2020 IL App (2d) 190974WC-U No. 2-19-0974WC Order filed November 10, 2020
NOTICE: This order was filed under Illinois 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
SECOND DISTRICT
Workers’ Compensation Commission Division ______________________________________________________________________________
RLES CONSOLIDATED UNIT SCHOOL ) Appeal from the Circuit Court DISTRICT #303, ) of Kane County, Illinois ) Appellant, ) ) v. ) No. 19-MR-186 ) THE ILLINOIS WORKERS’ ) COMPENSATION COMMISSION et al. ) Honorable ) Kevin T. Busch, (Eileen Budzban, Appellee). ) Judge, Presiding. ______________________________________________________________________________
JUSTICE CAVANAGH delivered the judgment of the court. Presiding Justice Holdridge and Justices Hoffman, Hudson, and Barberis concurred in the judgment
ORDER
¶1 Held: (1) By finding that the petitioner’s current condition of ill-being was caused by an accident arising out of and in the course of her employment, the Illinois Workers’ Compensation Commission did not make a finding that was against the manifest weight of the evidence. (2) The amounts of permanent partial disability benefits and temporary total disability benefits that the Illinois Workers’ Compensation Commission awarded to the petitioner are not against the manifest weight of the evidence. 2020 IL App(2d) 190974WC-U
¶2 Petitioner, Eileen Budzban, was a school bus driver for respondent, St. Charles
Consolidated Unit School District #303. While walking around a bus, inspecting it before setting
out on her route, petitioner slipped on ice and fell, striking her head. The Illinois Workers’
Compensation Commission (Commission) awarded her permanent partial disability benefits
pursuant to 8(d)(2) of the Workers’ Compensation Act (Act) (820 ILCS 305/8(d)(2) (West 2010))
and temporary total disability benefits pursuant to section 8(b) of the Act (id. § 8(b)). Respondent
appealed to the Kane County circuit court, challenging the amounts of those benefits as excessive.
The court confirmed the Commission’s decision, finding it to be not against the manifest weight
of the evidence. Respondent appeals, challenging the amounts of the benefits and the
Commission’s finding of causation. Because the Commission’s decision is not against the manifest
weight of the evidence, we affirm the circuit court’s judgment, which confirmed the Commission’s
decision.
¶3 I. BACKGROUND
¶4 In the proceedings before the Commission, it was undisputed that petitioner was injured in
an accident at work. The parties stipulated that on December 6, 2010, she sustained accidental
injuries that arose out of and in the course of her employment as a school bus driver for respondent.
Petitioner, by her own account, was walking around a bus, doing a preliminary inspection, when
she slipped on ice and fell. Her head struck the ground. She was unable to get back on her feet or
even roll over, and she saw blackness. It was not until about 45 minutes to an hour later, petitioner
was told, that a coworker came looking for her and found her lying where she had fallen.
¶5 Petitioner was taken by ambulance to the emergency department of Delnor Hospital.
According to the medical history taken there, petitioner had suffered a head trauma but had not
lost consciousness. She complained of severe occipital pain and of pain in her neck and back. Also,
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she said that she felt drowsy. A computed tomography (CT) scan of her brain showed no acute
changes. The diagnostic impressions in the emergency department were (1) an acute closed head
injury without loss of consciousness and (2) an acute cervical and lumbar strain. Petitioner was
discharged that same day with head-injury instructions.
¶6 On December 13, 2010, petitioner followed up with her primary-care physician, Dr. John
K. Boblick of Loyola Medicine (Loyola), who was board-certified in internal medicine. Petitioner
reported to him that she had fallen at work and had lost consciousness; that, after bouts of vomiting,
she had returned to the emergency room; and that she still suffered from dizziness, headaches, and
a feeling of fuzziness. It does not appear, from Dr. Boblick’s records, that petitioner had ever
reported such symptoms before. (Petitioner testified in the arbitration hearing that Dr. Boblick had
been her primary-care physician for 29 years.) Dr. Boblick diagnosed post-concussion syndrome
and advised her to remain off work.
¶7 Petitioner saw Dr. Boblick several more times, complaining of dizziness, fatigue, achiness,
and headaches. In January 2011, Dr. Boblick decided to keep her off work, and he referred her to
the neurology department of Loyola.
