Special Events Service, Inc. and Zurich American Insurance Co. v. Roberto Dominguez
228 Ariz. 332
Ariz. Ct. App.2011Background
- Dominguez sustained a left-wrist injury at Special Events on April 30, 2008.
- Zurich initially accepted the claim and later closed it with no permanent disability.
- Zurich reopened the claim and, on April 26, 2010, filed Form 104 closing the claim and stating permanent disability.
- On the same day Zurich filed Form 107 designating unscheduled permanent partial disability under § 23-1044(C).
- Zurich later rescinded the Form 107 and filed Form 106 designating a scheduled eighteen percent disability to the upper extremity.
- The ALJ held Form 107 was entitled to finality under res judicata and closed the claim as unscheduled; the petitioners challenged this decision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Form 107 designations are subject to res judicata finality | Dominguez; Special Events and Zurich argue Form 107 cannot be final under res judicata. | Dominguez; Special Events and Zurich contend Form 107 is a final, protestable determination subject to finality. | Form 107 is not subject to res judicata finality. |
| Whether the 90-day protest/notice finality rules apply to Form 107 unscheduled designations | Form 107’s unscheduled designation should be final after 90 days if not protested. | Form 107 cannot be protested and thus cannot become final under § 23-947. | The 90-day finality rule does not apply to Form 107 unscheduled designation. |
| Whether Form 107 can be protested or become final despite lack of protest rights notice | Form 107 can become final even without protest rights notice due to forms’ nature. | Form 107 cannot become final as it lacks protest rights and is not a final determination. | Form 107 cannot be protested and does not become final under § 23-947. |
| What is the proper effect when Form 107 is rescinded and Form 106 later issued | Finality of Form 107 should control; rescission does not alter the issue. | Form 106 supersedes Form 107 and governs the disability designation. | Rescinding Form 107 and issuing Form 106 requires reconsideration outside § 23-947 finality. |
| Need for expeditious compensation and agency interpretation in light of bad-faith processing and rules | Procedural safeguards exist (R20-5-107(D), R20-5-163) to promote expeditious compensation. | Agency interpretation supports not treating Form 107 as final. | Administrative rules support timely processing and discourage delay; Form 107 not subject to res judicata. |
Key Cases Cited
- Polanco v. Indus. Comm’n, 214 Ariz. 489 (App. 2007) (liberal construction but constrained by plain language of Act)
- Special Fund Div./No Ins. Section v. Indus. Comm’n, 181 Ariz. 387 (App. 1994) (Form 107 not protestable; not final within § 23-947)
- Tucson Steel Div. v. Indus. Comm’n, 154 Ariz. 550 (App. 1987) (form finality and protest rights discussed; Form 107 context)
- Phoenix Cotton Pickery v. Indus. Comm’n, 120 Ariz. 137 (App. 1978) (unprotested notice of claim status final as to merits)
- Aldrich v. Indus. Comm’n, 176 Ariz. 301 (App. 1993) (preclusion applies to issues previously litigated; agency interpretation given weight)
- Latter Day Saints v. Indus. Comm’n, 150 Ariz. 495 (App. 1985) (carrier bound by notice of claim status after ninety days; Form 104 context)
- Magma Copper Co. v. Indus. Comm’n, 139 Ariz. 38 (App. 1983) (Form 107 initiates process; issue raised for review not first time)
- Grammatico v. Indus. Comm’n, 208 Ariz. 10 (App. 2004) (expedite compensation as purpose of workers’ comp system)