Swift v. Wesco Insurance Company

CourtDistrict Court, D. Arizona
DecidedFebruary 24, 2021
Docket2:18-cv-01531
StatusUnknown

This text of Swift v. Wesco Insurance Company (Swift v. Wesco Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Swift v. Wesco Insurance Company, (D. Ariz. 2021).

Opinion

1 WO 2

8 IN THE UNITED STATES DISTRICT COURT 9 FOR THE DISTRICT OF ARIZONA 10

11 Dale Swift, No. CV-18-01531-PHX-RM 12 Plaintiff, ORDER 13 v. 14 Wesco Insurance Company, et al., 15 Defendants. 16

17 Pending before the Court are five Motions in Limine: (1) Plaintiff’s Motion in 18 Limine re: Res Judicata of ICA Findings (Doc. 70); (2) Defendants’ Motion in Limine re: 19 Claims-Close Ratios (Doc. 72); (3) Defendants’ Motion in Limine re: Per Diem Damage 20 Calculations (Doc. 73); (4) Defendants’ Motion in Limine re: Chiropractor Cradic (Doc. 21 74); and (5) Defendants’ Motion in Limine re: Employee Discipline Records (Doc. 75). 22 I. Background1 23 On February 28, 2017, Plaintiff slipped and was injured while working for 24 Biltmore Properties as a maintenance technician at an apartment building in Yuma, 25 Arizona. Plaintiff reported his injury to his supervisor, who informed Creative Business 26 Resources (“CBR”), a company that handled human resources and workers’ 27

