In arbitration, Mr. Goldstein was able to secure a very favorable decision for the grounds worker who was awarded: temporary total disability benefits of $722.20/week for 61 weeks; 6% loss of use of the person as a whole which corresponds to 30 weeks of permanent partial disability benefits at a weekly rate of $649.97; and payment of outstanding medical services totaling $9,133.89.
Scott Goldstein Represents Slip and Fall Victim in Arbitration
1. ILLINOIS WORKERS’ COMPENSATION COMMISSION
DECISION SIGNATURE PAGE
Case Number
Case Name v. State of Illinois
Consolidated Cases
Proceeding Type
Decision Type Arbitration Decision
Commission Decision Number
Number of Pages of Decision 9
Decision Issued By , Arbitrator
Petitioner Attorney Scott Goldstein
Respondent Attorney Joseph
DATE FILED: 11/30/2022
THE INTEREST RATE FOR THE WEEK OF NOVEMBER 29, 2022 4.55%
,Arbitrator
Signature
CERTIFIED as a true and correct copy
pursuant to 820 ILCS 305/14
November 30, 2022
, Secretary
Illinois Workers’ Compensation Commission
2. STATE OF ILLINOIS )
Injured Workers’ Benefit Fund (§4(d))
)SS. Rate Adjustment Fund (§8(g))
COUNTY OF Cook ) Second Injury Fund (§8(e)18)
None of the above
ILLINOIS WORKERS’ COMPENSATION COMMISSION
ARBITRATION DECISION
Case # WC
Employee/Petitioner
v. Consolidated cases:
State of Illinois
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 , Arbitrator of the Commission, in the city of
Chicago, on 9/30/22 After reviewing all of the evidencepresented, the Arbitrator hereby makes findings on
the disputed issues checked below, and attaches those findings to this document.
DISPUTED ISSUES
A. Was Respondent operating under and subject to the Illinois Workers' Compensation or Occupational
Diseases Act?
B. Was there an employee-employer relationship?
C. Did an accident occur that arose out of and in the course of Petitioner's employment by Respondent?
D. What was the date of the accident?
E. Was timely notice of the accident given to Respondent?
F. Is Petitioner's current condition of ill-being causally related to the injury?
G. What were Petitioner's earnings?
H. What was Petitioner's age at the time of the accident?
I. What was Petitioner's marital status at the time of the accident?
J. 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. What temporary benefits are in dispute?
TPD Maintenance TTD
L. What is the nature and extent of the injury?
M. Should penalties or fees be imposed upon Respondent?
N. Is Respondent due any credit?
O. Other
ICArbDec 2/10 69 W. Washington, 9th Floor, Chicago, IL 60602 312/814-6611 Toll-free 866/352-3033 Web site: www.iwcc.il.gov
Downstate offices: Collinsville 618/346-3450 Peoria 309/671-3019 Rockford 815/987-7292 Springfield 217/785-7084
3. FINDINGS
On March 1, 2016, Respondent was operating under and subject to the provisions of the Act.
On this date, an employee-employer 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 earned $56,331.08; the average weekly wage was $1,083.29.
On the date of accident, Petitioner was 29 years of age, single with 2 dependent children.
Petitioner has received all reasonable and necessary medical services.
Respondent has not paid all appropriate charges for all reasonable and necessary medical services.
Respondent shall be given a credit of $41,020.75 for TTD, $0 for TPD, $0 for maintenance, and $0 for other
benefits, for a total credit of $41,020.75.
Respondent is entitled to a credit of $0.00 under Section 8(j) of the Act.
ORDER
Respondent shall pay Petitioner directly for the following outstanding medical services, pursuant to the medical
fee schedule and Sections 8(a) and 8.2 of the Act: Orland Park Orthopedics ($5,450.89); Advocate Trinity
Hospital ($2,732.00); and City of Chicago EMS ($951.00).
Respondent shall pay Petitioner temporary total disability benefits of $722.20/week for 61 weeks (3/2/16 to
10/31/16 and 12/19/16 to 6/19/17), as provided in Section 8(b) of the Act.
The Arbitrator makes an award of 6% loss of use of the person as a whole under Section 8d2 which corresponds
to 30 weeks of permanent partial disability benefits at a weekly rate of $649.97. See Conclusions of Law for
Arbitrator’s considerations under §8.1b(b) of the Act.
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 OF 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 either no change or a decrease in this award, interest shall not
accrue.
