Court of Appeals of Illinois, First District, Sixth Division
Appeal from the Circuit Court of Cook County No. 11 L 51413 Honorable Daniel T. Gillespie, Judge Presiding.
JUSTICE REYES delivered the judgment of the court, with opinion. Justices Hall and Lampkin concurred in the judgment and opinion.
¶ 1 Plaintiff Grazyna Dratewska-Zator (Dratewska-Zator) appeals an order of the circuit court of Cook County dismissing her amended complaint against defendants Illinois State Treasurer Dan Rutherford (Treasurer) in his capacity as ex officio custodian of the Illinois Injured Workers' Benefit Fund (Fund), Mitch Weisz (Weisz) in his official capacity as Chairman (Chairman) of the Illinois Workers' Compensation Commission (Commission), and Weisz, Thomas Tyrrell, Charles Devriendt, David Gore, Daniel Donohoo, Yolaine Dauphin, Michael Latz, Kevin Lamborn, Ruth White and Mario Basurto in their official capacities as Commissioners (Commissioners) of the Commission. On appeal, Dratewska-Zator argues: (1) her claim against the Treasurer for a judgment on the full amount of an award received from the Commission states a cause of action for which effective relief may be granted and is not barred by sovereign immunity; (2) her claims against the Chairman and the Commissioners for mandamus also state a cause of action; and (3) her claims are not barred by the doctrine of exhaustion of administrative remedies. For the following reasons, we affirm the judgment of the circuit court.
¶ 2 BACKGROUND
¶ 3 Dratewska-Zator's amended complaint, filed on April 12, 2012, alleged the following facts. In April 2006, Dratewska-Zator was involved in an accident compensable under the Illinois Worker's Compensation Act (Act) (820 ILCS 305/1 et seq. (West 2004 & Supp. 2005)). At the time of the accident, Dratewska-Zator's employer failed to have valid workers' compensation insurance. Accordingly, Dratewska-Zator added the Treasurer as a party to the claim, in his capacity as ex officio custodian of the Fund. As the amended complaint explains, the Fund is a special statutory fund created by the Act, which holds penalties collected by the Commission from employers who violate the insurance requirements of the Act and disburses moneys to eligible claimants injured while working for uninsured employers. See 820 ILCS 305/4(d) (West Supp. 2005).
¶ 4 On June 8, 2011, the Commission entered an award in favor of Dratewska-Zator. The Commission awarded Dratewska-Zator temporary total disability benefits totaling $2, 904.38, while also ordering that the employer would receive a $500 credit for payments made prior to arbitration. The Commission in addition awarded a total of $17, 141.52 in permanent partial disability payments. The Commission further awarded $35, 470.86 for medical expenses in accordance with a fee schedule,  as the employer did not dispute the nature of Dratewska-Zator's injury and there was no evidence her treatment was not reasonable and necessary. Neither the employer nor the Treasurer appealed the Commission's decision.
¶ 5 Dratewska-Zator notified the Commission of her award. The Commission subsequently sent Dratewska-Zator's counsel a letter dated October 31, 2011, purportedly accompanying payment from the Fund. The letter stated all claims for fiscal year 2011 were being paid at "100% of the claimed amount, after necessary adjustments, " including "any direct reimbursements made to the Department of Healthcare and Family Services." The letter explained Dratewska-Zator was not entitled to reimbursement for her medical expenses because the cost of all of her medical treatment was paid by the Department of Healthcare and Family Services, which was directly reimbursed by the Fund.
¶ 6 Dratewska-Zator allegedly received a partial payment from the Fund in the amount of $16, 641.52, which did not include payment for medical expenses or the award of temporary total disability benefits. In her appellate brief, Dratewska-Zator states she subsequently received the latter amount, leaving only the amount representing medical expenses in dispute.
