Csizmadia v. Natl peo/the Mint
1 CA-IC 15-0059
| Ariz. Ct. App. | Dec 8, 2016Background
- Matthew Csizmadia injured his left knee on Sept. 22, 2012 while working as a door host in Arizona; he continued working that shift and sought medical care a few days later.
- He moved to New Jersey about 5–6 days after the injury without prior written approval from the Industrial Commission of Arizona (ICA); he later requested permission on Aug. 30, 2013 and the ICA approved that request retroactively to that date only.
- Employer’s carrier accepted the claim but concluded no benefits were due; formal hearings followed and the ALJ issued an award covering medical/surgical/hospital benefits from Sept. 22, 2012 through Apr. 13, 2014, minus the unapproved absence period (Sept. 22, 2012–Aug. 30, 2013).
- The ALJ denied any total temporary or temporary partial compensation and concluded the industrial injury produced no permanent impairment to the left knee.
- Medical testimony conflicted: claimant’s treating physician (Dr. Greenberg) said claimant had persistent knee laxity and was slow to respond to treatment but was at maximum medical improvement by July 2014; ICA’s expert (Dr. Carter) found no objective basis tying ongoing symptoms to the industrial event and no need for further treatment.
- The Court of Appeals affirmed the ALJ, deferring to the ALJ’s credibility determinations and concluding benefits were properly suspended during the unapproved out‑of‑state absence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ICA erred in terminating benefits/declaring claimant medically stationary | Csizmadia: ongoing treatment and additional impairments related to the industrial injury mean benefits should continue | ICA/Employer: medical evidence (Dr. Carter) shows no causal link, no permanent impairment, and no need for further treatment | Held for ICA: ALJ reasonably credited Dr. Carter; termination affirmed |
| Whether medical benefits should have been paid for care obtained while claimant lived in NJ without ICA approval | Csizmadia: seeks coverage for treatment during the out‑of‑state period because treatment continued | ICA/Employer: A.R.S. § 23‑1071 prohibits leaving Arizona >2 weeks without written approval; forfeiture applies to unapproved period | Held for ICA: benefits properly suspended from departure to Aug. 30, 2013 (retroactive approval could not cure earlier forfeiture) |
Key Cases Cited
- Lane v. Indus. Comm’n, 218 Ariz. 44 (App. 2008) (ALJ factual findings deferred to; legal questions reviewed de novo)
- Ortega v. Indus. Comm’n, 121 Ariz. 554 (App. 1979) (ICA not required to continue benefits absent proof of permanent disability related to industrial incident)
- Lawler v. Indus. Comm’n, 24 Ariz. App. 282 (App. 1975) (claimant bears burden to prove causal relation and that condition is not medically stationary)
- Malinski v. Indus. Comm’n, 103 Ariz. 213 (1968) (ALJ is sole judge of witness credibility and resolves conflicting medical evidence)
- Waxler v. Indus. Comm’n, 116 Ariz. 213 (App. 1977) (courts decline to create exceptions to A.R.S. § 23‑1071 leaving‑state rule)
- Cont’l Cas. Co. v. Indus. Comm’n, 113 Ariz. 116 (1976) (statute does not allow retroactive cure of an unapproved departure prior to filing for permission)
