctors, such
as whether a medical condition is stationary, competent medical testimony
must support a worker’s claim that her condition is not static. Rosarita
Mexican Foods v. Indus. Comm’n, 199 Ariz. 532, 535, ¶ 12 (App. 2001).

¶9           In this case, the medical experts uniformly testified that
Douglas sustained a work-related injury, which had since healed. Because
Douglas alleged that her work-related injury aggravated a separate
condition, she bore the burden of presenting evidence demonstrating a
causal connection between the original injury and the aggravated
condition.

¶10           ICA awards must make findings of fact and conclusions of
law. Post v. Indus. Comm’n, 160 Ariz. 4, 6–7 (1989). When presented with
competing medical opinion evidence, the ALJ must “resolve the conflicts in
the testimony, draw one of the conflicting inferences, [and] reach one of

1 She does not argue the permanent impairment issue in her brief.

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                        DOUGLAS v. LOVES/ACE
                          Decision of the Court

[the] ultimate conclusions.” Id. An ICA award that simply sets forth general
principles of workers’ compensation law and an ultimate legal conclusion,
does not provide an adequate basis for review. Id.

¶11            Douglas argues that both the award and the decision on
review are insufficient because they do not make factual findings on
material issues. Relying on Post, she contends that the decision on review is
so deficient that this court cannot properly review it.

¶12             “It is the rule that the findings of administrative agencies
must be explicit to enable the reviewing court to review the decision
intelligently and to ascertain whether the facts as found afford a reasonable
basis for the decision or be sufficiently definite and certain to permit
[] judicial interpretation.” Wammack v. Indus. Comm’n, 83 Ariz. 321, 325
(1958). “Although findings need not be exhaustive, they cannot simply state
conclusions.” Douglas Auto & Equip. v. Indus. Comm’n, 202 Ariz. 345, 347
(2002). “[I]f the findings lack precision and are too indefinite to aid the
courts in reviewing the award,” the award must be set aside. Hatfield v.
Indus. Comm’n, 89 Ariz. 285, 289 (1961). However, if an ICA award provides
a sufficient basis for the ALJ’s ultimate conclusion, even if the ALJ’s
findings are “not as detailed as [reviewing courts] would prefer,” the lack
of robust findings will not automatically defeat the award. Douglas Auto &
Equip., 202 Ariz. at 347, ¶ 8.

¶13           In this case, the award on review does not expressly set forth
findings of fact, specific or otherwise. However, the issue to be decided is
not factually complex, requiring only a weighing of the expert opinions,
and the ALJ opined that the employer’s expert’s views were
“well-founded.” While we would prefer that the award expressly set forth
the reason for giving one opinion more weight than another, the decision
on review provides the ALJ’s basis for reaching a different outcome when
she reweighed the expert opinions. On this record, the only conflict in the
experts’ opinions was whether the work-related injury aggravated
Douglas’s preexisting slipped vertebrae condition. Because the ALJ has the
authority to resolve conflicting medical opinions, Am. Ins. Co. v. Indus.
Comm’n, 144 Ariz. 364, 369 (App. 1984), and the ALJ here fully resolved the
conflict based on the character of the expert testimony, characterizing Dr.
Mahoney’s opinion as “more speculative” than the others, we will not set
aside the decision.

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              DOUGLAS v. LOVES/ACE
                Decision of the Court

                       CONCLUSION

¶14   We affirm.

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

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