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jbi/twin v. Palacios - Workers' Compensation Appeal

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Filed March 12th, 2026
Detected March 13th, 2026
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Summary

The Arizona Court of Appeals affirmed an Industrial Commission award finding that an employee requires further active medical treatment, including lower back surgery. The decision is designated as non-precedential.

What changed

The Arizona Court of Appeals, in a non-precedential decision (1 CA-IC 25-0017), affirmed an Industrial Commission of Arizona award concerning a workers' compensation claim filed by Francisco Palacios against his employer JBI LLC and its carrier Twin City Fire Insurance Co. The award found that Palacios requires further active medical treatment, including authorization for lower back surgery, and this decision is supported by substantial evidence in the record.

This decision is designated as non-precedential under Arizona Supreme Court Rule 111(c), meaning it can only be cited as authorized by that rule. While the case itself is specific to the parties involved, it reinforces the importance of substantial evidence in supporting Industrial Commission awards for medical treatment and surgery in workers' compensation cases. Employers and insurers should be aware that such awards, even if appealed, can be upheld if supported by the medical record.

Source document (simplified)

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Top Caption [Combined Opinion

                  by Samuel A. Thumma](https://www.courtlistener.com/opinion/10807959/jbitwin-v-palacios/about:blank#o1)

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March 12, 2026 Get Citation Alerts Download PDF Add Note

jbi/twin v. Palacios

Court of Appeals of Arizona

Combined Opinion

                        by [Samuel A. Thumma](https://www.courtlistener.com/person/6251/samuel-a-thumma/)

NOTICE: NOT FOR OFFICIAL PUBLICATION.
UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL
AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

IN THE
ARIZONA COURT OF APPEALS
DIVISION ONE

JBI LLC, Petitioner Employer,

TWIN CITY FIRE INSURANCE CO, Petitioner Carrier,
v.

THE INDUSTRIAL COMMISSION OF ARIZONA, Respondent,

FRANCISCO PALACIOS, Respondent Employee.

No. 1 CA-IC 25-0017
FILED 03-12-2026

Special Action - Industrial Commission
ICA Claim No. 20223010101
Carrier Claim No. Y3VC33273
The Honorable Kevin B. Berkowitz, Administrative Law Judge

AFFIRMED

COUNSEL

Ritsema Law, Phoenix
By Alissa J. Mack, Karolyn F. Keller
Counsel for Petitioner Employer and Carrier

Industrial Commission of Arizona, Phoenix
By Afshan Peimani
Counsel for Respondent

Snow & Carpio PLC, Phoenix
By Erica Gonzalez-Melendez
Counsel for Respondent Employee
JBI/TWIN v. PALACIOS
Decision of the Court

MEMORANDUM DECISION

Presiding Judge Samuel A. Thumma delivered the decision of the Court, in
which Judge Andrew J. Becke and Judge Kent E. Cattani joined.

T H U M M A, Judge:

¶1 Petitioners JBI, LLC, doing business as Western Millwork,
and Twin City Fire Insurance Co. challenge an Industrial Commission of
Arizona (ICA) award finding Francisco Palacios requires further active
medical treatment and authorizing lower back surgery. Because it is
supported by substantial evidence in the record, the award is affirmed.

FACTS AND PROCEDURAL HISTORY

¶2 Palacios had worked for Western Millwork for about 10 years
at the time of his claim. His job included lifting sheets of granite and marble.
Medical records show that, in 2019, he sought medical treatment at an
emergency room (ER) for low back pain. An X-ray revealed mild disc
degeneration, and he was given pain medication and told to avoid heavy
lifting. In 2021, he again sought medical treatment for work-related low
back pain.

¶3 In the fall of 2022, Palacios made three ER visits for back pain.
On September 11, 2022, the ER took lumbar spine X-rays and noted a
normal impression. Palacios was referred to his primary care physician for
follow-up. On September 15, 2022, again at the ER, he was diagnosed with
a muscle spasm and sent home with pain medications. The treatment notes
state “no numbness tingling or radiculopathy” in his lower extremities. A
medical record for the third ER trip on October 15, 2022, states that Palacios
had suffered an exacerbation of preexisting back pain, noting “no
numbness or tingling or weakness.”

¶4 Palacios filed a workers’ compensation claim in October 2022,
designating a September 29, 2022 injury date. Petitioners accepted his claim
and he received treatment. In February 2024, based on an independent
medical examination (IME) by Dr. Dennis Crandall, Petitioners closed the
claim with no permanent impairment. Palacios protested the closure as well
as Petitioners’ denial of authorization for back surgery recommended by
his treating physician.

