MORE FAVORABLE FIRM OUTCOMES - Disproving Entitlement to Permanent Disability and Medical Expenses
Robert Ulrich successfully argued to the Commission that a workers' compensation claimant failed to prove she sustained any permanent disability in Tracie Galloway v. Aldi, 09 IWCC 0808. Though the petitioner established that she performed repetitive wrist flexion activities as part of her job duties and that those activities were a cause or aggravating factor in the development of bilateral carpal tunnel syndrome, her Arbitration testimony that she had an uneventful recovery from release surgeries and a great deal of improvement was cited by the Commission in vacating the arbitrator's awards of 15% loss of use of each hand. The Commission noted that the petitioner testified that she was "a hundred percent better" and had no ongoing problems with her hands.
Although Illinois law does not have standardized awards for particular injuries, arbitrators and the Commission all too often render permanency awards based solely on the diagnosis and treatment. The Commission here clearly followed the mandate that permanent disability is not automatic and must be proven. As it was not proven in this case, the Commission properly denied entitlement to permanency and vacated the rather "standard" awards of the arbitrator.
Robert T. Newman of our firm also obtained a favorable outcome from a very pro-petitioner arbitrator who denied over $24,000 in chiropractic charges. The employer had paid for three months’ worth of chiropractic care until its examining physician opined that the employee had sustained only a sprain/strain injury and required no further treatment. The employee himself testified before the arbitrator that initial chiropractic treatment provided some relief, but after a few months any benefit was temporary and minimal. Another examiner had opined that the maximum benefit available from chiropractic methods or modalities occurred within six to ten weeks of treatment. Based on this evidence, the arbitrator found that the unpaid portion of the chiropractic bill was unreasonable and could not be collected from the employee either. In the same decision, the arbitrator knocked $2000 off the bill of another provider of therapy and injections, awarding only amounts for treatment rendered after the cessation of chiropractic care and limiting recovery to the amounts provided for in the Medical Fee Schedule.
As seen in many other cases, chiropractors treat injured workers month after month with minimal or no improvement. Often, the records themselves show no change in physical findings. Yet, arbitrators and commissioners have historically been reluctant to deny mounting chiropractic charges. This case outcome indicates the importance of having a physician conduct an independent medical examination and review of ongoing chiropractic or even therapy records and opine as to the lack of any benefit from the treatment. Thus, an arbitrator or the Commission has a basis to find that the ongoing was neither reasonable or necessary to cure or relieve the effects of an injury. Here, it also helped that the claimant himself admitted he got no relief from the chiropractic care.
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