Carpal Tunnel Release Surgery [2012]

ILLINOIS WORKERS’ COMPENSATION COMMISSION
NOTICE OF 19(b) DECISION OF ARBITRATOR
____________________                Case # _________________
Employee/Petitioner
____________________
Employer/Respondent
On 1/12/2012, an arbitration decision on this case was filed with the Illinois Workers’ Compensation Commission in Chicago, a copy of which is enclosed.
If the Commission reviews this award, interest of 0.05% shall accrue from the date listed above to the day before the date of payment; however, if an employee’s appeal results in either no change or a decrease in this award, interest shall not accrue.
A copy of this decision is mailed to the following parties:
1067 ANKIN LAW OFFICE, LLC
162 W GRAND AVE.
CHICAGO, IL  60654
STATE OF ILLINOIS  )
)
COUNTY OF COOK    )

    Injured Workers’ Benefit Fund (§4(d))
Rate Adjustment Fund (§8(g))
Second Injury Fund (§8(e)18)
x   None of the above

ILLINOIS WORKERS’ COMPENSATION COMMISSION
ARBITRATION DECISION
19(b)

____________________                                                                          Case # _________________
Employee/Petitioner
v.                                                                                                           Consolidated cases:_____
____________________
Employer/Respondent
An Application for Adjustment of Claim was filed in this matter, and a Notice of Hearing was mailed to each party.  The matter was heard by the Honorable ______________ Arbitrator of the Commission, in the city of Joliet, on February 14, 2011.  After reviewing all of the evidence presented, the Arbitrator hereby makes findings on the disputed issues, and attaches those findings to this document.
DISPUTED ISSUES:
A.        Was Respondent operating under and subject to the Illinois Workers’ Compensation or Occupational Diseases Act?
B.        Was there an employee-employer relationship?
C.        Did an accident occur that arose out of and in the course of Petitioner’s employment by Respondent?
D.        What was the date of the accident?
E.        Was timely notice of the accident given to Respondent?
F.    x   Is Petitioner’s present condition of ill-being causally related to the injury?
G.        What were Petitioner’s earnings?
H.        What was Petitioner’s age at the time of the accident?
I.        What was Petitioner’s marital status at the time of the accident?
J.        Were the medical services that were provided to Petitioner reasonable and necessary?  Has Respondent paid all appropriate charges for all reasonable and necessary medical services?
K   x    Is Petitioner entitled to any prospective medical care?
L.        What temporary benefits are in dispute?
TPD      Maintenance      TTD
M.        Should penalties or fees be imposed upon Respondent?
N.        Is respondent due any credit?
O.        Other _____
FINDINGS
On the date of accident, 4/14/2009, Respondent was operating under and subject to the provisions of the Act.
On this date, an employee-employer relationship did exist between Petitioner and Respondent.
On this date, Petitioner did sustain an accident that arose out of and in the course of employment.
Timely notice of this accident was given to Respondent.
Petitioner’s current condition of ill-being is causally related to the accident.
In the year preceding the injury, Petitioner earned $37,180.00; the average weekly wage was $715.00.
On the date of the accident, Petitioner was 38 years of age, single with 1 dependent children.
Respondent has paid all reasonable and necessary charges for all reasonable and necessary medical services.
Respondent shall be given a credit of $0.00 for TTD, $0.00 for TPD, $0.00 for maintenance, and $0.00 for other benefits, for a total credit of $0.00.
Respondent is entitled to a credit of $0.00 under Section 8(j) of the Act.
ORDER
Respondent will authorize the surgical procedure as recommended by Dr. __________, as provided under Section 8(1) the Act.
In no instance shall this award be a bar to subsequent hearing and determination of an additional amount of medical benefits or compensation for a temporary or permanent disability, if any.
RULES REGARDING APPEALS  Unless a party files a Petition for Review within 30 days after receipt of this decision, and perfects a review in accordance with the Act and Rules, then this decision shall be entered as the decision of the Commission.
STATEMENT OF INTEREST RATE  If the Commission reviews this award, interest at the rate set forth on the Notice of Decision of Arbitrator shall accrue from the date listed below to the day before the date of payment; however, if an employee’s appeal results in either no change or a decrease in award, interest shall not accrue.
Signature of Arbitrator                                                                             Date

