McMahan v. Industrial CommissionMcMahan v. Industrial Commission
Lead Opinion
delivered the opinion of the court:
Clаimant, Robert McMahan, sought benefits pursuant to the Workers’ Compensation Act (Act) (
On review, the Industrial Commission (Commission) modified the amount of medical expenses awarded by the arbitrator and eliminated the award of attorney fees and section 19(k) penalties. One commissioner dissented, arguing that claimant is entitled to penalties under section 19(k) and attorney fees under section 16. The circuit court subsequently сonfirmed the Commission’s decision. Claimant then appealed, challenging only the Commission’s refusal to award attorney fees and section 19(k) penalties.
The Industrial Commission division of the appellate court, with one justice dissenting, affirmed in part and reversed in part, reinstating that portion of the arbitrator’s decision awarding section 16 attorney fees and section 19(k) penalties.
On this appeal, there is no dispute as to claimant’s entitlement to temporary total disability and medical benefits. The employer is not contesting the amount of such benefits claimant is entitled to receive. There is also no dispute as to claimant’s entitlement to penalties under section 19(1) of the Act or the amount of such penalties. The sole issue for our consideration is whether claimant is also entitled to an award of penalties under section 19(k) of the Act and attorney fees under section 16. For the reasons that follow, we hold that he is. We therefore affirm the appellate court’s judgment, with one modification.
The pertinent facts were stated succinctly by the appellate court. At the time of his accident, claimant, then age 36, worked as a lаborer doing such things as climbing, shoveling, painting, and lifting at the employer’s grain elevator. Claimant began working for the employer full time in March 1990 and, although he had undergone back surgery in August 1985, he experienced very little difficulty with his back while working for the employer. Claimant admitted that he periodically experienced mild left leg pain and pain down his left foot, but said that the pain did not keep him from working.
On May 20, 1992, while attempting to shut a large gate at the elevator, claimant slipped on some loose rock and fell on his buttocks. He immediately felt a sharp pain in his left buttock that extended down his left leg to his knee. Because it was the end of the day, claimant limped to his vehicle and went home. The pаin did not resolve itself, however, and claimant reported the incident the next day to his supervisor, Jenny Colburn.
On Colburn’s advice, claimant went to see a doctor about his pain. The doctor gave claimant several prescription medications, but the pain did not subside. Claimant remained on the job despite the pain, although he often had to lie on a couch with a pillow under his legs when he went home after work.
On July 15, claimant returned to his chiropractor complaining of continued low-back pain on the left side. He also sought treatment from Springfield Urgent Care (Urgent Care). X rays of the lumbar spine taken on August 25, 1992, at Urgent Care revealed narrowing at the L4-L5 interspace. A computerized axiаl tomography (CAT) scan conducted on September 11 showed a mild posterior central bulging disc at L5-S1.
From September through October claimant underwent physical therapy three times a week during his lunch hour. When this did not work either, claimant was referred to a neurosurgeon, Dr. Russell. Claimant first saw Dr. Russell in November and was referred to Memorial Medical Center for epidural injections. The injections proved unsuccessful. Dr. Russell then recommended that claimant undergo a lumbar myelogram. The myelogram revealed an extradural defect at L4-L5 with some compression of the nerve root sleeve. Claimant was next referred to an orthopedic surgeon, Dr. Walter Baisier, who recommended surgery. Claimant did not immediately schedule surgery because of his fear of surgery and because it was harvest time, the employer’s busiest time of the year.
Surgery was ultimately performed in January of 1994, when the pain had become intolerable. Dr. Baisier performed a lumbar laminectomy and diskectomy at L4-L5 on the left. Dr. Baisier opined that surgery was necessary to relieve claimant of his symptoms and that claimant’s condition was causally connected to his fall of May 20, 1992. No other physician gave a contrary opinion.
Claimant’s attorney contacted the employer on January 5, 1994, and requested that temporary total disability benefits commence on January 7, 1994, to coincide with claimant’s having to miss work duе to the back surgery. Several weeks later claimant’s attorney contacted the employer again requesting that temporary total disability benefits be started and that claimant’s medical bills be paid. The employer did not comply with these requests.
Jenny Colburn, claimant’s supervisor, testified that claimant informed her of his accident on May 21, 1992. Colburn faxed the information to the superintendent who was in charge of workers’ compensation claims for the employer. The superintendent denied any knowledge of the accident until he was contacted by the employer’s attorney in March 1994. Colburn testified it was the employer’s policy to take care of small workers’ compensation claims internally and not to submit accident reports on such claims to the insurance company. The superintendent confirmed this practice.
By November 1992, Colburn realized claimant’s condition was more serious than first believed and therefore completed an accident report that was forwarded to the insurance carrier. The carrier informed her there was a problem with coverage on the accident because the employer had not complied with its policy provisions. As a result, the carrier refused to pay any of claimant’s medical bills. Colburn was also .told not to pay any more of claimant’s bills internally. Claimant was left to deal with those bills on his own.
