Crispell v. Industrial Commission

861 N.E.2d 1026, 369 Ill. App. 3d 1022, 308 Ill. Dec. 461, 2006 Ill. App. LEXIS 1273
CourtAppellate Court of Illinois
DecidedDecember 1, 2006
DocketNo. 5—05—0575WC
StatusPublished
Cited by2 cases

This text of 861 N.E.2d 1026 (Crispell v. Industrial Commission) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Crispell v. Industrial Commission, 861 N.E.2d 1026, 369 Ill. App. 3d 1022, 308 Ill. Dec. 461, 2006 Ill. App. LEXIS 1273 (Ill. Ct. App. 2006).

Opinion

JUSTICE HOLDRIDGE

delivered the opinion of the court:

Truman Crispell (petitioner) filed an application for adjustment of claim against his employer, Transervice Corporation (respondent), seeking workers’ compensation benefits for an amputation injury to his right leg. He also filed a third-party lawsuit against Heidtman Steel Products, the owner of the premises where the accident occurred. Petitioner recovered $984,750 in the third-party suit. His workers’ compensation claim then proceeded to an arbitration hearing, where the issues centered on respondent’s entitlement to lien credit against the third-party judgment for certain payments required under the Workers’ Compensation Act (Act) (820 ILCS 305/1 et seq. (West 2002)). The payments pertained to replacing and servicing petitioner’s prosthesis. The arbitrator held that respondent was entitled to the disputed credit.

Petitioner appealed to the Illinois Industrial Commission (Commission),1 which affirmed the arbitrator’s holding in a unanimous decision. Petitioner further appealed to the Madison County circuit court, which reversed the Commission’s decision. Specifically, the court disagreed with the Commission’s conclusion that respondent’s lien covered expenses associated with maintenance, refitting, or replacement of petitioner’s prosthesis. Respondent filed the instant appeal from the circuit court’s order. We reverse that order and reinstate the Commission’s decision.

BACKGROUND

Petitioner’s industrial accident occurred in July of 1991. As noted above, he obtained a judgment of $984,750 in his third-party suit. For workers’ compensation purposes, the instant parties have stipulated that petitioner’s accident caused 100% loss of use of his right leg. At the time of the arbitration hearing, respondent had made payments under the Act totaling $113,284.14 ($50,647.20 in medical bills, $56,988.88 in temporary total disability benefits, and $5,648.06 for 22 weeks of permanent partial disability benefits). Currently, respondent has made all disability payments to which petitioner is entitled under the Act. There is apparently no dispute that the aforementioned sums are part of respondent’s lien against the third-party recovery. Indeed petitioner has already paid respondent $80,727.07 in reimbursement.2

The instant dispute pertains to: (1) additional medical bills totaling $31,786.63 for necessary maintenance, repair, and replacement of petitioner’s prosthesis prior to arbitration; and (2) similar prosthetic expenses in the future. Petitioner claims these expenses do not qualify as part of respondent’s lien (and thus that respondent is not entitled to reimbursement or a credit for such expenses). Respondent, on the other hand, argues that its lien covers prosthetic expenses.

The arbitrator’s decision stated: “The respondent is entitled to a credit and is relieved from its obligation to make payments on the aforementioned medical bills totaling $31,786.63 or on any medical bills in the future by reason of the third-party recovery by the petitioner until the applicable third-party settlement amount has been exhausted.” The Commission affirmed this holding. In reversing the Commission’s decision, the circuit court declared that prosthetic expenses invoke a statutory exception to the general rule of employer reimbursement from proceeds of third-party suits.

ISSUE AND STANDARD OF REVIEW

The question before us is whether such an exception truly exists. The statutes at issue are sections 5(b) and 8(a) of the Act. Our review is de novo. Sun Choi v. Industrial Comm’n, 182 Ill. 2d 387 (1998).

ANALYSIS

Section 5(b) contains the Act’s lien and reimbursement provisions. In pertinent part, it reads:

“Where the injury *** for which compensation is payable under this Act was caused under circumstances creating a legal liability for damages on the part of some person other than his employer to pay damages, then legal proceedings may be taken against such other person to recover damages notwithstanding such employer’s payment of or liability to pay compensation under this Act. In such case, however, if the action against such other person is brought by the injured employee *** and judgment is obtained and paid, *** then from the amount received by such employee *** there shall be paid to the employer the amount of compensation paid or to be paid by him to such employee *** including amounts paid or to be paid pursuant to paragraph (a) of Section 8 of this Act. ***
* * *
If the injured employee or his personal representative agrees to receive compensation from the employer or accept from the employer any payment on account of such compensation, or to institute proceedings to recover the same, the employer may have or claim a lien upon any award, judgment or fund out of which such employee might be compensated from such third party.” (Emphasis added.) 820 ILCS 305/5(b) (West 2002).

These provisions show that the measure of an employer’s lien is the amount of “compensation” due under the Act — specifically including payments required by section 8(a).

The first sentence of section 8 reads, “The amount of compensation which shall be paid to the employee for an accidental injury not resulting in death is ***.” 820 ILCS 305/8 (West 2002). The section then outlines various types of payments, such as payments for: first aid; emergency medical treatment; certain medical, surgical, and hospital services; artificial members; braces; and maintenance, refitting, or replacement of artificial limbs. Then section 8(a) concludes with language central to the instant case:

“The furnishing by the employer of any such services or appliances is not an admission of liability on the part of the employer to pay compensation.
The furnishing of any such services or appliances or the servicing thereof by the employer is not the payment of compensation.” (Emphasis added.) 820 ILCS 305/8(a) (West 2002).

Petitioner claims that since the lien statute (section 5(b)) applies only to “compensation,” this last sentence in section 8(a) excepts prosthetic-related expenses from respondent’s lien. For the following reasons, we disagree.

The appellate court has repeatedly cited the last sentence of section 8(a) in a context signaling its applicability to medical services generally, not just to prosthetic services. See Ahlers v. Sears, Roebuck & Co., 54 Ill. App. 3d 638 (1977), aff’d, 73 Ill. 2d 259 (1978) (nursing care services); Herlihy Mid-Continent Co. v. Industrial Comm’n, 252 Ill. App. 3d 211 (1993) (medical expenses, including expenses for chiropractic services); Vulcan Materials Co. v. Industrial Comm’n, 362 Ill. App. 3d 1147 (2005) (first aid and medical, surgical, and hospital services). This construction comports with the statutory language.

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Bluebook (online)
861 N.E.2d 1026, 369 Ill. App. 3d 1022, 308 Ill. Dec. 461, 2006 Ill. App. LEXIS 1273, Counsel Stack Legal Research, https://law.counselstack.com/opinion/crispell-v-industrial-commission-illappct-2006.