1.
Dorothy Jackson v. Brach & Brock Confections (95 WC 24428)
The petitioner sought
benefits claiming that the repetitive nature of her work in the maintenance
department aggravated her degenerative hip condition to the point where
she could never work again. The arbitrator, however, held that the
petitioner had not suffered an injury which arose out of and in the
course of the petitioner's employment and awarded the petitioner no
benefits. The arbitrator's decision was primarily based on the successful
cross examination of the petitioner's treating physician, who had opined
that the petitioner's condition was aggravated by her work.
2. Richard
Mercado v. Globe Fasteners (94 WC 16760)
The petitioner sought
benefits for a low back herniated disc which he testified occurred
when he lifted a heavy box at work. During the petitioner's cross examination,
several inconsistencies in his accident description compelled the arbitrator
to hold that he had not suffered an injury which arose out of or in
the course of his employment.
3. Viola
McLaughlin v. McGill Plastics (93 WC 23955)
The petitioner sought
permanent and total disability benefits as a result of a herniated
disc at C3-C4 and permanent sedentary work restrictions outlined for
her by her treating and examining physicians. At the time of her accident,
the petitioner was 59 years old and her regular job required frequent
heavy lifting. The petitioner's claim for permanent and total disability
was defeated as a result of a modified duty position offered by the
respondent to the petitioner which she refused to accept. The arbitrator's
decision reflected that he was persuaded by the evidence offered by
respondent which consisted of the actual pieces the petitioner would
have been required to work with had she accepted the modified position.
4. Del
Davis v. Jewel Food Stores, (91 WC 20487)
The petitioner was
beaten up while collecting carts in the employer's parking lot. The
arbitrator found that the petitioner had not suffered an accident which
arose out of and in the course of his employment because there was
no credible evidence presented that the attack (1) had anything to
do with the petitioner's employment or (2) occurred in a dangerous
area.
5. Guadalupe
Ochoa v. Brach & Brock Confections (91 WC 59915)
The petitioner argued
that she was permanently and totally disabled because (1) she did heavy
work (2) had permanent sedentary work restrictions and (3) spoke little
English. Therefore, the petitioner claimed she was entitled to an award
of permanent disability under the "odd lot" theory. The arbitrator
held that the petitioner was not permanently and totally disabled because
it was credibly established at hearing that the petitioner made no
legitimate effort to find work within her restrictions.
6. Daniel
Grahm v. Ace Hardware (96 WC 1554)
The petitioner claimed
he broke his foot when he tripped over clutter in the aisle of a warehouse
where he was working. A co-worker testified at the hearing that the
aisle was clean and that the petitioner fell because he broke into
a run and attempted to hurdle a pallet full of boxes. The arbitrator
found that the petitioner's injury was not compensable under the "horseplay" defense.
7. Maria
Valadez v. Brach & Brock Confections (95 WC 09115)
The petitioner was
seeking TTD benefits after a general layoff when the petitioner still
had work restrictions. The arbitrator declined to award the petitioner
TTD because the petitioner's treating physician admitted during cross
examination at his evidence deposition that the petitioner had reached
maximum medical improvement, thereby eliminating her right to TTD benefits.
8. Christine
Stelmach v. ABN AMBRO (98 WC 65523)
The petitioner was
asserting that her involvement in a bank robbery constituted a "sudden,
severe, emotional" trauma sufficient enough to fit into the Pathfinder
exception to the rule in Illinois that stress without an underlying
physical injury (i.e., mental-mental claims) are not compensable. The
Arbitrator held that the petitioner did not carry her burden of proof
on that issue at hearing.
9. Sara
Sandberg v. Ace Hardware Retail Support Center (98 WC 49816)
The petitioner filled
orders with the use of a push cart on a cement surface in a warehouse.
Pursuant to her job duties, she walked 15-20 miles per shift. The petitioner
developed plantar fascitia which her treating orthopedic surgeon claimed
was related to her work. The arbitrator held that the petitioner did
not prove that she suffered a compensable accident since she did not
prove that the act of walking and pushing the cart exposed her to any
greater danger than the general public.
10. Penny
Furtado v. J& L Oil (99 WC 37247)
The petitioner was
scheduled to undergo a lumbar laminectomy. The petitioner alleged she
injured her lumbar spine in an unwitnessed accident lifting cases of
pop while working. At trial, two co-workers testified that the petitioner
injured herself falling down the stairs at home. The arbitrator held
that no injury occurred which arose out of or in the course of petitioner's
employment.
11. Vicki
Anderson v. Ace Hardware Retail Supply Center (96 WC 59315)
The petitioner alleged
that excessive walking caused severe foot problems. The petitioner's
treating physician opined that her problems were related to her work.
The arbitrator held that the act of walking was not a compensable activity
under the Act.
