Illinois Appellate Court Upholds IWCC’s Determination that Exceeded AMA Impairment Rating

WeldingWhen you are injured on the job and seek workers’ compensation benefits, there are many things that will go into your case. At some point, a doctor may examine you and give you an AMA impairment rating. In a recent First District Appellate Court decision, the court upheld an Illinois Workers’ Compensation Commission determination finding a welder 25% impaired despite an AMA impairment rating below 10%. While the AMA impairment rating was an important part of the impairment determination process, the statutes list five factors, which go beyond simply what a doctor’s opinion says.

The injury took place when the worker was employed by a staffing company in a job as a welder-fabricator. The worker was welding a section of rail (which was similar to a railroad track), when the rail fell off the sawhorse. As many of us might instinctively do, he attempted to catch the rail. Unfortunately, the rail weighed 400 pounds. The catch attempt triggered a “snap” and great pain in the man’s arm. Medical analysis and diagnosis revealed a ruptured biceps tendon in his right arm. The worker underwent physical therapy and later elbow surgery to address the damage.

The worker also filed a claim for workers’ compensation and was awarded benefits. At the welder’s hearing, a doctor testified that, after examining the welder, he concluded that the welder had already reached his maximum medical improvement. Following the “AMA Guides to Evaluation of Permanent Impairment,” the doctor assessed the damage done by the injury as leaving the welder with a “6% upper-extremity impairment and a 4% disability rating of the person as a whole.”

However, the welder had additional evidence on his side. The pain and numbness in the man’s arm never fully went away. The welder never recovered his full range of motion. This latter piece of proof was important in his line of work, since welders working jobs like this man’s were required to hold their arms in various positions.

Based on all of this evidence, the arbitrator in the welder’s case judged him to have lost 30% of the use of his right arm. The Workers’ Compensation Commission lowered that figure, but only slightly, to 25%.

The employer challenged this decision, arguing that the decisionmakers should have given the doctor’s opinion (and his 6% impairment conclusion) more weight than they did. The commission rejected this argument, deciding that the employer’s argument did not accurately reflect the law. Under the statute, a worker’s level of impairment is just one among many factors that must be considered in reaching a determination. In addition to the “reported level of impairment,” other factors included the worker’s occupation, his age at the time of the injury, his future earning capacity, and “evidence of disability corroborated by the treating medical records.”

To go solely by the doctor’s opinion would amount to discarding all of the other factors, which was contrary to what the law demanded, the commission stated. In this case, the welder was a person who had always worked physically demanding jobs and was relatively young at the time of the accident (45). All of these things indicated that a higher disability figure was warranted.

The employer appealed but lost. The appeals court noted that bodies like the commission were entitled to substantial deference in the decisions they make. In this case, concluding that (as the commission did), given the man’s age, job field, injury history, and current medical condition, this welder’s employability would only continue to decline going forward was not an unreasonable decision. The court also agreed with the commission that the employer’s argument — that the commission should have relied more closely on the doctor’s opinion — was a misapplication of the law. Doing so, the court stated, would mean that workers’ compensation arbitrators and the commission “could only rely upon the first and, to an extent, the fifth” of five different elements listed by the statute.

In your workplace injury and workers’ compensation case, there may be many things you have to overcome, including a low AMA impairment rating. One way to help yourself seek a fair outcome is to retain experienced counsel to represent you. The determined Chicago workers’ compensation attorneys at Katz, Friedman, Eagle, Eisenstein, Johnson & Bareck have been representing injured workers for many years and have the skills and resources to help you with your workers’ compensation case. To set up a free case evaluation, contact us at 800-444-1525 or through our website.

More Blog Posts:

Determining ‘Wage Differential’ in Your Illinois Workers’ Compensation Case, Chicago Injury Attorneys Blog, Dec. 21, 2016

Back Injuries An Increasing Concern For Airlines, Chicago Injury Attorneys Blog, Aug. 11, 2016