Failure to give history of accident in ER proves fatal to workers' comp claim
Ruling: The Illinois Workers' Compensation Commission denied a laborer's claim for work-related neck and shoulder injuries based on a failure to provide sufficient proof of a work accident.
Case name: Rivera v. Asmussen Waxler Group, 19 ILWCLB 133 (Ill. W.C. Comm. 2011).
Summary: Rivera worked in the defendant's warehouse packing and delivering food. On Dec. 5, 2003, he was moving, packing and taping boxes of frozen food for 15 to 20 minutes when he noticed pain in his left shoulder and chest. After sitting for a while, he continued working, finished his delivery to the defendant's warehouse, and went home. Rivera testified that after he was home for the evening, the pain in his chest and left arm got worse. The next day, he was taken by ambulance to the emergency room. He did not relate any history of an accident at work or elsewhere. A physical examination showed he had full range of motion of his neck. After obtaining an abnormal EKG, river signed himself out of the hospital against medical advice.
He followed up with his primary care physician Dec. 9, 2003, and complained of pain radiating from his neck into his left shoulder. The doctor advised Rivera to avoid heavy lifting or strenuous exercise, but she did not specifically take him off work.
One month later, an MRI revealed a right sided disk herniation and "extensive change" in the left shoulder area, where Rivera had prior shoulder surgery. Rivera testified that he has not worked since the work incident and is currently receiving Social Security disability due to medical conditions involving his neck, back, left shoulder, carpal tunnel syndrome, and obesity.
The arbitrator found Rivera failed to prove an accidental injury or a causal relationship between the alleged injury and his current condition of ill-being. Rivera failed to testify to either a precipitating specific event or precipitating repetitive trauma.
Upon review, the Illinois Workers' Compensation Commission affirms the denial of accident but on a failure of proof basis. In so holding, the Commission pointed to Rivera's testimony that on the day of the accident he spent 20 minutes moving boxes that weighed 10 to 15 pounds each before experiencing the onset of left-sided chest pain and left arm pain. He testified that his pain worsened after he finished his workday and went home.
However, the emergency room records contained to mention of any work-related activities. Rivera testified he did not mention any such activities to the emergency room personnel because he did not think he got injured at work.