Claimant initially filed аn application for adjustment of claim with the Industrial Commission on April 7, 1993. When the employer refused to pay the benefits to which claimant was entitled, he filed a petition with the Industrial Commission on March 7, 1994, requesting an immediate hearing pursuant to section 19(b — 1) of the Act (
“In case [sic] where there has been any unreasonable or vexatious delay of payment or intentional underpayment of compensation, or proceedings have been instituted or carried on by the one liable to pay the compensation, which do not present a real controversy, but are merely frivolous or for delay, then the Commission may award compensation additional to that otherwise payable under this Act equal to 50% of the amount payable at the time of such award. Failure to pay compensation in accordance with the provisions of Section 8, paragraph (b) of this Act, shall be considered unreasonable delay.”820 ILCS 305/19(k) (West 1992).
“In case the employer or his insurance carrier shall without good and just cause fail, neglect, refuse or unreasonably delay the payment of weekly compensation benefits due to an injured employee during the period of temporary total disability the arbitrator or the Commission shall allow to the employee additional compensation in the sum of $10 per day for each day that a weekly compensation payment has been so withheld or refused, provided that such additional compensation shall not exceed the sum of $2,500. A delay in payment of 14 days or more shall create a rebuttable presumption of unreasonable delay.”820 ILCS 305/19(1) (West 1992).
According to section 16,
“Whenever the Commission shall find that the employer, his or her agent, service company or insurance carrier has been guilty of delay or unfairness towards an employee in the adjustment, settlement or payment of benefits due such employee within the purview of the provisions of paragraph (c) of Section 4 of this Act; or has been guilty of unreasonаble or vexatious delay, intentional under-payment of compensation benefits, or has engaged in frivolous defenses which do not present a real controversy, within the purview of the provisions of paragraph (k) of Section 19 of this Act, the Commission may assess all or any part of the attorney’s fees and costs against such employer and his or her insurance carrier.”820 ILCS 305/16 (West 1992).
Following a hearing, an Industrial Commission arbitrator issued a decision finding that claimant was temporarily totally disabled for a period of 13 6/7 weeks and that his disability was causally related to his injury at work on May 20, 1992. The arbitrator further held that the employer was liable for $23,477.04 in medical expenses. In addition, the arbitrator ruled that the employer’s failure to pay temporary total disability benefits was “without good and just cause, vexatious and for mere purposes of harassment and delay.” Accordingly, he sustained claimant’s request for penalties under
The employer petitioned the Industrial Commission to review the arbitrator’s decision. On review, the arbitrator’s award of medical benefits had to be modified because a bill for services unrelated to claimant’s work injuries had been erroneously included in the arbitrator’s calculations. The actual amount of compensable medical expenses was $21,795.11, not $23,477.04. Aside from that, the only matters in disрute were the award of penalties under
The Commission agreed with the arbitrator that claimant was entitled to additional compensation of $970 under
One member of the Commission dissented. She held that there was no dispute about claimant’s entitlement to compensation and that the emplojmr had denied compensation only because it had waited too long in advising its insurance carrier of the accident, in contravention of its statutory and contrаctual obligations, and would have to pay the benefits out of its own pocket. According to the dissenting commissioner, the employer’s conduct in refusing to pay benefits fell within the terms of
The Commission’s decision was subsequently confirmed on judicial review (see
Citing this court’s decisiоn in Brinkmann v. Industrial Comm’n,
In its appeal to our court, the employer first argues that the appellate court was wrong to hold that Brinkmann is not fatal to claimant’s entitlement to
The employer next argues that the award of
While we cannot dispute the difference in phrasing between the statutes, we do not believe that it has the significance suggested by the employer. By including a reference to arbitrators as well as the Commission in
Contrary to the employer’s claim, the necessity for Commission review does nоt mean that the propriety and amount of
“In all cases in which the hearing before the arbitrator is held after December 18, 1989, no additional evidence shall be introduced by the parties before the Commission on review of the decision of the Arbitrator.”820 ILCS 305/ 19(e) (West 1992).
As an alternative basis for challenging the award of attorney fees in this case, the employer argues that the arbitrator calculated the fee award improperly. Under the Workers’ Compensation Act, attorney fees are normally limited to 20% of the amount recovered by the claimant.
The employer rests its position on Childress v. Industrial Comm’n,
Childress is distinguishable from the present case. Here, unlike Childress, the delay was not limited to payment of medical expenses. It involved the temporary total disability payments as well. Accordingly, the predicate for a section 16 attorney fee award found missing in Childress was present here.