12. Timothy Washington v. Eagle Food Center, Inc. (94
WC 06686)
The petitioner alleged
that his psychological condition of depression was related to a physical
altercation with his supervisor at work. The arbitrator found that
the petitioner's injuries did not arise out of his employment.
13. John
Cataudella v. City of Chicago. (96 WC 19213)
The petitioner had
a herniated disc at L4-l5. The petitioner refused to undergo surgery
to relieve his symptoms. The petitioner’s treating physician
opined that the petitioner could never work in any capacity. Therefore,
petitioner attempted to prove up permanent and total disability. Based
on a Supreme Court case cited in respondent’s proposed decision,
the arbitrator rejected petitioner’s argument that he was permanently
and totally disabled.
14. Curtis
Hudson v. City of Chicago (93 WC 39548)
The petitioner,
a paramedic for the City of Chicago, argued that he was not barred
by Section 1(b)(1) of the Act or by the Pension Code from recovering
working compensation benefits. At arbitration, before the Commission
and before the Circuit Court of Cook County, it was held that the petitioner
was barred from recovery under the Act.
15. Richard
Binion v. Delgado Erection (95 WC 38745)
The petitioner filed
a §19(b) petition alleging that his torn rotator cuff in his left
shoulder, as diagnosed in July of 1996 was causally related to his
work accident on March 29, 1995. On March 29, 1995, the petitioner
was performing his job duties as a structural ironworker when a 400
pound piece of steel fell from a crane and glanced off petitioner’s
left shoulder. The issue during the §19(b) hearing came down to
a disagreement between several treating and consulting physicians regarding
whether the petitioner’s original left shoulder MRI on April
10, 1995 revealed the torn rotator cuff. Based on video surveillance
of the petitioner using his left arm above his head on February 27,
1996, the arbitrator held that the petitioner’s left shoulder
torn rotator cuff was not related to his March 29, 1995 accident.
16. Mary
Woodard v. Clinton Electronics (97 WC 43399)
The petitioner worked
as a utility trainer for the respondent for eleven years. On November
13, 1996 the petitioner was involved in a non-work-related car accident.
Shortly after the accident, the petitioner developed carpal tunnel
syndrome. The petitioner’s treating surgeon opined that the petitioner’s
carpal tunnel syndrome was related to her work activities, not her
car accident. The employer’s consulting physician opined that
the carpal tunnel surgery was “traumatically induced” by
petitioner’s car accident. The arbitrator held that the petitioner’s
carpal tunnel syndrome was related to her car accident and not her
work activities.
17. Omah Mercuri v. Hunt and Screw Manufacturing (98
WC 541 and 99 WC 54654)
The petitioner suffered
a soft tissue shoulder injury followed several weeks later by a stroke.
The petitioner had not worked since 1997 and was alleging that she
was permanently and totally disabled as a result of a work-related
stroke. At arbitration, the arbitrator found that the petitioner’s
work activities had no relation to her stroke and awarded the petitioner
permanency on the basis of a soft tissue shoulder injury. This decision
was affirmed by the Industrial Commission, the Circuit Court and the
Appellate Court.
18. Gary
Stover v. Printers Express(01 WC 4329)
The petitioner suffered
a compensable injury on December 18, 2000 resulting in a herniated
disc at L4-L5, which was the responsibility of the referring insurer.
On June 17, 2002, the petitioner claimed a recurrence of low back pain.
By that date, the employer had a new insurer. In a §8(a) hearing
regarding which injury caused the need for the petitioner’s prescribed
surgery, the Arbitrator held that all responsibility for the petitioner’s
low back condition after June 17, 2002 was wholly related to petitioner’s
June 17, 2002 accident.
19. Jose
Agudelo v. Hirsh (98 WC 63764)
The petitioner was
struck by a forklift and thrown several feet. He eventually underwent
low back surgery for a L5-S1 herniated disc and a chondral fracture
of his knee. To defend against the employer’s liability for the
back surgery, I stressed that while the petitioner immediately began
to complain of low back pain, he did not make radicular complaints
until several months after the accident. To defend against the employer’s
liability for petitioner’s knee surgery, I presented an argument
through the employer’s IME physician that the petitioner’s
knee condition was more likely related to a congenital difference in
the length of his legs as opposed to the accident. The demand was for
permanent and total disability. The Arbitrator found in favor of the
employer on both causal connection issues and awarded the petitioner
$3,450.00.
20. Kastra
Jarmon v. Caribou Coffee, (03 WC 23928)
The petitioner was
struck in the face with a heavy door to an ice cooler. The petitioner
claimed total blindness in one eye and post traumatic stress syndrome.
