Haepp v. Ill. Workers' Comp. Comm'n

2022 IL App (1st) 210634 WC

219 N.E.3d 640

467 Ill.Dec. 630

Donald HAEPP, Appellant,

v.The ILLINOIS WORKERS’ COMPENSATION COMMISSION et al., (City of Chicago, Appellee).

No. 1-21-0634 WC

Appellate Court of Illinois, First District, WORKERS’ COMPENSATION COMMISSION DIVISION.

Filed December 9, 2022

Kevin T. Veugeler and Neil Schelhammer, of Healy Scanlon, of Chicago, for appellant.

Jack M. Shanahan, of Inman & Fitzgibbons, Ltd., of Chicago, for appellee.

OPINION

JUSTICE BARBERIS delivered the judgment of the court, with opinion.

¶ 1 Claimant, Donald Haepp, appeals the order of the circuit court of Cook County, confirming the decisions of the Illinois Workers’ Compensation Commission (Commission), which awarded claimant benefits under the Workers’ Compensation Act (Act) ( 820 ILCS 305/1 et seq. (West 2010)) for four separate injuries he sustained while working for respondent, the City of Chicago, on May 4, 2010 ( 10 WC 25879 ), January 26, 2011 ( 11 WC 17266 ), June 27, 2014 ( 14 WC 24735 ), and December 15, 2014 ( 15 WC 1963 ). On appeal, claimant argues that the Commission erred by (1) declining to award wage-differential benefits under section 8(d)(1) of the Act (id. § 8(d)(1)), (2) declining to award penalties and fees under sections 19(k), 19(l ), and 16 of the Act (id. §§ 19(k), 19(l ), 16), and (3) awarding respondent credits under section 8(j) of the Act (id. § 8(j)).

¶ 2 I. BACKGROUND

¶ 3 On July 7, 2010, claimant filed an application for adjustment of claim, seeking benefits for an injury he sustained to his left knee while working for respondent as a carpenter on May 4, 2010 ( 10 WC 25879 ). Claimant filed a second application for adjustment of claim on May 3, 2011, seeking benefits for a separate injury he sustained to his left knee while working for respondent as a carpenter on January 26, 2011 ( 11 WC 17266 ). The cases were consolidated for a hearing before an arbitrator pursuant to section 19(b) of the Act (id. § 19(b)).

¶ 4 Following the hearing, the arbitrator found that claimant sustained compensable injuries on each of the alleged dates and awarded him temporary total disability (TTD) benefits under section 8(b) of the Act (id. § 8(b)), as well as reasonable and necessary medical expenses under sections 8(a) and 8.2 of the Act (id. §§ 8(a), 8.2). With regard to claim 10 WC 25879, the arbitrator also ordered respondent to pay penalties under sections 19(k) and 19(l ) of the Act (id. §§ 19(k), 19(l ), and attorney fees under section 16 of the Act (id. § 16). The arbitrator did not order respondent to pay penalties or fees in claim 11 WC 17266. Respondent sought review of the arbitrator's decision before the Commission in claim 10 WC 25879, and both parties sought review of the arbitrator's decision before the Commission in claim 11 WC 17266.

¶ 5 On review, the Commission affirmed and adopted the arbitrator's decision in claim 10 WC 25879, including the award of penalties and fees. The Commission modified the arbitrator's decision in claim 11 WC 17266 to include an award of penalties and fees under sections 19(k), 19(l ) and 16. The Commission remanded both matters back to the arbitrator for further determination on additional amounts of temporary or permanent disability benefits, if any, pursuant to Thomas v. Industrial Comm'n , 78 Ill. 2d 327, 35 Ill.Dec. 794, 399 N.E.2d 1322 (1980). Neither party sought judicial review of the Commission's decisions.

¶ 6 On July 23, 2014, claimant filed a third application for adjustment of claim, seeking benefits for an umbilical hernia he sustained while working for respondent on June 27, 2014 ( 14 WC 24735 ). Claimant filed a fourth application for adjustment of claim on January 21, 2015, seeking benefits for an injury he sustained to his right shoulder on December 15, 2014 ( 15 WC 1963 ). All four claims ( 10 WC 25879, 11 WC 17266, 14 WC 24735, and 15 WC 1963 ) were consolidated for a hearing before an arbitrator on March 26, 2018.

¶ 7 A. Arbitration Hearing

¶ 8 At the arbitration hearing held on March 26, 2018, the parties disputed the following issues in all four claims: causal connection, medical expenses, nature and extent of the injuries, penalties and fees, and respondent's entitlement to credit. In claims 10 WC 25879 and 11 WC 17266, the parties disputed the additional issue of claimant's entitlement to a wage-differential award.