NOVEMBER 30, 2022
__________________________________________________
Signature of Arbitrator
4. 1
STATE OF ILLINOIS )
) SS
COUNTY OF COOK )
ILLINOIS WORKERS’ COMPENSATION COMMISSION
, )
)
Petitioner, )
)
v. )
) Case No. 16WC8939
State of Illinois, )
)
)
Respondent. )
FINDINGS OF FACT
This matter roceeded to hearing on September 30, 2022 in Chicago, Illinois before Arbitrator
on Petitioner’s Request for Hearing. Issues in dispute include causation, average
weekly wage, unpaid medical bills, temporary total disability “TTD,” and nature and extent of
the injury. Arbitrator’s Exhibit “Ax” 1.
Petitioner testified tha he worked as a grounds worker for the Respondent at Chicago State
University. Some of his job duties included maintenance of grounds, shoveling snow, and
cutting and trimming trees. Petitioner testified to having no medical history to the affected body
parts, his back, and his left shoulder, prior to his March 1, 2016 work injury. Petitioner testified
his wage at the time of the accident was $27.08 an hour and he worked 40 hours a week.
Petitioner testified that he worked the same 40 hours for the same rate of pay every week.
On March 1, 2016, Petitioner testified he was assigned a task to move a dumpster that blew
away from a building. As he was walking to move the dumpster he slipped and fell to the ground
on ice. He was helped up by a coworker and transported by ambulance to Advocate Trinity
Hospital with complaints of left arm and back pain. PX2.
At the hospital X-rays of the left arm and chest were normal. Id. He was diagnosed with a chest
wall contusion and a left shoulder strain and discharged the same day. Id. Four days later, he
presented to Family Care Partners with low back pain and was prescribed physical therapy and
taken off-work for 1 week. PX4. On March 18, 2016, he presented to Orland Park Orthopedics
(OPO) with left arm and low back pain. PX3. He underwent an MRI which showed rotator cuff
tendonitis, biceps tendonitis, but no evidence of a full-thickness tear. Id. He was again
prescribed physical therapy and taken off-work. Id. He began attending physical therapy at
OPO until June 1, 2016 when his treating physician said he would return to work full duty with
likely MMI in 4 weeks. Id.
5. 2
On June 6, 2016, he returned to OPO and stated he had significant scapular pain after returning
to work. Id. His physician took him off-work again and recommended further physical therapy.
Id. On July 16, 2026, he was cleared for light/medium duty. Id. On August 31, 2016, he
reported a setback of pain roughly two weeks prior. Id. On October 26, 2016, he was released
full duty with likely MMI in 4 weeks. Id.
On December 19, 2016, he returned to OPO and stated he had a setback of pain three weeks
prior. Id. He was again placed on modified duty and prescribed further physical therapy. Id.
On February 13, 2017, his physician again noted that he is beginning to plateau and instructed
him to return in two weeks. Id.
Res ondent sent Petitioner for a Section 12 Exam with Dr. C on March 20, 2017. Dr.
C provides causation for Petitioner and feels he has not yet reached MMI for at least another
3 to 4 weeks from the date of the exam. He suggested a trigger point injection for Petitioner as
additional treatment.
On March 27, 2017, he underwent an injection. PX3. On May 15, 2017, he underwent an MRI
that showed a small thoracic herniation. Id. On June 7, 2017, he was released full duty with
likely MMI in 4 weeks. Id.
On November 8, 2017, he returned to OPO complaining of increased left arm pain after carrying
a 5lb bucket. He was placed on modified duty and recommended for further therapy. Id. He
returned to OPO, and his physician kept him at full-duty, and continued to recommend therapy.
Id.
Petitioner was initially off of work from March 2, 2016 until October 31, 2016 and Respondent
paid TTD benefits for this period. Petitioner returned to work in a light duty capacity for
Respondent on November 1, 2016 until December 18, 2016. Petitioner testified that Respondent
could not accommodate his light duty restriction after December 18, 2021. Petitioner testified he
was off work from December 19, 2016 to June 19, 201. He did not return to work for Chicago
State.
Petitioner testified that his back and left shoulder still hurt constantly. He testified that he never
had pain or medical care in either body part before the March 1, 2016 work injury.
