Mitelsztet v. Illinois Workers' Compensation Comm'n

2020 IL App (1st) 191017WC
CourtAppellate Court of Illinois
DecidedJune 30, 2020
Docket1-19-1017WC
StatusUnpublished

This text of 2020 IL App (1st) 191017WC (Mitelsztet v. Illinois Workers' Compensation Comm'n) 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
Mitelsztet v. Illinois Workers' Compensation Comm'n, 2020 IL App (1st) 191017WC (Ill. Ct. App. 2020).

Opinion

2020 IL App (1st) 191017WC-U No. 1-19-1017WC Order filed June 30, 2020

NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).

______________________________________________________________________________

IN THE

APPELLATE COURT OF ILLINOIS

FIRST DISTRICT

WORKERS’ COMPENSATION COMMISSION DIVISION ______________________________________________________________________________

SCOTT MITELSZTET, ) Appeal from ) Circuit Court of Plaintiff-Appellee, ) Cook County v. ) No. 18L50132 THE ILLINOIS WORKERS’ COMPENSATION ) COMMISSION et al. (Andersen Logistics, ) ) Honorable Defendant-Appellant). ) Michael Francis Otto, ) Judge Presiding. ______________________________________________________________________________

JUSTICE CAVANAGH delivered the judgment of the court. Presiding Justice Holdridge and Justices Hoffman, Hudson, and Barberis concurred in the judgment.

ORDER

Held: The Illinois Workers’ Compensation Commission had jurisdiction to consider plaintiff’s post-settlement petition for penalties and fees but was without jurisdiction to consider the parties’ post-settlement petitions related to further payment of necessary medical services when the parties did not timely seek review of the award and specifically waived their rights to such benefits in the settlement agreement.

¶1 In June 2004, plaintiff, Scott Mitelsztet, age 37, was involved in a work-related

motor vehicle accident while employed by defendant, Andersen Logistics. After plaintiff filed a workers’ compensation claim, in September 2010, the parties entered into a written settlement

agreement. The parties contemplated that plaintiff would require future Medicare-covered medical

benefits, so they agreed to leave open plaintiff’s rights to medical benefits from defendant until

such time as defendant funded a set-aside amount.

¶2 In May 2013, disputes began to arise about plaintiff’s medical treatment. The

set-aside amount had not yet been determined or approved by Medicare, so defendant had

continued paying plaintiff’s medical bills. Defendant claimed some of the medical bills were not

related to the 2004 accident. Plaintiff disagreed and filed a “Petition for Medical Benefits Pursuant

to Section 8(a)” and a “Petition for Penalties Pursuant to Section 19(k), 19(l), and Section 16 of

the Illinois Workers’ Compensation Act.” Defendant filed a motion to terminate medical benefits.

¶3 In March 2017, the Illinois Workers’ Compensation Commission (Commission)

conducted an evidentiary hearing and, for the most part, ruled in defendant’s favor. Plaintiff sought

review of the Commission’s decision with the Cook County circuit court. The circuit court found

the Commission had no jurisdiction or authority to reopen the case in light of the settlement

agreement. The court vacated the Commission’s order and dismissed the case for lack of

jurisdiction.

¶4 Here, defendant claims the circuit court erred in vacating the Commission’s order

for lack of jurisdiction. We affirm in part and reverse in part.

¶5 I. BACKGROUND

¶6 On June 24, 2004, plaintiff was involved in a work-related automobile accident. He

suffered injuries, mainly to his back. In January 2006, he underwent back surgery—a lumbar

fusion and laminectomy. The surgery did not relieve his back pain, and he was diagnosed with

failed back surgery syndrome. In February 2005, plaintiff filed an application for benefits pursuant

-2- to the Illinois Workers’ Compensation Act (Act) (820 ILCS 305/1 to 30 (West 2004)).