¶ 9 During opening statements, claimant's attorney argued, inter alia , that the imposition of penalties and fees was warranted based on respondent's failure to timely pay various medical bills. Claimant's attorney expressed an intention to submit the medical bills, along with corresponding cover sheets, into evidence at the hearing. In response, respondent's attorney maintained that the imposition of penalties and fees was unwarranted because many of the medical bills were paid by claimant's group health insurance plan and respondent was entitled to credit for such payments. Respondent's attorney further asserted that claimant listed incorrect balances for the medical bills on the cover sheets. When claimant's attorney sought to admit the medical bills and corresponding cover sheets into evidence at the hearing, respondent's attorney asked that the arbitrator "scrutinize the documents themselves and the payment listings themselves and not accept the face value of the charges listed on the cover sheets." In support of respondent's request for credit, respondent's attorney sought to admit payment listings that itemized the medical bills paid by claimant's group health insurance in each claim. Claimant's attorney objected on the grounds of form, foundation, and hearsay. The arbitrator reserved ruling on the objection.

¶ 10 The following factual recitation was taken from the evidence adduced at the arbitration hearing. Claimant testified that he became a union carpenter in 1985 and began working for respondent as a carpenter in 1999. Prior to the events giving rise to the present claims, claimant sustained an injury to his left knee while working for respondent on October 27, 2000. Respondent submitted into evidence a settlement agreement, wherein claimant agreed to settle the claim arising from his October 27, 2000, knee injury and was awarded 22.5% loss of use of the leg. Thereafter, claimant sustained four additional injuries while working for respondent as a carpenter from 2010 to 2014.

¶ 11 1. 10 WC 25879

¶ 12 Claimant testified that he sustained an injury to his left knee when he stepped in a hole while carrying a ladder at work on May 4, 2010. Claimant was 55 years old at the time of his injury, and his average weekly wage (AWW) was $1620.40. Claimant first sought medical treatment at MercyWorks, respondent's occupational clinic. Claimant submitted into evidence his medical records from MercyWorks, which revealed that he was initially seen by Dr. J.R. Mejia on May 11, 2010, and that X-rays were taken of his left knee on that date. Claimant also submitted into evidence a medical bill from Radiological Physicians for the X-rays taken on May 11, 2010, along with a corresponding cover sheet that indicated the medical bill totaled $46. The medical bill listed a $46 charge but indicated no balance was due after various adjustments, including an adjustment described as "Collection-Bad Debt."

¶ 13 Claimant followed up with Dr. Homer Diadula at MercyWorks on May 18, 2010, and May 24, 2010. After magnetic resonance imaging (MRI) of claimant's left knee revealed a lateral meniscus tear on May 27, 2010, Dr. Diadula referred claimant to Dr. Michael Maday at Midland Orthopedics for further treatment. Dr. Maday performed a left knee arthroscopic surgery to repair claimant's lateral meniscus tear on September 20, 2010. Following surgery, claimant began physical therapy and remained off work. Dr. Maday recommended that claimant begin a work hardening program on December 8, 2010. Claimant completed the recommended program and returned to work for respondent as a full-duty carpenter without restrictions on January 10, 2011.

¶ 14 2. 11 WC 17266

¶ 15 Claimant testified that he sustained a subsequent injury to his left knee when he tripped over an uneven floor while carrying tools at work on January 26, 2011. At the time of his injury, claimant was 56 years old, and his AWW was $1630.80. Claimant believed he reinjured his left knee and returned to Dr. Maday for further treatment on February 9, 2011. Claimant underwent a second MRI of his left knee on March 19, 2011, which revealed a moderate-sized, radial free-edge tear of his lateral meniscus. After comparing the March 19, 2011, MRI to prior imaging of claimant's left knee, Dr. Maday concluded that claimant sustained a new tear as a result of his January 26, 2011, work accident and recommended another left knee arthroscopic surgery. Dr. Maday performed the recommended surgery on September 8, 2011. Following surgery, claimant began a new course of physical therapy and remained off work.

¶ 16 Claimant's physical therapist reevaluated claimant on November 23, 2011, after he completed 25 physical therapy sessions. During the evaluation, claimant reported ongoing pain and limited range of motion in his left knee. The therapist directed claimant to "avoid kneeling activities and excessive squatting" when he returned to work. Shortly thereafter, Dr. Maday released claimant to return to work with a restriction of no kneeling. At respondent's request, a physician at Advocate Occupational Clinic evaluated claimant, who agreed with Dr. Maday's recommended work restriction and recommended additional physical therapy.

¶ 17 Claimant testified that he returned to work for respondent as a carpenter on December 1, 2011, and that respondent accommodated his restriction by assigning him work that required no kneeling. Claimant experienced ongoing difficulties with his knee, but he was able to "do the job, the ceilings and the stand-up work and that." He sought further treatment with Dr. Maday on January 25, 2012, and underwent a...