Ankin Law workers’ compensation attorney, Jonel Metaj helped an injured tire repairman secure needed surgery after being injured at work on two separate occasions. The Illinois Workers’ Compensation Commission arbitrator ruled that Mr. Metaj’s client would receive $30,054.90 for unpaid medical bills, and 208-2/7 weeks of Temporary Total Disability payments at the rate of $455.53 per week. He has also been awarded all reasonable and necessary costs of a three-level laminectomy as prescribed by a doctor and all associated care.
(Read the First-Accident Arbitrator Decision Here)
(Read the Second-Accident Arbitrator Decision Here)
Metaj’s client (henceforth-Petitioner) testified he was employed by the tire shop (henceforth-Respondent) for six or seven years as of December, 2012. The petitioner repaired commercial tires on trucks and big machines, both inside and outside of the respondent’s shop. The tires weighed over 100 pounds. The petitioner was required to lift the tires when doing repairs. He worked over 40 hours a week; Monday through Friday and sometimes Saturdays. He was paid $15.00 per hour.
Beginning in December, 2012, and into January, 2013, the petitioner was doing his usual heavy lifting of tires when he began having pain in his back. In January, 2013, the pain was getting worse and worse. He reported to his boss, that he was having pain in his back.
He sought treatment and was declared fit to return to work even though he still was experiencing pain. Not long after his return, the pain became unbearable and he underwent another series of doctor visits.
After multiple trips to various doctors, pain management strategies, steroid injections, and tests that included MRI’s the pain did not go away. Finally, after other doctors offered no relief, a three-level laminectomy was recommended by Doctor M. The arbitrator hearing established that the petitioner was entitled to payment for prospective medical treatment including the surgery.
First Injury Arbitration Conclusions
CONCLUSIONS OF LAW:
The Arbitrator adopts the Finding of Facts in support of the Conclusions of Law.
With respect to the issue of whether the petitioner’s condition of ill-being is related the injury, the Arbitrator makes the following conclusions of law:
There was no evidence petitioner had prior back problems before his employment with respondent which began six or seven years before December, 2012 The unrefutted evidence was that petitioner repeatedly lifted tires that weighed 100 pounds or more that resulted into an injury to his back on January 17, 2013. Although he was released to return to work on February 27, 2013, it was not without pain. Petitioner also returned to performing his same repetitive work of lifting 100 pound tires.
Dr. M testified that petitioner’s heavy lifting at work was a competent cause of petitioner’s repetitive injury to his back. Although Dr. M agreed that the December 10, 2014 MRI showed there was a resorption of the left paracentral disc extrusion at L5-S1, there was still stenosis at L3-L4, L4-5 and L5-S1. Dr. M agreed that although petitioner had congenital spinal stenosis, the work-related injury exacerbated the condition. Petitioner’s EMG of March 29, 2016 was positive for multilevel lumbosacral radiculopathy at L4, L5 and S1 levels.
Based upon the foregoing, the Arbitrator finds petitioner’s current back condition, for which petitioner now requires a three-level laminectomy, was caused by the work accidents of January 17, 2013 and December 9, 2014.
The Arbitrator makes this finding despite the opinion of Dr. Z Dr. Z who ignored the findings on the MRIs, the positive EMG, the diminished pinprick in the lower left extremity and the absence of deep tendon reflexes in petitioner’s lower extremities. He did double-speak when asked about the positive EMG. The Arbitrator agrees with Dr. M’s assessment of Dr. Z’s opinion that it was ridiculous for Dr. Z to find there was no medical basis to suggest petitioner’s symptoms and lumbar condition were caused or made symptomatic as a result of the work injury or any work activities.
With respect to the issue regarding prospective medical care, the Arbitrator makes the following conclusions of law:
Petitioner has received conservative treatment, including various injections and physical therapy, without relief. In reliance on the opinion of Dr. M the workers’ compensation Arbitrator awards the costs of surgery consisting of the three-level laminectomy, and the attendant care, to be paid in accordance with the fee schedule and 88 and 88.2 of the Act.
Second Injury Arbitration Conclusions
CONCLUSIONS OF LAW:
The Arbitrator adopts the Finding of Facts in support of the Conclusions of Law.