¶ 7 On December 7, 2011, Dratewska-Zator filed suit against defendants in the circuit court. Dratewska-Zator's amended complaint is divided into three counts. Count I seeks entry of judgment against the Treasurer and Dratewska-Zator's employer for the amount awarded but not paid to Dratewska-Zator by the Commission, plus costs and attorney fees, pursuant to section 19(g) of the Act (820 ILCS 305/19(g) (West 2004)). Count II seeks a writ of mandamus compelling the Chairman of the Commission to pay 100% of the amount purportedly due Dratewska-Zator under the Commission's award to her. Count III seeks a similar writ of mandamus against the Commissioners.
¶ 8 On May 10, 2012, the Treasurer filed a hybrid motion to dismiss count I of the amended complaint pursuant to section 2-619.1 of the Code of Civil Procedure (Code) (735 ILCS 5/2-619.1 (West 2010)). The motion asserted the claim against the Treasurer should be dismissed pursuant to section 2-619 of the Code (735 ILCS 5/2-619 (West 2010)) because: (1) section 19(g) of the Act specifically excludes applying for judgment "in the case of a claim against the State of Illinois"; and (2) the application for judgment challenges the propriety of the Commission's determination to reduce payment to Dratewska-Zator based on the direct reimbursement to the Department of Healthcare and Family Services, an issue the Treasurer maintained was within the exclusive jurisdiction of the Commission under section 18 of the Act (820 ILCS 305/18 (West 2004)). The Treasurer's motion also asserted count I of the amended complaint should be dismissed pursuant to section 2-615 of the Code (735 ILCS 5/2-615 (West 2010)), asserting the circuit court cannot grant effective relief because the Commission, rather than the Treasurer, has the statutory authority and duty to pay awards from the Fund.
¶ 9 On May 10, 2012, Dratewska-Zator's employer also filed a hybrid motion to dismiss count I of the amended complaint pursuant to section 2-619.1 of the Code. The motion asserted the claim against the employer should be dismissed pursuant to section 2-619 of the Code because the employer paid the compensation due under the award to the Fund. The motion also maintained the claim against the employer should be dismissed pursuant to section 2-615 of the Code, asserting section 4(d) of the Act prohibits the fund from paying Dratewska-Zator's costs and attorney fees.
¶ 10 On June 14, 2012, the Chairman and Commissioners filed a combined hybrid motion to dismiss counts II and III of the amended complaint pursuant to section 2-619.1 of the Code. The motion asserted the claims against these defendants should be dismissed pursuant to section 2-619 of the Code, arguing Dratewska-Zator failed to exhaust her administrative remedies where section 18 of the Act provided "[a]ll questions arising under this Act shall, except as otherwise provided, be determined by the Commission." 820 ILCS 305/18 (West 2004). The motion also maintained counts II and III should be dismissed pursuant to section 2-615 of the Code, arguing Dratewska-Zator cannot allege a clear right to the full award because section 8(a) of the Act provides that where a medical payment is not in dispute, an employer "shall make such payment to the provider on behalf of the employee." 820 ILCS 305/8(a) (West Supp. 2005).
¶ 11 Dratewska-Zator responded to these motions, and following a hearing on September 11, 2012, the circuit court entered an order dismissing Dratewska-Zator's amended complaint with prejudice. On the same date, Dratewska-Zator filed a timely notice of appeal to this court. Dratewska-Zator subsequently filed a motion to proceed with her appeal against only the Treasurer, Chairman and Commissioner, as her employer had filed for bankruptcy. On December 7, 2012, this court granted Dratewska-Zator's motion to proceed.
¶ 12 DISCUSSION
¶ 13 On appeal, Dratewska-Zator contends the circuit court erred in dismissing her amended complaint pursuant to section 2-619.1 of the Code, which allows a party to file a motion combining a section 2-615 motion to dismiss (see 735 ILCS 5/2-615 (West 2010)) with a section 2-619 motion to dismiss (see 735 ILCS 5/2-619 (West 2010)). 735 ILCS 5/2-619.1 (West 2010). A section 2-615 motion to dismiss challenges the legal sufficiency of the nonmovant's pleadings whereas a section 2-619 motion to dismiss admits the legal ...