workers-compensation-illinois-case-ends-over

If your workers’ compensation claim ends, sometimes, it really isn’t over yet.  It depends on the exact circumstances of your situation.  One way this happens is when a condition at least in part causally related to your work injury ends up causing you serious medical issues after your workers’ compensation case ends.

One such recent case was Kenneth Eric Cole v. State of Illinois, Shawnee Correctional Center:

  • Mr. Cole was a correctional officer. On December 5, 2007, he was attacked by an inmate.
  • He injured his right knee (meniscal tear) and lumbar spine (annular tear at L5-S1).
  • He hired a workers’ compensation attorney, who filed the claim on December 21, 2007.
  • Mr. Cole had surgery on his right knee and lumbar spine (two-stage fusion). The spine surgery occurred in November 2008.
  • He returned to work full duty following a period of post-op recovery.
  • On May 4, 2009, the Arbitrator awarded him $217,673.60 for medical expenses, 20 % loss of use of his right leg, and 22.5% loss of use of the person as a whole with respect to the lumbar injury.
  • From November 2010 through July 2013, he did not see his treating doctor. During this time, he had “occasional flare-ups” related to his old spine injury.
  • On July 28, 2013, Mr. Cole began experiencing worsening symptoms that included back pain, numbness and tingling in his legs and feet, and there was not any precipitating incident.
  • In August 2013, his treating doctor ordered an MRI, which showed a new tear on the right at L4-5, and the doctor gave his opinion that a fusion causes more stress on the nearby or adjacent segments of the spine, and therefore, the tear at L4-5 was causally related to the earlier lumbar fusion at L5-S1.
  • His doctor took him off work, then tried conservative care options: physical therapy, nerve root injections, and epidural steroid injections (ESI’s).
  • He received temporary total disability (TTD) benefits for the period he was off work.
  • He was sent to an IME (independent medical exam), which is a hand-picked insurance company doctor.  The IME doctor unsurprisingly rejected the treating doctor’s causation theory, claiming that recent research had disproved that theory.
  • His attorney filed a Section 8(a) Petition for prospective medical treatment, and a hearing was held before a Commissioner on March 25, 2015.
  • The Commissioner ruled in favor of the Petitioner, as he was persuaded more by the treating doctor’s experience, both as a whole, and specifically regarding Mr. Cole’s care.
  • The Respondent was ordered to pay for the conservative care and lumbar fusion surgery at L4-5.

For Mr. Cole, even though the Arbitrator ruled in his favor in 2009, and he did not even see his treating doctor for any issues from November 2010 through July 2013, it really wasn’t over for him at that point.  He ended up needing a second lumbar surgery, and his attorneys won him such benefits before a Commissioner in 2015.

There are some circumstances where it really is over for an injured worker, but it never hurts to consult with an attorney who concentrates in workers’ compensation in Illinois.  You have everything to gain and nothing to lose.  A free, private and confidential consultation is just one short phone call away.

 

Illinois Workers’ Compensation Commission, Independent Medical Exam (IME), Medical Care, Section 8(a) Petition, Temporary Total Disability (TTD)