The Illinois Industrial Commission Awarded Claimant An Additional 14 Weeks Of Disability Benefits, Relying On Second Physician’s Opinion Of When Claimant Reached Maximum Medical Improvement

The Commission held the claimant was entitled to 14 additional weeks of temporary total disability benefits for injuries he suffered wile lifting sheets of steel, based on a physician’s second opinion of the date the claimant achieved maximum medical improvement. (James Hopkins v. Custom Stainless Steel, [Ill. Ind. Com.], Nos 99 WC 2108, 02 IIC 0426, 05/31/02.)

The claimant, a steelworker with the defendant, testified he felt low back pain while lifting sheets of stainless steel. He claimed his pain progressively increased throughout the day. The claimant sough medical care from a chiropractor and informed him of the work injury. After the chiropractor took him off work, the claimant sough treatment from another doctor. The doctor concluded the claimant had lumbar strain and bulging disc, and recommended the claimant work in a position that did not involve bending, stooping or lifting. When the claimant still complained of pain three months later, the physician renewed the work restrictions.

Relying on his chiropractor’s opinions, the claimant refused the defendant’s offer to return to light-duty work. The defendant paid temporary total disability benefits, but terminated them when the claimant’s physician determined he reached maximum medical improvement. A second doctor recommended the claimant see a psychiatrist, who concluded the claimant was exaggerating his symptoms and had reached maximum medical improvement. A third physician testified the claimant’s complaints were consistent with his physical examination.

The arbitrator found the third physician lacked credibility because he ignored A rational medical opinions@ in advocating the claimant’s case. Noting the inconsistencies between the claimant’s complaints and the findings of his various physicians, the arbitrator agreed with the first physician and found the claimant was capable of working in a light-duty position. The arbitrator refused to grant the claimant’s benefits beyond the date his physician determined he reached maximum medical improvement. The arbitrator also denied the claimant payment for medical bills he incurred after reaching maximum medical improvement.

On appeal, the Commission found the second doctor’s diagnosis was the determinative date for maximum medical improvement. The Commission thus modified the arbitrator’s decision, granting the claimant an additional 14 weeks of temporary total disability benefits. The Commission also awarded the claimant medical expenses incurred with the second physician.