On March 10, 2015, the Illinois Workers’ Compensation Commission decided the case of Betancourt, Petitioner, v. Oxy Dry Corporation, Respondent. This decision affirmed the decision of the arbitrator, in almost all aspects of the original decision. There was no question that the injured worker suffered a contusion and laceration to his left ankle that arose out of and in the course of his employment on March 26, 2012. However, the employer disputes whether Betancourt suffers from a condition known as complex regional pain syndrome, or CRPS (formerly known as reflex sympathetic dystrophy, or RSD), a very significant pain syndrome which in most, if not all, cases is very debilitating and also progressive.
Mr. Betancourt received treatment from a chiropractic neurologist, who examined him on July 16, 2012. After some testing, the chiropractic neurologist stated that, both clinically and diagnostically, there was support for a possible CRPS diagnosis. That year, Mr. Betancourt also saw an orthopedic foot specialist on October 22, 2012, and that doctor recommended that the injured worker go to a pain clinic for evaluation of this significant disease process. On January 29, 2013, the pain doctor noted that the injured worker presented with burning and tingling pain in the left foot, weakness in the left lower extremity, and pain that was worsened by weight-bearing activities, including walking and standing. The doctor also concluded that it was possible that the injured worker was suffering from the early stages of the disease. The pain doctor noted and agreed that, objectively, the petitioner met the criteria for complex regional pain syndrome (CRPS).
The employer obtained two surveillance videos, which were placed into evidence. In these videos, the petitioner was performing various activities on March 3, March 7, March 26, August 17, and August 18, 2013. On March 3, the petitioner was repeatedly filmed walking without a cane or limp, with no outward signs of pain or discomfort, and also bending at the waist and loading various items into the car without any signs of discomfort or favoring of his left leg. The injured worker was also filmed on March 7, the same day he saw the employer’s section 12 examination doctor, for an appointment also known as an “independent” medical exam. In the film, he is seen using a cane and limping as he enters and exits the doctor’s office. He was filmed later that same day walking through a parking lot carrying a cable box without a limp or assistance of a cane, and without any outward sign of pain or discomfort. That section 12 “independent” doctor the employer hired concluded that he did not suffer from CRPS. The employer next sent the injured worker to a board-certified internist, anesthesiologist, and pain management physician for another section 12 examination. On the day of this examination, on March 26, 2013, the injured worker was again recorded on videotape both before and after the examination. Prior to arriving at the section 12 doctor’s office, he was filmed placing items in the back of his vehicle, and entered and exited a car without the need to brace himself. Later that same day, as he was walking towards the IME doctor’s office, he was recorded using a cane; as he exited the doctor’s office, he was recorded holding onto a railing. At the appointment, the injured worker limped and complained of decreased strength, but this did not meet the criteria for the disease. After leaving the doctor’s office, later that same day, video surveillance showed the injured worker getting out of his vehicle and walking without the use of a cane. Finally, on August 17, 2013, the injured worker was filmed walking at a brisk pace with his wife, without a cane or limp, for approximately 30 minutes.
The Commission resolved the difference between the opinion of the chiropractic neurologist and the two employer experts in favor of the employer, despite the orthopedic foot doctor and subsequent pain physician that testified to the existence of the disease of CRPS. The Commission remanded the case back to the arbitrator for further proceedings consistent with their decision regarding the CRPS.
An employer’s workers’ compensation insurance carrier will go to great lengths to destroy the credibility of the injured worker, and video surveillance is the number one way in which they do this. In this case, I estimate the insurance carrier spent more than $10,000 to obtain this credibility evidence. The reason for the large expense is because of the significance of the injury. If indeed complex regional pain syndrome (CRPS) was the diagnosis and could have been proven, then it would have been a very expensive workers’ compensation claim, both in lost time and medical benefits.
The moral of the story is that a chiropractor and two doctors who will only say that the presence of a medical condition is possible will not trump extensive video surveillance combined with employer doctors who say the condition is probably not present.
Complex Regional Pain Syndrome (CRPS), Illinois Workers’ Compensation Commission, Independent Medical Exam (IME), Reflex Sympathetic Dystrophy (RSD), Video Surveillance