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12/29/97 PLANTATION MANUFACTURING CO. v. INDUSTRIAL

December 29, 1997

PLANTATION MANUFACTURING CO., PETITIONER-APPELLANT,
v.
THE INDUSTRIAL COMMISSION, ET AL., (MARIA RAZO, RESPONDENT-APPELLEE.)



Appeal from Circuit Court, Lake County. No. 94MR97. Honorable Stephen E. Walter, Judge Presiding.

The Honorable Justice Rarick delivered the opinion of the court. McCULLOUGH, P.j., and Rakowski, Colwell, and Holdridge, JJ., concur.

The opinion of the court was delivered by: Rarick

The Honorable Justice RARICK delivered the opinion of the court:

Claimant, Maria Razo, sought benefits pursuant to the Workers' Compensation Act (the Act) (820 ILCS 305/1 et seq. (West 1992)) for injuries sustained while in the employ of Plantation Manufacturing Company (Plantation). On August 21, 1985, Razo slipped on a wet floor and fell, injuring her back. She was ultimately diagnosed with a herniated disc. Her physician, Dr. Allan Minster, recommended lumbar surgery, but Razo declined. She did undergo a work hardening program and rehabilitation at Plantation's expense. An arbitration hearing was held on February 9, 1988. The arbitrator found Razo to be permanently partially disabled to the extent of 30% of the person as a whole, and awarded temporary total disability (TTD) benefits for 54 4/7 weeks. This decision was confirmed by the Industrial Commission (the Commission).

On October 20, 1992, Razo filed a petition pursuant to section 8(a) of the Act, seeking an order requiring Plantation to pay for a lumbar surgery that her physician had prescribed, but had not yet performed.

A hearing on Razo's section 8(a) petition was held July 15, 1993. Razo testified that since the date of her original arbitration hearing, the pain and numbness in her back had gotten worse. Razo also stated that at the time of arbitration she declined to have surgery because she feared death from anesthesia. Admitted into evidence were the results of a September 28, 1990, CT scan. According to the report, the scan revealed a central and right lateral herniated disc at L3-L4, which was not present in 1985, and a small central herniated disc at L4-L5. The test also indicated a spinal stenosis at the L4-L5 level which could possibly be made worse by a herniated disc. Oddly, the report concluded that the examination ruled out a herniated disc at the L3-L4 level, central and to the right. On November 9, 1990, Razo was examined by Dr. Marshall Matz at Plantation's request. His report indicated that in addition to an examination, he reviewed the September 28, 1990, CT scan. Dr. Matz opined that given the subjective nature of Razo's complaints, surgery offered only a remote probability of relief and would be hazardous.

On January 16, 1991, Dr. Minster had again recommended surgery based on the failed conservative treatments, two ineffective epidural steroid injections, physical therapy and work hardening that worsened Razo's symptoms, and no work since 1985. Dr. Minster had scheduled Razo for surgery on November 9, 1991, but Plantation refused to authorize payment for the procedure based on Dr. Matz's report.

Razo was examined on October 28, 1992, by Dr. Irwin Barnett. He found reduced lumbar range of motion, diminished sensation at the right thigh and anterior right leg below the knee, and atrophy in the right thigh and calf. Based on his examination and on x-ray, Dr. Barnett opined that the clinical and x-ray findings indicated the possibility of a herniated disc at L3-L4 and/or L4-L5, and recommended that surgery be considered. Dr. Barnett concluded that Razo had sustained a major loss of the person as a whole.

Dr. Matz examined Razo again on November 27, 1992. He found some limited range of motion and weakness in her legs, no sensory loss and no atrophy. He concluded that her complaints were not substantiated by the neurological examination. He also opined that Razo's choice of no work since 1985 was motivational in nature because there was no evidence of residual organic low back impairment. Dr. Matz further opined that Razo needed no further medical treatment for any work accident residuals. Based on Dr. Matz's reports, Plantation declined to pay for Razo's prescribed surgical treatment.

On February 17, 1994, the Commission ruled that Razo had established that her condition was causally connected to the August 21, 1985, work accident and, relying in part on Zephyr, Inc. v. Industrial Comm'n, 215 Ill. App. 3d 669, 576 N.E.2d 1, 159 Ill. Dec. 332 (1991), ordered Plantation to pay for the prescribed surgery. The circuit court of Lake County remanded the cause to the Commission for a review of the decision and issue of an order regarding the Commission's findings under section 8(a). The Commission subsequently ordered Plantation to provide written authorization to the surgeon and to pay all reasonable and necessary bills related to that surgery. The circuit court again remanded the cause, this time for a determination of Razo's ability to pay. At a hearing on November 30, 1995, Razo testified that she had no health insurance, received no public aid, and had no money to pay for the surgery. The Commission found that Razo was unable to pay for the surgery, but noted its opinion that a claimant's ability to pay for medical care was not relevant to an employer's obligation under section 8(a). The circuit court confirmed the decision.

On appeal, Plantation first argues that section 8(a) of the Act does not require it to pay for future, speculative medical costs not yet incurred. Plantation contends that both the plain language of section 8(a) and the statute's legislative history support its position.

Section 8(a) of the Act provides in relevant part: The employer shall provide and pay for all the necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services thereafter incurred, limited, however, to that which is reasonably required to cure or relieve from the effects of the accidental injury. The employer shall also pay for treatment, instruction and training necessary for the physical, mental and vocational rehabilitation of the employee, including all maintenance costs and expenses incidental thereto. If as a result of the injury the employee is unable to be self-sufficient the employer shall further pay for such maintenance or institutional care as shall be required. 820 ILCS 305/8(a) (West 1994). (emphasis added)

Plantation argues that the language of the statute is plain and unambiguous, and precludes awards for prospective medical treatment. Specifically, Plantation maintains that the word "incurred" is in the past tense, demonstrating the legislature's intent that the employer's liability for medical expenses be limited to those already provided for prior to arbitration. In support of its argument, Plantation points to the legislative history of section 8(a), as well as other sections of the statute which speak in the past tense.

The word "incurred" was added to section 8(a) by P.A. 79-79, effective July 1, 1975. The Senate Debates on P.A. 79-79, Plantation argues, demonstrate that the legislature added the word "incurred" to limit an employer's liability for prospective medical treatment. Plantation has included the text of the debate in an appendix in its brief. Reviewing the debate, we conclude that it does not support Plantation's position. The debate indicates that the practice of the employer affording the injured worker medical care shall continue unless the employee later on elects to secure his own ...


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