¶8 In February 2011, petitioner went to Dr. Murray Flaster of Loyola for a neurological
evaluation. He reviewed some previous diagnostic studies, specifically an X-ray of the cervical
spine and a CT scan of the head and cervical spine, all of which, he agreed with the interpreters,
showed no abnormality. His neurological examination of petitioner determined her cognition to be
intact, without any apparent problems with memory or doing calculations. She seemed to have no
difficulty in using, comprehending, or articulating words. Her gait and balance were normal. After
his examination of petitioner, Dr. Flaster diagnosed a mild post-concussive disorder that, as far as
he could tell, was beginning to go away. Nevertheless, because petitioner was still having
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headaches, he ordered magnetic resonance imaging (MRI) of her brain. The MRI showed no
abnormality.
¶9 When petitioner returned to Dr. Flaster in March 2011, he again found no neurological
abnormality. Gait was normal, and petitioner could bend over and move her head without
discomfort. She reported that her headaches and dizziness were subsiding and that she had been
driving her granddaughter to places. Dr. Flaster assumed that the post-concussive syndrome would
go away completely and that when petitioner felt well enough, she could resume her work as a
school bus driver.
¶ 10 In May 2011, though, petitioner complained to Dr. Flaster that she still was having
headaches and that she now was struggling with fatigue and an inability to concentrate. The latter
two symptoms were new. Dr. Flaster ordered an MRI of the cervical spine and an
electroencephalogram (EEG), both of which came back normal. Nevertheless, he recommended
that petitioner stay off work until she obtained another medical opinion.
¶ 11 Petitioner continued to see Dr. Boblick, who noted that, ever since the head trauma,
petitioner seemed to be suffering from some sort of functional disorder. In June 2011, petitioner
reported to Dr. Boblick that, because of dizziness, she had not been driving. In August 2011, Dr.
Boblick ordered a neuropsychological evaluation.
¶ 12 In March 2012, Dr. Kyle Bonesteel of Loyola performed the neuropsychological
evaluation. His diagnostic impressions were that petitioner had a neurocognitive impairment
beyond what would be expected for someone her age and that she had post-concussive syndrome.
He deemed her to be neurologically unfit to drive a bus.
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¶ 13 In April 2012, according to Dr. Boblick’s notes, petitioner was still having headaches, and
now she was having memory problems too. Dr. Boblick’s assessment was post-concussive
encephalopathy. He believed that petitioner was in need of brain rehabilitation.
¶ 14 In June 2014, on referral from Dr. Boblick, petitioner saw Dr. Michael J. Schneck of Loyola
for a neurological consultation. Petitioner told Dr. Schneck that she had dizziness, headaches,
photosensitivity, anxiety, and difficulty in walking and finding words. In his neurological
examination of petitioner, Dr. Schneck found exaggerated speech and atypical aphasia (difficulty
using or comprehending words) that, to him, were not suggestive of any organic speech defect. He
concluded, rather, that petitioner had a somatization disorder.
¶ 15 Dr. Schneck later wrote in his report of June 2016: “[Petitioner] likely has a somatization
disorder based on the exam. I disagree with the interpretation of findings by Dr. Bonsteel [sic] that
her [symptoms] are related to a postconcussion syndrome at this time (though that might have been
the initial trigger for her problem.[)]” Suspecting that petitioner had a “more complex[,]
longstanding psychiatric syndrome,” Dr. Schneck recommended that she undergo a psychiatric
evaluation and neuropsychological testing.
¶ 16 In July 2014, again on referral from Dr. Boblick, petitioner underwent a
neuropsychological examination by Dr. Susan Walsh of Loyola. She diagnosed posttraumatic
stress disorder and somatoform disorder.
¶ 17 In January 2016, petitioner was further evaluated by Dr. Anjum Sayyad of Marionjoy
Rehabilitation Hospital (Marionjoy). Petitioner complained to Dr. Sayyad that she was sensitive
to noise and light, there was a tingling in the back of her head, her speech was slurred, and she had
difficulty finding words. It was Dr. Sayyad’s impression that petitioner had post-concussive
syndrome. Dr. Sayyad recommended physical, occupational, and speech therapy as well as a
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neuro-optometry evaluation. Petitioner continued to follow up with Dr. Sayyad, who in May 2016
recommended that she continue a home exercise program.
