One thing that Illinois work comp insurance companies LOVE to do is to try and deny a claim stating that there is a pre-existing condition. This strategy flies in the face of actual Illinois law that states you get work comp benefits if your job causes, aggravates or accelerates a condition/injury.
In other words, if you are not actively treating for an injury, then you should get work comp. I have two examples that demonstrate this.
In the first one, a caller to our office tore his rotator cuff working out at the gym. Two days later he was at work and claims it got way worse by having to lift a box. That would be a hard case to win as the underlying injury was clearly caused outside of work and lifting the box is likely a temporary aggravation. To win, he’d likely need a MRI after the gym incident and a different one after lifting the box. That would be the only realistic way to prove things got worse.
The second example which worked out for an injured worker is the subject of an Illinois Appellate Court decision that came out within the last year. Below is a summary. Note that we were not involved in this case.
The Facts Of This Illinois Workers’ Compensation Claim
John Barickello worked as a drywall laborer for Engler, Meier & Justus. His job was physically demanding and included carrying drywall, loading heavy carts, and traveling between job sites. On October 21, 2016, while driving between jobs for work, he hit a semi-truck tire lying on the highway. After pulling over, another vehicle rear-ended his truck. Barickello immediately felt pain in his neck and back and was taken to the hospital by ambulance.
Barickello had a history of back problems from a 2009 work injury with a different employer. He had back surgery in 2011 and continued to receive pain management treatment for several years. Even with those problems, he was still able to work full-time as a drywall laborer up until the 2016 accident.
After the 2016 crash, Barickello began experiencing serious pain in his neck, middle back, and lower back. MRIs showed issues in his cervical spine, including herniated discs. His treating doctors believed the car accident either caused new injuries or made his existing back condition worse. They recommended treatments such as physical therapy, injections, and a spinal cord stimulator to help control his pain.
The employer’s doctor disagreed. He believed Barickello only suffered a temporary strain and said he could return to work without further treatment.
The Court Ruling
The Illinois Workers’ Compensation Commission sided with Barickello. It found that the 2016 accident was a major factor in his current medical problems. The Commission noted that he had been able to work a heavy labor job for several years despite his earlier injury. After the accident, however, he could no longer work.
The Commission awarded Barickello payment for his medical treatment, including future care such as therapy, injections, and a spinal cord stimulator. It also awarded him temporary total disability (TTD) benefits for the time he was unable to work.
The employer appealed, but the appellate court upheld the Commission’s decision. The court agreed that the 2016 accident was a cause of Barickello’s neck and back problems and that the medical treatment and disability benefits awarded by the Commission were supported by the evidence.
What This All Means
This case, in my opinion, is typical of the insurance company nonsense you see all the time in Illinois workers’ comp cases. Sure this guy hurt his back around seven years before the new work accident. And yes, that was a major injury.
But he clearly had recovered to the point where he could work a heavy duty job without any restrictions. Then he was involved in a serious car accident on the job which obviously caused new injuries and made the old ones worse.
But insurance companies will always find hack doctors willing to state what they want, so they fought this one, probably hoping to save money on a compromised settlement. Fortunately this worker and their lawyer saw the case through. It’s surprising the insurance company kept appealing, but in the end justice prevailed.
The bottom line is that his condition clearly was made worse as evidenced by the fact that he went from being able to work to not being able to work as well as needing treatment for new injuries.
So do not get frustrated or worried if you have a pre-existing condition. If you are not receiving major medical care when your job makes it worse, you will likely prevail.
If you have questions, want a free case review or a referral to a great lawyer in your area who can help, please contact us any time.
