ICA Special Fund Division v. Rey - COA Div 1 - January 23, 2025 - Memo Decision

Facts:

Nelson Rey, an employee of Northern Arizona Healthcare, suffered two industrial injuries: one to his right elbow in 2003 and another to his right foot and ankle in 2015.

Both injuries resulted in permanent impairments. The 2003 injury was classified as a "scheduled" impairment with a 10% permanent impairment to his right upper extremity. The 2015 injury also resulted in a scheduled impairment to his lower right extremity.

CopperPoint Premier Insurance Co., the carrier for Northern Arizona Healthcare, sought partial reimbursement from the Industrial Commission of Arizona's (ICA) Special Fund for the disability benefits paid to Rey, arguing that the combination of the two scheduled impairments made the 2015 claim eligible for apportionment under A.R.S. § 23-1065(B)(2).

Issue(s):

1. Whether Rey’s 2015 workers’ compensation claim is eligible for apportionment under A.R.S. § 23-1065(B)(2), allowing CopperPoint to receive partial reimbursement from the Special Fund.

2. Whether the reopening and reclosure of Rey’s 2015 claim, which included a new injury to his right elbow, affected the eligibility for apportionment.

Holding: The Arizona Court of Appeals affirmed the award, holding that Rey’s 2015 claim was eligible for apportionment under A.R.S. § 23-1065(B)(2).

The court found that the reopening and reclosure of the 2015 claim did not result in any additional impairment beyond the preexisting 10% impairment from the 2003 injury, and thus did not affect the eligibility for apportionment.

Key Takeaways:

1. Apportionment Eligibility: A claim involving a worker with a preexisting scheduled impairment who suffers an additional scheduled impairment is eligible for apportionment under A.R.S. § 23-1065(B)(2).

   
   

2. Reopening and Reclosure: The reopening and reclosure of a claim do not affect apportionment eligibility if the reopening does not result in any additional impairment beyond the preexisting condition.

3. Medical Evidence: The court relied on medical evidence indicating that Rey’s new elbow injury did not increase the impairment beyond the existing 10% impairment from the 2003 injury.

4. Legal Reasoning: The court emphasized that eligibility for apportionment hinges on the nature of the impairment, not the nature of the disability compensation.

5. Procedural Considerations: The court declined to address arguments not raised before the ICA, such as the timeliness of CopperPoint’s notice for apportionment.