Fall-down Case Results in Initial Denial

Monday, March 1, 2010 | 0

By Eugene Keefe

Synopsis: Fall-down case results in initial denial by Arbitrator of knee injury due to questionable credibility; reversal by Commission and affirmation by reviewing courts.
 
While we hate to see this outcome, from a purely academic perspective, the Appellate Court got it right; you have to read the administrative ruling to make your own judgment on the Illinois Workers' Compensation Commission’s determination which related a condition not treated or reported for several weeks after the claimed event.
 
In R & D Thiel v. Illinois Workers' Compensation Commission, (No. 1-08-3666WC February 9, 2010); the Appellate Court, Workers’ Compensation Division ruled the Commission's decision was not contrary to the manifest weight of evidence as to necessity and reasonableness of medical expenses and causal relationship, although their ruling was contrary to the Arbitrator's findings, including credibility. The Court noted the Commission explained its reasons.
 
Claimant testified without rebuttal to a fall off a ladder. He saw a chiropractor the next day. He did not report any problems with his right leg for over two weeks. He went on to treat over 100 times with the chiropractor, primarily for his back. He later wanted and fought to get approval for surgery to his leg.
 
The Arbitrator concluded claimant suffered only a soft-tissue injury to the low back related to a fall at work. The Arbitrator further ruled Plaintiff failed to prove permanent injury and denied future medical treatment to his knee. In contrast, the Commission reversed and found Plaintiff proved a work-related disk protrusion with annular tear and fracture with possible meniscal tear of knee caused by the admitted work-related fall.
 
The Appellate Court followed the Commission’s ruling and re-affirmed the legal concept which holds the Commission’s ruling is not affected by the prior determination of the Arbitrator—the Commission rules on the facts and law in a de novo setting. Our only hope is the Appellate Court consistently adheres to this simple rule for both sides of the workers’ comp matrix.

WorkCompCentral subscribers may access the opinion by clicking the case title in the sidebar.
 
Eugene Keefe is a partner with Keefe, Campbell & Associates, a Chicago workers' compensation defense law firm. This column was reprinted with permission from the firm's client newsletter.