With respect to the issue of whether an accident occurred on December 9, 2014 that arose out of and in the course of petitioner’s employment by respondent, the Arbitrator finds the following facts:
Respondent does not dispute petitioner injured his back on January 17, 2013, which is the subject of 15 WC 191. Petitioner returned to work after the January 17, 2013 accident on February 27, 2013, but was in pain. Petitioner’s unrefutted testimony was that he continued to work, lifting tires that weighed as much as 100 pounds, until December 8, 2014. His conditioned worsened. He was seen by Dr.C on December 8, 2014 due to overuse injury.
The Arbitrator finds, based upon the foregoing, that petitioner re-injured his back, as a result of a repetitive accident that arose out of and in the course of his employment with respondent on December 9, 2014.
With respect to the issue of the date of the accident, the Arbitrator finds the following facts:
The Arbitrator finds petitioner’s repetitive work accident occurred on December 9, 2014, which is the date petitioner received for the overuse work injury; thus the date his condition was connected to his work activities. :
With respect to the issue of whether petitioner gave timely notice of the claimed accident to respondent:
Petitioner, without rebuttal, testified he reported the work injury to his then-supervisor, C.R.. C.R. advised petitioner he would complete an incident report. According to petitioner’s unrebutted testimony, the service manager offered petitioner to return to [Dr. W] or seek treatment on his own.
Based upon the foregoing, the Arbitrator finds petitioner gave timely notice of the work accident of December 9, 2014.
With respect to the issue of whether the petitioner’s condition of ill-being is related to the injury, the Arbitrator makes the following conclusions of law:
There was no evidence petitioner had prior back problems before his employment with respondent which began six or seven years before December, 2012. The unrefuted evidence was that petitioner repeatedly lifted tires that weighed 100 pounds or more that resulted into an injury to his back on January 17, 2013. Although he was released to return to work on February 27, 2013, it was not without pain. Petitioner also returned to performing his same repetitive work of lifting 100 pound tires.
Dr. M testified that petitioner’s heavy lifting at work was a competent cause of petitioner’s repetitive injury to his back. Although Dr. M agreed that the December 10, 2014 MRI showed there was a resorption of the left paracentral disc extrusion at L5-S1, there was still stenosis at L3-L4, L4-5 and L5-S1. Dr. M agreed that although petitioner had congenital spinal stenosis, the work-related injury exacerbated the condition. Petitioner’s EMG of March 29, 2016 was positive for multilevel lumbosacral radiculopathy at L4, L5 and S1 levels.
Based upon the foregoing, the Arbitrator finds petitioner’s current back condition, for which petitioner now requires a three-level laminectomy, was caused by the work accident of December 8, 2014.
The Arbitrator makes this finding despite the opinion of Dr.Z. Dr.Z ignored the findings on the MRIs, the positive EMG, the diminished pinprick in the lower left extremity and the absence of deep tendon reflexes in petitioner’s lower extremities. He did double-speak when asked about the positive EMG. The Arbitrator agrees with Dr. M’s assessment of Dr.Z’s opinion that it was ridiculous for Dr.Z to find there was no medical basis to suggest petitioner’s symptoms and lumbar condition were caused or made symptomatic as a result of the work injury or any work activities.
With respect to the issue regarding medical bills, the Arbitrator makes the following conclusions of law:
The Arbitrator finds the following bills were reasonable and necessary to treat petitioner December 9, 2014 and awards same pursuant to the fee schedule, with credit to be given for payments made directly by respondent or by the group insurance.
$20,885,00 Suburban Orthopaedics
$2,517.81 Workers’ Compensation RX Solutions
$4,201.09 MedArbor
With respect to the issue regarding prospective medical care, the Arbitrator makes the following conclusions of law:
Petitioner has received conservative treatment, including various injections and physical therapy, without relief. In reliance on the opinion of Dr. M, the Arbitrator awards the costs of surgery consisting of the three-level laminectomy, and the attendant care, to be paid.
With respect to the issue regarding TTD, the Arbitrator makes the following conclusions of law:
The evidence supports petitioner claimed he has been disabled from December 15, 2014 through the date of hearing of December 11, 2018, which is 208-2/7 weeks, and awards TTD for this period at the rate of $455.53 per week.
