Loyola University of Chicago v. Illinois Workers Compensation Commisssion

2015 IL App (1st) 130984WC, 31 N.E.3d 905
CourtAppellate Court of Illinois
DecidedMay 1, 2015
Docket1-13-0984WC
StatusUnpublished
Cited by1 cases

This text of 2015 IL App (1st) 130984WC (Loyola University of Chicago v. Illinois Workers Compensation Commisssion) 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.

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Loyola University of Chicago v. Illinois Workers Compensation Commisssion, 2015 IL App (1st) 130984WC, 31 N.E.3d 905 (Ill. Ct. App. 2015).

Opinion

2015 IL App (1st) 130984WC No. 1-13-0984WC Opinion filed May 1, 2015 _____________________________________________________________________________

IN THE

APPELLATE COURT OF ILLINOIS

FIRST DISTRICT

WORKERS’ COMPENSATION COMMISSION DIVISION ______________________________________________________________________________

LOYOLA UNIVERSITY OF CHICAGO, ) Appeal from the Circuit Court ) of Cook County. Plaintiff-Appellee, ) ) v. ) No. 12-L-51120 ) THE ILLINOIS WORKERS’ ) COMPENSATION COMMISSION and ) ANNE MIKESH, ) Honorable ) Eileen O’Neil Burke, Defendants-Appellants. ) Judge, Presiding. ______________________________________________________________________________

JUSTICE HUDSON delivered the judgment of the court, with opinion. Presiding Justice Holdridge and Justices Hoffman, Harris, and Stewart concurred in the judgment and opinion.

OPINION

¶1 Claimant, Anne Mikesh, appeals from the judgment of the circuit court of Cook County

finding that the Illinois Workers’ Compensation Commission (Commission) did not have

jurisdiction to construe the settlement contract entered into by her and respondent, Loyola

University of Chicago. For the reasons set forth below, we affirm the judgment of the circuit

court in part, reverse in part, and reinstate the decision of the Commission as modified.

¶2 I. BACKGROUND No. 1-13-0984WC

¶3 The facts underlying this appeal are not in dispute. Claimant worked for respondent as a

secretary in the cardiology department of Loyola University Medical Center. Claimant filed two

applications for adjustment of claim pursuant to the Workers’ Compensation Act (Act) (820

ILCS 305/1 et seq. (West 2002)) alleging injuries to her back and left lower extremity while

moving patient records on December 1, 2003, and February 16, 2005. During the pendency of

the case, respondent did not pay any temporary total disability benefits and claimant applied for

both long-term disability benefits and social security disability benefits. In conjunction with her

application for long-term disability benefits, claimant signed a “Reimbursement Agreement.”

The Reimbursement Agreement provided that under the terms of the policy governing long-term

disability, claimant’s benefits may be reduced by any other benefits that she receives, such as

social security disability. The Reimbursement Agreement further provided:

“If I later receive Other Benefits for myself or my dependents, if applicable, I

agree to reimburse the full amount of any overpayment within 30 days after receiving the

award. In addition, I understand that the Insurance Company, at is [sic] option, will

retain any future benefits payable, including Minimum Monthly Benefits, and use it to

reduce the overpayment not refunded within 30 days. The Insurance Company reserves

the right to obtain lump payment to recover an overpayment even if future benefits are

being withheld.”

In a letter dated September 16, 2005, CIGNA Group Insurance (CIGNA) notified claimant that

her request for long-term disability benefits had been approved. The letter also reiterated that the

award would be reduced by any other benefits claimant receives.

¶4 Meanwhile, claimant’s workers’ compensation case proceeded to arbitration. On

February 21, 2006, the arbitrator determined that claimant’s condition of ill-being was causally

-2- No. 1-13-0984WC

related to the February 16, 2005, work injury. The arbitrator awarded claimant temporary total

disability benefits (see 820 ILCS 305/8(b) (West 2002)) and reasonable and necessary medical

expenses (see 820 ILCS 305/8(a) (West 2002)). Both parties sought review before the

Commission. On December 24, 2007, the Commission affirmed and adopted the decision of the

arbitrator and remanded the matter for further proceedings pursuant to Thomas v. Industrial

Comm’n, 78 Ill. 2d 327 (1980). Thereafter, respondent sought judicial review in the circuit court

of Cook County.

¶5 In August 2008, while claimant’s case was pending in the circuit court, claimant was

notified that she had been approved for social security disability benefits. During this time, the

parties also engaged in settlement negotiations. On January 20, 2009, the Commission approved

the parties’ settlement contract lump-sum petition and order (settlement contract). The terms of

the settlement contract are set forth in an exhibit attached thereto. Those terms provide in

relevant part:

“Respondent offers and [claimant] accepts $318,651.44 in a lump sum and other

good and valuable consideration herein recited in a full, final, and complete settlement of

all claims of any nature or kind, whatsoever, known or unknown, resulting or to result

from the described accidental injuries of December 1, 2003 and February 16, 2005, and

any other accident, incident, aggravation, or exposure during the period of [claimant’s]

employment by the Respondent, to and including the date of this contract.

The additional consideration for the settlement and the total and complete release

of the employer from any and all possible liability is the Respondent’s obligation to hold

[claimant] harmless from any claim for reimbursement by any entity, which provided

long term or short term disability payments, made as a result of the previously described

-3- No. 1-13-0984WC

accidental injuries at anytime from the date of the claimed accidents to the date of the

approval of this contract.

***

[Claimant] waives any and all rights under the *** Act, including, but not limited

to Sections 8(a) and 19(h), except as to enforcement of the terms of this [settlement

contract].”

Neither party sought review of the Commission’s approval of the settlement contract.

¶6 In a letter dated February 3, 2009, CIGNA wrote claimant regarding an overpayment of

long-term disability benefits which occurred as a result of her social security disability award.

The letter provided in pertinent part as follows:

“We received notification that you were awarded Social Security Disability

benefits in the monthly amount of $901.00 effective as of September 1, 2005. Per your

policy, Social Security Disability benefits are considered ‘Other Income’ and must reduce

your Long Term Disability benefits. Therefore, effective in your February check, your

Long Term Disability benefits will be reduced to $618.00. Additionally, because we paid

benefits to you from September 1, 2005 through September 11, 2008 with no reduction

for the Social Security Disability benefits, your claim is overpaid in the amount of

$32,766.36.

In addition, the Long Term Disability benefits that are due for the time frame

September 12, 2008 through January 11, 2009 have been applied towards the current

overpayment balance. This reduces your overpayment to $29,676.36.”

-4- No. 1-13-0984WC

After receiving CIGNA’s letter, claimant’s attorney contacted respondent and demanded that it

tender a check in the amount of the overpayment. Respondent refused to provide

reimbursement.

¶7 On September 22, 2009, claimant filed a petition for penalties pursuant to sections 19(k)

and 19(l) of the Act (820 ILCS 305/19(k), 19(l) (West 2008)) and attorney fees pursuant to

section 16 of the Act (

Related

Loyola University of Chicago v. Illinois Workers Compensation Commisssion
2015 IL App (1st) 130984WC (Appellate Court of Illinois, 2015)

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