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WCLA MCLE 11-15-2016 Section 12, Section 16 & Ghere
Tuesday November 15, 2016 12:00 noon to 1 pm James R. Thompson Center Auditorium, Chicago, IL 1 hour general MCLE credit
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Section 12 “In all cases where the examination is made by a surgeon engaged by the injured employee, and the employer has no surgeon present at such examination, it shall be the duty of the surgeon making the examination at the instance of the employee, to deliver to the employer, or his representative, a statement in writing of the condition and extent of the injury to the same extent that said surgeon reports to the employee and the same shall be an exact copy of that furnished to the employee, said copy to be furnished the employer, or his representative, as soon as practicable but not later than 48 hours before the time the case is set for hearing. Such delivery shall be made in person either to the employer, or his representative, or by registered mail to either, and the receipt of either shall be proof of such delivery. If such surgeon refuses to furnish the employer with such statement to the same extent as that furnished the employee, said surgeon shall not be permitted to testify at the hearing next following said examination.”
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Section 16 RG Construction v. IWCC, 2014 IL App (1st) 132137WC
Arbitrator :“I offered the opportunity to take this deposition, but I felt it only fair that the [employer] pay for it since I think under the Act the only thing that [claimant] needs to do is have a certified record or have these records via subpoena which I understand[he has]adhered to those requirements” Commission: "While we are in agreement with the decision of the Arbitrator on this issue, we further address [the employer's] constitutional argument. We find no violation [of the employer's] Fourteenth Amendment right to due process. The Arbitrator offered to continue the hearing if [the employer] elected to obtain the depositions of the Drs. Nam and Silver, but [the employer] declined. The treatment records were therefore properly admitted pursuant to Section 16 of the Act On judicial review, the circuit court of Cook County confirmed the Commission's decision. The employer appeals, arguing it was denied its due process right to cross-examine witnesses and present rebuttal evidence by the admission into evidence of claimant's medical records, which contained the opinions of two of claimant's treating physicians Appellate Court: “The employer does assert that ‘[i]t is undeniable that the doctors' records contain opinions beyond medical and surgical matters admissible pursuant to Section 16.’ However, it cites no authority for this statement other than section 16 itself. After reviewing the statutory language, we find no indication that the legislature intended to exclude a treating doctor's opinion, which was offered during the course of the doctor's treatment of the employee and memorialized in the doctor's treating records, from the phrase ‘medical and surgical matters.’”
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Ghere v. IIC, 278 Ill.App.3d 840 (1996) Decedent flagman has heart attack on hot day Dr. Stuart Frank, cardiologist, testifies by evidence dep for Petitioner; apparently no 48 hour rule problem; wishy washy testimony Dr. Stephen Schuman, cardiologist, testifies by evidence dep for Respondent; apparently no 48 hour rule problem; strong testimony Petitioner calls Dr. Climaco to testify at hearing; ER doctor who treated decedent on “occasion” but never for heart problems; Respondent objects to Dr. Climaco’s causation opinion based on 48 hour rule; Arbitrator sustains objection (affirmed all the way up) Arbitrator denies benefits (affirmed all the way up)
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Ghere v. IIC, 278 Ill.App.3d 840 (1996) Petitioner argues Section 12 does not apply to treating physicians Standard of review? Statutory construction?; first impression (Abuse of discretion?) “We believe the purpose of section 12 would be frustrated if we read section 12 to only apply to examining physicians…purpose…is to prevent…springing surprise medical testimony…With this purpose in mind, we see no justification in limiting Section 12 of the Act to examing doctors and we now so hold.”
