Garcia v. dms/hartford
1 CA-IC 16-0036
| Ariz. Ct. App. | Apr 18, 2017Background
- Claimant (custodian) fell in Jan 2012, injuring sacrum/coccyx; carrier initially accepted and provided conservative care.
- After an IME by Dr. Beghin the carrier closed the claim with a permanent impairment; claimant protested seeking continuing active medical care.
- ALJ Long (2013) resolved the medical conflict in favor of treating Dr. Patel, ordered continuing active care (claim not medically stationary at that time).
- Later, following a different IME and administrative proceedings, the ICA found no loss of earning capacity (LEC); claimant requested a hearing before ALJ Radke.
- ALJ Radke adopted IME Dr. Gary Dilla’s work restrictions and a labor-market expert’s opinion, finding no LEC; claimant appealed, arguing issue preclusion barred reliance on Dr. Dilla because his diagnosis matched Dr. Beghin’s (which Judge Long rejected).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether issue preclusion barred ALJ Radke from adopting Dr. Dilla’s restrictions because they relied on the same diagnosis rejected by ALJ Long in 2013 | The earlier ALJ’s resolution in favor of Dr. Patel on medical care should preclude later reliance on the same diagnosis | The 2013 proceeding concerned whether claimant needed continuing active medical care (not permanency/LEC); the issues are different stages and not preclusive here | Issue preclusion did not apply; Radke could adopt Dr. Dilla’s opinion because the prior ruling addressed a different claim stage (medical treatment), not permanency/LEC |
| Whether the claimant’s request for administrative review was timely | Claimant contended she timely sought review | Respondents argued the supporting memorandum was filed late so review was untimely | Request for review was timely (notice filed before deadline); memorandum of points not required, so review preserved |
Key Cases Cited
- Young v. Indus. Comm’n, 204 Ariz. 267 (App. 2003) (standard of review: deference to ALJ findings; law reviewed de novo)
- Hardware Mut. Cas. Co. v. Indus. Comm’n, 17 Ariz. App. 7 (App. 1972) (workers’ compensation progresses through sequential claim stages)
- Parkway Mfg. v. Indus. Comm’n, 128 Ariz. 448 (App. 1981) (timely protest opens all issues in the NCS for ALJ consideration)
- Janis v. Indus. Comm’n, 27 Ariz. App. 263 (App. 1976) (definition of medically stationary)
- Cassey v. Indus. Comm’n, 152 Ariz. 280 (App. 1987) (explains bifurcated procedure: permanency then LEC)
- Circle K Corp. v. Indus. Comm’n, 179 Ariz. 422 (App. 1994) (res judicata effect of ICA awards; elements of issue preclusion)
- LeDuc v. Indus. Comm’n, 116 Ariz. 95 (App. 1977) (administrative determinations nullified by a timely protest are not binding in subsequent LEC proceedings)