¶ 18 In May 2016, petitioner consulted Dr. Silpa Katta of Marionjoy, reporting to Dr. Katta that
she still was having intermittent headaches. Dr. Katta diagnosed post-concussive syndrome and
chronic intractable headaches and gave petitioner information about Botox injections.
¶ 19 In June 2016, Dr. Boblick’s evidence deposition was taken. He opined that, in her fall at
work, petitioner sustained a significant head injury that had left her with post-concussive
encephalopathy, or post-concussive syndrome, a condition from which she was unlikely to recover.
Dr. Boblick attached particular significance to petitioner’s self-reported loss of consciousness for
45 minutes as a result of her fall—although Dr. Boblick could not recall reviewing the records
from Delnor Hospital to see if petitioner had reported a loss of consciousness to the emergency-
department personnel. Dr. Boblick had reached his opinions as to causation and duration even
though, as he acknowledged, all of the imaging studies and other diagnostic studies had been
normal and even though he had found no organic pathology that would explain petitioner’s
functional disorders. He believed that she had continuing problems from her fall and that the
problems were real. She no longer had the coordination and mental ability to be a school bus driver.
Dr. Boblick was unaware of any other physician who had placed restrictions on what petitioner
could do, and admitted that his perception of petitioner’s inability to work was based at least in
part on her own reporting of symptoms. It was impossible to confirm, by objective testing, whether
her complaints of headaches and unsteadiness were genuine.
¶ 20 In April 2017, Dr. Sayyad’s evidence deposition was taken. She testified that she was
board-certified in physical medicine and rehabilitation and also in brain injury medicine and that
she was the director of the brain injury program at Marionjoy. According to Dr. Sayyad, petitioner
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had post-concussive syndrome caused by her fall at work, and this work-related injury “probably
exacerbated the [petitioner’s] psychological symptoms.” Dr. Sayyad explained:
“[P]ost-concussion syndrome has a component that affects the psychological realm
in these patients. It can impact sleep. It can impact mood. It can impact headaches, balance.
All of those things are under the umbrella of post-concussion syndrome.
Having said that, my sense is that there was probably some psychological
impairment prior to, though I have no real evidence, objective evidence for it, that preceded
the actual injury.”
¶ 21 When asked on what evidence she based her opinion that the fall had caused post-
concussive syndrome, Dr. Sayyad answered: “That her symptoms, the specific symptoms of not
being able to walk, her balance, her sensitivity to light, those specific symptoms following the
injury; and, therefore, the injury was the source of her post-concussive syndrome.” Despite those
symptoms, Dr. Sayyad had never placed any physical restrictions on petitioner, who “was able to
walk independently with a walker, meaning it was a modified independent level.” The impaired
balance and other symptoms could be party psychological. Dr. Sayyad testified: “Often
psychological symptoms are worsened after an injury like this and are difficult to treat following
injury, much more so than individuals who don’t have a prior history of it.”
¶ 22 From either petitioner or her husband, Dr. Sayyad had received a history that petitioner lost
consciousness for 45 minutes. Dr. Sayyad would “describe that as a fairly significant period of loss
of consciousness following a head injury.” Dr. Sayyad could not recall if she had reviewed any
records from Delnor Hospital. Respondent’s attorney asked Dr. Sayyad:
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“Now if the records from that facility record that [petitioner] reported no loss of
consciousness following this incident, would that be a significant inconsistency with the
history that you were originally provided by her and/or her husband?
A. It could be.”
¶ 23 In March and June 2011 and December 2014, at respondent’s request, petitioner underwent
physical examinations by Dr. Gary S. Skaletsky, a board-certified neurosurgeon. See 820 ILCS
305/12 (West 2010). In September 2017, his evidence deposition was taken.
¶ 24 In his evidence deposition, Dr. Skaletsky recounted his three examinations of petitioner.
He initially examined her on March 17, 2011, receiving from her a history that she had fallen to
the ground, struck the back of her head, and lost consciousness. She told him that, ever since her
fall at work, she had suffered from unremitting occipital headaches, dizziness with activity, and a
failing memory. She trusted herself to drive only short distances.
