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ILLINOIS WORKERS’ COMPENSATION COMMISSION
NOTICE OF 19(b) ARBITRATOR DECISION

ALGUIRE,  DAVID Case# QVQQJQ
Employee/ Peti...
STATE OF ILLINOIS )

 
 

[: l Injured Workers’ Benefit Fund (§4(d))

    
   
 

)SS- l: l Rate Adjustment Fund (§8(g))
CO...
FINDINGS

On the date of accident,  10-22-13, Respondent was operating under and subject to the provisions of the Act. 
On...
STATE OF ILLINOIS

COUNTY OF COOK

ILLINOIS WORKERS’ COMPENSATION COMMISSION
ARBITRATION DECISION

David Alguire 13 WC 357...
Petitioner stated that afier he slipped and fell onto his fit knee he did not seek medical
treatment but instead waited unti...
;~

Petitioner underwent an IME with Dr.  Joshua Jacobs on June 23, 2014. RX 1 ex.  2. Dr. 

Jacobs is a Professor and the...
injured his lefi knee and the need for crutches was due to surgery on his right knee.  Id.  Petitioner
underwent left knee ...
CTA machinist receives two knee replacements
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CTA machinist receives two knee replacements

Arbitrator Decision
19 b arbitrator decision 13 wc 035779

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CTA machinist receives two knee replacements