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Homebrite Ace Hardware v. IIC, 351 Ill.App.3d 333 (2004)
Petitioner paint department manager injured back with delayed onset of neck complaints Dr. Heffner, Petitioner’s treating neurosurgeon, opined in evidence dep over Respondent’s Ghere objection that neck “was causally related;” Arbitrator overrules objection, affirmed by Commission with specific finding of “no surprise” Dr. Mirkin, Respondent’s IME, testified no causation as to neck Arbitrator awards TTD and prospective medical based on causal connection to condition including neck (affirmed all the way up) Appellate Court: abuse of discretion regarding evidentiary issues
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Homebrite Ace Hardware v. IIC, 351 Ill.App.3d 333 (2004)
Here, employer contends that the Commission cannot arbitrarily determine when an opinion constitutes surprise testimony. It suggests that the Commission must strictly adhere to Ghere and thus any undisclosed opinion testimony must be deemed as surprise and be barred. Employer argues that it would be unduly burdensome for a court to have to regularly inquire as to what parties expect an opposing witness to testify to in order to guarantee no surprise. We disagree. We find no indication in Ghere that its holding must be so strictly interpreted. The Ghere court examined the physician's records and treatment history to determine whether the employer was put on notice regarding the possibility that the physician might provide causation testimony. The court did not set forth a bright-line rule or presumption that undisclosed opinion testimony constitutes surprise. Furthermore, Ghere is factually distinguishable because the physician in Ghere had never treated the employee's heart condition, whereas Dr. Heffner did treat claimant for his neck problems.
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Kishwaukee Community Hospital v. IIC, 356 Ill.App3d 915 (2005)
Petitioner nursing assistant alleged repetitive trauma resulting in bilateral CTS, left thumb basilar joint athritis and left cubital tunnel Dr. Glasgow, Petitioner’s treating orthopedic surgeon, opined over Respondent’s Ghere objection that there was a causal connection to the CTS and thumb Dr. Ruder, Respondent’s IME, opined no causal connection to either Arbitrator overrules Ghere objection and awards benefits (affirmed all the way up)
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Kishwaukee Community Hospital v. IIC, 356 Ill.App3d 915 (2005)
Whether the Commission erred in overruling its objection to Dr. Glasgow's causation testimony, which was based upon Ghere …because no report was issued notifying the employer as to what Dr. Glasgow's opinions would be on the issue of causal connection. The employer contends that claimant's attorney's letter notifying the employer's attorney that Dr. Glasgow would render opinions regarding causal connection was too broad. Contrary to Ghere, in the instant case, Dr. Glasgow's records contain details about his treatment of claimant's bilateral carpal tunnel syndrome and basilar joint arthritis, making the instant case more akin to Homebrite. Likewise, in the instant case, the employer could not have been surprised by Dr. Glasgow's opinions regarding causation, especially in light of the fact that claimant's attorney even provided the employer's attorney with a letter indicating that he intended to inquire into the issue of causal connection with regard to both the bilateral carpal tunnel and basilar joint arthritis conditions…Relying on Homebrite, we find there was no error in allowing Dr. Glasgow to offer opinion testimony regarding causation.
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Certified Testing v. IIC, 367 Ill.App.3d 938 (2006)
Petitioner sheet metal worker hurt knee climbing down ladder Petitioner’s IME, Dr. Watson, opined that Petitioner “would not be able to do all of his duties as a sheet metal worker” Respondent’s lawyer objected pursuant to “Section 12” Objection overruled and Arbitrator awarded TTD (affirmed all the way up)
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Certified Testing v. IIC, 367 Ill.App.3d 938 (2006)
Abuse of discretion standard Employer admits that it received a written report from Dr. Watson, dated August 19, 2003, and it does not suggest that the report was furnished less than 48 hours prior to hearing. Rather, employer contends that Dr. Watson's opinion regarding whether he would restrict claimant's employment as a sheet metal worker went beyond the opinions rendered in his August 19, 2003, report. Here, Dr. Watson examined claimant's knee, opined on the severity of claimant's knee injury, and, in his report, expressed doubt as to whether claimant would be able to perform aspects of his job. Specifically, Dr. Watson's narrative report states that he found claimant's condition to be severe and that claimant may now have difficulty climbing stairs and ladders, particularly while carrying heavy equipment, "which is required by his job.“ In his deposition, Dr. Watson was asked whether, based on his assessment of claimant's knee, he would recommend that claimant's work be restricted. It was reasonable for the Commission to find that Dr. Watson's deposition testimony was a natural continuation of the opinion in his narrative report and that his opinion, that claimant's condition would restrict his ability to perform his job as a sheet metal worker, did not come as a surprise to employer. Thus, we conclude that the Commission did not abuse its discretion in overruling employer's section 12 objection.
