When a worker files a workers’ compensation claim, a major hurdle can be proving that the injury or illness was caused by or at work. Too frequently, the employer and/or insurance provider may try every means possible to deny responsibility. One tactic is to deny a claim by stating that the injury or illness is due to some factor other than those at work. But a recent ruling by the Illinois Appellate Court may help workers whose claims are wrongly denied on the inflated basis of preexisting or mitigating factors.
William Gross worked for the Freeman United Coal Mining Company for nearly forty years until 2003. Beginning in 1999, he began to notice breathing problems. He noted that, “there was often so much coal dust blowing around in the area the coal was loaded that he could not see.” As time progressed, his ability to perform regular activities such as walking, exercising, chores and hobbies became limited by shortness of breath. In 2005, he filed an adjustment of claim for benefits under the Workers’ Occupational Diseases Act. In the application, he stated that he received lung injuries as a result of “inhalation of coal mine dust including but not limited to coal dust, rock dust, fumes and vapors.” Among workers in coal mines, illnesses like black lung disease and chronic obstructive pulmonary disease (COPD) are often more common as a result of the cumulative effect of breathing in coal dust.
Gross’s physician, Dr. Houser, diagnosed him with mild COPD caused by long-term inhalation of coal and rock dust combined with Gross’ past use of cigarettes. Dr. Houser, a pulmonary specialist and medical director for a hospital specializing in black lung disease, noted, however, that even in nonsmokers he had seen similar damage in those exposed to coal dusts.
Gross’ employer requested his records be reviewed by another physician, Dr. Renn. Dr. Renn, who never actually examined Gross directly, disagreed with the diagnosis, instead diagnosing him with mild emphysema from tobacco smoking. He stated, “None of his diagnosis were either caused, or contributed to, by his exposure to coal mine dust.” He admitted, however, that smoking and dust inhalation damage is indistinguishable from one another on a cellular level and that COPD can have multiple contributing factors. He also failed to explain how testing could or would differentiate between COPD caused by smoking versus coal dust.
In 2008, a Workers’ Compensation Commission arbitrator denied Gross’ claim, finding that his illness was not an occupational illness. Gross appealed this finding to the Appellate Court, citing “the Commission erred in accepting the opinion of Dr. Renn that coal dust exposure did not contribute to cause his COPD when Dr. Renn failed to give an adequate explanation of the basis of his opinion.”
The Appellate Court agreed. Specifically, they acknowledged that Dr. Renn gave no evidence to support that smoking was solely to blame for Gross’ illness. As Dr. Renn agreed that smoking and dust exposure both contribute to lung disease, and that there was no way to determine if one was to blame over the other, he could not have sufficiently shown coal dust was not totally or partly to blame for Gross’ medical problems.
As this case shows, when it comes to proving their injuries are real and significant, workers are too often treated as though they are “guilty until proven innocent.” Their employer and/or insurance provider hopes that with enough resistance, an injured worker will give up his or her claim. With the help of a legal advisor, however, many such workers are able to successfully receive the care and benefits they deserve. If you’ve been injured at work, contact a Chicago workers compensation attorney who can assist you.
About the Author: Brooke Haley is a Marketing Associate at Millon & Peskin, Chicago workers compensation lawyers that practice in the areas of Workers’ Compensation and Personal Injury. Millon & Peskin is a General Civil Litigation Practice with the goal of representing the interests of injured workers, throughout all applicable Courts in the State of Illinois. For more information about Illinois workers compensation attorney,please visit www.millonpeskin.com.