Wholly aside from this distinction, we do not find the reasoning of Childress to be persuasive. Since it was decided in 1982, Childress has been infrequently cited by other courts, and with good reason. The court’s holding in Childress was premised on an overly nаrrow and incorrect reading of the relevant statutory provisions.
As indicated earlier in this disposition, section 16 authorizes an award of attorney fees when the employer is
“guilty of unreasonable or vexatious delay, intentional under-payment of compensation benefits, or has engaged in frivolous defenses which do not present a real controversy, within the purview of the provisions of paragraph (k) of Section 19 of this Act ***.”820 ILCS 305/16 (West 1992).
In rejecting the notion that a delay in paying medical expenses could trigger an award of attorney fees under this statute, the court in Childress opined that the phrase “unreasonable or vexatious delay” was qualified by the clause “within the purview of the provisiоns of paragraph (k) of Section 19 of this Act.” It further held that under
The assertion that section 16’s reference to “unreasonable or vexatious delay” is qualified by the clause “within the purview of the provisions of paragraph (k) of Section 19 of this Act” is contrary to a fundamental principle of statutory construction known as the last antecedent doctrine. Under the doctrine of the last antecedent, relative or qualifying words or phrases in a statute serve only to modify words or phrases which are immediately preceding. They do not modify those which are more remote. In re Application for Judgment & Sale of Delinquent Properties for the Tax Year 1989,
In any case, we do not read
Our conclusion is not altered by the fact that the last sentence of
Further supporting our construction of
As with
If the term “compensation” embraces payments for medical expenses for the purposes of
Further supporting our conclusion is the principle that no statute should be construed in a manner which will lead to consequences which are absurd, inconvenient, or unjust. People v. Partee,
The employer argues, in the alternative, that the appellate court was wrong to reinstate the arbitrator’s award of
Viewing the statute as a whole, we believe that
In contrast to
While the Commission is right that a higher standard is required for
Although reinstatement of the penalties and fees was proper, the appellate court’s opinion contains an oversight which must be corrected. The $5,558.48 fee award granted by the arbitrator and reinstated by the appellate court was determined by multiplying the 20% statutory fee rate times the $27,792.40 total compensation amount awarded to claimant. This $27,792.40 compensation amount included all $23,477.04 in medical expenses awarded by the arbitrator. The problem is that the Commission subsequently determined that claimant’s compensable medical expenses were only $21,795.11, a reduction of $1,681.93. The propriety of the reduction is not disputed, and the reduction should therefore have been applied to the attorney fee calculation. Taking the reduction into account, the attorney fee award to claimant should actually have been $5,222.09 (($27,792.40 - $1,681.93) x .20). Correspondingly, the appеllate court’s reinstatement of the fee awarded should have been limited to that sum.
For the foregoing reasons, the appellate court was correct to reverse the Commission’s denial of penalties under
Affirmed as modified.
Concurrence Opinion
specially concurring:
I agree with the majority that
Brinkmann expressly and unequivocally held that
Brinkmann’s holding is also unsupported by the plain language of both
Finally, I am mindful that “[t]he doctrine of stare decisis is the means by which courts ensure that the law will not merely change erratically, but will develop in a principled and intelligible fashion.” Chicago Bar Ass’n v. Illinois State Board of Elections,
Concurrence Opinion
concurring in part and dissenting in part:
I do not agree with the part of the majority opinion that overrules Childress v. Industrial Comm’n,
In overruling Childress, the majority relies primarily on the last antecedent rule, a maxim invoked by the dissenting justice in Childress. Childress,
“The legislature is presumed to know the construction the courts have placed upon a statute. When it amends a statute but does not alter a previous interpretation by this cоurt, we assume that the legislature intended for the amendment to have the same interpretation previously given. Williams v. Crickman,81 Ill. 2d 105 , 111 (1980). Moreover, where the legislature has acquiesced in a judicial construction of the law over a substantial period of time, as it did here, the court’s construction becomes part of the fabric of the law, and a departure from that construction by the court would be tantamount to an amendment of the statute itself. Charles v. Siegfried,165 Ill. 2d 482 , 492 (1995). The power to make such amendments does not lie in the courts. Independent Voters v. Illinois Commerce Comm’n,117 Ill. 2d 90 , 100 (1987).”
These same considerations compel our continued adherence to Childress and its interpretation of section 16. Like Justice Harrison in Berlin, I believe that in this case “a departure from that construction by the court would be tantamount to an amendment of the statute itself.” The legislature has amended this provision of the Act three times since Childress was decided 16 years ago, in 1982, yet the legislature has chosen not to alter the language this court interpreted in its earlier decision. By now, that interpretation has become part of the “fabric of the law.” For these reasons, I would not overrule Childress. Any amendments to the statute at this late date should be made by the legislature and not by this court.
Finally, I would note that, unlike Childress, Brinkmann v. Industrial Comm’n,