Court of Appeals of Illinois, Third District, Workers' Compensation Commission Division
Appeal from the Circuit Court of Cook County, Illinois Circuit No. 11-L5-1071, Honorable Margaret Brennan, Judge, Presiding.
Justices Hoffman, Hudson, Harris, and Stewart concurred in the judgment and opinion.
HOLDRIDGE, PRESIDING JUSTICE
¶ 1 The claimant, Joseph Locasto, filed an application for adjustment of claim under the Workers' Compensation Act (the Act) (820 ILCS 305/1 et seq. (West 2008)) seeking benefits for injuries which he sustained while working for the employer, the City of Chicago (the City). After conducting a hearing, the arbitrator found that the claimant had proven a work-related injury and awarded him 75 5/7 weeks of temporary total disability (TTD) benefits plus medical expenses. However, the arbitrator denied the claimant's claim for temporary partial disability (TPD) benefits and/or maintenance benefits.
¶ 2 Both parties appealed the arbitrator's decision to the Illinois Workers' Compensation Commission (the Commission). The claimant appealed the arbitrator's denial of TPD and/or maintenance benefits. The City appealed the Commission's award of TTD benefits and medical expenses, arguing that: (1) the claimant's claims are barred by section 1(b)(1) of the Act (820 ILCS 305/1(b)(1) (West 2008)), which excludes "duly appointed member(s)" of the City's fire department from the Act's definition of a covered "employee" for purposes of the claims at issue in this case; (2) the claimant's claims are barred under the doctrines of res judicata and/or collateral estoppel because the Retirement Board of the Firemen's Annuity and Benefit Fund of Chicago (the Board) denied the claimant's claim for duty disability benefits arising out of the same accident and injuries at issue in this case. The Commission unanimously rejected the City's arguments, modified the arbitrator's decision by awarding TPD benefits and reducing the award of medical expenses, and affirmed and adopted the arbitrator's decision in all other respects.
¶ 3 The City sought judicial review of the Commission's decision in the circuit court of Cook County, which confirmed the Commission's ruling. This appeal followed.
¶ 4 FACTS
¶ 5 In May 2008, the claimant was employed by the City as a candidate in training at the Chicago Fire and Paramedic Academy (the Academy). The claimant was training to become a paramedic with the Chicago fire department. At that time, the claimant had been licensed as a paramedic by the State of Illinois for eight years. Prior to his employment with the City, the claimant worked as a paramedic with Children's Memorial Hospital (Children's). Before he was admitted to the Academy, the claimant was examined and declared fit for duty by the City's physician and by his own doctor, and he passed a physical fitness and agility test.
¶ 6 On May 6, 2008, the claimant reported to the Academy for training at 6:00 a.m. The claimant testified that the candidates underwent rigorous physical training (including intense, continuous physical exercises) for several hours in an extremely hot environment with very minimal water breaks. He stated that the training included military-style hazing with yelling, verbal abuse, and the assignment of additional exercises as punishment for the entire group if a single candidate did not complete a task in a timely manner. He testified that, following a 45-minute lunch break at noon, the candidates were required to exercise vigorously straight through until 4:30 p.m. with only a single, one-minute water break. The claimant did not request special permission to get a drink of water out of fear of punishment for the entire group.
¶ 7 After completing his first day of training, the claimant experienced cramps in his right quadriceps. That evening, he drank Gatorade and water, took Advil, and iced his leg.
¶ 8 The following morning, the claimant reported to the Academy for training at 7 a.m. He testified that the candidates were required to work out straight through until lunchtime with no water breaks. According to the claimant, the instructors yelled at individual candidates, telling them to "quit or go the hospital" if they could not take it. He testified that, following a 45-minute lunch break, the workouts became more intense and lasted for longer periods of time. During the late afternoon, the claimant noticed severe cramping in his right leg. He testified that, by the end of the training session, his leg was so sore he had difficulty climbing into his sport utility vehicle to drive home.
¶ 9 Although the claimant took Advil later that evening, he continued to experience severe cramping in his right leg. He hydrated and applied ice and heat to his leg. At 5:30 a.m., the claimant noticed his urine was tea colored and looked like blood. When he phoned his instructor to report his condition, the instructor told him to go to the emergency room.
¶ 10 The claimant sought treatment at Illinois Masonic Hospital where he was diagnosed with rhabdomyolysis, acute kidney failure, and compartment syndrome. Rhabdomyolysis is a condition of the kidneys that occurs when muscle tissue rapidly breaks down (due to overexertion and dehydration, crush injury or toxins) and releases the protein myoglobin into the bloodstream, causing the kidneys to lose function. Compartment syndrome is a condition caused by the compression of nerves, blood vessels and muscle inside a closed space within the body. The compression can lead to tissue death due to lack of oxygenation as the blood vessels are compressed by the raised pressure within the compartment. This can cause subsequent loss of function, including paralysis. Amputation of the affected area might be required in some cases.
¶ 11 The medical records of the emergency room reflect that orthopedic surgeons were consulted regarding the swelling of the claimant's legs. Dr. David Hoffman, an orthopedic surgeon, diagnosed compartment syndrome and performed immediate surgery. The claimant underwent a fasciotomy wherein his right leg was cut open and left open for several weeks to relieve the pressure and swelling in the leg and to allow the muscles to expand. He remained in the intensive care unit for approximately 15 days. The claimant required over 100 staples to close the fasciotomy. Moreover, the claimant was placed on dialysis due to his rhabdomyolysis from dehydration. He was discharged from the hospital on June 13, 2008, and he continued to undergo dialysis for several months thereafter.
¶ 12 Following his discharge from the hospital, the claimant saw Dr. Steven Fox, his primary care physician, Dr. Eduardo Cremer, a nephrologist, and Dr. Hoffman. All three doctors opined that the claimant's conditions of ill-being were causally related to the intense workouts and subsequent dehydration he suffered at the Academy. The claimant also saw physicians at the Chicago fire department. The City's physicians continued the claimant off work through at least February 25, 2009.
¶ 13 On August 26, 2008, Dr. Hoffman opined that the claimant's compartment syndrome had resolved and he released the claimant to return to work from an orthopedic point of view. However, Dr. Hoffman advised that claimant continue to follow up with his nephrologist.
¶ 14 After examining the claimant and evaluating the condition of his kidneys, Dr. Cremer released the claimant to return to work at a regular job on September 17, 2008, provided that he stayed well hydrated and did not overexert himself. On November 11, 2008, Dr. Cremer released the claimant to return to "regular activities." However, during his December 3, 2009, evidence deposition, Dr. Cremer testified that the claimant should "absolutely not" return to the strenuous and intense rigors of the Academy training. Dr. Cremer opined that the claimant's kidneys will never be normal. He stated that the claimant should avoid nonsteroidal anti-inflammatory medications, antibiotics, and anything that causes extreme exhaustion or severe muscle soreness. He noted that the claimant requires annual metabolic testing. However, Dr. Cremer acknowledged that claimant could possibly run a marathon if he used extreme caution, conditioned properly, and hydrated appropriately.
¶ 15 The claimant continued to follow up with Chicago fire department physicians. The claimant testified that one of the City's nurses told him that he needed a written release from his doctor to allow him to enter the next Academy class in November 2008. Accordingly, the claimant returned to Dr. Fox and asked him for a work release. On November 5, 2008, Dr. Fox wrote a note stating that the claimant was in excellent health and that he had been cleared for "unrestricted physical activity." One week later, the claimant met with Commander Edenburgh, a doctor who heads the Chicago fire department's medical division, and gave him Dr. ...