¶ 25 In addition to taking this history from petitioner, Dr. Skaletsky reviewed the diagnostic
studies, all of which showed no abnormality. Also, he reviewed the emergency-department records
from Delnor Hospital, which, he noted, lacked any mention of a loss of consciousness. Even so,
Dr. Skaletsky testified, concussion syndrome “[did] not require a loss of consciousness.” On the
basis of the history he had received from petitioner, his physical examination of her, and his review
of her medical records, Dr. Skaletsky diagnosed a cerebral concussion and an acute cervical strain.
He recommended four weeks of physical therapy to alleviate the cervical sprain, after which, he
anticipated, she could resume normal activities without any restrictions.
¶ 26 The next examination that Dr. Skalestsky performed of petitioner was on June 21, 2011.
Her reported symptoms had not subsided, and maybe they had even grown worse. Now all areas
of her head hurt, and she had become hypersensitive to light and sound. Dr. Skaletsky thought that
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because petitioner had not received the physical therapy he had recommended, she was suffering
from the effects of deconditioning. He recommended physical therapy and muscle relaxants for
six weeks, after which she could return to work without restrictions.
¶ 27 On December 1, 2014, Dr. Skaletsky examined petitioner a third time. She complained to
him of headaches, neck pain, mid and lower back pain, slowness of speech, and muscle weakness
over her entire body. She was overly sensitive to light and sound, and she was unsteady on her
feet, needing something to hold onto as she walked. Also, she reported decreased sensation on the
entire right side of her body, including her face. Petitioner told him she had not driven a vehicle
since the date of the accident (although, Dr. Skaletsky noted, she had told him in March 2011 that
she drove short distances), and she said that all the tasks of daily life, including housework,
cleaning, and the preparation of meals, had to be done by family members.
¶ 28 Dr. Skaletsky found the following in his third physical examination of petitioner. She was
wearing prescription glasses under her sunglasses, and even though the room was dark, she
squinted when the sunglasses were removed. She had an unsteady gait, but the unsteadiness did
not appear to be specific or uniform: when unassisted, she did not lurch in any particular direction.
When requested to touch her nose, she touched near her ears, both when her eyes were open and
when they were closed. In her complaint of diffuse weakness, she exhibited no particular
neurologic pattern. Her speech was slow except when she was describing her limitations and
expressing her frustrations with trying to obtain approval for treatment.
¶ 29 After this third physical examination of petitioner, Dr. Skalestsky was unable to square the
current findings and complaints with the diagnosis from 2011. He could find no anatomic or
physiological reason for the current clinical presentation. In his view, petitioner should have been
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able to return to work, without restrictions, in July 2011. He considered her to be in no need of
further treatment. He agreed with Dr. Schneck that petitioner had a somatization disorder.
¶ 30 According to petitioner’s testimony in the arbitration hearing, she still had head pain that
remained with her all day. She was overly sensitive to light and noise. She got dizzy bending over,
and she had to use a walker for balance. She noticed that her speech was different. She testified:
“[I]t’s either I drag [out the words,] or for some reason I don’t get the other part of the word.” She
no longer drove. She no longer had a driver’s license.
¶ 31 Prior to her fall, she testified, her health was just fine. For several years before December
2010, she had been driving school buses. Before that, she had a laundry business, in which she
hired employees, filled out forms, and made calculations. Ever since her fall on the ice, she had
not worked, and effective May 21, 2016, she had officially retired from her job as a school bus
driver. On June 14, 2016, respondent notified her that it had accepted her retirement.
¶ 32 On cross-examination, petitioner testified that she did not know personally but had been
told it was 45 minutes to an hour after she fell that she was found lying on the ground. Because
she had not shown up for her scheduled pickups, her coworkers went looking for her and found
her. She had no memory of that period of 45 minutes to an hour. Nor could she remember providing
a history at Delnor Hospital.
¶ 33 In her recommended decision, the arbitrator observed that because the parties had
stipulated that petitioner was injured in an accident arising out of and in the course of her
employment with respondent, the only remaining question was whether petitioner’s current
condition of ill-being was causally related to that accident. The answer to that question depended
partly on whether petitioner (1) suffered a loss of consciousness as a result of the fall and (2) had
any prior medical or neurological problems.
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¶ 34 “Even without expert medical opinion,” the arbitrator wrote, “[p]etitioner’s loss of mental
capabilities is obvious in her extreme difficulty in answering questions, recalling facts and as she
struggles to find simple words to answer basic questions. She walks with a walker and had obvious
physical limitations.” Although petitioner appeared to have “some history of depression and
[attention deficit hyperactivity disorder],” she was “perfectly functional” before the accident. The
“downward spiral in her health” after the accident was “amply supported by the medical records.”