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City of Chicago v. IWCC, 387 Ill.App.3d 276 (2008)
Given this court's prior determination that the purpose of section 12 is to prevent surprise medical testimony at the arbitration hearing, the Commission's ruling in Marks that the "hearing" referred to in Section 12 is the treating physician's deposition is completely at odds with this court's statement of the purpose of Section 12. The Commission's decision to exclude Dr. Slack's report was error as a matter of law. We note that had Dr. Slack's report been completed but withheld until after Dr. Chmell's deposition the outcome may have been different.
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Mulligan v. IWCC, 408 Ill.App.3d 205 (2011)
The employer presented the live testimony of Dr. Kornblatt and the evidence deposition testimony of Dr. Hopkinson on the issue of whether the 1994 accidents caused the claimant's right knee conditions. The claimant objected to the testimony of these doctors, arguing that the employer had not timely furnished him copies of the doctors' medical reports as required by section 12 of the Act In his objection to the employer's motion for a dedimus potestatem, the claimant's attorney stated that he had never received Dr. Hopkinson's report until he received a letter from the employer's counsel dated July 15, 2004…The arbitrator overruled the claimant's objection to the employer's request for an evidence deposition of Dr. Hopkinson. In doing so, the arbitrator simply noted that "the examination of the doctor has not started" and that the parties "have not completed the hearing." No finding was made that the employer had shown good cause for taking the deposition after the arbitration hearing had commenced The employer also retained a new medical expert, Dr. Kornblatt, to conduct a review of the claimant's medical records and render opinions concerning the claimant's knee conditions. On September 24, 2004, Dr. Kornblatt prepared a report that set out his findings and opinions based on his document review, and that report was then furnished to the claimant. When the parties appeared at the arbitration hearing on July 27, 2005, the employer called Dr. Kornblatt as a witness. The claimant objected to his testimony, arguing that section 12 required that the employer furnish him a copy of Dr. Kornblatt's report at least 48 hours prior to the start of the April 20, 2004, hearing. The claimant's attorney argued that section 12 bars the testimony of a new examining physician retained by the employer after the arbitration hearing has commenced, the claimant has testified, and the depositions of the claimant's physician witnesses have been taken. The arbitrator overruled the claimant's objection and again ruled that the 48 hour requirement in section 12 applied to the day of the hearing on which the doctor testified, not to the first day of the hearing on April 20, The arbitrator, therefore, allowed Dr. Kornblatt to testify on July 27, 2005, over the claimant's objection.
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Mulligan v. IWCC, 408 Ill.App.3d 205 (2011)
The claimant raises several issues on appeal, including that the Commission's admission of the testimony of Dr. Kornblatt and Dr. Hopkinson violated section 12 of the Act…The claimant further argues that, without their testimony, the Commission's finding that his right knee condition was not causally connected to the 1994 work accidents and the Commission's decision to deny benefits for permanent total disability (PTD) as a result of the 1994 accidents were against the manifest weight of the evidence. Our analysis of the claimant's objection to the testimony of Dr. Kornblatt and Dr. Hopkinson requires us to construe this language of section 12 of the Act. [HN3] When resolution of an issue on appeal involves a question of statutory construction, the proper standard of review is de novo. With respect to Dr. Kornblatt's testimony, the first issue we must address is whether his testimony, based on a review of medical documents rather than an examination of the claimant, falls within the purview of section 12. In doing so, we note that [HN4] section 12, on its face, applies to "physical examinations."
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Mulligan v. IWCC, 408 Ill.App.3d 205 (2011)
The purpose of section 12 would be frustrated if parties were allowed to spring surprise medical testimony at the arbitration hearing from doctors who form their opinions exclusively through a review of medical records without conducting an examination of the injured employee. Accordingly, we hold that the testimony of a physician that is based upon a review of medical records rather than a physical examination falls within the 48-hour disclosure requirements of section 12. We now give the term "hearing" its plain and ordinary meaning and hold that compliance with section 12 of the Act dictates that the proponent of medical testimony provide the other party with the required medical reports 48 hours before evidence is presented on the first day of the arbitration hearing. This holding is consistent with the purpose of section 12, which is to prevent one party from springing surprise medical testimony on the other party. …Since Dr. Kornblatt was not even retained to perform a records review until after the arbitration hearing had commenced, his report could not have been timely submitted. His report was not submitted until September 2004, several months after the time the case was set for hearing. Accordingly, pursuant to section 12 of the Act, the Commission should not have allowed Dr. Kornblatt to testify and should have sustained the claimant's objection to his testimony.
