Josh Rudolfi Secures Knee Surgeries for Truck Driver

Josh Rudolfi Secures Knee Surgeries for Truck Driver

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  ILLINOIS WORKERS’ COMPENSATIONCOMMISSION DECISION SIGNATURE PAGE Case Number 24WC Case Name v. Lakeshore Beverage Consolidated Cases Proceeding Type 19(b) Petition Decision Type Arbitration Decision Commission Decision Number Number of Pages of Decision 9 Decision Issued By Arbitrator Petitioner Attorney Joshua Rudolfi Respondent Attorney DATE FILED: 5/30/2025 Signature INTEREST RATE WEEK OF MAY 28 2025 4.16%
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  STATE OF ILLINOIS) Injured Workers’ Benefit Fund (§4(d)) )SS. Rate Adjustment Fund (§8(g)) COUNTY OF COOK ) Second Injury Fund (§8(e)18) None of the above ILLINOIS WORKERS’ COMPENSATION COMMISSION ARBITRATION DECISION 19(b) Case # 24 WC Emp oyee Pet t oner v. Consolidated cases: ----- Lakeshore Beverage Employer/Respondent An Application for Adjustment of Claim was filed in this matter and a Notice of Hearing was mailed to each party. The matter was heard by the Honorable , Arbitrator of the Commission, in the city of Chicago, on 4/17/2025. After reviewing all of the evidence presented, the Arbitrator hereby makes findings on the disputed issues checked below, and attaches those findings to this document. DISPUTED ISSUES A. Was Respondent operating under and subject to the Illinois Workers' Compensation or Occupational Diseases Act? B. Was there an employee-employer relationship? C. Did an accident occur that arose out of and in the course of Petitioner's employment by Respondent? D. What was the date of the accident? E. Was timely notice of the accident given to Respondent? F. Is Petitioner's current condition of ill-being causally related to the injury? G. What were Petitioner's earnings? H. What was Petitioner's age at the time of the accident? I. What was Petitioner's marital status at the time of the accident? J. Were the medical services that were provided to Petitioner reasonable and necessary? Has Respondent paid all appropriate charges for all reasonable and necessary medical services? K. Is Petitioner entitled to any prospective medical care? L. What temporary benefits are in dispute? TPD Maintenance TTD M. Should penalties or fees be imposed upon Respondent? N. Is Respondent due any credit? O. Other ICArbDec19(b) 4/22 Web site: www.iwcc.il.gov
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  FINDINGS On the dateof accident, 4/30/2024, Respondent was operating under and subject to the provisions of the Act. On this date, an employee-employer relationship did exist between Petitioner and Respondent. On this date, Petitioner did sustain an accident that arose out of and in the course of employment. Timely notice of this accident was given to Respondent. Petitioner's current condition of ill-being is causally related to the accident. In the year preceding the injury, Petitioner earned $80,600.00; the average weekly wage was $1,550.00. On the date of accident, Petitioner was 53 years of age, married with 1 dependent children. Respondent has not paid all reasonable and necessary charges for all reasonable and necessary medical services. Respondent shall be given a credit of $0 for TTD, $0 for TPD, $0 for maintenance, and $0 for other benefits, for a total credit of $0. Respondent is entitled to a credit of $0 under Section 8(j) of the Act. ORDER Medical Benefits • Respondent shall pay reasonable and necessary medical services of $23,560.04, as provided in Section 8(a) and 8.2 of the Act. • Respondent shall a reasonable and necessary medical services, pursuant to the medical fee schedule, of $8125.00 to Therapy, $14,785.04 to Health, and $650.00 to Anesthesia & Pain, as provided in Sections 8(a) and 8.2 of the Act. • Respondent shall be given a credit of $0.00 for medical benefits that have been paid, and Respondent shall hold petitioner harmless from any claims by any providers of the services for which Respondent is receiving this credit, as provided in Section 8(j) of the Act. Prospective Medical Care • Res ondent shall authorize and pay for the bilateral knee meniscectomies as recommended by Dr. S along with all reasonable and necessary post-operative care. Respondent shall authorize and pay for medial branch blocks at C5-C7 as recommended by Anesthesia & Pain. • In no instance shall this award be a bar to subsequent hearing and determination of an additional amount of medical benefits or compensation for a temporary or permanent disability, if any. RULES REGARDING APPEALS Unless a party files a Petition for Review within 30 days after receipt of this decision, and perfects a review in accordance with the Act and Rules, then this decision shall be entered as the decision of the Commission. STATEMENT OF INTEREST RATE If the Commission reviews this award, interest at the rate set forth on the Notice of Decision of Arbitrator shall accrue from the date listed below to the day before the date of payment; however, if an employee's appeal results in either no change or a decrease in this award, interest shall not accrue. __________________________________________________ Signature of Arbitrator ICArbDec19(b)
