Worker’s Compensation

UPDATE

Illinois Law Update

Qualifications of a Commissioner

 

Christopher Sleeter v. Industrial Commission, No. 4-02-1044 WC

 

             This case discussed the qualifications of a Commissioner. Petitioner, a warehouse worker, sought benefits for injuries he suffered during a fall backwards while carrying a box weighing approximately 80 pounds.

 

             The arbitrator found that Petitioner proved that he suffered accidental injuries arising out of and in the course of his employment and awarded benefits.  The Industrial Commission reversed the arbitrator’s decision finding that Petitioner failed to prove his alleged fall.  In particular, the Commission found Petitioner’s testimony to be “grossly inconsistent with the more trustworthy contemporaneous medical histories.” The Circuit Court affirmed the decision of the Commission.

 

             On appeal to the Appellate Court, Petitioner for the first time raised the argument that the Commission’s decision was void because Commissioner Madigan, a member of the commission panel, was not qualified to serve as a Commissioner.  In particular, Petitioner argued that he could find no “discussion” of Mr. Madigan’s “labor relations experience” in the Illinois Senate confirmation hearing transcript of November 7, 2001, nor in the various letters of appointment by the governor.  Based thereon, Petitioner argued that Mr. Madigan was unqualified to serve as a commissioner.

 

             The Appellate Court, in a 3-2 decision, rejected Petitioner’s arguments and affirmed the decision of the Circuit Court.  In so doing, the Appellate Court noted that the Workers’ Compensation Act requires that commissioner candidates must have at least one of the following credentials: 1.  A license to practice law in Illinois; 2.  At least three years of service as an arbitrator for the Industrial Commission; or 3.  At least four years of professional labor relations experience. 

    

====================================================================

“…the Appellate Court pointed out that the statute specifically provides that a

commission chairman candidate’s experience be determined by the governor”

====================================================================

 

             The Appellate Court stated that it did not find persuasive Petitioner’s argument that because he could not find “discussion” of Mr. Madigan’s labor relations experience in the Senate transcript nor the various letters of appointment by the governor, that Mr. Madigan did not have the required labor relations experience to serve as a commissioner.  In particular, the Appellate Court noted that Petitioner did not cite any authority for a required “discussion” in the Senate or for a requirement that the various letters of appointment prepared by the governor set forth the commissioner candidate’s labor relations experience.  Furthermore, the Appellate Court pointed out that the statute specifically provides that a commission chairman candidate’s experience be determined by the governor.  Finally, the Appellate Court stated that there was nothing in the record to suggest that Mr. Madigan was not qualified to serve as a commissioner and likewise there was no showing that the appointment was improper.

 

             The two dissenting judges based their dissent on the fact that there was no dispute that Mr. Madigan did not meet the first two possible criteria in that he was neither a lawyer nor had he served as an arbitrator.  In addition, they noted that there was a dispute as to whether Mr. Madigan had the four years of professional labor relations experience, under the third possible criteria.

 

             Based on this decision, it appears as though the courts will not disturb the gubernatorial appointment of Industrial Commission Commissioners nor will they inquire of the Senate confirmation process.

 

Indiana Law Update

 

Plaintiffs May Now Have A “Good Reason”

For Unauthorized Medical Care

 

             In a recent decision, the Indiana Supreme Court created a new test to determine whether workers’ compensation plaintiffs may have a “good reason” exception to the general rule that only authorized medical care will be paid for by the employer.

 

             Daugherty v. Industrial Contracting & Erecting, 802 N.E.2d 912, (Ind. 2004), involved a plaintiff with a knee injury.  Plaintiff was evaluated by an Independent Medical Examiner appointed by the Industrial Board, who found him to be at maximum medical improvement.  Plaintiff disagreed with this finding and sought treatment on his own.  Plaintiff’s doctor recommended a knee replacement, which was not authorized by the employer.  Plaintiff elected to proceed with the surgery and had a successful result.

 

             The Board denied the bills, which finding was affirmed by the Appellate Court.  In reversing this decision, the Supreme Court pointed out that there are three exceptions to the general rule disallowing the plaintiff to obtain unauthorized medical treatment, one of which is for “other good reason.”  Ind. Code 22-3-3-4(d).

 

====================================================================

“Plaintiff’s doctor recommended a knee replacement, which was not authorized by the employer.”

====================================================================

   

             Indiana had no interpretation on this, but the Court looked favorably on a Virginia case which provided a test for “good reason.”  That test is in three parts.  First, the employee must act in good faith in obtaining alternate treatment. Second, the treatment provided by the employer must prove to be not adequate for the condition.  Third, the unauthorized treatment must be reasonable and appropriate, which the Court defines as the functional equivalent of the Indiana language that requires the treatment to be “reasonable and necessary.” Daugherty at 918-19.

 

             Plaintiff in Daugherty complied with all three parts of the test, according to the Court.  First, he acted in good faith by requesting approval for the surgery, and the second part of the test was passed because he continued to have pain despite the MMI finding.  The third part was passed based on the plaintiff doctor’s finding that the surgery was required (and successful).

 

             We advise our Indiana clients to be watchful for those claimants who are never satisfied with their treatment results.  An aggressive plaintiff’s attorney may try to use this case to justify doctor shopping.  For questions or recommendations on handling this type of situation, please contact our office.  

 

The attorneys at BryceDowney constantly strive to keep you updated regarding the latest developments in Illinois and Indiana workers’ compensation law. If you would like more information on any of the topics discussed above, or have any questions regarding these issues or any aspect of Illinois and Indiana Workers’ Compensation Law, please contact Richard Lenkov at (312) 327-0032 or rlenkov@brycedowney.com, or any member of our workers’ compensation team.© Copyright 2005 by BryceDowney, LLC, all rights reserved.  Reproduction in any other publication or quotation is forbidden without express written permission of copyright owner.

News & Events