Tower Automotive v. Illinois Workers' Compensation Commission
407 Ill. App. 3d 427
| Ill. App. Ct. | 2011Background
- Tower Automotive appeals circuit court confirmation of an Illinois Workers' Compensation Commission award for Robert Nawrot arising from an incident on June 30, 2005.
- Claimant had preexisting cervical degenerative disease; symptoms began May–June 2005 while employed as a forklift operator.
- Claimant's treating physicians linked cervical condition and carpal tunnel symptoms to workplace activities; surgery occurred in late 2005.
- Arbitrator and Commission found the injury arose out of and in the course of employment and that it aggravated preexisting cervical stenosis.
- Overtime was deemed mandatory; the average weekly wage calculation included overtime as part of earnings; medical expenses of $165,289.16 were awarded under Section 8(a).
- Court reversed the medical-expenses portion, remanding to award actual amounts paid by providers, and upheld all other awards.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Did the claimant's current illness arise out of and in the course of employment? | Nawrot; work aggravated preexisting cervical stenosis. | Tower; condition degenerative and not work-related. | No; the Commission's finding that employment aggravated preexisting cervical stenosis is not against the manifest weight of the evidence. |
| Was the claimant's average weekly wage correctly calculated including overtime? | Nawrot; overtime should be included as mandatory and part of earnings. | Tower; overtime should be excluded under Section 10. | The Commission's inclusion of overtime in the AWW calculation is lawful and not against the manifest weight. |
| Is the medical-expenses award under Section 8(a) correct as to amount? | Nawrot entitled to full billed amount. | Tower liable only for amounts actually paid to providers. | No; collateral-source discounts/write-offs may reduce the amount to be paid; award vacated and remanded to pay only amounts actually paid. |
| Does the collateral source rule apply to workers' compensation medical expenses? | Collateral source rule should apply; third-party payments do not reduce liability. | Rule does not apply; Act requires payment of amounts actually paid to providers. | No; collateral-source rule does not apply to Act claims; employer must pay the reasonable value actually paid to providers. |
| Should the case be remanded for recalculation or further development? | N/A | N/A | Remand to award only amounts actually paid and to address future medical expenses consistent with holdings. |
Key Cases Cited
- Illinois Bell Telephone Co. v. Industrial Comm'n, 131 Ill.2d 478 (1989) (arising-out-and-in-the-course standard; causation and weight of evidence)
- Caterpillar Tractor Co. v. Industrial Comm'n, 129 Ill.2d 52 (1989) (preexisting condition aggravated or accelerated by employment)
- Sisbro Inc. v. Industrial Comm'n, 207 Ill.2d 193 (2003) (preexisting conditions; aggravation/acceleration standard)
- O'Dette v. Industrial Comm'n, 79 Ill.2d 249 (1980) (credibility and weight of medical evidence standard)
- Airborne Express, Inc. v. Workers' Comp. Comm'n, 372 Ill.App.3d 549 (2007) (regular-hours vs. overtime in averaging wage; mandatory overtime)
- Nabisco Brands, Inc. v. Industrial Comm'n, 266 Ill.App.3d 1103 (1994) (reasonableness standard for medical expenses under Act)