Industrial Indemnity Co. v. Industrial Commission

Citations: 152 Ariz. 195; 731 P.2d 90; 1986 Ariz. App. LEXIS 640Docket: No. 1 CA-IC 3389

Court: Court of Appeals of Arizona; July 8, 1986; Arizona; State Appellate Court

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The review involves a consolidated Industrial Commission award regarding a workers' compensation case. The court addresses whether a new injury exists when recent work exacerbates an already symptomatic back condition, leading to new medical treatment and increased disability. The claimant initially injured his back in 1975 while working as a carpet layer and underwent surgeries, resulting in ongoing symptoms and a 25% permanent impairment rating. After various treatments, the claimant returned to work as a supervisor but experienced flare-ups. In 1984, after being required to perform heavier work, the claimant's back pain worsened following the movement of a heavy dresser, leading to hospitalization and a claim for exacerbation of the original injury. Industrial Indemnity denied this request, prompting the claimant to file a new injury claim with EBI Insurance Company, which was also denied. The two claims were consolidated for a hearing where the claimant detailed his heavy work and worsening symptoms. The court concludes that the exacerbation constitutes a new injury, ultimately setting aside the award.

Claimant experienced a gradual worsening of back pain, which he attributed to physical activities such as lifting a desk and laying carpet while in Tucson. Despite having ongoing pain prior to this, it escalated after returning from Tucson, leading him to seek medical attention and hospitalization on May 4, 1984. Dr. Morgan noted that while no new objective physical condition emerged from diagnostic tests, significant fibrosis related to a prior injury and surgeries was present. He indicated that such fibrosis could cause symptoms, which usually could be managed with rest and over-the-counter medications. Dr. Harrington, who examined the claimant later, acknowledged that heavy work might exacerbate existing symptoms but could not definitively link the claimant's condition to recent activities or specify the cause of the increased pain. The administrative law judge granted reopening of the case without determining the existence of a new injury. Industrial Indemnity argued that a new injury occurred, invoking the successive injury doctrine, while EBI denied this claim, referencing relevant case law.

The review affirmed the award with an amendment regarding a new injury claim filed on June 20, 1984. Industrial Indemnity Co. requested a negative finding, which is deemed appropriate given the lack of a specific incident linking to the applicant's pain in May 1984. The applicant's ongoing issues since a prior claim closure in 1978 culminated in hospitalization in 1984, yet there was no discernible new injury or diagnosable condition resulting from the increased activity at that time. Industrial Indemnity argued that exacerbated symptoms could be classified as a new injury, invoking the successive injury doctrine that places liability on the most recent responsible party, EBI. However, the administrative law judge's conclusion that the evidence met the criteria for reopening a claim did not necessarily indicate a new injury. The determination hinges on whether the exacerbation constitutes a new injury, which requires both causation and compensable consequences. While EBI contends that a specific precipitant or organic change is necessary for a new injury, previous rulings affirm that a gradual injury can be compensable without these requirements. An organic change is sufficient to establish a new injury, and if caused by recent work activity, the new injury carrier typically assumes responsibility for the underlying condition. However, Industrial Indemnity did not assert that liability for the underlying condition had shifted to EBI in this case.

The dispute focuses on the liability for compensable consequences resulting from exacerbated symptoms rather than anatomical changes. It is established that a symptomatic aggravation, without a new injury, can still be compensable, as demonstrated in Schreven v. Industrial Commission, where an industrial strain did not worsen a congenital spine deformity but triggered symptoms. Although Schreven’s case involved a congenital condition, the same legal test applies to industrial conditions. In the present case, the claimant's underlying condition was already symptomatic, and recent work activity intensified these symptoms, constituting a new injury. This exacerbation necessitated hospitalization and additional treatment, as Dr. Morgan indicated that supportive care would have sufficed in the absence of this work activity. The claimant's disability has increased from being able to perform light work to being unable to work at all, making this increased disability a compensable consequence of the work activity. The argument from EBI that the administrative law judge found the hospitalization to be a natural progression of the underlying condition is disputed, as the judge acknowledged that increased activity likely exacerbated the condition. Consequently, the successive injury doctrine applies, holding EBI accountable solely for the exacerbation of symptoms. The award is therefore set aside.