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  1 BEFORE THE ILLINOISWORKERS’ COMPENSATION COMMISSION ) ) Petitioner, ) ) v. ) Case No. 24 WC ) Lakeshore Beverage, ) ) Respondent. ) STATEMENT OF FACTS Petitioner has worked for Respondent as a semi-truck driver for the past 32 years. (Transcript of Arbitration, hereinafter referred to as “R”, 6) As a driver he makes deliveries and unloads pallets from his trailer using an electric pallet jack. Id. Petitioner was working as a driver for Respondent on April 30, 2024 and was returning back to Respondent’s warehouse when his semi-truck was struck by an SUV that ran a red light. R 7. Petitioner testified that he was in the middle of an intersection when the SUV “t-boned” him. Id. Petitioner testified that he struck both of his knees on the dashboard and felt pain in both knees, his back, and his neck. R 7-8. Petitioner immediately reported the accident to his company. R 8. Accident and notice are not in dispute. Arb. Ex. 1. Petitioner testified that Respondent sent him to Medical Center ( ). R 8. Petitioner was seen on May 3, 2024 at . Pet. Ex. #1, at 12. Petitioner reported being involved in an MVA, striking his knees on the dash. Id. He complained of pain primarily in the left knee along with the upper back, left shoulder, and back. Id. at 15. Petitioner was referred to physical therapy and allowed to continue to work full duty. Id. at 16-17. Petitioner followed up at on May 6, 2024. Id. at 32 Petitioner indicated his pain was getting better but he was still noted to be limping. Id. He was instructed to continue working full duty and continue physical
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  2 therapy. Id. at33. On May 7, 2024 Petitioner was discharged by at two physical therapy visits on May 6 and May 7. Id. at 25-26. Petitioner testified that he continued to have pain in his neck, back and knees. R 9-10. Due to continued pain Petitioner sought a second opinion with Pain Specialists ( ) on May 10, 2024. R 10. Petitioner reported being involved in the MVA on April 30, 2024 indicating that he struck both of his knees on the dash and his body jerked, causing pain to his neck and back. Pet. Ex. #2, 7. His physical exam revealed tenderness in both knees and his neck. Id. Petitioner was sent for physical therapy and kept on full duty work. Id. at 10-11. The doctor also noted that “I feel that the injuries reported in today’s visit are causally related to the injuries sustained during the accident.” Id. at 11. Petitioner underwent a course of physical therapy at from May 14, 2024 to June 21, 2024. Pet. Ex. #4. In his initial physical therapy assessment Petitioner indicated that he had pain in both knees and the neck. Id. at 61. Petitioner followed up with on June 7, 2024 and indicated that his neck pain was getting better (7/10) and his knees continued to be “sharp and achy in the morning”, 6/10. Pet. Ex. #2, 12. Due to continue pain, Petitioner was referred for bilateral MRIs of the knees. Id. at 16. An MRI of the right knee performed on July 5, 2024 revealed a grade 2 ACL sprain, quadriceps femoris tendinosis vs. partial tear, post-traumatic Hoffa’s fat pad impingement, and grade 4 chondromalacia patellae. Pet. Ex. #3, 29. An MRI of the left knee performed on July 5, 2024 revealed an MCL partial tear, medial meniscus tear, an interstitial tear of the quadriceps, and various ligament sprains. Id. at 31. Petitioner followed up at on July 15, 2024 and continued to complain of 3-4/10 neck pain, 7/10 left knee pain, and 6/10 right knee pain. Pet. Ex. #2, 18. His physical examination
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  3 was positive forfacet loading in the neck, and his valgus/vargus tests were positive bilaterally in the knees. Id. at 21-22. Petitioner was recommended for cervical facet joint injections, but refused them. Id. He was also referred to an orthopedic surgeon due to the multiple partial-thickness tears seen on the MRIs of the knees. Id. Petitioner was seen by orthopedic surgeon Dr. S at on August 5, 2024. Pet. Ex. #3, 15. Petitioner reported bilateral knee pain, left greater than right, following his April 30, 2024 MVA. Id. He denied any prior history of knee issues. Id. Physical examination of the knees indicated positive anterior drawer and Lachman testing. Id. Dr. S reviewed the MRIs and indicated that Petitioner had a medial meniscus tear on the left, and a small medial meniscus tear on the right. Id. For these conditions, Dr. S recommended bilateral meniscus repairs, starting with the left knee first. Id. Petitioner testified that he continued to follow up with approximately once per month following the surgical recommendation from Dr. S . R 12. On November 7, 2024 Respondent sent Petitioner for an Independent