Keefe, Campbell & Associates, LLC

Editor’s comment: For those industry insiders who know Illinois Workers Compensation law like the back of their hands, this may be a bit of a review, but we recently updated our “Noteworthy Cases” spreadsheet and thought we would take this opportunity to point out some of the cases that have impacted Illinois over the years.

Hansel and Gretel Day Care Center v. Industrial Commission; Board of Trustees of the University of Illinois v. Industrial Commission; Wal-Mart Stores v. Industrial Commission – Turning in chair is not an accident; standing up from a chair is not an accident; if employers do not require employees to park in a certain area, falls in employer-owned parking lot not compensable—in theory these cases confirm the idea that Illinois workers’ compensation law rejects the “positional risk” doctrine. In practice, compare the outcome of these cases with Tinley Park Hotel and Convention Center v. Industrial Commission, where a fall-down was ruled compensable if Petitioner presents impossible-to-rebut evidence that “other people” stumbled previously in the area of fall-down. Still remains a tricky area of the law, but a defense is possible based on these rulings.

Hydraulics, Inc. v. Industrial Commission – Ex parte communications between workers’ compensation claimant’s healthcare providers and employer or employer’s legal representatives are supposedly inadmissible as evidence, to the extent such communication is considered contrary to the patient’s interests in litigation. Reliance on such opinions to deny benefits may result in penalties and fees if Petitioner seeks them. Please note the Hydraulics decision was rendered prior to enactment of HIPAA and may be unnecessary due to the sweeping parameters of federal law on medical privacy, requiring detailed releases. It remains to be seen whether this will have the same effect if the employer or his representative has a full HIPAA release authorizing such contact.

Interstate Scaffolding v. Industrial Commission (Cert. granted, ruling not final) – An injured worker may be terminated for just cause and the employer will not be required to pay further compensation after such a termination. This is a major defense precedent and an appeal has been granted by the Supreme Court of Illinois, a truly rare occurrence in workers compensation cases. At present, the ruling is good law, and we await the ruling of the Supreme Court. In the case at bar, a worker was returned to light duty and was found vandalizing company property by writing religious graffiti, and was terminated for such actions. Petitioner argued he should have been entitled to TTD until he received a release to return to full duty employ, and the Appellate Court ruled he was not entitled to further temporary benefits after a termination for just cause. This ruling could impact Wage Loss claims if Petitioner would have a position available at his prior rate but for the justifiable termination. We will be sure to update you when the Supreme Court ruling comes down.

Legris v. Industrial Commission – Payment of medical bills extends the statute of limitations for filing a workers compensation action. In Illinois an injured worker has three years in which to file his or her claim, but if the employer pays any medical bills submitted, the statute of limitations to file the suit extends two years from the date of payment. Something to watch out for on old claims, as it can re-open a potential claim even after it would have been barred.

McMahan, Robert v. Industrial Commission – 50% penalties, payable to claimant and a 20% attorney fee are imposed on medical bills not paid for frivolous reasons. Please note Illinois has no “bad faith” provision. Defense industry is petrified the IWCC and reviewing courts may some day extend these penalties/fees to all medical bills and/or benefits paid and unpaid. What this means for employers is that if you get medical bills forwarded for payment, get your denial letter out quickly if the bills are not accepted, along with a good explanation of the reasons why the bills are being denied.

Nascote Industries v. Industrial Commission; Mechanical Devices v. Industrial Commission – Claimant entitled to TTD for disputed periods based upon a variety of factors with maximum medical improvement (or MMI) clearly most important; if Petitioner is working on part-time or other basis prior to MMI, claimant can keep all income and be entitled to full TTD without any credit to employer. We consider this a radical interpretation of the statute–defense view is that the word “total” in temporary total disability has its plain meaning and should provide that if injured worker can work at all, TTD wage replacement benefit shouldn’t be due.

If you have any questions or comments, please forward them to our resident Blog Administrator, Arik D. Hetue, J. D. who can be reached at ahetue@keefe-law.com or post them later today on the blog at www.keefe-law.com/blog.