  1. 1. ILLINOIS WORKERS’ COMPENSATION COMMISSION NOTICE OF 19(b) ARBITRATOR DECISION ALGUIRE, DAVID Case# QVQQJQ Employee/ Petitioner nwcozgoez CHICAGO TRANSIT AUTHORITY Employer/ Respondent On 9/15/2015, an arbitration decision on this case was filed with the Illinois Workers’ Compensation Commission in Chicago, a copy of which is enclosed. ' If the Commission reviews this award, interest of 0.26% shall accrue from the date listed above to the day before the date of payment; however, if an employee’s appeal results in either no change or a decrease in this award, interest shall not accrue. A copy of this decision is mailed to the following parties: 1067 ANKIN LAW OFFICE SCOTT GOLDSTEIN 162 W GRAND AVE SUITE 1810 CHICAGO, IL 60654 0515 CHICAGO TRANSIT AUTHORITY DEREK FALLST ROM 515 W LAKE ST 6TH FL CHICAGO. IL 60661 I
  2. 2. STATE OF ILLINOIS ) [: l Injured Workers’ Benefit Fund (§4(d)) )SS- l: l Rate Adjustment Fund (§8(g)) COUNTY OF Cook ) E Second Injury Fund (§8(e)l8) X None of the above ILLINOIS WORKERS’ COMPENSATION COMMISSION ARBITRATION DECISION 19(b) David Alguire Case # 1§ WC 35779 Employee/ Petitioner v. Consolidated cases: 13 WC 29062 Chicago Transit Authority Employer/ Respondent An Application for Adjustment of Claim was filed in this matter, and a Notice of Hearing was mailed to each party. The matter was heard by the Honorable Kurt Carlson, Arbitrator of the Commission, in the city of Chicago, on July 8, 2015. After reviewing all of the evidence presented, the Arbitrator hereby makes findings on the disputed issues checked below, and attaches those findings to this document. DISPUTED ISSUES A. I: Was Respondent operating under and subject to the Illinois Workers’ Compensation or Occupational Diseases Act? . El Was there an employee-ernployer relationship? . l: l Did an accident occur that arose out of and in the course of Petitioner's employment by Respondent? . El What was the date of the accident? D Was timely notice of the accident given to Respondent? XI Is Petitioner's current condition of ill-being causally related to the injury? . D What were Petitioner's earnings? . D What was Petitioner's age at the time of the accident? D What was Petitioner's marital status at the time of the accident? IE Were the medical services that were provided to Petitioner reasonable and necessary? Has Respondent paid all appropriate charges for all reasonable and necessary medical services? K. Is Petitioner entitled to any prospective medical care? L. E What temporary benefits are in dispute? I: ] TPD El Maintenance IE TTD M. I: Should penalties or fees be imposed upon Respondent? N. l_—_l Is Respondent due any credit? 0. | :] Other lCArbDecl9(b) 2/10 100 W. Randolph Street #8400 Chicago, IL 60601 312/814-6611 Toll-free 866/352-3033 Web site: www. iwt. 'c. il. gov Downstale oflices: Collimville 618/346-3450 Peoria 309/671-3019 Rockford 815/987-7292 Sprinyield 217/785-7084 . ~<t-tmcarztrnuoua
  3. 3. FINDINGS On the date of accident, 10-22-13, Respondent was operating under and subject to the provisions of the Act. On this date, an employee-ernployer relationship did exist between Petitioner and Respondent. On this date, Petitioner did sustain an accident that arose out of and in the course of employment. Timely notice of this accident was given to Respondent. Petitioner's current condition of ill-being is causally related to the accident. In the year preceding the injury, Petitioner eamed $91,353.60; the average weekly wage was $1,756.80. On the date of accident, Petitioner was 57 years of age, single with 0 dependent children. Respondent has not paid all reasonable and necessary charges for all reasonable and necessary medical services. Respondent shall be given a credit of $45,457.20 for TTD, $0 for TPD, $0 for maintenance, and $0 for other benefits, for a total credit of $45,457.20. Respondent is entitled to a credit of $0 under Section 80) of the Act. ORDER Petitioner’s bilateral knee condition is causally related to the incident of October 22, 2013. Respondent shall pay reasonable and related medical expenses for the Petitioner’s bilateral knee condition in the amount of $141 .00 to Orthopaedics of North Shore pursuant to Section 8(a) and 8.2 of the Act. Respondent is liable for past medical expenses incurred for treatment to Petitioner’s bilateral knee condition. Respondent liable for prospective medical care to Petitioner’s bilateral knee condition, including but not limited to bilateral total knee replacement surgery prescribed by Dr. Silver. Respondent shall pay Petitioner temporary total disability benefits of $ 1,171.07 / week for 89 1/7 weeks, commencing on October 23 2013 through July 8, 2015, as provided in Section 8(b) of the Act. -————«—I-fl—: -‘. .-. *.. -. . -.. : . .e : :.-e: . 5 medical benefits or compensation for ate ‘I an po - ary or permannt disability, if any. RULES REGARDING APPEALS Unless a party files a Petition for Review within 30 days after receipt of this decision, and perfects a review in accordance with the Act and Rules, then this decision shall be entered as the decision of the Commission. STATEMENT or INTEREST RATE If the Commission reviews this award, interest at the rate set forth on the Notice of Decision of Arbitrator shall accrue from the date listed below to the day before the date of payment; however, if an employee's appeal results in cit 0 change or a decrease in this award, interest shall not accrue. 09-15-15 Date
