Illinois Appellate Court Discusses Pre-Existing Injury Dispute and upholds Reauthorization of Surgery

Workers’ compensation claims can become incredibly complicated and overwhelming for the injured worker. At Therman Law Offices, our experienced Chicago workers’ compensation lawyers have guided people through the process to ensure that they receive the treatment that they should receive. A common issue that comes up in a workers’ compensation claim is whether the claimant suffered from any preexisting injury that is the primary cause of his or her injury. If a pre-existing injury is at play, then the reviewing judge will need to determine whether the work injury is the substantial cause of the injury before awarding benefits. Contact our office today to start learning more about your potential work injury claim and how we can assist you.

In a recent claim, an injured worker filed a claim seeking benefits for an injury he suffered to his right knee while working as a marine technician. He injured his knee when he lowered it onto a concrete floor to install a swim platform on the back of the boat. He received ongoing medical treatment for this injury and was required to take time off of work to heal.  Eventually, the insurance carrier for the employer approved a surgical procedure to address his ongoing pain and issues with mobility in the knee. The claimant was then told that the insurance carrier revoked authorization for the procedure due to a note found in his medical records indicating that he had a prior medical procedure on the same knee several years prior. It said in its note to the surgeon who was going to perform the procedure that additional investigation was needed.

The claimant denied receiving medical treatment for that knee and said that he received surgery on his shin and showed the scar to the presiding arbitrator. The arbitrator ultimately concluded that the surgery should be reauthorized and that there was a causal relationship between his current injury and the work injury. It noted that the insurer did not offer any evidence suggesting that the right knee pain he was experiencing was not causally related to the workplace accident. The arbitrator then awarded attorney’s fees to the claimant on the grounds that the insurer engaged in a frivolous claim that did not present a real controversy in asserting that there was a pre-existing condition with the knee in question.

The insurer filed a petition for review and ultimately the Illinois Court of Appeal concluded that the arbitrator did not have the authority to impose penalties in the form of attorney’s fees on the respondent. The judgment that surgery was appropriate to treat his condition, however, was still valid.

If you were hurt at work, you deserve compassionate and responsive legal counsel to help you ensure that you are treated fairly through the long and complex workers’ compensation system. Our team of attorneys offers a free consultation so that you can learn about your services and whether we can assist you. To schedule your appointment, call us today at 773-545-8849 or contact us online. Don’t wait, time may be running out on your claim.

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