City of E. Peoria v. Melton

2023 IL App (4th) 220281

218 N.E.3d 471

467 Ill.Dec. 136

The CITY OF EAST PEORIA, Illinois, Plaintiff-Appellant,

v.Charles MELTON II; the Board of Trustees of the Firefighter's Pension Fund of the City of East Peoria; and Randy Hurd, in His Official Capacity as President of the Board of Trustees of the Firefighter's Pension Fund of the City of East Peoria, Defendants-Appellees.

NO. 4-22-0281

Appellate Court of Illinois, Fourth District.

Filed March 22, 2023

Robert B. McCoy, of Miller, Hall & Triggs, LLC, of Peoria, for appellant.

Jennifer Bonesteel, of Stephen P. Kelly, Attorney at Law, LLC, of Peoria, for appellee Charles Melton II.

Richard J. Reimer and Nemura Pencyla, of Reimer Dobrovolny & Labardi PC, of Hinsdale, for other appellee.

JUSTICE BRIDGES delivered the judgment of the court, with opinion.^*

¶ 1 Plaintiff, the City of East Peoria (City), contests the occupational disease disability pension awarded to defendant and firefighter Charles Melton II by the codefendant Board of Trustees of the Firefighter's Pension Fund of the City of East Peoria (Board). Melton sought the disability pension based on a stroke that he suffered in March 2020. The City argues that (1) the applicable statute required that the physicians appointed to examine Melton conduct in-person physical examinations, (2) the Board relied on the erroneous belief that the City conceded that the cause of Melton's prior renal disease was work-related, (3) Melton's need for anticoagulants was a disabling condition that predated his stroke and disqualified him from receiving an occupational disease pension, and (4) the Board erred in finding that Melton's stroke resulted from his service as a firefighter. We affirm.

¶ 2 I. BACKGROUND

¶ 3 Melton made a written application dated July 8, 2020, for an occupational disease disability pension. He alleged a "work[-]related stroke brought on by exposure as a firefighter for the City of East Peoria." He alleged that he was "[p]recluded from performing normal work activity by statute and medical recommendations."

¶ 4 The Board selected three physicians to submit written medical opinions answering various questions, including whether Melton was disabled, whether the disability resulted from his service as a firefighter, and the duration of the disability. The physicians did not conduct a physical examination of Melton but rather responded to written questions of the Board based on the physicians’ review of Melton's medical records as provided by the Board. The physicians did not testify at any hearings.

¶ 5 The report of Dr. Michael I. Peters, who was board-certified in emergency medicine, stated as follows. Melton was a 56-year-old lieutenant on the East Peoria Fire Department who suffered a stroke while at home and off duty on March 11, 2020. Melton's medical history consisted of:

"Factor V Leiden deficiency

Right lower extremity superficial venous thrombosis 2009

Pulmonary embolus right lower lobe 2017

Right cerebellar ischemic stroke 3/11/20

Novel MYH9 gene mutation with thrombocytopenia diagnosed 2009 ***

Hereditary persistent fetal hemoglobin ***

Hypertension since age 20 years

Chronic kidney disease stage 3 with secondary hyperparathyroidism

Left renal cell carcinoma without metastasis 2013

Hyperlipidemia

Obesity

Obstructive sleep apnea using CPAP

Benign prostatic hypertrophy

Gilbert's syndrome

Gastroesophageal reflux disease

Hypothyroidism

Left lumbar radiculopathy."

¶ 6 Dr. Peters opined that Melton had three disabilities, namely his stroke, his need for lifelong anticoagulation medication due to his history of factor V Leiden deficiency and renal cell carcinoma with recurrent thrombosis, and his long-standing hypertension. Melton was "fully recovered" from the stroke but was "disabled for at least one year after the stroke per [National Fire Protection Association (NFPA)] 1582 9.13.4.1.1 (2018)." See generally Standard on Comprehensive Occupational Medical Program for Fire Departments, NFPA 1582 (Nat'l Fire Prot. Ass'n 2018). Further, his use of anticoagulant medication "disable[d] him from full firefighter duties due to the risk of life[-]threatening hemorrhage per NFPA 1582 9.16.4.1." Also, Dr. Peters stated that Melton was disabled due to his hypertension, which he had since age 20 but was well controlled until the stroke, and Melton now required "confirmation of blood pressure control." Regarding the likely duration of the disabilities, Dr. Peters stated that Melton could be reassessed in March 2021 regarding his stroke and that he was presently without residual stroke symptoms or neurologic deficit, such that Dr. Peters expected that the stroke disability would not be permanent. Melton's need for lifelong anti-coagulant use was permanent. Melton was likely to return to good blood pressure control, but he had permanent renal and organ damage, and the "end organ damage may require permanent disability."

