Sisbro, Inc. v. Industrial Commission

764 N.E.2d 1163, 327 Ill. App. 3d 868, 262 Ill. Dec. 46, 2002 Ill. App. LEXIS 102
CourtAppellate Court of Illinois
DecidedFebruary 8, 2002
Docket4-01-0007 WC
StatusPublished
Cited by9 cases

This text of 764 N.E.2d 1163 (Sisbro, Inc. 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
Sisbro, Inc. v. Industrial Commission, 764 N.E.2d 1163, 327 Ill. App. 3d 868, 262 Ill. Dec. 46, 2002 Ill. App. LEXIS 102 (Ill. Ct. App. 2002).

Opinions

JUSTICE O’MALLEY

delivered the opinion of the court:

The claimant, George Rodriguez, sought benefits under the Workers’ Compensation Act (Act) (820 ILCS 305/1 et seq. (West 1998)) for a degenerative condition in his right foot that he alleged was precipitated when he twisted his ankle in disembarking from a truck on March 26, 1998, while delivering dairy products for his employer, Sis-bro, Inc. (Sisbro). The arbitrator awarded claimant temporary total disability payments and medical expenses. The Industrial Commission (Commission) corrected arithmetical errors in the arbitrator’s decision and awarded claimant 6D/7 weeks of temporary total disability payments (TTD) at an average weekly wage of $1,152.51 and $983.65 for medical expenses. The Commission otherwise affirmed and adopted the decision. The circuit court confirmed the Commission’s decision. We reverse.

BACKGROUND

It is undisputed that on March 26, 1998, claimant twisted his right ankle when he stepped into a pothole in disembarking from his truck while delivering dairy products for Sisbro. Also undisputed is that claimant subsequently was diagnosed with a degenerative condition in his foot known as Charcot arthropathy, which prevented him from working for several weeks.

At the arbitration hearing, claimant offered the deposition testimony of Dr. Brennan Reed, a podiatrist. Dr. Reed testified that he has treated claimant for several years for foot problems related to claimant’s diabetes, including ulcerations on the bottoms of the feet. Dr. Reed explained that claimant suffers from diabetic neuropathy, a condition that affects the sensory nervous system, causing decreased sensitivity in the extremities to pain and temperature and thereby weakening the individual’s protective mechanism. Neuropathy involves the autonomic and muscular nervous systems as well. Dr. Reed testified that he saw claimant on April 6, 1998, for a routine preventative care appointment. At that time, claimant mentioned that he had twisted his right ankle at work and experienced pain in his foot and ankle, which had decreased since the accident. Because he saw no swelling and detected no pathology in palpating the foot, Dr. Reed decided not to X-ray it. Dr. Reed testified claimant returned to his office on April 24, 1998, complaining that he had experienced swelling and pain in the foot over the past week. Dr. Reed found that the foot was red and grossly swollen. Claimant experienced mild pain upon palpation. X rays revealed marked chronic degenerative changes involving the ankle as well as the presence of multiple osteophytes. There was marked soft tissue swelling but no evidence of acute fracture or dislocation. Dr. Reed diagnosed “acute onset of diabetic Charcot osteoarthropathy.” Charcot, Reed explained, is a destruction or breakdown of the joints in the extremities. Charcot usually is initiated by trauma. Even “very minor trauma” can initiate it. A subject suffering from decreased sensitivity due to diabetic neuropathy might develop Charcot as the consequence of “insidious” trauma, that is, trauma of which he was unaware at the time it occurred. Dr. Reed testified that he was “absolutely” sure that claimant’s Charcot arthropathy was causally related to his work-related accident of March 26, 1998. Dr. Reed explained that the main treatment for Charcot arthropathy in an extremity is to decrease the amount of weight the extremity bears to avoid further deterioration.

Dr. Reed testified on cross-examination that some Charcot patients cannot recall any specific trauma that might have triggered the condition. Dr. Reed acknowledged that “really anything” can cause the trauma, even “stepping off of a curb or walking on uneven ground [or] stepping on a stone.” Charcot can be caused by insidious trauma that does not leave evidence of itself — e.g., trauma associated with walking on an uneven surface. Trauma leading to Charcot can also be caused even by the subject’s wearing shoes to which he is unaccustomed. Foot ulcerations like claimant has also can lead to Charcot. Asked how soon he would expect to see evidence of Charcot in a subject following trauma to the subject’s foot, Dr. Reed replied, “It can be as early as immediate as far as swelling that could occur with a trauma that doesn’t resolve, it just continues, or it can be as late as several weeks.” Asked whether “the Charcot syndrome could have been caused by a trauma that [claimant] was unaware of because of the neuropathy problems in his foot,” Dr. Reed replied in the affirmative. Asked whether “any trauma could have caused the Charcot,” Dr. Reed replied in the affirmative. Dr. Reed stated that claimant could have developed the Charcot simply by “stepping off a curb” or “stepping on top of a stone.” Dr. Reed admitted that Charcot arthropathy “is still somewhat of an enigma.” Nonetheless, Dr. Reed maintained that claimant did not already have Charcot in his right foot at the time of the March 1998 accident.

On redirect, Dr. Reed, when asked to take into account claimant’s prior history of diabetes and foot ulcerations and all examinations- he performed on claimant from April 6, 1998, to the present, reiterated his opinion that, within a reasonable degree of medical certainty, claimant’s Charcot arthropathy was causally related to his work-related accident of March 1998. Asked if it was more likely that claimant’s Charcot arthropathy was caused by the accident in March 1998 than by some insidious trauma simply because claimant had felt the former trauma and brought it to his attention, Dr. Reed replied, “Yes.”

Sisbro offered the evidence deposition of Dr. John Gragnani, who examined claimant at Sisbro’s request. Dr. Gragnani testified that he specializes in physical medicine and rehabilitation and is board certified in occupational and environmental medicine. Dr. Gragnani agreed with Dr. Reed that claimant suffers from diabetic neuropathy and has Charcot arthropathy in the right ankle and foot. Dr. Gragnani explained that persons with neuropathy tend to place more stress on their joints because they have decreased sensation. A joint becomes afflicted with Charcot when it is traumatized but is not given occasion to heal because the neuropathy prevents the subject from sensing the level of stress he places on the joint. Left untreated, a Charcot joint deteriorates over time. Dr. Gragnani opined, within a reasonable degree of medical certainty, that the Charcot arthropathy in claimant’s ankle could not have been caused by the March 26, 1998, accident. He explained that the advanced Charcot deterioration evidenced by X rays taken on April 24, 1998, could not have developed in only a month. Moreover, the fact that the joint was “cold” and lacked edema on that date indicated that the Charcot deterioration was not an “acute process” but a “long-standing old process.” Dr. Gragnani explained that Charcot joints “don’t develop in a matter of days,” but over the course of “several months.” Dr. Gragnani agreed with Dr. Reed that even minor trauma can result in a Charcot joint. He stated that “[wjalking around normally will cause” a person with diabetic neuropathy “eventually to develope [sic] a Charcot joint.”

Dr. Gragnani also denied the possibility that claimant might have aggravated a preexisting Charcot condition by twisting his right ankle in March 1998. Dr. Gragnani explained that only a “significant injury” could have aggravated or accelerated a Charcot condition in claimant’s foot.

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Sisbro, Inc. v. Industrial Commission
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Bluebook (online)
764 N.E.2d 1163, 327 Ill. App. 3d 868, 262 Ill. Dec. 46, 2002 Ill. App. LEXIS 102, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sisbro-inc-v-industrial-commission-illappct-2002.