¶ 35 On the question of whether petitioner suffered a loss of consciousness as a result of her
fall, there was a conflict between the emergency-department records from Delnor Hospital and
petitioner’s testimony. But the conflict had been explained, and the arbitrator found the explanation
to be credible. Petitioner inferred, from what people told her afterward, that she must have been
unconscious for 45 minutes to an hour. Petitioner “[did] not remember what happened after her
fall until she was treated.” But fellow workers had told her that she was discovered after 45
minutes. The arbitrator reasoned: “In order to discount the evidence that [petitioner] suffered a
[loss of consciousness], one would have to suppose [she] chose to [lie] on an icy, cold parking lot
and pretend to [lie] there for 45 minutes until someone, hopefully, would come and discover her.”
After her visit to the emergency department, petitioner learned, from what coworkers told her, that
she must have lost consciousness. The arbitrator wrote: “She does not specifically recall a [loss of
consciousness]. Her belief that she lost consciousness is honest and based on circumstances of the
accident. She does not embellish the facts but plainly explains what she recalls and believes.”
¶ 36 Four treating doctors had diagnosed petitioner as suffering from post-concussive
syndrome: Dr. Boblick, Dr. Flaster, Dr. Bonesteel, and Dr. Sayyad. Dr. Schneck thought that the
post-concussive syndrome might be of a somatization style. Dr. Sayyad found a causal connection
between the accident and petitioner’s current condition of ill-being because the accident
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exacerbated any preexisting psychological problem. On the other hand, the independent medical
examiner, Dr. Skaletsky, opined that petitioner’s current condition was unrelated to the workplace
accident. The arbitrator gave more weight to Dr. Sayyad’s testimony than to Dr. Skaletsky’s
testimony because Dr. Sayyad was board-certified in the treatment of brain injuries and she
directed a brain injury program. By comparison, only five percent of Dr. Skaletsky’s practice was
devoted to the treatment of concussions.
¶ 37 The arbitrator concluded that petitioner was temporarily totally disabled from December
7, 2010, which was the day after the stipulated accidental injuries, until May 31, 2016, the effective
date of petitioner’s retirement as a school bus driver for respondent: a period of 285 6/7 weeks.
See 820 ILCS 305/8(b) (West 2010). The arbitrator further concluded that petitioner had sustained
accidental injuries causing a 40% loss of use of her whole person. See id. § 8(d)(2).
¶ 38 A majority of the Commission affirmed and adopted the arbitrator’s decision, without
further discussion.
¶ 39 Commissioner Simpson dissented, “find[ing] the opinions of Dr. Skaletsky more
persuasive than those of [p]etitioner’s treaters, Dr. Boblick, her primary care physician, and Dr.
Sayyad, her physiologist/rehabilitation doctor.” All of the neurological and cognitive tests had
yielded normal results, and “there were never any objective findings to support [petitioner’s]
subjective complaints.” She did not report any loss of consciousness until about a month after the
accident, and her symptomology was inconsistent. Commissioner Simpson wrote:
“During the last examination, [Dr. Skalestsky] noted that [p]etitioner reported a completely
different set of symptoms from those she reported in 2011, which he could not attribute to
abnormalities in her nervous system. The symptoms that she reported ‘did not follow any
known neuro pathways.’ He noted her various inorganic behaviors and concluded that ‘all
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of these things combined with objective normal finding, normal deep tendon reflexes, no
atrophy, no sensory loss in a neurologic pattern would be inconsistent with any organic or
medical’ problem. Dr. Skaletsky agreed with Dr. Schneck’s diagnosis of somatization
disorder.”
Commissioner Simpson, therefore, would have terminated the temporary total disability benefits
as of August 4, 2011, and would have awarded petitioner only 40 weeks of permanent partial
disability benefits, representing a loss of 10% of the person as a whole.
¶ 40 Respondent sought review in the Kane County circuit court, which confirmed the
Commission’s decision, finding it to be not against the manifest weight of the evidence.
¶ 41 This appeal followed.
