On July 22, 2014, an arbitration decision on a case was filed with the Illinois Workers’ Compensation Commission in Chicago, Illinois, in the case of Elizabeth Ray, the employee, v. Apostolic Christian Skylines, the employer.  The employer disputed the issue of whether the worker’s current condition was related to the injury that occurred on April 16, 2012, and they also disputed whether the medical expenses that were provided to the employee were both reasonable and necessary.  Finally, they disputed whether the employee was entitled to any medical care in the future.

The arbitrator found for the injured worker on all of these issues, and against her employer.  The employer appealed to the Commission on all three issues, claiming that, in fact, the petitioner had been injured while babysitting her granddaughter, and that this constituted an intervening accident, therefore breaking the connection between the original accident and the worker’s current condition.  The intervening accident, according to the plaintiff’s testimony before the arbitrator, was nothing more than a stumble at the bottom of her staircase, in which she only skinned her knees when she fell.  The injured worker denied seeking medical treatment at an emergency room as a result of the fall in her home.

However, the E.R. records on November 30, 2012, indicated that the injured worker arrived at an emergency room at approximately 1:49 PM.  The E.R. records showed that she gave an extensive history of her current medications, and a history of the following patient problems: nausea, kidney stone, hematuria, pneumonia, and flank pain.  The E.R. chart shows that at 2:31 PM, the petitioner signed an AMA form and left the E.R. without being seen by a medical provider.  The injured worker denied she sustained any injury at home on November 30, that she fell on her right side, or that she had any increased SI joint or low back complaints as a result of the incident.

The employer seized on this information, and in the subsequent appeal to the Commission, the decision was reversed, at least in part, with regard to these three issues, concluding that the worker’s current condition was not a natural consequence of her April 16, 2012 injury at work, and that indeed the November 30, 2012 accident constituted an independent intervening accident that broke the chain of causation.

The Commission further found that the employer’s liability for weekly disability benefits and medical benefits stopped on November 30, 2012.  The Commission specifically found that the worker’s testimony was less than credible regarding the mechanics of her fall, the injuries she suffered from her fall, and the treatment she sought following her fall, all based on the records of the E.R., physical therapist and her own treating doctor.  Any injured worker whose testimony is found less than credible may ultimately defeat his or her workers’ compensation claim.

Chain of Causation, Illinois Workers’ Compensation Commission, Intervening Accident, Testimony Credibility

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