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Mulligan v. IWCC, 408 Ill.App.3d 205 (2011)
Likewise, the Commission improperly allowed the admission of the evidence deposition of Dr. Hopkinson over the claimant's section 12 objection. As noted above, after the arbitration hearing commenced on April 20, 2004, the parties appeared before the arbitrator in August 2004 on the employer's motion for a dedimus potestatem to take the evidence deposition of Dr. Hopkinson. Dr. Hopkinson examined the claimant and prepared a report in February The claimant objected to Dr. Hopkinson's testimony, arguing that he did not receive Dr. Hopkinson's report until July 2004, well beyond the time the case was set for hearing. The claimant's attorney denied that he had ever received Dr. Hopkinson's report prior to July 2004, and the employer offered no proof that the report had been submitted to the claimant on any earlier date. We conclude that Dr. Hopkinson's testimony was improperly admitted. We hold that when a party objects to the admission of medical testimony on section 12 grounds, the proponent of the medical testimony has the burden to prove compliance with the requirements of section 12 of the Act. In addition, Dr. Hopkinson's testimony should have been excluded because the employer failed to show "good cause" for taking his evidence deposition after the start of the arbitration hearing. Section of]the Rules …governs the timing of evidence depositions in workers' compensation proceedings. 50 Ill. Adm. Code § 7030 (2008). Section provides that "[e]vidence depositions of any witness may be taken after the hearing begins only upon order of the Arbitrator or Commissioner, for good cause shown…. However, our review of the record does not reveal any showing of good cause to allow Dr. Hopkinson's late evidence deposition after the hearing had begun
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Connie Love v. RGIS Inventory 15WC013194; 16IWCC0251
Arbitration Decision During the conclusion/evidentiary hearing on July 8, 2015 , Respondent objected to the admission of several treatment notes from June 23,2015, June 29, and July 2, 20 15, as well as a letter addressed to Petitioner's attorney dated July 2, 2015 (which the Arbitrator notes is not a report prepared for use in litigation, but a detailed treatment/progress report on Petitioner's injury, her treatment, her current condition and response to treatment, her prognosis and an outline for future care), on the basis that they were not provided 48 hours prior to the start of the initial hearing pursuant to Ghere & Mulligan. Petitioner responded that these exhibits should be admitted, as they are records from the treating physician, which, as discussed recently by the Appellate Court in the matter of City of Chicago - Dept. of Aviation (R23) , are not subject to the 48 hour rule regarding § 12 examination reports, and further that the records are admissible on their face pursuant to § 16 of the Act.
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Connie Love v. RGIS Inventory 15WC013194; 16IWCC0251
As a preliminary matter, the Arbitrator notes that Ghere and Mulligan predominantlypertain to the testimony of physicians, a distinction which is crucial to proper application of thelaw in this evidentiary ruling. The purpose of the Court' s findings in aforementioned cases,which require treating physicians and § 12 examiners alike to provide reports 48 hours prior tohearing or evidence deposition is to prevent surprise testimony as to causation, which wouldprejudice one of the parties. In this case, however, no deposition testimony has been tendered byeither party, and no physician testified at the hearing. Rather, the only evidence at issue is writtentreatment records. Treatment records, specifically treatment records generated by a treatingphysician, fall squarely under § 16 of the Act. Specifically, Section 16 states that the records,reports and bills kept by a treating provider, once certified " shall be admissible without anyfurther proof as evidence of the medical and surgical matters stated therein." Further, the Arbitrator notes that even assuming arguendo expert testimony was involved in thismatter, the opinions of treating physicians are not subject to Ghere when records in theemployer' s possession are sufficient to put the employe r on notice that the treating physician willhave an opinion as to causation.
