Chavez v. Industrial Commission

520 P.2d 1178, 21 Ariz. App. 501, 1974 Ariz. App. LEXIS 357
Court of Appeals of Arizona·Decided April 16, 1974·No. No. 1 CA-IC 916·Published·Cited by 4 cases

Opinion

OPINION

STEVENS, Judge.

The two basic questions presented in this review of the award of The Industrial Commission of Arizona are:

1. Where there has been a partial lami-nectomy with the excision of a herniated nucleus pulposis resulting in a permanent anatomical change in the injured workman, can there be an award which finds the absence of a physical functional impairment or the absence of a percentage rating thereof attributable to the industrially related surgery ?; and

2. Where there is an error on the part of the employer in reporting the earnings of the injured workman and the Commission has issued its “notice of average monthly wage” (Form ICA 109) with a 60-day clause and the average monthly wage so determined has become “final” by reason of the absence of a request for a hearing made within the 60-day period, may the correct wage figure be shown and a new average monthly wage determination be calculated where there is a specific request for recomputation, which request is included in a timely request for a hearing relating to a later notice of claim status which was issued by the carrier?

[502] Melisendro Chavez is the workman who sustained an industrially related injury to his low back on 9 July 1971. He will herein be referred to as the petitioner. Prior thereto, in 1966, he sustained a low back injury resulting in a surgical spinal fusion. As a result of the 1966 injury he received a permanent award of a 15% general physical functional disability with no loss of earning capacity. Thereafter the petitioner returned to heavy physical labor which he fully performed with occasional pain.

Following the July 1971 low back injury, the injury here in question, and on 4 August 1971, John W. McCracken, Jr. D. O., a neurosurgeon, performed:

“A partial laminectomy at the level of L4 — L5 on the left, which was accomplished with the excision of a herniated nucleus pulposis.”

In due time the carrier issued its notice of claim status terminating temporary compensation stating as its reason that the petitioner had been released for regular work. A timely request for a hearing was filed on 3 December 1971. A hearing was held. The hearing officer’s award extended the period of compensation and medical benefits, and in other respects sustained the notice of claim status.

PHYSICAL FUNCTIONAL IMPAIRMENT

The petitioner’s treating physician and surgeon was Dr. McCracken who was the only witness as to the medical aspects of the case.

Dr. McCracken admitted that as an incident to the surgery, and in relation to the petitioner’s presurgical body condition, there was a permanent change in the physical structure of the petitioner’s body. The doctor was steadfast in his opinion that the petitioner's condition was stationary and that as of the date of his final report, as well as a reexamination shortly before the hearing, there was no physical functional impairment causally related to the 1971 industrial injury and surgery. He was extensively examined in relation to the then applicable Industrial Commission Rule 13(d) 1 and in relation to the AMA guidelines.

We, as lay people, cannot say that the doctor’s opinions are without foundation in medical fact.

AVERAGE MONTHLY WAGE

There are four critical dates which we must consider. These are:

19 August 1971, the date upon which the Commission entered its “notice of average monthly wage”. The notice contained a 60-day clause, the 60th day being 18 October 1971;

12 October 1971, the date of a carrier notice of claim status which terminated temporary compensation as of 13 October 1971 giving as the reason that “claimant released for, or has returned to, light work wage loss due to injury.” (Emphasis added) This notice contained a 60-day clause;

12 November 1971, the date of a carrier notice of claim status which terminated temporary compensation as of 14 November 1971 giving as the reason that “claimant released for, or has returned to, regular work without wage loss due to injury.” (Emphasis added) This notice contained a 60-day clause; and

3 December 1971 (46 days after the expiration of the 60-day period following the 19 August Commission notice on the fixing of the average monthly wage), through counsel, the petitioner filed a timely request for a hearing in relation to the 12 October and the 12 November carrier’s notices of claims status. That request [503] further recited “applicant also objects to the earlier average monthly wage determination as being incorrect and based upon an obvious mistake * *

A.R.S. § 23-9472 makes express reference to A.R.S. § 23-1061. In Aetna Insurance Company v. The Industrial Commission of Arizona, 19 Ariz.App. 262, 506 P.2d 653 (1973), this Court held that by virtue of A.R.S. § 23-1061 (F) the 60 days commenced to run, not from the carrier’s determination of the average monthly wage, but from the Commission notice.

In the past there have been average monthly wage cases which permitted exceptions to the finality of the Commission’s wage notice, as for example, Garcia v. The Industrial Commission of Arizona, 13 Ariz.App. 128, 474 P.2d 847 (1970), and cases which did not permit an exception, as for example, Cowan v. The Industrial Commission of Arizona, 18 Ariz.App. 155, 500 P.2d 1143 (1972). In Garcia the error was detrimental to the employee and in Cowan it was detrimental to the employer. We must explain that the rationale of Cowan was a legal one and was not based upon the sustaining of a windfall to the employee.

The pattern of a series of successive final determinations in the processing of the claims of injured workmen is well established by Russell v. The Industrial Commission of Arizona, 104 Ariz. 548, 456 P.2d 918 (1969), and by Talley v. The Industrial Commission of Arizona, 105 Ariz. 162, 461 P.2d 83 (1969). In Talley the finality of the average monthly wage was considered.

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Chavez v. Industrial Commission, 520 P.2d 1178, 21 Ariz. App. 501, 1974 Ariz. App. LEXIS 357 (Ark. Ct. App. 1974).

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Related

Chavez v. Industrial Commission
575 P.2d 340 (Court of Appeals of Arizona, 1977)
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529 P.2d 1181 (Arizona Supreme Court, 1974)