Lindquist v. hospice/sentry
1 CA-IC 16-0060
| Ariz. Ct. App. | Jun 8, 2017Background
- In October 2014 Lindquist, a certified nursing assistant, injured her left shoulder while transferring a patient and reported the injury; the carrier initially accepted the claim and paid temporary benefits.
- After conservative treatment and differing specialist opinions, Dr. Dave discharged Lindquist as medically stationary on August 17, 2015, finding no permanent impairment; benefits were terminated that date.
- Lindquist later consulted Dr. McClure, who recommended and performed shoulder surgery after diagnosing labral and partial-thickness rotator cuff tears he attributed to the industrial injury.
- Lindquist requested a hearing challenging the termination of benefits and contended the later surgery was causally related and reasonably necessary due to the work injury.
- The ALJ found conflicting medical testimony and credited Dr. Bailie (a shoulder specialist) over Dr. McClure, concluding Lindquist was stationary with no permanent impairment as of August 17, 2015, and that the surgery was not reasonably necessary or causally related to the industrial injury.
- The Court of Appeals affirmed, holding the ALJ’s resolution of conflicting medical evidence was supported by substantial evidence and not an abuse of discretion.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether benefits and medical care were properly terminated when claimant was declared stationary | Lindquist: surgery and later diagnoses show ongoing injury causally related to the work incident, so benefits should continue | ICA/Employer: treating and independent exams showed no objective shoulder pathology and claimant was stationary as of Aug 17, 2015 | Held: ALJ reasonably credited defense experts; termination and denial of surgery-related benefits affirmed |
| Whether the later shoulder surgery was reasonably necessary and causally related to the industrial injury | Lindquist: Dr. McClure’s intraoperative findings (labral and partial rotator cuff tears) were caused by the October 2014 injury | Employer/carrier: specialists and imaging did not show objective pathology tied to the industrial event; surgery repaired ‘‘normal’’ tissue | Held: ALJ credited Dr. Bailie’s opinion that surgery was not related to the industrial event |
| Whether the ALJ properly resolved conflicting medical testimony | Lindquist: ALJ erred by discrediting treating surgeon and reweighing evidence | ICA/Employer: ALJ properly weighed expert qualifications, methods, and probative value | Held: Standard of review defers to ALJ on credibility and weighing; no abuse of discretion |
| Whether ALJ’s demeanor required relief | Lindquist: alleged ALJ yelled at her, affecting fairness | Respondents: transcript does not support claim; ALJ’s comments were procedural | Held: Transcript did not substantiate the claimed misconduct; no reversible error |
Key Cases Cited
- Lovitch v. Indus. Comm’n, 202 Ariz. 102 (court will not disturb ICA award if reasonably supported by evidence)
- Perry v. Indus. Comm’n, 112 Ariz. 397 (ALJ resolves conflicts in testimony and may determine which testimony is more probably correct)
- Home Ins. Co. v. Indus. Comm’n, 23 Ariz. App. 90 (terminating benefits is proper when claimant’s condition is medically stationary)
- Carousel Snack Bar v. Indus. Comm’n, 156 Ariz. 43 (ALJ may consider diagnostic methods, speculative testimony, and expert qualifications when evaluating medical opinions)