Garcia v. Industrial Com'n of Arizona

685 P.2d 1336, 141 Ariz. 184, 1984 Ariz. App. LEXIS 578
CourtCourt of Appeals of Arizona
DecidedApril 24, 1984
Docket1 CA-IC 3044
StatusPublished
Cited by6 cases

This text of 685 P.2d 1336 (Garcia v. Industrial Com'n of Arizona) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garcia v. Industrial Com'n of Arizona, 685 P.2d 1336, 141 Ariz. 184, 1984 Ariz. App. LEXIS 578 (Ark. Ct. App. 1984).

Opinion

*186 OPINION

CONTRERAS, Judge.

The issues in this special action review of an award denying benefits to petitioner pursuant to A.R.S. § 23-1061(M), are (1) whether the insurance carrier was notified of petitioner’s Widow’s Claim for Benefits as contemplated by law and (2) whether a Notice of Claim Status has been issued denying the widow’s claim. Because we conclude that the insurance carrier was properly notified of the widow’s claim and has failed to issue a Notice of Claim Status denying the claim, the award is set aside.

The pertinent facts are as follows. On May 18, 1979, the Industrial Commission (Commission) received a Widow’s Claim signed by Berta Garcia on behalf of herself and four dependent children in which she stated that her husband, Abran Luna Garcia, died on February 25, 1979 as a result of injuries sustained in an industrial accident that occurred on that date. 1 On May 25, 1979, the Commission sent what is designated as Notification of Workmen’s Compensation Claims to the employer’s insurance carrier. It was in the form of a two-page computer printout. This document contained notification of industrial injuries which apparently occurred during the months from February through May of 1979. On page 2 of this document under the column entitled “CLAIMANT-NAME-ADDRESS” appears the name “GARCIA ABRAN L”. The deceased’s social security number is listed and under the column “INJURY MO/DA/YR” appears “02/25/79.” No address is listed. Other than the name of the employer, no other information is provided concerning the “injury” in question. Petitioner’s name is not listed nor is any clue provided as to the nature of the claim. The carrier also received from the Commission a copy of the petitioner’s Widow’s Claim, submitted by BERTA GARCIA, listing her as the claimant. It provided all the pertinent information including the time, place and manner of Abran Garcia’s death along with the name and address of his widow.

The defendant insurance carrier, on June 15, 1979, mailed a Notice of Claim Status which was directed and addressed to Abran Garcia as the claimant. This notice denied the claim for benefits. On December 16, 1982, petitioner notified the Commission that no Notice of Claim Status had been directed to petitioner Berta Garcia and requested that the Commission “direct the carrier to pay immediate compensation as if the claim were accepted as of the date of notification” pursuant to A.R.S. § 23-1061(M). The Commission responded by referring the case to an administrative law judge for further proceedings pursuant to A.R.S. § 23-1061(J). A formal hearing was held in which testimony was received from petitioner and from the claims manager of the Commission.

Subsequently, the administrative law judge issued a decision upon hearing and findings and award denying petitioner’s claim for benefits pursuant to A.R.S. § 23-1061(M). While the administrative law judge found that no Notice of Claim Status denying petitioner’s claim had been issued, he determined that the carrier was not liable to pay immediate compensation to petitioner pursuant to A.R.S. § 23-1061(M) because the Commission did not officially notify the carrier of petitioner’s claim. The award was affirmed on administrative review and this special action — Industrial Commission followed. Because we conclude that the carrier did in fact receive "adequate notice of petitioner’s claim, and did not issue a Notice of Claim Status denying petitioner’s (widow’s) claim, the award is set aside.

An employee, or a party entitled to compensation because of an employee’s death, *187 is required to file a claim with the Commission within one year after the injury occurred or the right to compensation accrued. When the Commission receives the claim, it is required to notify the carrier of the claim. A.R.S. § 23-1061(A). There is no question in this case that petitioner complied with the statutory requirement of timely filing a claim with the Commission. We must look therefore, at the type of notice the Commission provided to the carrier and determine whether the notice provided was sufficient to meet the statutory notice requirement.

If the notice of claim provided by the Commission was sufficient under the statute, the carrier was required to issue a Notice of Claim Status within twenty-one days from the date it is notified of a claim. A.R.S. § 23-1061(M) provides in pertinent part:

M. If the insurance carrier or self-insurer does not issue a notice of claim status denying the claim within twenty-one days from the date the carrier is notified by the commission of a claim ..., the carrier shall pay immediately, compensation as if the claim were accepted, from the date the carrier is notified by the commission of a claim ... until the date upon which the carrier issues a notice of claim status denying such claim____

Thus, if the Commission has in fact notified the carrier of petitioner’s claim and the carrier has failed to issue a Notice of Claim Status denying her claim, petitioner is entitled to receive “compensation as if the claim were accepted, from the date the carrier” was notified of her claim “until the date upon which the carrier issues a notice of claim status denying such claim.” A.R.S. § 23-1061(M). See Kasprowiz v. Industrial Commission, 14 Ariz.App. 75, 480 P.2d 992 (1971) and Kasprowiz v. Industrial Commission, 20 Ariz.App. 116, 510 P.2d 427 (1973).

In this case, the Commission sent two documents to the carrier. The administrative law judge acknowledged that the Commission sent the carrier both the computer printout and a copy of the Widow’s Claim but found that only the computer printout could be official notice to the carrier of a claim. He further found that “the sending of that [widow’s] claim did not officially notify the carrier that such a claim had been made.” Since the computer printout simply listed the employer, the employee, the date of injury and the employee’s social security number, the administrative law judge further found that it was impossible for the carrier to determine from the printout that the claim was made by petitioner for the widow’s benefits. The administrative law judge relied on the testimony of the Commission claims manager that the Commission’s policy was to give official notice of claims by sending the computer printouts to the carrier.

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Bluebook (online)
685 P.2d 1336, 141 Ariz. 184, 1984 Ariz. App. LEXIS 578, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garcia-v-industrial-comn-of-arizona-arizctapp-1984.