¶ 42 II. ANALYSIS
¶ 43 Respondent contends that, in two ways, the Commission’s decision is against the manifest
weight of the evidence: (1) the degree of permanent partial disability that the Commission assigned
to petitioner’s injuries is excessive, and (2) the award of temporary total disability benefits is
excessive.
¶ 44 The Commission may award various types of compensation to a claimant who has
sustained some degree of disability from a workplace injury. Under section 8(d)(2) of the Act (820
ILCS 305/8(d)(2) (West 2010)), the Commission may award permanent partial disability benefits
on the basis of a “loss of a percentage of the person as a whole.” Ming Auto Body/Ming of Decatur,
Inc. v. Industrial Comm’n, 387 Ill. App. 3d 244, 258 (2008). Claimants are entitled to permanent
partial disability benefits if they have sustained “serious and permanent injuries that partially
incapacitate [them] from pursuing the usual and customary duties of [their] line of employment or
which have otherwise resulted in physical impairment.” Id.
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¶ 45 In Ming, the appellate court explains how an award of permanent partial disability benefits
is calculated:
“Under section 8(d)2 of the Act, a claimant receives compensation for that percent of 500
weeks that his partial disability bears to his total disability. 820 ILCS 305/8(d)(2) (West
2002). Thus, although [permanent partial disability] benefits are calculated based on the
appropriate percentage of 500 weeks that correlates to the claimant’s partial disability, a
[permanent partial disability] award is designed to compensate a claimant for a permanent
disability resulting from a physical impairment and is not premised on a particular number
of weeks of incapacity.” Ming, 387 Ill. App. 3d at 258.
¶ 46 In other words, the number of weeks is merely a variable in a formula that aims to
compensate the claimant for an employment-inflicted disability. To apply the formula to the
present case, the Commission found that petitioner had “sustained accidental injuries that caused
[a] 40% loss of use of her whole person” (to quote from the arbitrator’s recommended decision,
which a majority of the Commission adopted). Forty percent of 500 weeks was 200 weeks (500
weeks times 0.4). Accordingly, the Commission ordered respondent to “pay [p]etitioner permanent
partial disability benefits of $391.93 per week for 200 weeks.”
¶ 47 Respondent contends that, instead, the loss of the person as a whole should have been only
10%, as Commissioner Simpson opined in her dissent. That would have made the award of
permanent partial disability benefits come to $391.93 per week for only 50 weeks (500 weeks
times 0.1).
¶ 48 The other award the amount of which respondent disputes is the temporary total disability
benefits. “Temporary total disability is to be awarded for the period of time from when an injury
incapacitates an employee to the date the employee’s condition has stabilized or the employee has
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recovered as far as the character of the injury will permit.” Whitney Productions, Inc. v. Industrial
Comm’n, 274 Ill. App. 3d 28, 30 (1995). The Commission found that petitioner was temporarily
totally disabled for a period of 285 6/7 weeks, which was from December 7, 2010, the day after
the stipulated workplace injuries, to May 31, 2016, the effective date of petitioner’s retirement
from her job as a school bus driver for respondent. Thus, pursuant to section 8(b) of the Act (820
ILCS 305/8(b) (West 2010)), the Commission awarded petitioner temporary total disability
benefits in the amount of $435.37 per week for 285 6/7 weeks. Respondent maintains, with
Commissioner Simpson, that petitioner’s post-concussion syndrome was resolved by August 4,
2011, and that petitioner, therefore, was entitled to temporary total disability benefits only for the
period of December 7, 2010, to August 4, 2011.
¶ 49 “The time during which a worker is temporarily totally disabled presents a question of fact
to be determined by the *** Commission, and the Commission’s decision will not be disturbed
unless it is against the manifest weight of the evidence.” Archer Daniels Midland Co. v. Industrial
Comm’n, 138 Ill. 2d 107, 118-19 (1990). The same holds true for permanent partial disability.
“[T]he Commission’s decision regarding the nature and extent of a claimant’s disability will not
be set aside on review unless it is contrary to the manifest weight of the evidence.” Steak ’n Shake
v. Illinois Workers’ Compensation Comm’n, 2016 IL App (3d) 150500WC, ¶ 51. This is a
deferential standard of review, not a retrial. See Shockley v. Industrial Comm’n, 75 Ill. 2d 189, 193
(1979) (noting that the supreme court’s “role is not to discard the findings of the Commission,
even though [the supreme court] might have decided differently on the same facts, unless those
findings are contrary to the manifest weight of the evidence.”). A decision is against the manifest
weight of the evidence only if the “clearly evident, plain[,] and indisputable” weight of the
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evidence demands the opposite decision. (Internal quotation marks omitted.) Board of Education,
School District No. 90 v. United States Fidelity & Guaranty Co., 115 Ill. App. 2d 416, 425 (1969).