In regard to petitioner’s eye, four treating physicians opined
that the petitioner lost complete sight in her eye as a result of her
work accident. The employer’s IME physician, however, was the
only physician that tested to determine the legitimacy of the petitioner’s
complaints. The IME physician opined that the petitioner was significantly
exaggerating her symptoms. I stressed to the Arbitrator that the IME
physician’s opinion on the issue of the legitimacy of petitioner’s
symptoms was unrebutted. The Arbitrator agreed and denied benefits
to the petitioner for her eye injury.
In regard to petitioner’s
post traumatic stress syndrome, two of the petitioner’s treating
physicians opined that the petitioner was suffering from post traumatic
stress disorder and that it was related to her work accident. Because
of inconsistencies in the petitioner’s conduct after the accident
and the strength of a Section 12 exam finding no causal connection,
the Arbitrator also awarded the petitioner no benefits for her post
traumatic stress disorder.
21. Charles
Welsh v. Yellow Freight (03 WC 51342)
The petitioner was
driving a truck for the employer when a drunk driver struck a car in
the oncoming left turn lane in the rear and forced the car into the
path of the truck the petitioner was driving. The accident involved
a fatality in the car the petitioner’s truck struck. The petitioner
struck his left knee on the inside of the truck cab during the accident,
reported the accident immediately and had two visits to the company
clinic. The petitioner was diagnosed with a sprain/strain injury. There
was a nine month gap in medical treatment. When the petitioner began
to treat again, he reported that his knee bothered him and became progressively
worse during the nine month gap in treatment. On the basis of the gap
in treatment, the Arbitrator found no causal connection between the
petitioner’s injury and his knee condition after the nine month
gap.
22. Thomas
Potenzo v. Jewel (97 WC 28230)
The petitioner was
unloading his truck in a dock behind his employer’s store. The
petitioner was attacked and suffered numerous severe injuries. All
the petitioner could testify to at hearing about the assault was that
his foot was grabbed and he slipped striking his head and he lost consciousness.
The case was defended as not compensable because the petitioner could
not prove the assault arose out of his employment since there was no
evidence as to why he was attacked and the petitioner failed to establish
that the employer’s store was in a dangerous area. The Arbitrator
agreed and awarded the petitioner no benefits.
23. Jerome
Scott v. Standard Parking (00 WC 55406)
The petitioner was
employed by the employer as a parking lot attendant at Midway Airport.
According to the petitioner, he was driving from lot to lot in his
own car changing tickets at the entrance to each lot and counting open
spaces when he lost control of his car and was involved in a very serious
accident. The employer denied that the petitioner’s job duties
included any of the tasks he was allegedly performing at the time of
the accident. The employer also denied the petitioner was ever authorized
to be in the lot he was in at the time of his injury. On cross examination,
the petitioner was impeached several times. The Arbitrator found petitioner’s
testimony was not credible and denied benefits.
24. Claudio Gallegos v. Flexi-Van (01 WC 64664, 03 WC 09090 and
03 WC 09091)
The petitioner had three separate accidents and was seeking
$26,532.00 in medical, TTD and permanency at hearing. The Arbitrator
awarded only permanent impairment of $9,864.49 and found in favor
of respondent on the issues of disputed medical and TTD.
1994
June
29, 1994 Rules Governing Practice Before the Illinois
Industrial Commission and their impact on claims handling -
Presented to Kemper Insurance claim staff
December
8, 1994 Basic Aspects of the Illinois Workers'
Compensation Act - Presented to Universal Underwriters claim
staff
December
15, 1994 Basic Defense Strategies and Defense
Counsel's Role in Resolving Claims - Presented to Interlake
Corporation supervisor at training seminar
1995
February
21, 1995 Strategies for Resolution of Workers'
Compensation Claims - Presented to Alexsis claims staff
August
3, 1995 Illinois Worker's Compensation Case Law
Changes - Presented to Alexsis claim staff
December
5, 1995 Subrogation and the Worker's Compensation
Lien - Presented to Marriott claims staff
1996
March
5, 1996 Strategies for Effective Use of Defense
Counsel - Presented to Illinois Claims Manager's Association
August
7, 1996 Compensability Issues and Perfecting a
Circuit Court Review - Presented to Kemper claims staff
August
28, 1996 The Compensability of Workers' Compensation
Claims - Training seminar for disability adjustors working
on Ameritech claims
August
29, 1996 Basic Aspects of Illinois Workers' Compensation
Act - Presented to American Stores claims staff
November
13, 1996 Basic Strategies for Taking Effective
Recorded Statement - Presented to Dominick's claims staff
1997
February
3, 1997 Recognition of Workers' Compensation Forms -
Presented to Sedgwick claims staff
March
11, 1997 The Recorded Statement - Discussion and
mock trial - Presented to Wausau claims staff
April
24, 1997 Structure of Industrial Commission and
Lawyers Role in Defending Claim - Presented to International
Paper's National symposium on workers' compensation
May 21,
1997 The Role of Defense and Basic Strategies
in Defending Workers' Compensation Claim -Presented at National
Risk Management conference for Litton Industries International
June
17, 1997 Basic Aspects of the Illinois Workers'
Compensation Act and Case Law Update - Presented to CNA Insurance
staff and CNA clients
December
9, 1997 Structure of Industrial Commission and
General Information about its Operation - Presented to Illinois
Claims Managers Association
1998
January
7, 1998 Kotecki and its Progeny; Defending Employers
in Third Party Litigation: Presented to Kemper claims staff
February
3, 1998 Kotecki and its Progeny; Defending Employers
in Third Party Litigation: Presented to Alexsis claims staff
February
18, 1998 Kotecki and its Progeny; Defending Employers
in Third Party Litigation: Presented to Westfield Insurance
claims staff
May 11,
1998 Kotecki and its Progeny; Defending Employers
in Third Party Litigation: Presented to Wausau claims staff
August
28, 1998 The Compensability of Recreational Activity
Under §11 of the Act: Presented to Dominick's claims staff.
