ILLINOIS WORKERS’ COMPENSATION COMMISSION
NOTICE OF ARBITRATOR DECISION
____________________ Case # _________________
Employee/Petitioner
____________________
Employer/Respondent
On 6/17/2011, 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 0.10% 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
____________________ 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 Chicago, on March 3, 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. x 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 What temporary benefits are in dispute?
TPD Maintenance X TTD
L. x What is the nature and extent of the injury?
M. Should penalties or fees be imposed upon Respondent?
N. Is respondent due any credit?
O. Other _____
FINDINGS
On 07/20/2009, 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 $4,351.33; the average weekly wage was $312.35.
On the date of the accident, Petitioner was 37 years of age, single with 3 dependent children.
Petitioner has received all reasonable and necessary medical services.
Respondent has not paid all appropriate 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
Temporary Total Disability
Respondent shall pay Petitioner temporary total disability of $309.33/week for 9 3/7 weeks, commencing 8/3/2009 through 10/7/2009 as provided in Section 8(b) of the Act.
Respondent shall pay Petitioner the temporary total disability that have accrued from 8/3/2009 through 10/7/2009 and shall pay the remainder of the award, if any, in weekly payments.
Respondent shall be given a credit of $0.00 for temporary total disability benefits that have been paid.
Medical Benefits
Respondent shall pay reasonable and necessary medical services of $4,520.00 as provided in Section 8(a) of the Act.
Respondent shall pay reasonable and necessary medical services, pursuant to the medical fee schedule, of $4,520.00 to __________, as provided in Sections 8(a) and 8.2 of the Act.
Respondent shall pay reasonable and necessary medical services of $4,520.00 as provided in Sections 8(a) and 8.2 of the Act.
Respondent shall be given a credit of $0.00 for medical benefits that have been paid, and Respondent shall hold Petitioner harmless from any claims by any providers of the services for which Respondent is receiving this credit, as provided in Section 8(j) of the Act.
Permanent Partial Disability: Schedule Injury
Respondent shall pay Petitioner permanent partial disability benefits of $309.33/week for 11.4 weeks because the injuries sustained caused the 15% loss of the Left Thumb as provided in Section 8(e) of the Act.
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
STATE OF ILLINOIS )
)
COUNTY OF COOK )
)
____________________ )
Petitioner )
v. ) Case No.
)
____________________ )
Respondent
STATEMENT OF FACTS
The Petitioner was employed by the Respondent, __________, (hereinafter referred to as “the Respondent”) as a temporary employee. The Petitioner testified that he worked for the Respondent at __________ in Wheeling, Illinois and had worked at this location for approximately four months starting in March 2009. The Petitioner testified that on July 20, 2009 he was working for the Respondent at __________. On that date the Petitioner was operating a punch-press machine that creates pots with a coworker. The Petitioner testified that his coworker, __________, ran the machine while the Petitioner’s left hand was under the press, crushing the Petitioner’s left thumb. The Petitioner testified that he immediately felt pain in his left thumb and that his left thumb was bleeding. The Petitioner testified that he reported this accident to his supervisor, __________, but was not referred for medical attention at that time. Accident and notice are not in dispute.
The Petitioner testified that on the next day, July 21, 2009, the Petitioner received a telephone call from __________ informing him that he was terminated effective immediately. The Petitioner testified that he continued to feel pain in his left thumb, but did not seek medical treatment due to his lack of money. The Petitioner testified that when the pain in his left thumb did not abate the Petitioner sought medical treatment on __________. The Petitioner sought medical treatment at __________ on August 3, 2009, at which time he complained of pain in his left hand and low back as a result of work. (Pet. Ex. #2, pp. 25) The Petitioner testified that he was then placed in a physical therapy program for his left thumb crush injury. The Petitioner was placed off work on August 3, 2009 for a period of two and one half weeks. (Pet. Ex. #2, pp. 24)
The Petitioner testified that he received physical therapy for his left thumb from August 3, 2009 to October 7, 2009. On August 25, 2009 the Petitioner was again seen at __________ for a re-evaluation at which time the Petitioner was released to work in a light duty capacity. (Pet. Ex. #2, pp. 40) However, the Petitioner testified that he had no job to return to due to his July 21, 2009 firing and his light duty restrictions were therefore not accommodated. The Petitioner testified that he returned to __________ on October 7, 2009. At that visit the Petitioner reported that the pain in his left thumb had abated and the Petitioner was released to full duty work in regard to his left thumb injury. (Pet. Ex. #2, pp. 36-8)
The Petitioner testified that he continues to experience pain in his left thumb. The Petitioner further testified that he did not receive any compensation from the Respondent after his July 21, 2009 firing. The Respondent produced no witnesses at trial.