  4. 4. STATE OF ILLINOIS COUNTY OF COOK ILLINOIS WORKERS’ COMPENSATION COMMISSION ARBITRATION DECISION David Alguire 13 WC 35779 V. Chicago Transit Authority MEMORANDUM OF DECISION OF ARBITRATOR This matter proceeded to trial on July 8, 2015. Petitioner testified that he works for the Chicago Transit Authority (CTA) as a machinist. He stated his job duties include running lathes, operating drill presses, and using grinders. Petitioner testified that he is responsible for cutting metal for parts for CTA buses and trains. He stated that certain tasks, such as removing screws Petitioner testified that over the 18 months prior to the October, 22, 2013 incident he felt general pain which he described as achy, normal discomfort. He filed a workers’ compensation claim for repetitive trauma. Petitioner testified that he mentioned his discomfort from kneeling to his manager during a discussion about different techniques available for working on the bus was cutting metal on a lathe when he twisted his right knee as he reached for a part on the other end of the lathe. His right foot “kinda stuck” to the rubber mat, as a result it twisted and he fell to the floor. Petitioner testified that he felt his right knee pop. At the time, he was standing on a rubber mat and was wearing safety shoes. Petitioner testified that he initially sought treatment at the emergency room and then sought treatment with Dr. Ronald Silver. Petitioner stated that on October 23, 2013, Dr. Silver ordered an MRI of his right knee, which was performed on November 4, 2013. Dr. Silver also prescribed physical therapy. Petitioner stated he followed up with Dr. Silver after his MRI and Dr. Silver recommended surgery. He stated he underwent right knee surgery on January 15, 2014.
  5. 5. Petitioner stated that afier he slipped and fell onto his fit knee he did not seek medical treatment but instead waited until his next appointment with Dr. Silver. At his next office visit, Dr. Silver recommended an MRI of Petitioner’s left knee and then recommended surgery. Left knee surgery was performed on May 9, 2014. As accident was not disputed, the Petitioner received workers’ compensation benefits until June 29, 2014. He testified that Dr. Silver has recommended bilateral knee replacement surgery. Petitioner continues to treat with Dr. Silver. On cross-examination Petitioner agreed he worked out of the South Shops. He testified that he had filed prior short term disability and workers’ compensation claims. Regarding the repetitive trauma claim, Petitioner testified that he did not remember when he discussed the kneeling complaints with his supervisor. He stated he never completed any injury on duty paperwork regarding that claim. Petitioner stated he was at his home the day after his right knee surgery when he fell injuring his left knee. He testified that he caused water to splash onto the floor of the bathroom in his home while washing his hands. He agreed this could’vc happened at any time while washing his hands. Petitioner stated there was nothing defective with the crutches at the time of his fall. Petitioner stated he underwent an Independent Medical Examination (IME) with Dr. Joshua Jacobs on June 23, 2014. He testified he was truthful and honest with Dr. Jacobs during the examination. Respondent’s doctor stated the Petitioner suffers from bilateral osteoarthritis and degenerative meniscal tears. Both conditions were pre-existing. The Petitioner could retum to work with restrictions. Any work or home injury was simply a temporary exacerbation of a pre-existing condition. Petitioner was at maximum medical improvement, but agreed with Dr. Silver’s opinion that the Petitioner needed bilateral total knee replacement surgery. " F. CAUSAL CONNECTION The Arbitrator finds that both knee conditions were permanently aggravated, accelerated or exacerbated by his work accident on October 22, 2013.. Regarding Petitioner’s right knee, Petitioner initially treated with Dr. Ronald Silver on October 22, 2013.. PX 1 p. 7. Dr. Silver ordered an MRI, which revealed 21 tom medial meniscus of Petitioner’s right knee. Id. at 10. Dr. Silver recommended arthroscopic surgery, which he performed on 1/ 15/2014. Id. at 1 1. The surgery consisted of partial medial and lateral meniscectomies, a synovectomy, removal of adhesions, and removal of loose cartilage. Id. Dr. Silver also noted severe cartilage damage. Id. Following the right knee surgery, Petitioner testified that his knee felt better temporarily. Petitioner continues to treat with Dr. Silver for his right knee. Dr. Silver has . __ n -. .-A g | n. ..‘ Oto 2, 013aidn. I