September
1, 1998 Kotecki and its Progeny: Defending Employers
in Third Party Litigation: Presented to United Fire & Casualty
claims staff in Cedar Rapids, Iowa.
1999
January 22, 1999 The Impact of the McMahan Decision
on Claims Involving Disputed Medical Issues: Presented to Illinois Compensation
Trust claims staff.
February
22, 1999 Compensability of Stress Claims in Illinois
and Basic Strategies for Taking Effective Recorded Statements -
Presented to Chubb Insurance claims staff.
March
16, 1999 The Second Injury Fund and Defense Counsel's
Role in Settlement: Presented to warehouse managers at National
Workers' Compensation Training Seminar for Union Tank Car.
May 5,
1999 Fraud and Its Use in the Defense of Workers'
Compensation Claims: Presented to warehouse supervisors and
managers at Ace Hardware's warehouse facility in Princeton, Illinois.
September
29, 1999 Mock Trial/Trial Techniques presented
to Workers' Compensation Claims Association.
2000
February
21, 2000 Mock Trial/Trial Techniques: Presented
to worker's compensation staff at RSKCo.
August
24, 2000 Mock Trial/Trial Techniques: Presented
to several local adjusters in the Indianapolis area.
September
14, 2000 Mock Trial/Trial Techniques: Presented
to workers' compensation staff at Chubb Insurance.
December
5&6, 2000 Proper Investigation Techniques: Presented
to over 100 front line supervisors for Yellow Freight Systems.
2001
March
16, 2001 A Defense Attorney’s Perspective
on Cost Cutting in the Claims Process: Presented to risk managers
and claim professionals.
March
24, 2001 Proper Investigation Techniques: Presented
to shift supervisors at Nestle.
September
26, 2001 Relationship Between OSHA and Workers’ Compensation: Presented
to various safety managers in coordination with OSHA expert.
October
4, 2001 Mock Trial/Trial Techniques: Presented
to numerous risk managers.
2002
January
24, 2002 Accident Investigation and Recorded Statements
for Claims Adjusters: Presented to Kemper Insurance Claims
Staff.
May 16,
2002 Accident Investigation: Presented to
numerous human resource professionals as part of joint workers'
compensation, labor and employment and immigration seminar.
October
17, 2002 Mock Trial: Presented to over 100
Risk Managers and Captive Program Administrators.
2004
March
26, 2004 Mock Trial: Presented to 25 adjusters
in the St. Louis area.
April
4, 2004 Seminar: Medicare Set Aside: Served
on panel to discuss Medicare set aside issue in detail.
May 20,
2004 Effective Use of Independent Medical Exams: Presented
to workers' compensation supervisors from a large international
client.
June
30, 2004 Sisbro and the Stats of Pre-Existing
Condition Defenses in Illinois: Presented to 14 adjusters at
large national third party administer.
October
26, 2004 Sisbro and the Stats of Pre-Existing
Condition Defenses in Illinois: Presented to over 30 adjusters
and supervisors at large mutual third party administrator.
November
30, 2004 Sisbro and the Stats of Pre-Existing
Condition Defenses in Illinois: Presented to claims analysts
and producers at large insurance broker/agent.
2006
January
20, 2006 Changes to the Illinois Act and Their
Effect: Delivered
to large self insured and adjusters for National T.P.A. assigned to
self insured's clients.
January
24, 2006 Changes to the Illinois Act and Their
Effect: Delivered
to diverse audience of 125 risk managers and claims professionals.
April
5, 2006 Changes to the Illinois Act and Their
Effect: Delivered
to claims adjusters at ESIS.
June
23, 2006 Mock Trial: Presented to 70 risk managers and adjusters
from around the country.
November
14, 2006 Accident Investigation: Presented to 110 State Farm
adjusters.