Medical Data Nail Down Carpenter's Need for Continued Benefits, Work Restrictions

Chicago, IL (WorkersCompensation.com) – Sometimes a workers' compensation dispute boils down to the quality and quantity of medical data on one side or the other. 

That was the case in Service Drywall and Decorating v. Illinois Workers' Compensation Commission, No. 1-21-0965WC (Ill. App. Ct. 04/2/22), where the opinion of a company's physician stood little chance against the opinions of three doctors who treated a journeyman carpenter who injured his back. 

The carpenter hurt himself at work when he slipped and fell down approximately nine metal stairs of scaffolding. 

The carpenter had no back pain prior to the incident, but experienced significant pain immediately afterward. Although he obtained substantial medical treatment, including repeated steroid injections, the pain continued beyond Sept. 30, 2016. Both an MRI and a discogram indicated he had suffered a herniated disc.  

The carpenter's doctors allowed the carpenter to return to work with restrictions, such as a limitation on the amount of weight he should lift.  

But the company's doctor found that the carpenter suffered only a lumbar strain that healed by September 30. Based on that opinion, the company ceased paying benefits and accommodating the carpenter's work restrictions as of that date. An arbitrator agreed with the decision, and the Workers' Compensation Commission reversed.  

The employer subsequently challenged a state circuit court's ruling affirming the Commission.  

To secure continued benefits, the appeals court explained, the carpenter had to establish that he suffered a disabling work-related injury that persisted beyond September 30. 

The court pointed out that the Commission justified its decision by pointing to the fact that the carpenter had no symptoms before the accident, and that he experienced debilitating symptoms immediately after the fall. Further, the Commission found the company's physician unpersuasive. The Commission concluded that the medical records, taken as a whole, showed the carpenter continued to have a severe injury even after the company terminated his benefits. 

"Indeed, the evidence demonstrates that claimant sought extensive medical treatment for pain in his lower back extending to his left upper leg after the accident and well beyond September 30, 2016," the court wrote. Moreover, three of the carpenter's physicians agreed that the MRI showed the carpenter had suffered a herniated disc. A discogram provided further evidence of the symptoms the worker claimed he was experiencing. 

The court acknowledged that the carpenter returned to work. But he returned on light-duty restrictions, it noted. The court added that, prior to September 30, the carpenter received epidurals, nerve blocks, medication, and physical therapy, and that he experienced some temporary relief after each steroid injection. However, his symptoms did not significantly improve until he underwent fusion surgery, nearly a year after the company ended his benefits. 

The company's physician, the court acknowledged, saw nothing that would cause the reported symptoms. But he was alone in that view. Moreover, he based his opinion "solely on the utilization-review physicians, who neither examined nor treated claimant," the court wrote. Thus, the court found no error in the Commission's decision to reject that opinion, while concluding that the medical evidence and the carpenter's testimony supported the Commission's ultimate finding. 

The court upheld the circuit court's ruling that the accident and back injury were causally related, and that the injury persisted beyond September 30, 2016.