Rozalyn L. Childs v. Renaissance of South Shore

Steven L. Miller successfully defended a nursing home on the issue of medical causal connection at both arbitration on a 19(b)/8(a) trial and on review at the commission level.

A Certified Nurse Assistant alleged that she slipped and fell on a pool of water falling onto her left side, though testified that she sustained a “jarring” injury to her right side on her way down. The petitioner’s treating physician ultimately opined that the petitioner required surgical intervention to address impingement syndrome in the right shoulder. The respondent successfully relied on an independent medical examiner’s opinion that the petitioner’s physical exam findings were inconsistent with a diagnosis of impingement.

During cross-examination of the treating physician, the doctor admitted that he did not know if the petitioner fell backward or forward, did not know what distance she fell to the floor, did not know what kind of surface she fell on, and did not know what she was doing when she fell. He admitted that he would be in a better, more informed position regarding medical causation if he had known some of those factors. He also admitted that he was “speculating” that the petitioner had a jarring injury to her right side, as he never asked the petitioner this question.

Thomas M. Hickman v. Oak Park School District

The Arbitrator found that the petitioner’s current condition of ill-being was only partially medically causally related to the alleged accident. Specifically, the Arbitrator believed that the petitioner’s degenerative knee condition was unrelated to his fall and that his bone on bone arthritis was due to a prior meniscus tear and arthritis from 1986. The petitioner was 10% loss of use of the right leg.

Relative to the payment of temporary total disability benefits, the petitioner sought approximately 85 weeks of benefits. The Arbitrator sided with the independent medical examiner’s opinions that the petitioner’s right knee pain and need for medical care was due to his chronic long-standing, progressive, degenerative arthritis and that there was no evidence that the alleged accident, caused, aggravated or contributed to any symptoms or his need for treatment. The Arbitrator only awarded the period of TTD that had already been paid prior to the IME, or approximately 20 weeks.

As the Arbitrator found that the petitioner had reached maximum medical improvement as of the IME date, the respondent realized a savings relative to any claims for future medical and in particular any claims that the petitioner’s total knee replacement surgery was medically causally connected to the alleged accident. This of course acted as a safeguard against any future Section 8(a) petition seeking future medical care and treatment under this claim.

Margaret Rappe v. Sharon Healthcare Woods

Attorney Noah Hamann proved at trial that the petitioner subjected herself to a greater risk of injury and thus, the petitioner was not entitled to any benefits. Specifically, petitioner alleged that on March 3, 2013 she was injured walking from her car to the employer’s front door as she began her shift. She testified that she tripped on a loose brick that was covered by ice and snow. She was seeking a right knee replacement.

Prior to trial, Attorney Hamann personally visited the accident site and met with witnesses. He learned that the pathway taken by the petitioner to the front door was unusual. The employee did not park in the employee designated parking area on the date of accident. Instead, she parked in a loading zone that was much closer to the front door because the respondent alleged, she did not want to walk from the farther employee parking area because of snowy and cold weather conditions.

Additionally, when the petitioner parked in the loading zone, she had access to a shoveled sidewalk from her car to the front door. However, to take a shorter path, the petitioner cut through a grassy area, where she fell.

Thomas Culhane v. North Shore School District 112

Decision rendered on May 23, 2014

A 65-year-old school maintenance worker alleged an injury to his right knee on April 17, 2006 after falling down a stairwell. Although the petitioner sustained a compensable injury, the respondent denied that the condition of ill-being, lost time, and need for additional medical treatment were causally connected to the accident. The petitioner’s doctors placed him on varying degrees of work restrictions and rendered multiple treatment recommendations including Synvisc injections, arthroscopy and even a total knee replacement.

In advance of trial, the petitioner's attorney claimed he was seeking temporary total disability benefits from the petitioner’s date of retirement, June 30, 2006, to the present, totaling 403 4/7 weeks or $321,424.46. The petitioner's attorney believed his client would testify that he was “forced to retire” as a result of the accident and consequently sought an award for permanent total disability benefits. The permanent total exposure was approximately $567,000.00. This resulted in an adverse exposure in excess of $800,000.00 including open medical rights on the petitioner’s knee.

In an outstanding investigation, the claims representative uncovered a letter the petitioner drafted and signed in November of 2005 addressed to the school board that expressed his intent to retire on June 30, 2006. Our position was that the petitioner intended to voluntarily remove himself from the workforce as early as November of 2005 (approximately 5 months before the petitioner even sustained the April 2006 accident). We obtained additional evidence that the petitioner accepted a monetary incentive taking advantage of an early retirement program.

Mark Karnes v Wright Tree Service

Julia McCarthy and Noah Hamann obtained a favorable verdict from the Illinois Appellate Court in Mark Karnes v. Wright Tree Service, 03-13-0140WC. All issues were in dispute on an appeal by the petitioner following victories by the defense at Arbitration, the Commission and the Peoria County Circuit Court. During the appeal process petitioner’s attorney was unwilling to settle for anything other than full trial value and continued medical treatment involving a left shoulder acromioplasty. Petitioner’s last settlement demand was $100,000.00.

The case involved two alleged dated of accidents, 10/18/06 affecting the left shoulder and 4/7/07 affecting the right elbow and left shoulder. In the 2006 incident, petitioner claimed he was holding a chainsaw in his right hand while cutting branches that he was holding in his left hand. The petitioner claimed that when he sawed the branch, it dropped and the petitioner felt a pop in his left shoulder. With regard to the 2007 incident, the petitioner denied any acute injury but complained of general soreness to his right elbow and left shoulder as a result of his work duties. The petitioner attempted to argue that the 2007 condition was a continuation of the 2006 condition.

At arbitration, Julia McCarthy was able to show that no 2006 accident occurred. Through witness testimony, it was shown that the company had clear procedures in place for reporting injuries. The petitioner knew these procedures since he reported an injury following the alleged 2007 accident. In 2007 an accident report was filed, a workers’ compensation claim was submitted to the insurance carrier and the petitioner was given medical treatment. Attorney McCarthy used this information to show that had a 2006 accident occurred, similar procedures would have been followed.