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JBI/TWIN v. PALACIOS
Decision of the Court

¶5 At a September 2024 evidentiary hearing, Palacios testified
that the injury occurred on September 29, 2022, when he was lifting heavy
material and his lower back “popp[ed].” Western Millwork immediately
sent him to a clinic that diagnosed a lumbar strain and gave him pain
medication and instructions for home physical therapy. In April 2023 he
received an epidural steroid injection, but that did not help. He testified that
he wanted surgery recommended by his treating physician, Dr. Abhishiek
Sharma.

¶6 Dr. Sharma, a neurosurgeon, testified that he began treating
Palacios in June 2023 for back pain with numbness in his legs. He reviewed
a March 2023 MRI that showed a disc extrusion at L5-S1, along with
degenerative changes in the lumbar area. Dr. Sharma concluded that the
extrusion was caused by an acute event, a “re-aggravation of a chronic
issue,” consistent with the injury Palacios described from late September
2022. He treated Palacios through early 2024, when he recommended
surgery to repair the extrusion. Dr. Sharma opined that Palacios was not at
maximum medical improvement. Because conservative treatments had
failed, Dr. Sharma said surgery was consistent with standards for treatment
in the Official Disability Guidelines (ODG).

¶7 Dr. Crandall, an orthopedic surgeon, testified about the
results of his February 2024 IME. Based on his review of medical records
and a physical examination, Dr. Crandall opined that Palacios had suffered
an acute lumbar sprain/strain on top of chronic low back pain but no nerve
root compression, radiculopathy or neurologic abnormalities. He
concluded that Palacios was stationary and had no permanent impairment.
He added that Palacios was not a candidate for surgery under the ODG
because he met none of the four criteria: (1) pressure on a nerve; (2)
radiating pain down the nerve; (3) numbness, weakness or loss of reflex; or
(4) an EMG showing abnormal nerve signals.

¶8 After considering the evidence, the administrative law judge
(ALJ) gave more weight to Dr. Sharma’s opinion, concluding that “the disc
extrusion was an acute injury related to the September 29, 2022, industrial
injury that requires further active medical treatment to include surgery.”
Finding Palacios was not medically stationary, the ALJ’s award permitted
Palacios to undergo the surgery recommended by Dr. Sharma.

¶9 Petitioners requested reconsideration, contending that the
ALJ gave too much weight to Dr. Sharma’s opinion because he erred in
concluding that Palacios did not have radicular leg pain before the late
September 2022 work injury. Petitioners argued that Palacios’ testimony

3
JBI/TWIN v. PALACIOS
Decision of the Court

that his symptoms were similar for both the 2021 and 2022 injuries refuted
Dr. Sharma’s opinion that radicular leg pain began after the September 2022
injury. Palacios responded that his testimony about his symptoms caused
by the 2021 injury was general, not specific, and did not necessarily
contradict Dr. Sharma’s understanding of his history.

¶10 The ALJ denied the request for reconsideration, noting “there
is insufficient evidence to support the notion that radicular complaints pre-
date the date of injury . . . [partly because] medical records provided did
not document pre-existing radicular symptoms or radiculopathy. . . .”
Petitioners then timely filed this statutory special action. This court has
jurisdiction under Arizona Revised Statutes (A.R.S.) §§ 12-120.21(A)(2) and
23-951(A) and Arizona Rule of Procedure for Special Actions 10 (2026).1

DISCUSSION

¶11 This court views the evidence in a light most favorable to
upholding the award. See Avila v. Indus. Comm’n, 219 Ariz. 56, 57 ¶ 2 (App.
2008). An ALJ is empowered to resolve all conflicts in the medical evidence,
draw warranted inferences and assess witness credibility. See Carousel Snack
Bar v. Indus. Comm’n, 156 Ariz. 43, 46 (1988); Malinski v. Indus. Comm’n, 103
Ariz. 213, 217
(1968). This court will affirm an ALJ’s resolution of conflicting
medical opinions absent an abuse of discretion. Kaibab Indus. v. Indus.
Comm’n, 196 Ariz. 601, 605 ¶ 10 (App. 2000). An abuse of discretion occurs
when no reasonable theory of the evidence supports the decision. Malinski,
103 Ariz. at 217.

¶12 Petitioners argue the ALJ erred by: (1) making material
factual errors in the award; (2) giving significant weight to Dr. Sharma’s
opinion when it was based on a “flawed foundation” and (3) finding the
recommended surgery was authorized by the ODG.