CONCLUSION OF LAW
F. IN REGARD TO ITEM (F), WHETHER PETITIONER’S CURRENT CONDITION OF ILL-BEING IS CAUSALLY RELATED TO THE PETITIONER’S WORK INJURY, THE ARBITRATOR RENDERS THE FOLLOWING FINDINGS OF FACT AND CONCLUSION OF LAW:
The Petitioner’s current condition of ill being is causally related to his July 20, 2009 work injury. It is important to note that accident is not in dispute in this case. The Petitioner has sought consistent medical treatment for this injury. Further, when the Petitioner reported to __________ on August 3, 2009 he reported the fact the he had injured his left thumb at work. (Pet. Ex. #2, pp. 25) The Petitioner has had the same complaint since his July 20, 2009 undisputed work injury, namely that of pain in his left thumb. The Respondent produced no evidence at trial to suggest a mechanism of injury other than the July 20, 2009 work injury. The Petitioner presented credible testimony and medical evidence at trial. The Petitioner’s current condition of ill being is causally related to his July 20, 2009 work injury with the Respondent.
J. IN REGARD TO ITEM (J), WERE THE MEDICAL SERVICES PROVIDED PETITIONER REASONABLE AND NECESSARY AND HAS RESPONDENT PAID ALL APPROPRIATE CHARGES, THE ARBITRATOR RENDERS THE FOLLOWING FINDINGS OF FACT AND CONCLUSIONS OF LAW:
The medical services provided to the Petitioner have been both reasonable and necessary and the Respondent has not paid all appropriate medical charges. As a result of the Petitioner’s July 20, 2009 work related crush injury to his left thumb the Petitioner required medical treatment and physical therapy in an attempt to achieve maximum medical improvement. Physical therapy for a crush injury to a digit is a reasonable and necessary conservative course of treatment.
The Respondent has not paid all appropriate medical charges. The Petitioner produced evidence at trial that demonstrates that the Respondent has not paid all of the medical charges from __________ for the Petitioner’s reasonable and necessary course of physical therapy. (See generally Pet. Ex. #1) The fact that the Respondent did in fact pay some of the charges lends credence to the fact that these are reasonable and necessary medical bills. (Pet. Ex. #1, pp. 21) The Respondent, however, has not paid all charges. The Petitioner is awarded the charges for his medical treatment with __________ to be paid pursuant to the Illinois Medical Fee Schedule or charged amount, whichever is lower.
K. IN REGARD TO ITEM (K), WHAT TEMPORARY TOTAL DISABILITY BENEFITS ARE IN DISPUTE, THE ARBITRATOR RENDERS THE FOLLOWING FINDINGS OF FACT AND CONCLUSION OF LAW:
The Petitioner is entitled to temporary total disability benefits from August 3, 2009 through October 7, 2009. The Petitioner has presented credible testimony and supporting medical documentation to that demonstrate that the Petitioner was medically unable to work from August 3, 2009 through October 7, 2009 due to the injury he sustained on July 20, 2009. A work status slip from __________ dated August 3, 2009 place the Petitioner off of work. (Pet. Ex. #2, pp. 24) Further, on August 25, 2009 the Petitioner was released to work in a light duty capacity, however, due to the fact that he was terminated from employment by the Respondent on July 21, 2009, the Petitioner’s light duty restrictions were not accommodated. (Pet. Ex. #2, pp. 40) It was not until October 7, 2009 that the Petitioner was finally released back to work in a full-duty capacity. (Pet. Ex. #2, pp. 38)
The Request for Hearing form submitted by the parties at arbitration demonstrates that the Petitioner had an agreed upon average weekly wage of $312.35, thereby placing the Petitioner at the minimum temporary total disability rate of $309.33 due to his agreed upon three dependents. The Petitioner is awarded temporary total disability benefits from August 3, 2009 through October 7, 2009, a period of 9 3/7 weeks to be paid at a rate of $309.33 per week.
As the Petitioner has two claims that were arbitrated on March 3, 2011 and March 10, 2011, an award in __________ for temporary total disability benefits would be set against this award to avoid a duplicate award.
L. IN REGARD TO ITEM (L), WHAT IS THE NATURE AND EXTENT OF THE INJURY, THE ARBITRATOR RENDERS THE FOLLOWING FINDINGS OF FACT AND CONCLUSION OF LAW:
The Petitioner sustained an injury to his left thumb that caused a 15% loss of use of his left thumb. The Petitioner sustained a crush injury to his left thumb while employed by the Respondent on July 20, 2009. As a result of this crush injury the Petitioner required over two months of physical therapy for his left thumb as documented in Petitioner’s Exhibit #2. Further, the Petitioner credibly testified at trial that he still experiences pain in his left thumb. The Petitioner is awarded 15% loss of use of the Left Thumb.
