Sanders v. bowie/american
1 CA-IC 17-0011
| Ariz. Ct. App. | Nov 14, 2017Background
- Sanders, an in-home health aide for Bowie, developed right shoulder pain beginning in mid-2013 and first mentioned it to her primary care physician, Dr. Le, on March 12, 2014.
- MRI in September 2014 showed issues leading to shoulder surgery by Dr. Bennion on September 30, 2014; a second shoulder surgery occurred in May 2015.
- Sanders filed a workers’ compensation claim in December 2014; carrier American Liberty denied the claim and hearings/IMEs followed after remand from this court for lack of prior notice.
- At the remand hearings, testimony included Sanders, Bowie’s representative (Horne), Dr. Le (treating physician who said work “might” have contributed), and Dr. Shapiro (IME physician who opined within a reasonable degree of medical probability that work did not cause or contribute to the condition).
- The ALJ found Sanders’ claim noncompensable, crediting Dr. Shapiro over Dr. Le; the ALJ also denied subpoenas for Dr. Bennion and the physical therapist because procedural requirements were not met and their records did not establish causation.
- The Court of Appeals affirmed, holding the ALJ’s credibility and medical causation findings were supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Sanders’ shoulder condition was compensable (causation) | Sanders argued her work duties caused or contributed to the shoulder injury; treating physician suggested work “might” have contributed | Respondents argued medical evidence (IME) showed work did not cause or contribute; treating opinion speculative | ALJ and appellate court held Dr. Shapiro’s opinion more probable; claim noncompensable |
| Whether treating physician’s opinion met required medical probability standard | Sanders relied on Dr. Le’s testimony to establish causation | Respondents argued Dr. Le’s opinions were speculative and not within a reasonable degree of medical probability | Court held Dr. Le’s “might” opinions insufficient; admissible expert opinion required medical probability |
| Whether ALJ abused discretion by not issuing subpoenas for Dr. Bennion/PT | Sanders requested subpoenas for Dr. Bennion and PT to testify | Respondents noted Sanders did not follow A.A.C. R20-5-141 procedure or make an offer of proof | Court held ALJ did not abuse discretion; procedural rules not followed and records did not show causation |
| Alleged ALJ bias and improper questioning | Sanders claimed ALJ was biased and questioned witnesses improperly | Respondents argued ALJ questioning to clarify evidence is permissible | Court held questioning was proper and record did not show bias |
Key Cases Cited
- Helmericks v. AiResearch Mfg. Co., 88 Ariz. 413 (1960) (medical possibility opinions insufficient; need reasonable degree of medical probability)
- Gronowski v. Indus. Comm’n, 81 Ariz. 363 (1957) (same principle on medical probability)
- Carousel Snack Bar v. Indus. Comm’n, 156 Ariz. 43 (1988) (ALJ resolves conflicts in medical evidence and decides credibility)
- Malinski v. Indus. Comm’n, 103 Ariz. 213 (1968) (review considers facts in light most favorable to sustaining award)
- Young v. Indus. Comm’n, 204 Ariz. 267 (App. 2003) (appellate review: deferential to ALJ factual findings, independent review of legal conclusions)