¶13 Petitioners first argue the ALJ misstated the record in the
award’s findings of fact.2 Petitioners point out that finding four does not
mention Palacios’ ER visits in September and October 2022. Those ER visits,

1 Absent material revisions after the relevant dates, statutes and rules cited

refer to the current version unless otherwise indicated.

2 Petitioners’ opening brief does not cite to the documentary exhibits in the

record, which fails to comply with ARCAP 13(a)(5) and results in
uncertainty about the basis for some of Petitioners’ arguments.

4
JBI/TWIN v. PALACIOS
Decision of the Court

however, are specifically referenced through Dr. Sharma’s testimony in
findings five and nine.

¶14 Petitioners note that finding six misstates the record by
indicating that Dr. Crandall “reviewed the March 11, 2023, MRI, which
showed minor disc pinching but nothing that could explain the leg
symptoms. . . .” But Dr. Crandall testified that the MRI showed no disc
pinching and the MRI results support that conclusion. Moreover, there is
no dispute in the record or between the medical experts that the MRI shows
a disc extrusion. Dr. Sharma testified that this explained the current
symptoms in Palacios’ legs.

¶15 Petitioners argue that finding nine misstates the evidence
when it states that the October 2022 ER record shows new numbness and
tingling symptoms. The record shows there were no symptoms of
numbness or tingling recorded on that visit. But there is no evidence that
Dr. Sharma misunderstood the records. He addressed the lack of those
symptoms in his testimony, noting that the records showed “there was an
active issue that occurred on or near” the October 2022 ER visit, which was
consistent with the extrusion later revealed on the March 2023 MRI. This
evidence supports Dr. Sharma’s opinion and supports the ALJ’s reasonable
interpretation of the evidence.

¶16 Petitioners next argue that the ALJ gave too much weight to
Dr. Sharma’s opinion, which relied on Palacios’ purportedly unreliable
testimony about his symptoms before 2022. They contend that the ALJ
should not have given Dr. Sharma’s opinion more weight than Dr.
Crandall’s because Dr. Sharma’s opinion was based on an “inaccurate
factual background,” citing Fry’s Food Stores v. Indus. Comm’n, 161 Ariz. 119
(1989).

¶17 In Fry’s, the Arizona Supreme Court stated that an expert
opinion may be rejected if it is based on an incorrect factual assumption.
161 Ariz. at 122. But in Fry’s, the worker developed “baker’s lung” while
working around flour dust. Id. at 120. The workers’ compensation award
found permanent impairment after resolving a conflict in medical expert
opinion. Id. at 121. This court set aside the award, finding permanent
impairment was unsupported because the medical opinion of a Dr.
Dishner, adopted in the award, was based on “the erroneous assumption
that [the worker] had not worn a mask” in the workplace. Id. The supreme
court reversed, noting that the erroneous assumption “was only one part of
the history . . . and was mentioned only one time.” Id. at 122. In addition,
“th[e] evidence did not require the ALJ to conclude that whether claimant

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JBI/TWIN v. PALACIOS
Decision of the Court

wore a mask was an incorrect and material predicate of Dr. Dishner’s
opinion testimony.” Id. The supreme court stated the record supported a
conclusion that the mask issue was irrelevant:

We cannot conclude that the record requires a
finding that the possible error about whether
claimant wore a mask was necessarily a
material, incorrect factual foundation of Dr.
Dishner’s opinion. . . . Consequently, no basis
exists to reject the ALJ’s finding that Dr. Dishner
was more persuasive than Dr. Serbin in
testifying as to the cause of claimant’s condition.

Id. at 123. Here, too, Petitioners have not shown possible error based on
Palacios’ testimony about his symptoms from the 2021 injury as a material
and incorrect foundation for Dr. Sharma’s opinion. The ALJ did not abuse
his discretion by resolving conflicting medical expert testimony in Palacio’s
favor.

¶18 Finally, Petitioners argue that the recommended surgery is
not allowed under the ODG, even though Dr. Sharma testified otherwise.
Because this argument is raised for the first time on appeal, it is deemed
waived. Stephens v. Indus. Comm’n, 114 Ariz. 92, 94 (App. 1977).

CONCLUSION

¶19 The award is affirmed.

MATTHEW J. MARTIN • Clerk of the Court
FILED: JR

6

Source

Analysis generated by AI. Source diff and links are from the original.

Classification

Agency
Federal and State Courts
Filed
March 12th, 2026
Instrument
Enforcement
Legal weight
Non-binding
Stage
Final
Change scope
Minor

Who this affects

Applies to
Employers Insurers
Geographic scope
State (Arizona)

Taxonomy

Primary area
Employment & Labor
Operational domain
Legal
Topics
Industrial Commission Medical Treatment

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