¶ 7 In response to the question of whether the alleged disabilities were a result of Melton's service as a firefighter, Dr. Peters wrote:

"His ischemic stroke disability is likely secondary to long standing hypertension. His disability due to required lifelong anti-coagulation is for recurrent thrombosis due to malignancy and inherited factor V Leiden deficiency. Of the two, his history of renal cell carcinoma is the greater thrombosis risk. *** Renal cell carcinoma has been identified as a malignancy occurring with increased incidence in firefighters."

Dr. Peters opined that Melton could perform in a light duty capacity if it were made available to him.

¶ 8 Dr. Jeffrey D. Williamson-Link, who was board-certified in occupational medicine, similarly outlined Melton's medical history. On the subject of the nature and extent of any disability, Williamson-Link stated that Melton suffered from a cerebellar infarction that would, under NFPA 1582, require a waiting period of at least 12 months and meeting additional criteria before being considered to return to active duty without limitations or restrictions. "Additionally [Melton was] also on long term anticoagulation treatment for history of Factor V Leiden and Pulmonary Embolism which would restrict him from performing Essential Job Task #8 which involves climbing ladders, operating from heights and uneven surfaces." The lifelong need to remain on anticoagulation would prevent him from being "able to be cleared for full firefighting duties." In response to the question of whether any disabilities were the result of service as a firefighter, Williamson-Link wrote:

"It is my medical opinion that one cannot discount the cumulative effects of active duty of Firefighting in regards to his stroke. Though the firefighter did have other risk factors, the occupational stressors of active firefighting is well-documented and its effects on the Cardiovascular System. Additionally the Firefighter has a history of Factor V Leiden, and has subsequently developed Pulmonary Embolism. Based on the review of the medical records, this appears to be a genetic disorder and would not be considered to be part of cumulative effects of active duty."

Williamson-Link stated that Melton could perform in a light duty capacity if such a position were available.

¶ 9 Dr. Mark N. Rubin, a board-certified vascular neurologist, submitted a report that stated that Melton had made an excellent functional recovery from his cerebellar stroke and was cleared for unrestricted duty by his primary care physician in June 2020, but he had a "strict indication to be on anticoagulation for the rest of his life which, per se , according to the [NFPA standards], ma[de] him unable to perform multiple essential job tasks." Dr. Rubin stated that Melton had a lifelong disability caused by his need for anticoagulation.

¶ 10 Melton "had pre-existing conditions that contributed to his risk of stroke, including morbid obesity, hypertension, dyslipidemia, obstructive sleep apnea, chronic kidney disease, diabetes mellitus, and Factor V Leiden with a history of recurrent deep vein thrombosis and a history of pulmonary embolus." Dr. Rubin stated that Melton "mention[ed] an ‘exposure’ but no evidence of an occupational exposure, let alone one that would rise above his pre-existing conditions as a generator of stroke, was presented. It [was] most likely that his pre-existing conditions were the sole cause of his stroke." Dr. Rubin continued that Melton's "disability, generated by his need for life-long anticoagulation, preceded his stroke and [was] due solely to a genetic pre-existing condition." Dr. Rubin could not "formulate a means by which the aggregate of his occupational duties contribute[d] to his need for anticoagulation." Rubin stated that Melton could perform in a limited or light duty capacity if such a position were available.

¶ 11 The Board held a hearing on Melton's application for disability benefits on November 13, 2020. Melton testified in relevant part as follows. He was 56 years old and had been employed by the East Peoria Fire Department since 2000. At the time of hiring, he passed the preemployment physical. Leading up to March 10, 2020, he held the position of lieutenant. His normal duties included being in charge of the station, the calls, and everyone's safety on a call and coordinating with other crews on calls. While not on calls, he was involved with maintaining the station, education, and inspections. Melton performed all of the duties listed in the job description for his position.

¶ 12 On March 10, 2020, Melton got off of work at about 11 a.m. While at home later that day, he experienced dizziness for a few minutes while doing paperwork. At midnight, Melton woke up his wife because he was dizzy and could not sleep. She was a nurse and took his blood pressure, which was high. They decided to go to a hospital, where a computed tomography scan did not reveal anything but magnetic resonance imaging showed that he had a stroke in his right cerebellum.

¶ 13 Melton was released from the hospital on March 15, 2020. He...