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Connie Love v. RGIS Inventory 15WC013194; 16IWCC0251
Additionally, it is well settled that there is no provision for discovery in the Workers'Compensation Act, and neither party is under an obligation to provide medical records to the other. 50 Ill. Adm. Code§ et seq. ; Boyd Electric v. Illinoi s Workers ' Comp. Comm'n,403 Ill.App.3d 256, 932 N.E.2d 638, 641 (1st Dist. 2010). Even under Ghere, cited as theautho rity by Respondent, the Court noted that as discussed in Nollau, the burden is onRespondent to make an attempt to procure medical records before any objection can be sustainedto the admission of evidence. Ghere, 633 N .E.2d at 1 050; Noll au Nurseries, Inc. v. Indus.Comm'n , 32 Ill. 2d 190, 193, 204 N.E.2d 745, 747 ( Ill.l965). The Commission Rules confinnsame. Under 50 Ill. Adm. Code§ (c) , Respondent must initially seek the desi red recordsfrom the medical providers. The evidence subm]tted at the time of trial reveals that Respondentwas fully aware of t!)e identity of Petitioner's medica l providers and her course of treatment,including Dr. Gornet, to whom a clear, open and obvious referral was made in his May 20, 2015treatment record, which was in Respondent's possession well in advance of the hearing on June24 , (PX3 , 5/20/ 15). Yet, Respondent produced no evidence that it sought to procure therecords to which it objected. Based upon the aforementioned, the Arbitrator admits the di sputed treatment records overRespondent's objection. Respondent shallauthor ize and pay for the further necessary care recommended by Dr. Conkling and Dr. Gomet,including but not limited to injections, as required by § 8(a) of the Act.
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Connie Love v. RGIS Inventory 15WC013194; 16IWCC0251
Commission Decision The Commission modifies the Decision of the Arbitrator by striking the medical records ofDr. Conkling dated June 23, 201 5, June 29, 2015, and July 2, 2015, and Dr. Gomet's medical records from the record. The reason for this action is because all of those records were erroneously admitted into evidence, over Respondent's timely objection, as they were not disclosed to Respondent more than 48 hours prior to the commencement of the arbitration hearing on June 24, 2015. In support of its position, Respondent cited Ghere and Mulligan. Arbitrator found both cases "predominantly pertain to the testimony of physician .... "The Commission recognizes this to be true, but it also recognizes itis nevertheless the report that the physician is to testify about that must be disclosed no later than 48 hours prior to the arbitration hearing. Ghere, 278 Ill. App. 3d at 845. In the instant matter, the objected-to records were not proffered upon the commencement of the arbitration hearing on June 24, 2015, but at a subsequent hearing held on July 8, 2015, for the purpose of closing proofs.
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Connie Love v. RGIS Inventory 15WC013194; 16IWCC0251
Arbitrator also concluded that Respondent was made ''fully aware" of the identity of Petitioner's medical providers, including Dr. Garnet, and the recommended course of treatment as a result of the May , referral Petitioner received from Dr. Conkling to see Dr. Gamet. The Commission, however, notes that Petitioner 's evidence indicates she was to be seen by Dr. Gamet on July 6, 2015, but was actually seen by Dr. Garnet on June 17, The Commission is unable to find Respondent at fault for not being aware that Petitioner was seen on a date earlier than what had been communicated to them. For this reason, and consistent with Ghere, the Commission finds Dr. Gamet's medical records inadmissible under Section 12 of the Act. The C01mnission, in finding the above-referenced records inadmissible, vacates theprospective medical treatment awarded to Petitioner by Arbitrator Lee.
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City of Chicago Dept. Of Aviation v. IWCC 2015 Il App (1st) 131856WC-U
The employer also argues that the deposition was inadmissible surprise medical testimony in violation of our holding in Ghere. Specifically, the employer maintains that the claimant did not provide a complete set of Dr. Buvanendran's treatment records prior to the deposition. The employer's argument fails in two respects. First, it is well settled that there is no discovery in workers' compensation and thus neither party is under an obligation to provide medical records to the other. Boyd Electric. Second, opinions of treating physicians are not subject to Ghere where the records in the employer's possession are sufficient to put the employer on notice that the treating physician will have an opinion as to causation. Homebright Ace Hardware. The employer cannot claim that it was surprised by Dr. Buvanendran's opinion testimony when it: (1) had in its possession Dr. Buvanendran's treatment notes for all but the last three appointments; and (2) had issued a subpoena for the notes from those last three appointments but failed to take steps to enforce the subpoena. Given this record, it cannot be said that the Commission's admission of Dr. Buvanendran's deposition violated the principles articulated in Ghere.
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