Mansfield v. Ill. Workers' Comp. Comm'n

• Decision Date: 21 November 2013
• Docket Number: Docket No. 2–12–0909 WC.
• Citation: 376 Ill.Dec. 657,999 N.E.2d 832
• Parties: Cindy MANSFIELD, Appellant and Cross–Appellee, v. The ILLINOIS WORKERS' COMPENSATION COMMISSION, et al. (Naperville Park District, Appellee and Cross–Appellant).
• Court: United States Appellate Court of Illinois

999 N.E.2d 832

376 Ill.Dec. 657

Cindy MANSFIELD, Appellant and Cross–Appellee,

v.The ILLINOIS WORKERS' COMPENSATION COMMISSION, et al. (Naperville Park District, Appellee and Cross–Appellant).

Docket No. 2–12–0909 WC.

Appellate Court of Illinois, Second District.

Nov. 21, 2013

Affirmed in part and reversed in part, cause remanded with directions. Anthony L. Russo, Sr., of Russo & Russo, Ltd., of Wheaton, for appellant.

Jeffrey B. Huebsch, of Power & Cronin, Ltd., of Oak Brook, for appellee.

OPINION

Justice HARRIS delivered the judgment of the court, with opinion.

¶ 1 On March 19, 2004, claimant, Cindy Mansfield, filed two applications for adjustment of claim pursuant to the Workers' Compensation Act (Act) (820 ILCS 305/1 through 30 (West 2002)), seeking benefits from the employer, Naperville Park District, for injuries suffered to her low back, legs, neck, and arms on July 23, 2003 (No. 04WC13562), and on September 9, 2003 (No. 04WC13563).

¶ 2 Following a consolidated hearing, an arbitrator issued a separate decision for each case. Regarding the injury suffered on July 23, 2003, the arbitrator found that claimant proved she sustained injuries arising out of and in the course of her employment with the employer on that date. Specifically, the arbitrator found claimant “suffered a lumbar strain as a result of the initial injury on July 23, 2003, and that a causal relationship existed between said work injury and her condition of ill-being up through the date of the second injury on September 9, 2003, the subject of claim 04 WC 13563.” However, the arbitrator found claimant failed to prove she was entitled to temporary total disability (TTD) benefits and medical expenses from July 23, 2003, the date of the first accident, to September 9, 2003, the date of the second accident. The arbitrator stated his intent to address the issue of the nature and extent of claimant's injuries in his order in case No. 04WC 13563. Neither party sought review of the arbitrator's decision (No. 04WC 13562) before the Commission.

¶ 3 Regarding the injury suffered on September 9, 2003 (No. 04WC 13563), the arbitrator found claimant proved she sustained injuries arising out of and in the course of her employment with the employer on September 9, 2003, and “a causal relationship existed between the accident on September 9, 2003 and Petitioner's current condition of ill-being, including the need for the surgery she eventually underwent on December 13, 2004.” The arbitrator determined claimant's average weekly wage was $437.50, and awarded claimant TTD benefits in the amount of $291.67 per week, from September 9, 2003, through July 5, 2005; permanent partial disability (PPD) benefits in the amount of $262.50 per week for 125 weeks, representing 25% loss of her person as a whole; and medical expenses in the amount of $108,554.15.

¶ 4 The employer filed a petition for review of the arbitrator's decision (case No. 04WC 13563) before the Illinois Workers' Compensation Commission (Commission). On review, the Commission modified the arbitrator's decision finding claimant failed to prove a causal relationship between her injury on September 9, 2003, and her condition of ill-being after April 30, 2004. The Commission awarded claimant TTD benefits in the amount of $291.67 per week, from September 11, 2003, through April 12, 2004; PPD benefits in the amount of $262.50 per week for 50 weeks, representing 10% loss of her person as a whole; and medical expenses in the amount of $5,416.54. The Commission otherwise affirmed and adopted the arbitrator's decision.

¶ 5 Thereafter, both claimant and the employer filed petitions seeking judicial review in the circuit court of DuPage County. The circuit court modified the Commission's decision, finding claimant's average weekly wage was $517.56 and directing the Commission “to recalculate the average weekly wage and the benefits allowed in conformity with this Opinion.” The court otherwise confirmed the Commission's decision.

¶ 6 Claimant appeals, arguing the Commission's findings regarding causation, average weekly wage, TTD benefits, PPD benefits, and medical expenses are against the manifest weight of the evidence. The employer cross-appeals, arguing the Commission incorrectly calculated claimant's average weekly wage as including profits from claimant's self-employment providing piano lessons in her home.

¶ 7 I. BACKGROUND

¶ 8 The following factual recitation is taken from the evidence presented at the consolidated arbitration hearing.

