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Rosarita Mexican Foods v. Industrial Commission of Arizona3/27/2001
We must decide in this special action whether the administrative law judge ("ALJ") erred by continuing benefits to claimant Francisco Tapia and awarding him further diagnostic testing without proof that his condition was medically non-stationary. For the reasons that follow, we hold that the ALJ did not err in awarding diagnostic testing but incorrectly continued other benefits to Tapia. We therefore set aside the award.
FACTUAL AND PROCEDURAL HISTORY
Tapia, a cook employed by Rosarita Mexican Foods, injured his back at work while lifting boxes of vegetables in June, 1998. Initially, Tapia only experienced lower back pain. But one month later, while driving a forklift at work, Tapia felt an increase in back pain that ultimately extended to his groin, buttocks, and down one leg. Later that evening, Tapia went to the emergency room of a local hospital where he was diagnosed with lumbar strain. Tapia subsequently received physical therapy and other medical treatment.
An MRI scan of Tapia's lumbar spine was performed on July 30, 1998, and revealed that he had suffered a herniated disc with an extruded fragment. After reviewing the MRI scan results, Tapia's physician referred him to a neurosurgeon for consultation. Pursuant to the neurosurgeon's recommendations, Tapia underwent a series of epidural steroid injections.
Tapia filed a workers' compensation claim, which was accepted by Rosarita and its carrier (collectively "Rosarita") in July, 1998. Rosarita then referred Tapia to Dr. Kevin Ladin, a board-certified specialist in physical medicine rehabilitation, for an independent medical examination. After examining Tapia in December, Dr. Ladin concluded that Tapia had sustained a disc herniation as a consequence of the industrial injury suffered in June. He further opined that Tapia's injury was not medically stationary. Dr. Ladin then recommended a course of treatment, which he ultimately oversaw.
In March, 1999, Dr. Ladin determined that Tapia's injury was medically stationary without permanent impairment. Accordingly, he released Tapia to full-duty work status without restrictions and recommended follow-up supportive care on an as-needed basis. Rosarita then issued Tapia a Notice of Claim Status closing his claim without permanent impairment, and Tapia filed a timely protest under Arizona Revised Statutes Annotated ("A.R.S.") section 23-941 (1995).
Dissatisfied with Dr. Ladin's diagnosis and recommendation, Tapia consulted Dr. Jack K. Mayfield, a board-certified orthopedic surgeon limited to spinal disorders, who examined Tapia in April, 1999. A second MRI scan was conducted in June, 1999, but it did not reveal a disc herniation or extruded fragment.
During the subsequent Industrial Commission hearing, Tapia testified that he was still experiencing low-back pain that radiated down his buttocks and into his groin, which he perceived was worsening. Dr. Mayfield then testified that Tapia's course of treatment had not resolved his problem. Based upon his review of both MRI scan reports and his examination of Tapia, Dr. Mayfield expressed skepticism that the extruded disc fragment present in the first MRI scan had simply disappeared by the time of the second scan. Consequently, he recommended that Tapia undergo the more definitive myelogram CT scan in order to resolve the conflict in the "diametrically opposed MRIs." Although he tentatively diagnosed Tapia as having lumbar disc disease, attributable to the industrial injury , Dr. Mayfield testified that he could not assess the condition as stationary or non-stationary, or determine its permanency, without the benefit of the myelogram CT scan.
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