28 1 The factual background is adopted from the Court’s July 13, 2020 summary judgment order. (Doc. 65.) 1 compensation matters for Biltmore Properties. CBR instructed Plaintiff to go to Pinnacle 2 Healthcare to have his injury examined. Plaintiff states that he could not find Pinnacle 3 Healthcare, and so instead went to Family and Injury Care. Plaintiff asserts that he chose 4 to go to Family and Injury Care only because Biltmore had previously sent him there for 5 treatment of a previous work-related injury. John Smock, a physician assistant with 6 Family and Injury Care, examined Plaintiff and recommended certain temporary work 7 restrictions. Plaintiff returned to work briefly but claimed that he continued to experience 8 pain. His supervisor instructed him again to go to Pinnacle Healthcare, which he did. 9 Marlena Lopez, a nurse practitioner with Pinnacle Healthcare, examined Plaintiff, 10 confirmed his injury, and released him to light duty with work restrictions similar to 11 those required by Physician Assistant Smock at Family and Injury Care. 12 The next day, CBR contacted Plaintiff and advised him that his employer was 13 offering him a light duty position consistent with the restrictions approved by Pinnacle 14 Healthcare, and that his rate of pay and scheduled work hours would remain the same. 15 The same day, Plaintiff was evaluated by Chiropractor Donald Cradic, who had also 16 previously seen Plaintiff after a prior work-related accident. Chiropractor Cradic gave 17 Plaintiff a temporary “no work” status, and Plaintiff informed CBR that he would not 18 return to light duty because of this recommendation. 19 On March 7, 2017, Plaintiff spoke with Sebastian Lara, a claims adjuster with his 20 employer’s workers’ compensation carrier. Defendants state that Mr. Lara informed 21 Plaintiff during that conversation that Plaintiff could not rely upon Chiropractor Cradic’s 22 “no work” recommendation unless he petitioned the Industrial Commission of Arizona 23 (“ICA”) for a change of treating doctor. Plaintiff denies that Mr. Lara said this. Plaintiff 24 had previously gone through the process of officially changing his treating doctor but did 25 not do so again because he believed he still had the right to choose his own doctor 26 without going through this process. 27 In emails dated March 15 and March 17, CBR informed Plaintiff that his employer 28 was revoking its offer of a light-duty position and was now requiring a “full duty release” 1 before he would be allowed to return to work. Defendant Lara was not 2 contemporaneously copied on these emails. A letter from CBR to Plaintiff dated March 3 20, 2017, also explained that Defendants would require “a Fitness for Duty with ‘no 4 restrictions’ form from your chiropractor before you return to an active work status.” On 5 March 21, 2017, Mr. Lara denied temporary compensation benefits, stating that 6 Plaintiff’s employer was able to accommodate the restrictions set by Nurse Practitioner 7 Lopez. Mr. Lara states that he was not aware that Plaintiff’s employer was now requiring 8 a full duty release, and he asserts that he would have released temporary benefits to 9 Plaintiff if he had known. 10 In late March 2017, Mr. Lara began receiving records from Chiropractor Cradic. 11 On April 17, 2017, Mr. Lara scheduled Plaintiff to undergo a medical examination with 12 John Beghin, MD, an orthopedic surgeon. After the examination and a later MRI, Dr. 13 Beghin opined that Plaintiff did not need ongoing chiropractic care and that Plaintiff 14 could perform light duty work with certain restrictions. 15 On May 18, 2017, Plaintiff filed a Request for Hearing challenging the denial of 16 his temporary benefits. The Request for Hearing noted that Plaintiff’s employer was not 17 offering him light duty and that Plaintiff’s doctor (i.e., Chiropractor Cradic) had him on 18 temporary total disability. Mr. Lara received the Request for Hearing, and states that he 19 “checked his file” to confirm that Plaintiff had been offered a light duty job but turned it 20 down. Plaintiff asserts that whatever investigation Mr. Lara did was objectively 21 unreasonable because he did not obtain or review CBR’s communications to Plaintiff that 22 a “full duty release” was required for Plaintiff to return to work. 23 On March 28, 2018, following hearings and the submission of evidence, an ICA 24 Administrative Law Judge awarded Plaintiff temporary compensation benefits. The 25 award became “final” after no objections were made after 30 days, and Mr. Lara paid the 26 award on May 15, 2018, approximately 18 days later. Mr. Lara claims that the delay in 27 paying the award was “unintentional” and happened because he “was used to receiving 28 1 awards like this directly from the industrial commission,” but instead received this award 2 from Plaintiff’s attorney and so “inadvertently overlooked it.” 3 Plaintiff brought this action alleging various claims arising out of Defendants’ 4 delay in paying Plaintiff’s worker’s compensation claims. (See Doc. 65.) Plaintiff’s 5 claims against Mr. Lara were dismissed. (Id.) Defendants moved for entry of summary 6 judgment on Plaintiff’s bad faith and punitive damages claims. (Id.) In a July 13, 2020 7 Order, the Court denied summary judgment as to Plaintiff’s bad faith claim and granted 8 summary judgment as to Plaintiff’s claim for punitive damages. (Id.) The parties filed the 9 Motions in Limine discussed herein and a pretrial conference was held on December 9, 10 2020, at which the Court heard oral argument on the Motions. 11 II. Motion in Limine re: Res Judicata of ICA Findings (Doc. 70) 12 Plaintiff seeks to preclude Defendants from “introducing any evidence or making 13 any argument disputing that [Plaintiff] suffered a compensable injury and was entitled to 14 workers’ compensation benefits.” (Doc. 70.) Plaintiff argues that he “should not be 15 required to re-litigate his workers’ compensation claim and need of benefits,” because the 16 ICA issued findings and an award on March 28, 2018 confirming he was entitled to 17 benefits, and the ICA’s award is entitled to preclusive effect. (Id.) 18 Defendants respond that they do not intend to contest either Plaintiff’s work- 19 related injury or Plaintiff’s entitlement to compensation as set forth in the ICA’s March 20 28, 2018 award. (Doc. 84.) Defendants argue that the same preclusive effect given to that 21 award should also be applied to the ICA’s August 21, 2020 findings, including that 22 Defendants had overpaid the amount of benefits owed to Plaintiff as of that date, that 23 Plaintiff was capable of working 40 hours per week, and that Plaintiff’s injuries resulted 24 in a permanent partial disability equal to $421.88 per month, which Defendants are 25 paying.

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Swift v. Wesco Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/swift-v-wesco-insurance-company-azd-2021.