STATEMENT OF FACTS

Petitioner originally was injured on April 14, 2009.  Her testimony about how her original injury occurred has previously been litigated.  (Pet. Ex. #2) Following her original work injury, Petitioner underwent bilateral carpal tunnel release surgeries performed by Dr. __________ at __________, the right being performed on October 21, 2009 and the left performed on February 5, 2010. (PX 1)
On February 18, 2010, Petitioner saw Dr. __________ with a chief complaint that “my thumb still hurts.”  The doctor noted Petitioner’s “…main complaint today is that she is experiencing significant triggering and locking involving her right thumb.  She did discuss this with us on the date of surgery; however, we were not able to perform a cortisone injection at that time… She reports that her symptoms of triggering and locking involving her right thumb have been ongoing… and began while in therapy…”.  An examination of the thumb revealed swelling along the A1 pulley region of the thumb with palpable triggering and locking with extension/flexion of the MP joint.  Dr. __________ diagnosed right thumb A1 stenosing tenosynovitis, active, and administered a right thumb A1 pulley injection.  (PX 1)
Petitioner testified that her symptoms in her left ring finger were sometimes more severe than other times; however, she always had symptoms.  Petitioner ended up having right shoulder surgery done by Dr. __________ on February 8, 2011, after a referral from Dr. __________.  Petitioner returned to work on a light duty trial basis in June 2011.  Petitioner testified that the symptoms in her left ring finger were aggravated by the light duty work she was performing which included counting significant amounts of cash using both hands on a daily basis.
Petitioner testified that because of the increase in symptoms she followed up with Dr. __________ on August 18, 2011.  Dr. __________ records indicate Petitioner reported that her left ring trigger finger returned about a month ago noting same was sporadic in triggering and pain.  An examination revealed mild tenderness to direct palpation along the A1 pulley region of the left ring finger.  At that time, Dr. __________ discussed surgery.  The doctor noted Petitioner opted not to proceed with surgical intervention.  (PX 1)
At Respondent’s request Petitioner underwent a Section 12 examination with Dr. __________ on September 20, 2011.  Petitioner complained of recurrence of her right carpal tunnel syndrome.  Petitioner stated that she had swelling in her right hand.  Petitioner also stated that she had triggering of her left ring finger.  Dr. __________ reviewed Petitioner’s medical treatment and performed an examination.  The doctor also reviewed a video of what was purported to be Petitioner’s work activities.  After examination, the doctor noted tenderness over A1 pulley of the left ring finger.  There was no significant triggering present.  He noted the two point discrimination in light touch localization was per the OT report.  Dr. __________ noted that Petitioner presented with what appeared to be recurrence of her right carpal tunnel syndrome and a recurrence of her left ring trigger finger.
Upon reviewing the video submitted, Dr. __________ wrote, “The patient had ample opportunity to rest her hands between the various activities she performs.  She states that her most repetitive activity was that of placing the money in the safe.  She states she uses her left hand to do this as she had been trying to protect her right hand.  That particular activity was somewhat repetitive.  The patient’s original left ring finger trigger finger was noted on April 2, 2010.  No particular precipitating event was noted.  It then resolved and she responded well to a steroid injection.  One could state the trigger finger was the result of an aggravation of her previous stenosing tenosynovitis.  The patient had only mild findings in regard to her trigger finger to date.  While the patient is convinced her trigger finger is related to her work-related activities, based on the video seen today it is difficult to attribute her trigger finger to those activities.  Feeding of currency into a safe would not require taking her left ring finger through full range of motion.  In fact, that activity would involve the thumb, index and long fingers more than the ring finger.  Based on the information I reviewed, I am unable to attribute her trigger finger to her work-related activities.”  Dr. __________ also indicated that regardless of the causation, a repeat injection should be considered and if that didn’t lead to resolution, a trigger finger release could be considered.  He also felt Petitioner’s care to date had been reasonable and necessary.  (RX 1)
Petitioner testified that her job duties at this time include working in cash box, taking CODs, stamping tickets and distributing money into a machine one at a time.  Petitioner testified that she would collect anywhere from $8,000 to $10,000 per day, sometimes more and sometimes less.  Petitioner testified that she did not experience any of her symptoms prior to her carpal tunnel surgery.  Petitioner testified that initially she was hesitant about undergoing further surgical treatment, but due to her persistent symptoms in her left ring finger she now wishes to undergo the treatment as recommended by Dr. _________.
WITH REGARD TO ITEM (F), WHETHER PETITIONER’S CURRENT CONDITION OF ILL-BEING IS CAUSALLY RELATED TO THE PETITIONER’S WORK INJURY and (K), WHETHER PETITIONER IS ENTITLED TO ANY PRSPECTIVE MEDICAL TREATMENT, THE ARBITRATOR FINDS AS FOLLOWS:  
Petitioner underwent bilateral carpal tunnel release surgeries as a result of the work injury.  After the left carpal tunnel release surgery on February 5, 2010, Petitioner developed trigger finger symptoms.  She treated with Dr. __________ on April 2, 2010 for those symptoms with a pain injection.  Respondent authorized that treatment with Dr. __________.  Petitioner returned to work in a light duty capacity for Respondent in June 2011 and her symptoms recurred following being assigned job duties that involved significant use of her hands.  Petitioner the followed up with Dr. __________ on August 18, 2011 and Dr. __________ recommended surgery to address the trigger finger at that time.  It is noted that Petitioner has no history of trigger finger symptoms prior to her work injury.  The issue of her original injuries as being causally related to her job duties with Respondent has previously been litigated in her favor.  Further, the issue of Dr. __________’s treatment being reasonable and necessary medical care has also been previously decided in her favor. (Pet. Ex. #2) Accordingly, the need for the left trigger finger release surgery is sequelae of her original work injuries.  Accordingly, the Arbitrator finds that Petitioner’s left trigger finger condition and the associated recommendation for surgery are causally related to Petitioner’s April 14, 2009 injuries.
The Arbitrator notes that although Respondent’s IME doctor, Dr. __________ opined that he was unable to attribute her trigger finger to her work-related activities he also indicated “…one could state the trigger finger is the result of an aggravation of her previous stenosing tenosynovitis.”  This seems to be at odds with his previous statement in his report.  Nonetheless, Dr. __________ does conclude that the trigger finger release surgery is an appropriate treatment for Petitioner’s condition.
Based on all the above, the Arbitrator finds that Petitioner’s left ring rigger finger condition of ill-being is causally related to her April 14, 2009 work related.  The Arbitrator also fins that Respondent shall authorize the surgery as recommended by Dr. __________.

Chicago personal injury and workers’ compensation attorney Howard Ankin has a passion for justice and a relentless commitment to defending injured victims throughout the Chicagoland area. With decades of experience achieving justice on behalf of the people of Chicago, Howard has earned a reputation as a proven leader in and out of the courtroom. Respected by peers and clients alike, Howard’s multifaceted approach to the law and empathetic nature have secured him a spot as an influential figure in the Illinois legal system.

Years of Experience: More than 30 years
Illinois Registration Status: Active
Bar & Court Admissions: Illinois State Bar Association, U.S. District Court, Northern District of Illinois, U.S. District Court, Central District of Illinois
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