Opinion
1 CA-IC 22-0019
01-10-2023
ANN TAYLOR, Petitioner Employee, v. THE INDUSTRIAL COMMISSION OF ARIZONA, Respondent, PROFESSIONAL SEARCH ASSOC., Respondent Employer, COPPERPOINT WESTERN INSURANCE CO., Respondent Insurance Carrier.
Ann Taylor, Phoenix Petitioner Employee CopperPoint Western Insurance Company, Phoenix By Chiko Swiney Counsel for Respondent Employer and Respondent Insurance Carrier
Not for Publication - Rule 111(c), Rules of the Arizona Supreme Court
Special Action - Industrial Commission ICA Claim No. 2018162019 Carrier Claim No. 18W00995 The Honorable Paula R. Eaton, Administrative Law Judge
Ann Taylor, Phoenix Petitioner Employee
CopperPoint Western Insurance Company, Phoenix By Chiko Swiney Counsel for Respondent Employer and Respondent Insurance Carrier
Judge D. Steven Williams delivered the decision of the court, in which Presiding Judge David D. Weinzweig and Judge Randall M. Howe joined.
MEMORANDUM DECISION
WILLIAMS, JUDGE
¶1 Ann Taylor seeks review of the denial of her petition to reopen her workers' compensation claim. For the following reasons, we affirm.
FACTUAL AND PROCEDURAL HISTORY
¶2 While working as a custodian in 2018, Taylor fell and hit her head on a tree branch. She briefly lost consciousness and was taken to a hospital where she was diagnosed with a closed head injury. Taylor filed an injury report with the Industrial Commission of Arizona ("ICA") and was awarded workers' compensation through her employer.
¶3 Taylor followed up with her primary care physician, Dr. Cheng Zhong, as well as with Dr. Steven Erickson. Dr. Zhong diagnosed Taylor with post-concussive syndrome and noted a hematoma on the side of her forehead, but did not otherwise treat Taylor for her injuries from the fall. At her first visit to Dr. Erickson, Taylor reported a "severe, constant, throbbing left-sided headache." But by her next visit, just weeks after her fall, Dr. Erickson noted that Taylor had not experienced headaches for the prior four days and had "no cognitive complaints." Taylor's workers' compensation claim closed in early July 2018.
¶4 One year later, Taylor was involved in a car crash, which caused her neck and back pain, along with daily headaches. One year after that, in late 2020, Taylor petitioned to reopen her workers' compensation claim due to severe headaches and memory loss. The ICA denied Taylor's petition, and she requested a hearing.
¶5 An Administrative Law Judge ("ALJ") presided over the hearing, which was held on two separate days. On the first day, in June 2021, Taylor testified about her condition, symptoms, and their onset. On the second day, in November 2021, Dr. Zhong testified about Taylor's current injuries from the car crash, and her condition since her industrial injury in 2018. Dr. Zhong testified that he treated Taylor shortly after her fall in 2018, that he diagnosed her at the time with post-concussive syndrome, and that there was nothing significant about her condition aside from the hematoma. He further stated that Taylor never saw him for headaches, or anything related to her current injuries until October 2020 when she presented with a "persistent headache." Dr. Zhong provided no testimony linking Taylor's headaches in 2020 to the 2018 injury.
¶6 The ALJ denied Taylor's petition to reopen her workers' compensation claim because she "set forth no evidence which might establish that she has any new, additional or previously undiscovered condition causally related to her May 31, 2018, industrial injury [.]" (Emphasis added). Taylor then submitted more than one hundred pages of new medical records and requested the ALJ review its decision. The ALJ refused to consider the additional records and affirmed the prior decision.
¶7 Taylor petitioned this court for special action review.
DISCUSSION
¶8 This court will affirm an ALJ's decision regarding a request to reopen a workers' compensation claim if it is reasonably supported by the evidence. See Lovitch v. Indus. Comm'n, 202 Ariz. 102, 105, ¶ 16 (App. 2002). We review the evidence in a light most favorable to sustaining the award. Id.
¶9 To reopen a workers' compensation claim, a claimant must show that there is: (1) a new, additional, or previously undiscovered temporary or permanent condition, and (2) a causal connection between the condition and the injury in the original claim. A.R.S. § 23-1061(H); See also Pascucci v. Indus. Comm'n, 126 Ariz. 442, 444 (App. 1980); Malinski v. Indus. Comm'n, 103 Ariz. 213, 216 (1968). Expert medical testimony is required to prove an injury and its cause if those elements are not apparent to a layman. See Spielman v. Indus. Comm'n, 163 Ariz. 493, 497 (App. 1989) (citing W. Bonded Prod. v. Indus. Comm'n, 132 Ariz. 526, 527-28 (App. 1982)).
¶10 Taylor has shown no error. Even if the headaches she experienced in 2020 following the car crash were a new or additional condition sufficient to reopen her case, Dr. Zhong never stated that those headaches were caused by her 2018 industrial injury. Causation is a required element to reopen a claim and without medical testimony establishing that connection, a petition to reopen must fail. See Spielman, 163 Ariz. at 496 (finding that a lack of medical expert testimony about causation gave an ALJ reasonable grounds to deny reopening.); see also W. Bonded Prod., 132 Ariz. at 528 ("examples of injuries which are clearly apparent to laymen both in their existence and causal relationship to the industrial accident, are the loss of a limb or an external lesion").
¶11 Because no evidence showed that Taylor's headaches in 2020 were caused by her industrial injury in 2018, the ALJ appropriately denied Taylor's petition to reopen.
¶12 Taylor also suggests that her employer should have never closed her claim in 2018 because she was still suffering from her job-related injury. But this argument also fails. An injured employee has only 90 days to request a hearing after a notice of termination of benefits is sent. A.R.S. § 23-947(A). "Failure to file [a request for a hearing] with the [ICA] within the required time by a party means that the determination . . . is final A.R.S. § 23-947(B).
¶13 Finally, Taylor asks this court to review the additional medical records she submitted to the ALJ after the ALJ issued its ruling. Because those documents were submitted after the fact-finding process concluded and are "not properly a part of the record" before us, we cannot consider them. Epstein v. Indus. Comm'n, 154 Ariz. 189, 195 (App. 1987).
CONCLUSION
¶14 We affirm the ICA's decision.