¶7 On September 9, 2010, the parties reached a settlement of the claim. In a written

settlement agreement, the parties agreed to a lump sum amount to be paid to plaintiff monthly over

the course of 35.2 years based on plaintiff’s life expectancy. The agreement stated: “All parties

agree to waive any rights under sections 19(h) and 8(a) of the [Act].” As part of the settlement

agreement, the parties agreed defendant would submit a proposal for a Workers Compensation

Medicare Set-Aside Arrangement (WCMSA) and keep section 8(a) medical benefits open until

plaintiff could be paid a lump sum for the total of the approved amount or obtain a Medicare

approved structured WCMSA. The agreement stated: “The parties agree that [plaintiff]’s rights to

further medical treatment under section 8(a) of the Act will remain open until the date the approved

WCMSA funds are tendered by [defendant] to [plaintiff] as a lump sum or on the date the seed

money is paid to [plaintiff] as part of a structured WCMSA, at which time [plaintiff]’s [section]

8(a) rights will terminate.”

¶8 Without funding the WCMSA, defendant continued to pay benefits until May 2013,

at which time defendant became more selective about what treatment was being paid. On April 9,

2014, and amended on June 19, 2014, plaintiff filed a “Petition for Medical Benefits Pursuant to

Section 8(a)” and a “Petition for Penalties Pursuant to Sections 19(k), 19(l), and Section 16 of the

[Act].”

¶9 The parties disagreed about whether plaintiff was entitled to further medical

benefits. For example, plaintiff suffered from varicose veins, the cause of which admittedly was

not directly related to the accident. However, according to plaintiff’s physician, the accident

inhibited his functioning, leading to, as one physician described it, a very sedentary lifestyle. This

sedentary lifestyle made him prone to deep vein thrombosis (DVT) or blood clots in deep veins in

-3- his lower extremities. Plaintiff developed DVTs approximately a year and a half after his back

surgery. As a result, plaintiff required a life-long regimen of an anticoagulant. On the other hand,

the physicians hired by defendant believed plaintiff could continue to work, albeit in a

sedentary-type position, which would help alleviate the risk of DVTs. Generally speaking,

defendant claimed that any of plaintiff’s medical issues that did not directly involve his back were

not caused by the accident and were not subject to payment of benefits. Accordingly, on March

22, 2016, defendant filed a motion to terminate further medical benefits.

¶ 10 On March 22, 2017, the Commission, Joshua Luskin presiding, heard the pending

petitions. On February 9, 2018, the Commission denied plaintiff’s petition for further medical

benefits except for one of plaintiff’s prescription medications. The Commission denied plaintiff’s

request for penalties and fees. The Commission granted defendant’s motion to terminate benefits

but noted that defendant had offered to pay for a detoxification program should plaintiff stop taking

narcotics for pain. The Commission held that “[s]hould any detoxification program accepted by

[plaintiff] prove ineffective, nothing in this opinion and order precludes [plaintiff] from filing a

new section 8(a) petition for other or additional treatment.”

¶ 11 Plaintiff filed a petition for review of the Commission’s decision with the Cook

County circuit court. He argued (1) his current medical conditions and prescription medications

were related to his 2004 work-related motor vehicle accident, (2) the Commission erred in denying

his request for penalties and fees, and (3) the Commission erred in giving defendant the choice to

either fund the WCMSA or keep medical benefits “open for life.” Defendant argued plaintiff

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Alvarado v. Industrial Commission
837 N.E.2d 909 (Illinois Supreme Court, 2005)
Gassner v. Raynor Manufacturing Co.
948 N.E.2d 315 (Appellate Court of Illinois, 2011)
Ferris, Thompson and Zweig, Ltd. v. Esposito
2015 IL 117443 (Illinois Supreme Court, 2015)
Loyola University of Chicago v. Illinois Workers Compensation Commisssion
2015 IL App (1st) 130984WC (Appellate Court of Illinois, 2015)
Crossroads Ford Truck Sales, Inc. v. Sterling Truck Corp.
2011 IL 111611 (Illinois Supreme Court, 2011)
Trigg v. Industrial Commission
5 N.E.2d 394 (Illinois Supreme Court, 1936)
Michelson v. Industrial Commission
31 N.E.2d 940 (Illinois Supreme Court, 1941)
Millennium Knickerbocker Hotel v. Illinois Workers' Compensation Comm'n
2017 IL App (1st) 161027WC (Appellate Court of Illinois, 2017)

Cite This Page — Counsel Stack

Bluebook (online)
2020 IL App (1st) 191017WC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mitelsztet-v-illinois-workers-compensation-commn-illappct-2020.