¶ 50 For essentially two reasons, respondent maintains that the Commission’s decision is
against the manifest weight of the evidence.
¶ 51 First, two of petitioner’s treating physicians, Dr. Boblick and Dr. Sayyad—both of whom
opined that petitioner was still suffering ill effects from her fall at work—had taken petitioner’s
word that she lost consciousness as a result of her fall. This supposed loss of consciousness was,
Dr. Boblick and Dr. Sayyad acknowledged, important to their causation opinions. According to
the emergency-department records from Delnor Hospital, however—which Dr. Boblick and Dr.
Sayyad could not remember reviewing—petitioner specifically denied to the emergency-
department personnel that she had lost consciousness. Respondent asserts that “the [a]rbitrator’s
attempt to remove the ‘smoking gun’ and dismiss the history in the [e]mergency [r]oom as false
has no support in the record.”
¶ 52 But it has support in the record if petitioner’s testimony in the arbitration hearing were
believed. According to her testimony, her loss of consciousness was a fact that she inferred from
what her coworkers told her presumably later on, after she was treated in the emergency
department of Delnor Hospital. Originally, petitioner was unaware she had lost consciousness,
and, consequently, after she was taken by ambulance from the accident site to Delnor Hospital,
she must have denied to the emergency-department personnel that she had lost consciousness.
(Petitioner testified she did not remember giving a history in the emergency department.) Later,
however, some coworkers told petitioner what had happened. They told her that, after 45 minutes
to an hour had elapsed without her making her usual bus stops, they went looking for her and found
her lying where she had fallen. It could be that being unconscious made petitioner oblivious to
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everything, including the passage of time and unconsciousness itself. It is not inherently
implausible that when petitioner fell, her head hit the pavement and literally her next sensory
impression was of a coworker crouching over her and asking her if she was all right. If that is what
happened, the discrepancy between the emergency-department records and what petitioner told
Dr. Boblick a few days later is reasonably explainable: loss of consciousness was a fact that
petitioner only was able to infer from what her coworkers told her afterward.
¶ 53 Respondent insists, though, that petitioner’s “testimony at trial on this issue was obviously
and significantly not credible despite the [a]rbitrator’s suggestion to the contrary.” In an effort to
convince us of petitioner’s unbelievability, respondent points out that petitioner contradicted
herself on her ability to drive. In March 2011, petitioner reported to Dr. Skaletsky that, since the
work-related accident, she had been driving her granddaughter short distances. By contrast, years
later, in December 2014, she told Dr. Skaletsky that she had not driven at all since the accident.
Likewise, in the arbitration hearing, petitioner testified she had not driven since the accident
“because [she had not] trusted [herself].” We acknowledge the contradiction, but “[w]e will not
reverse the Commission merely because some evidence incompatible with its finding exists in the
record.” Riteway Plumbing v. Industrial Comm’n, 67 Ill. 2d 404, 409 (1977). A self-contradiction
by a witness need not automatically make the witness’s entire testimony unbelievable. On the
question of petitioner’s credibility, we decline to substitute our judgment for that of the
Commission. See id.
¶ 54 The second reason why, in respondent’s view, the Commission’s decision is against the
manifest weight of the evidence is the lack of any objective evidence that petitioner had anything
physically wrong with her. Neither Dr. Flaster nor Dr. Schneck could find any neurological basis
for petitioner’s complaints, and they concluded, therefore, that petitioner’s condition was purely
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psychological. “Moreover,” respondent notes, “when Dr. Skaletsky reviewed Dr. Schneck’s
conclusions[,] he complete[ly] agreed.” (Emphasis added.)