¶ 9 The 47–year–old claimant testified that she began work teaching various preschool classes for the employer in approximately 1999. Claimant worked between 12 and 20 hours each week depending on class offerings and student enrollment. Claimant also taught piano in her home. She worked approximately the same number of hours from home as for the employer.

¶ 10 On July 23, 2003, claimant assisted two-year-olds with a program for their parents. Near the end of the program, claimant felt a child standing immediately behind her. In an effort to avoid falling on the child, claimant leaped back and fell on her low back, bottom, and arm. As a result, claimant experienced soreness in her back, arms, and shoulders. According to a wage statement prepared by the employer, claimant continued to work, reporting 9.75 hours worked for the pay period including July 26, 2003, through August 8, 2003. Claimant testified she did not seek immediate treatment because she thought she had bruised something and it would heal.

¶ 11 Claimant testified she had never injured her back prior to July 23, 2003, and did not have chronic problems with her back. Claimant identified her family doctor as Dr. Brian O'Leary, an internist. Claimant first treated with Dr. O'Leary in approximately 1994. Dr. O'Leary's treatment notes on April 18, 1994, reference claimant's 15–year history of muscle pain in the low back, and at times, in the neck and upper back. The treatment notes from 1994 through approximately 2008 make multiple references to claimant's fibromyalgia.

¶ 12 Claimant remained sore and at the direction of the employer sought treatment on August 7, 2003, with Dr. Vimal Patel, a doctor of osteopathy at Edward Corporate Health. Dr. Patel noted (1) tenderness bilaterally over the SI joint and (2) the lumbar spine X-rays were normal. Dr. Patel diagnosed lumbar strain and bilateral SI strain. He prescribed naproxen and a course of physical therapy. Dr. Patel's medical notes state that claimant was off of school and, thus, did not require specific work restrictions. A physical therapy evaluation prepared on August 8, 2003, states claimant suffered from chronic right knee pain, fibromyalgia, and hypertension, and had multiple abdominal surgeries. Claimant returned to Dr. Patel on August 21, 2003. She reported attending four physical therapy sessions and that it had helped significantly. Dr. Patel's treatment note states that claimant “for the most part * * * feels better.” Dr. Patel recommended one more week of physical therapy and no restrictions. Claimant was to resume work in September 2003, with the fall programing session. Claimant last attended physical therapy through Edward Hospital on September 4, 2003. A physical therapy summary noted claimant had attended four of nine visits.

¶ 13 The employer began new class offerings on September 8, 2003, and claimant resumed teaching for the employer. On September 9, 2003, claimant reached for a toddler who was running toward a classroom door and “fell into the door and made [her] back worse.” Claimant sought treatment from chiropractor Dr. Brad Pins on September 11, 2003. Claimant gave a history of the work accident on July 23, 2003. Dr. Pins' treatment notes reference a “continuing trauma” following the work accident on July 23, 2003, and include a reference to the work accident on September 9, 2003. Dr. Pins recommended “extreme limited duty” on September 11, 2003, and removed claimant from work on February 12, 2004. Dr. Pins treated claimant two or three times a week until April 12, 2004. Claimant experienced pain throughout her treatment with Dr. Pins and reported minimal improvement.

¶ 14 Claimant underwent a magnetic resonance imaging (MRI) of her lower back on September 16, 2003, read by chiropractic radiologist Dr. John A. Aikenhead. Dr. Aikenhead's impression was L5–S1 left lateral herniation compromising the canal and the foramen and small Modic changes at the adjacent endplates.

¶ 15 On September 22, 2003, claimant completed an initial patient history with the Synergy Institute, a physical therapy provider. Claimant identified fibromyalgia as a previous injury. Further, claimant wrote she was unable to work for the employer because she could not pick up the children but she was teaching piano at home, although in pain. Claimant identified a herniated disc as her major complaint and reported losing work days since her July 2003 accident.

¶ 16 On October 28, 2003, claimant was examined by Dr. David Spencer, at the request of the employer. Dr. Spencer is an orthopedic surgeon with a spine surgery practice at Lutheran General Hospital, Park Ridge, Illinois. According to his treatment notes, claimant reported work accidents on July 23, 2003, and September 9, 2003. Claimant did not seek immediate treatment following the July 2003 accident because she had a history of back pain and fibromyalgia and based on that history, believed she would get better. In a pain diagram, claimant noted occasional right leg “pins and needles,” constant stabbing pain across the low back, and constant low back aching on the left side. The September 16, 2003, MRI showed degenerative changes and a small disc herniation on the left at L5–SI without neurologic compromise. Dr. Spencer recommended claimant remain off work and prescribed four additional weeks of physical therapy. Dr. Spencer anticipated claimant would return to full activities without...