  6. 6. ;~ Petitioner underwent an IME with Dr. Joshua Jacobs on June 23, 2014. RX 1 ex. 2. Dr. Jacobs is a Professor and the Chairman of the Department of Orthopaedic Surgery at Rush Medical College and the Senior Attending Orthopedic Surgeon at Rush University Medical Center. RX 1 ex. 1. Dr. Jacobs reviewed Petitioner’s treatment records and physically examined him. RX 1 ex. 2. He diagnosed Petitioner with bilateral osteoarthritis of the knees. RX 1 p. 9. Dr. Jacobs testified that osteoarthritis is a wear and tear, degeneration, of the cartilage in the knee. Id. He testified that the right knee arthroscopic medial meniscal repair was related to the 10/22/2013 incident. RX 1 p. 15. However, Dr. Jacobs testified that the cause of Petitioner’s current complaints is pre-existing osteoarthritis of his knees. RX 1 p. 1 1. He testified that he believes Petitioner’s condition to be pre-existing because the findings on the radiographs showed joint space narrowing as early as the day of his injury and also Petitioner’s history of knee pain for at least 18 months prior to this injury. Id. Dr. Silver had an opportunity to review Dr. Jacobs’ report on 8/01/2014 and agreed that Petitioner has pre-existing degenerative arthritis of both knees. PX . While Dr. Jacobs did agree that Petitioner requires a right total knee replacement, he opined the need for that procedure was caused by Petitioner’s pre-existing osteoarthritis. RX 1 pp. 12-13. He stated that Petitioner’s osteoarthritis is progressive in nature and the typical outcome is a knee arthroplasty. Id. at 18. finds the opinion of Dr. Jacobs less credible and persuasive than that of the treating physician, Dr. Silver. Dr. Jacobs based this opinion on his examination of Petitioner and review of the treatment records and diagnostics. Specifically, Dr. Jacobs indicated the findings on the radiographs of Petitioner’s bilateral knees showed joint space narrowing as early as October 22, 2013, in addition to bilateral tricompartrnental osteoarthritis. While it is true that Petitioner suffered fiom knee pain for at least 18 months prior to the injury, he did not a significant amount of lost time fi'om work and had no prescription for knee surgery. Based on the evidence presented by both parties and Petitioner’s testimony, the Arbitrator finds that Petitioner’s current right knee condition is causally related to the October 22, 2013 incident. Regarding Petitioner’s lcfi knee, Petitioner testified that he injured his lefi knee on January 16, 2014, the day following his right knee arthroscopy. He stated he was at his home and proceeded to use the bathroom. Petitioner testified that while washing his hands he splashed water onto the hardwood floor of the bathroom. The tip of one of the crutches he was using came fell to the floor. He testified there was nothing defective with the crutches. Petitioner testified that he did not seek immediate treatment afier the fall, but waited until his next appointment with Dr. Silver to have his left knee examined. Petitioner saw Dr. Silver on January 29, 2014 where an MRI of the lefi knee was prescribed and later performed on February 7, 2014. It revealed a lefi knee torn medial meniscus. Id. Dr. Silver recommended arthroscopic surgery. Dr. Silver felt the left knee injury was related to the original accident because Petitioner was allegedly using crutches when he
  7. 7. injured his lefi knee and the need for crutches was due to surgery on his right knee. Id. Petitioner underwent left knee arthroscopic surgery on May 9, 2014. He testified that he felt relief temporarily following surgery. Dr. Silver has since recommended left knee replacement surgery. The Arbitrator finds that Petitioner’s left knee condition is causally connected to the October 22, 2013 incident. Petitioner admittedly injured his left knee at home on or about January 16, 2014. The injury occurred when he slipped and fell on a wet floor. The floor was wet due to Petitioner himself splashing water on the floor while washing his hands. Although Petitioner testified he was using crutches at the time, because he was recovering from his right knee surgery, he testified that the crutches were in no way defective. Accordingly, the Arbitrator finds causal connection between Petitioner’s left knee condition and the October 22, 2013 accident. J. MEDICAL Based on the medical evidence and Petitioner’s testimony, the Arbitrator finds that Respondent is liable for reasonable and related medical expenses related to both knees. K. PROSPECTIVE MEDICAL Based on the medical evidence and Petitioner’s testimony, the Arbitrator finds that Respondent is liable for prospective medical expenses for treatment to both Petitioners’ knees including bilateral total knee replacement surgeries. L. TTD Based on the medical evidence and Petitioner’s testimony, the Arbitrator finds that TTD benefits were appropriately paid from October 23, 2013 to July 29, 2014 and shall receive a credit in the amount of $45,457.20 for the same. Further TTD benefits are due to the present.

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