¶ 55 Therefore, Dr. Skaletsky must have agreed when Dr. Schneck wrote that the work-related
accident “might have been the initial trigger for” petitioner’s “somatization disorder.” See Mason
& Dixon Lines, Inc. v. Industrial Comm’n, 99 Ill. 2d 174, 182 (1983) (holding that “[a] finding of
a causal relation may be based on a medical expert’s opinion that an accident ‘could have’ or
‘might have’ caused an injury”). There is, in fact, some evidence in the record that post-concussive
syndrome versus somatization disorder is a false dichotomy. The testimony of Dr. Sayyad, the
brain injury expert, could be understood as undermining that dichotomy. She testified that post-
concussive syndrome “affects the psychological realm,” causing headaches and disturbances in
sleep and mood, and that psychological symptoms were “under the umbrella of post-concussion
syndrome.” Much like Dr. Schneck, Dr. Sayyad opined that, in petitioner’s case, post-concussive
syndrome “probably exacerbated” a preexisting “psychological impairment.” See Sisbro, Inc. v.
Industrial Comm’n, 207 Ill. 2d 193, 205 (2003) (holding that “[a]ccidental injury need not be the
sole causative factor, nor even the primary causative factor, as long as it was a causative factor in
the resulting condition of ill-being” (emphasis in original)).
¶ 56 After all, respondent insists that petitioner has a “psychiatric disorder.” “It is *** well[-
]established that a psychological injury is compensable if it results from an accidental injury.”
BMS Catastrophe v. Industrial Comm’n, 245 Ill. App. 3d 359, 365 (1993).
¶ 57 Take BMS, for example. In that case, the employee fell and struck her head at work. Id. at
361. Over the following two years and eight months, the employee, who previously was in good
health (id. at 365), complained of a variety of accumulating symptoms: headaches, sensitivity to
light and noise, dizziness, problems with balance, impaired judgment, neck and back pain, muscle
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spasms, numbness in the extremities, and forgetfulness (id. at 361-63). Several diagnoses were
made, but, ultimately, “[n]o reports *** established an organic basis for [the employee’s] physical
complaints.” Id. at 365. “After running a[n] MRI to rule out gross structural injury to the brain,” a
psychiatrist diagnosed “somatization disorder, a chronic condition in which a person has pain and
a preoccupation with pain and bodily symptoms far in excess of any known organic pathology.”
Id. at 364. The psychiatrist did not believe that the employee “was malingering.” Id. He believed,
rather, that the employee “truly was in pain based upon her reports of pain, her appearance of
considerable discomfort, her difficulty concentrating[,] and her restricted movement.” Id. In other
words, the employee was not faking it: she had a real mental illness, somatization disorder. The
psychiatrist opined that the employee’s somatization disorder was causally related to the work-
related accident “because she exhibited no pattern of similar symptoms in the past and because
there was no other plausible source of such stress.” Id. at 364-65. The Commission agreed,
awarding benefits to the employee, and the employer appealed. Id. at 360. On the following
reasoning, the appellate court found the Commission’s decision to be not against the manifest
weight of the evidence:
“A causal connection between a condition of ill-being and a work-related accident
can be established by showing a chain of events wherein an employee has a history of prior
good health, and, following a work-related accident, the employee is unable to carry out
his duties because of a physical or mental condition.” Id. at 365.
¶ 58 Petitioner is comparable to the employee in BMS. Before her fall at work, petitioner was
fully functional. Now she is preoccupied with debilitating symptoms. Several experts, including a
psychologist, have diagnosed petitioner as having somatization disorder. Even Skaletsky, the
independent medical examiner, agrees with that diagnosis, and he agrees with Schneck that the
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work-related injury could have triggered the somatization disorder. Petitioner did not have this
psychological disorder before falling at work and hitting her head. For years previously, she
performed her duties as a school bus driver without any apparent difficulty. Now she uses a walker
and complains of unremitting headaches. If, indeed, as Schneck and Skaletsky have concluded,
petitioner has somatization disorder, her debilitating pain is, by definition, real instead of feigned.
¶ 59 The “estimation of partial loss is peculiarly the function of the Commission,” and such an
estimation is “not capable of a mathematically precise determination.” Steak ’n Shake, 2016 IL
App (3d) 150500WC, ¶ 51. A 40% loss of the person as a whole does not seem unreasonable in
petitioner’s case. The circuit court was correct: the Commission’s decision is not against the
manifest weight of the evidence.
¶ 60 III. CONCLUSION
¶ 61 For the foregoing reasons, we affirm the circuit court’s judgment, which confirmed the
Commission’s decision.
¶ 62 Affirmed.
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