Petitioner testified that he is the founder, owner and manager of a company called
Construction that rehabs residential properties since 2015. He testified he doesn’t do physical
work relying on subcontractors instead. Petitioner manages and sells the properties when the
rehab process is complete. Petitioner continued to manage while off-work but could not recall
how much he earned from while he was off-work. He estimates the annual revenue of
Construction to be currently $200,000.00 most of which goes to the business.
6. 3
CONCLUSIONS OF LAW
The Arbitrator adopts the above Findings of Fact in support of the Conclusions of Law set forth
below.
Issue F, whether Petitioner’s current condition of ill-being is causally related to the injury,
the Arbitrator finds as follows:
To obtain compensation under the Act, a claimant must prove that some act or phase of his
employment was a causative factor in his ensuing injuries. A work-related injury need not be
the sole or principal causative factor, as long as it was a causative factor in the resulting
condition of ill-being. Even if the claimant had a preexisting degenerative condition which
made him more vulnerable to injury, recovery for an accidental injury will not be denied as long
as he can show that his employment was also a causative factor. Thus, a claimant may establish
a causal connection in such cases if he can show that a work-related injury played a role in
aggravating his preexisting condition. Sisbro, Inc. v. Industrial Comm'n, 207 Ill. 2d 193, 205,
797 N.E.2d 665, 278 Ill. Dec. 70 (2003). “A chain of events which demonstrates a previous
condition of good health, an accident, and a subsequent injury resulting in disability may be
sufficient circumstantial evidence to prove a causal nexus between the accident and the
employee’s injury.” International Harvester v. Industrial Com., 93 Ill. 2d 59, 63 442 N.E.2d 908
(1982).
Petitioner has demonstrated a previous condition of good health, an accident, and a subsequent
injury. Petitioner credibly testified that he did not have back and left shoulder pain (nor medical
care) before the March 1, 2016 work injury. Petitioner’s medical records document a causal
connection to his March 1, 2016 work injury. Further, causation was provided by Respondent’s
IME physician, Dr. C , as well.
The Arbitrator finds that Petitioner’s current condition of ill-being is causally related to
the injury of March 1, 2016.
Issue G, Petitioner’s earnings, the Arbitrator finds as follows:
Petitioner credibly testified that his wage at the time of the accident was $27.08 an hour and he
worked 40 hours a week. Petitioner further testified that he worked the same 40 hours for the
same rate of pay every week.
The Arbitrator finds that Petitioner’s earnings during the year preceding the injury were
$56,326.40 and the average weekly wage calculated pursuant to Section 10 of the Act was
$1,083.29.
7. 4
Issue J, whether the medical services that were provided to Petitioner were reasonable and
necessary and whether Respondent has paid all appropriate charges for all reasonable and
necessary medical services, the Arbitrator finds as follows:
Having found Petitioner’s current condition of ill-being causally related to his work accident, the
Arbitrator further finds Petitioner’s treatment to be reasonable and necessary. Petitioner’s
treatment included an ER visit by ambulance, physical therapy, medications, doctor’s visits, an
injection, and diagnostic testing by credible providers. Further, the treatment ordered and
recommended by Petitioner’s treating physicians align with the opinions of Respondent’s
Section 12 examiner.
Overall, the Arbitrator finds Petitioner’s treatment to be reasonable and necessary and
finds that Respondent has not paid for said treatment. As such, the Arbitrator orders
Respondent to pay Petitioner directly for the following outstanding medical services,
pursuant to the medical fee schedule and Sections 8(a) and 8.2 of the Act:
• Orland Park Orthopedics ($5,450.89)
• Advocate Trinity Hospital ($2,732.00)
• City of Chicago EMS ($951.00)
The parties stipulate that Respondent is entitled to a credit under Section 8(j) of the Act for any
amounts that have been paid by Petitioner’s group insurance. See also Perez v. Illinois Workers'
Compensation Comm'n, 2018 IL App (2d) 170086WC, ¶ 17, 96 N.E.3d 524.
Issue K, whether Petitioner is entitled to temporary total disability benefits, the Arbitrator
finds as follows:
A claimant is temporarily totally disabled from the time an injury incapacitates him from work
until such time as he is as far recovered or restored as the permanent character of his injury will
permit. Westin Hotel v. Indus. Comm’n, 372 Ill.App.3d 527, 542 (1st Dist. 2007).
