BCM wins credit for employer

Peter J. Stavropoulos prevailed at arbitration before Arbitrator Falcioni, resulting in the petitioner owing the employer $14,027.35 after a credit was awarded to the employer for payment of unrelated medical services and temporary total disability benefits. Coffin v. Monterey Mushrooms, No. 02 WC 60350 (decision filed July 21, 2004).

The petitioner alleged an accident that occurred on April 11, 2001. The truck that the petitioner was driving was involved in motor vehicle accident.

The petitioner, through his proposed decision, was seeking 10% loss of use of a man as a whole, temporary total disability benefits from April 11, 2001, to May 5, 2001, and from March 30, 2002, through December 12, 2002. The respondent had paid temporary total disability to the petitioner from April 11, 2001, to May 5, 2001, and from March 30, 2002, through June 6, 2002.

Petitioner was also seeking payment of unpaid medical bills totaling $742.44, and was seeking to avoid a credit for payment of unrelated medical bills totaling $13,743.41.

The Arbitrator found in favor of the respondent. While the petitioner was awarded 3% loss of use of a man as a whole or $4,875.45, for his low back strain, the Arbitrator also found that the respondent had overpaid temporary total disability benefits in the amount of $5,159.39, and had paid for unrelated medical services in the amount of $13,743.41. Consequently, the end result of the Arbitrator's decision is that the petitioner owed the respondent $14,027.35.

In reaching this conclusion, the Arbitrator found the petitioner's testimony not credible regarding the period of lost time and medical treatment beginning in February of 2002. Petitioner had not had any treatment since May 7, 2001, and had been involved in an argument with the employer regarding his work schedule. Respondent presented evidence that petitioner was able to work full time and full duty from May 7, 2001, through February of 2002. All of this evidence, combined with the video surveillance showing petitioner to be very active in the summer of 2002, led the Arbitrator to find that petitioner's condition had reached a state of permanency on May 7, 2001, and that none of the lost time and treatment after that date was causally related to the April 11, 2001, work accident.

Petitioner filed a Petition for Review. The Commission, in a decision dated August 30, 2006, modified the award by including some of the previously excluded medical bills. Consequently, under the Commission decision, the petitioner still owes the respondent $451.67 after all of the employer's credits have been applied to the award for the petitioner.

On August 2, 2007, the LaSalle County Circuit Court affirmed the Commission Decision, and on July 9, 2008, the Illinois Appellate Court affirmed.