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Work, Sleep, Eat and Repeat: The Importance of Expert Medical Rationale in Workers’ Compensation Claims
The importance of repetition in employment cannot be understated. Repetition is the mechanism through which employees achieve mastery of a job.
Every job involves repetition, even if job duties are varied overall. Truck drivers drive trucks, cooks cook, teachers teach and singers sing. If repetitiveness alone amounted to a compensable claim under Illinois law, many employees could muster up some rationale on why their long list of ailments could be work-related. Fortunately, our courts have generally required expert medical opinions to support compensability in repetitive trauma claims. Without an expert’s opinion, non-medical professionals would need to implement guess and conjecture to determine whether an employee’s medical condition is due to the repetitive tasks at work. For example, in a carpal tunnel case premised upon repetitive trauma, lawyers and judges would need to answer medical causation questions about the force, frequency and duration of the employee’s daily duties. Although many law students might eventually master The Rule Against Perpetuities, conclusions on medical causation will never be (and should never be) in the wheelhouse of judges and lawyers.
The petitioner in University of Illinois v. Illinois Workers’ Compensation Commission (2021 IL App (4th) 210236WC-U) was likely a little shocked when the Appellate Court denied benefits and disagreed with all of the lower courts on the compensability of his claim. Petitioner was a 19-year employee of the respondent who claimed that his condition of ill-being in his left shoulder was due to turning the steering wheel of a snowplow truck over and over. Petitioner eventually underwent left shoulder surgery and was thereafter released to full duty work.
Petitioner produced no medical opinion to support his causation theory at trial. Nevertheless, the Arbitrator found in his favor, relying on the petitioner’s self-described job duties and his lack of symptoms prior to the manifestation date. In support of her conclusions, the Arbitrator cited previous case law for the proposition that medical testimony was not needed in cases where the nature of the work activities are within the common knowledge of laypeople. The Arbitrator concluded that one-handed steering and maneuvering in tight spaces were within a layperson’s comprehension and that therefore, benefits were owed by respondent.
The Illinois Workers’ Compensation Commission affirmed the Arbitrator’s decision with one Commissioner dissenting. The dissenting Commissioner disagreed that the causation conclusions were within the knowledge of laypersons. The employer appealed the Commission’s decision. The Circuit Court affirmed the decision of the Commission, but only by a tad, noting that the case was a “close one.” The employer then appealed the decision again.
In an unpublished decision, the Fourth District of the Appellate Court reversed the decisions of the lower courts, determined that benefits were never owed to the petitioner, and concluded that the Commission’s decision was against the manifest weight of the evidence.
We agree with the Appellate Court and the dissenting Commissioner on the issue of denial of benefits. Although the Court noted that expert medical testimony is not necessarily required to establish causation, expert testimony is necessary where the issues are not within the common knowledge of laypersons. The relevant question did not involve petitioner’s exact mechanical movements on the job or the propensity of such movements to cause injury. Rather, the most important question was whether petitioner’s condition was caused or accelerated by his work activities.
The Appellate Court also discussed the fact that cases involving an aggravation of a preexisting condition primarily concern medical questions and not legal questions, especially in repetitive trauma claims. Even if the petitioner was entirely credible regarding the accuracy of his job duties, the Court concluded that his testimony alone was insufficient to establish medical causation.
According to the Appellate Court, petitioner’s claim would also fail under a “chain of events” theory for causal connection. According to this theory, causation can be established by demonstrating a chain of events that show that petitioner could perform the job duties before the date of accident, and an inability to perform the same duties following the accident.
The chain of events theory is more easily justified where a single, identifiable accident occurs. Repetitive trauma does not involve one “event” and arguably should never be compensable on a chain of events theory. Although the Court noted that a chain of events theory has been accepted in some repetitive trauma claims, the theory held no water here since petitioner’s case involved a preexisting condition.
Practitioners often argue that the manifestation of symptoms infers a cause-and-effect relationship, and this theory should be zealously rebutted at the time of depositions and trial. Employers cannot assume responsibility for all of life’s pain, especially in the gray area of repetitive job duties. Repetition and routine are an essential part of work life, social life, family life, hobbies, sports, and many aspects of the everyday world.
The Appellees in the case filed a Petition for Re-hearing, essentially hoping to re-argue the case on the substantive issues before the Appellate Court. Whether or not the Petition will be granted is unknown at this time.
Safely embrace a repetitive work routine, and if you need to master this article by reading it twice, do it with pride. If you have any questions about the developing law on repetitive trauma and how to navigate repetitive trauma claims, please feel free to reach out to our attorneys (at least twice) here.