In determining whether a claimant remains entitled to receiving TTD benefits, the primary
consideration is whether the claimant’s condition has stabilized and whether she is capable of a
return to the workforce. Interstate Scaffolding, Inc. v. Illinois Workers’ Comp. Comm’n, 236
Ill.2d 132, 148 (2010). Once an injured em7ployee's physical condition stabilizes, she is no
longer eligible for TTD benefits. Archer Daniels Midland Co. v. Indus. Comm’n, 138 Ill.2d 107,
118 (1990).
Petitioner testified that he was initially off work from March 2, 2016 until October 31, 2016
consistent with the medical records. Petitioner returned to work in a light duty capacity for
Respondent on November 1, 2016 until December 18, 2016, at which time Petitioner returned to
OPO and stated he had a setback of pain three weeks prior. Petitioner was placed on modified
duty. Petitioner testified that Respondent could not accommodate his light duty restriction after
December 18, 2021. On June 7, 2017, Petitioner returned to Dr. and was placed back on
full duty work effective June 20, 2017. (Px 3, p. 203).
8. 5
Petitioner drew a salary from his management of Construction, which he has done since
2015. This was in addition to his work for Respondent. Petitioner’s work with
Construction did not collide with any work restrictions he was given as he credibly testified that
he did not do any physical labor. The Arbitrator finds that Petitioner’s work with
Construction does not impede his claim for TTD.
Based on the above, the Arbitrator finds Respondent liable for 61 weeks of TTD benefits
(3/2/16 to 10/31/16 and 12/19/16 to 6/19/17) at a weekly rate of $722.20, which corresponds
to $44,054.20 to be paid directly to Petitioner. Respondent has paid TTD benefits in the
amount of $41,020.75.
Issue L, the nature and extent of the injury, the Arbitrator finds as follows:
In determining PPD benefits, Section 8.1b(b) of the Act directs the Commission to consider: "(i)
the reported level of impairment pursuant to subsection (a); (ii) the occupation of the injured
employee; (iii) the age of the employee at the time of the injury; (iv) the employee's future
earning capacity; and (v) evidence of disability corroborated by the treating medical records."
820 ILCS 305/8.1b(b); Con-Way Freight, Inc. v. Illinois Workers' Compensation Comm'n, 2016
IL App (1st) 152576WC, ¶ 22, 67 N.E.3d 959. “No single enumerated factor shall be the sole
determinant of disability." 820 ILCS 305/8.1b(b).
Under Section 8.1b(b)(i), the Arbitrator notes that no permanent partial disability impairment
report and/or opinion was submitted into evidence. The statute does not require the claimant to
submit an impairment rating. It only requires that the Commission consider such a report if in
evidence and regardless of which party submitted it. See Continental Tire of the Americas, LLC
v. Illinois Workers' Compensation Comm'n, 2015 IL App (5th) 140445WC, ¶ 17, 43 N.E.3d
556. Therefore, the Arbitrator gives no weight to this factor.
Under Section 8.1b(b)(ii), the occupation of the injured employee, the Arbitrator notes that
although Petitioner worked as a heavy labor job for Respondent as a grounds worker, he did not
return to work for Respondent. The Arbitrator therefore gives little weight to this factor.
Under Section 8.1b(b)(iii), the age of the employee at the time of the injury, the Arbitrator notes
that Petitioner was 29 years old at the time of the accident. The Arbitrator gives great weight to
this factor in favor of Petitioner as he is young, has some residual complaints of pain and has
many years in his working life ahead of him.
Under Section 8.1b(b)(iv), the employee's future earning capacity, the Arbitrator notes no known
impact on Petitioner’s future earning capacity. The Arbitrator gives great weight to this factor in
favor of Respondent.
Under Section 8.1b(b)(iv), evidence of disability corroborated by the treating medical records,
the Arbitrator gives great weight to this factor in favor of Petitioner. Petitioner’s left shoulder
MRI showed rotator cuff tendonitis, biceps tendonitis, but no evidence of a full-thickness tear.
Petitioner’s back MRI showed a small thoracic herniation. Petitioner’s treatment was
9. 6
conservative and limited to physical therapy, imaging, medication, one injection, and modified
work status. This is consistent with Petitioner’s testimony at trial of ongoing pain at present.
Based on the above factors, and the record taken as a whole, the Arbitrator finds that
Petitioner sustained permanent partial disability to the extent of 6% loss of use of the
person as a whole pursuant to §8(d)2 of the Act which corresponds to 30 weeks of
permanent partial disability benefits at a weekly rate of $649.97.
It is so ordered:
_