Medical Examination (IME) with Dr. F at at . Resp. Ex. #1. Dr. F noted a history of injury consistent with Petitioner’s testimony and all of Petitioner’s other medical records. Id. at 1, 3. Dr. F performed a physical examination and opined that Petitioner had resolve bilateral knee contusions that were causally related to the work accident. Id. at 5. Dr. F noted that he believed the MRIs were both negative for tears and indicated that Petitioner was an MMI and required no further medical care. Id. at 5-6. Petitioner followed up with Dr. S on January 20, 2025. Pet. Ex. #3, 3. Dr. S noted bilateral medial joint line tenderness and positive medial McMurray’s signs bilaterally, left wors than right. Id. Dr. S also reviewed the IME report re-reviewed the MRIs. Id. Dr. S noted
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  4 that both heand the radiologist who reviewed the MRIs disagreed with Dr. F ’s assessment that the MRIs were normal. Dr. S and the radiologist both noted acute changes on the right and left knee MRIs, noting specifically a medial meniscus tear on the left along with a partial MCL tear. Id. Dr. S again recommended bilaterally meniscus repairs (with possible ACL repairs depending on the intra-operative findings) starting with the left knee. Id. Petitioner followed up with on February 14, 2025 and March 14, 2025. Pet. Ex. #2. Petitioner was referred for left C5-C7 medial branch blocks due to continued pain in the neck. Id. at 53. Petitioner testified that if the Arbitrator were to award the recommended surgeries that he would have them performed immediately. R 13. He testified that prior to April 30, 2024 he never had any issues with either knee, nor sought treatment for either knee. Id. Petitioner testified that he has worked for the Respondent for 32 years. R 14. Petitioner continued to have pain in his knee and back even as of the date of trial and continues working full duty because he has bills to pay. Id. Petitioner denied ever having treatment for his neck prior to this accident. R 15. Petitioner continues taking Tylenol for his pain. R 20. CONCLUSIONS OF LAW Causal Connection The Arbitrator finds that Petitioner’s current condition of ill-being is causally related to his undisputed April 30, 2024 work accident. noted in every visit (starting on May 10, 2024) that they believed his conditions were causally related. Dr. S noted in both visits that Petitioner had no history of issues with either knee. Even Respondent’s own IME doctor, Dr. F , opined that Petitioner’s current condition of ill-being is causally related to the work accident. Resp. Ex. 1,
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  5 pp. 5. Further,the medical records are all consistent in terms of mechanism of injury. Accordingly, the Arbitrator finds that Petitioner’s current condition of ill-being is causally related to the undisputed work accident. Medical Bills The Arbitrator finds that Petitioner’s medical care has been reasonable and necessary and that Respondent has not paid all appropriate charges. Since being injured in the undisputed work accident Petitioner has undergone a conservative course of treatment consisting of office visits, physical therapy, and prescription medication/topicals. Respondent’s IME doctor even opined that all treatment has been reasonable and necessary. Resp. Ex. #1, pp. 5. The Arbitrator agrees and finds that Petitioner’s medical care has been reasonable and necessary. Further, Petitioner has introduced bills reflecting a total balance of $23,560.04 for this medical care. These medical bills are therefore awarded to Petitioner, to be adjudicated pursuant to the Illinois Medical Fee Schedule. Prospective Medical Care The Arbitrator finds that Petitioner is entitled to prospective medical care in the form of bilateral knee arthroscopies and cervical medial branch blocks. With regard to the bilateral knee conditions, there is no dispute that the conditions are causally related to the accident. The issue in this matter is whether or not Petitioner requires further medical care. Dr. S and the radiologist both read the MRIs as revealing meniscus tears bilaterally, and an MCL tear on the left side. Dr. F noted in his report that he also reviewed the images and opined that they revealed degenerative changes, with no acute meniscal or ligamentous injury. Both Dr. S and the
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  6 radiologist disagree withthis review. The Arbitrator finds that the opinions of Dr. S and the radiologist are more persuasive and adopts them. Accordingly, the recommendation for bilateral knee surgery is reasonable and necessary in light of the objective medical evidence revealed on the bilateral knee MRIs. Accordingly, the Petitioner is awarded bilateral knee arthroscopies along with all reasonable and necessary post-operative care. With regard to the cervical spine has recommended left-sided medial branch blocks from C5-C7 and noted in each visit that Petitioner’s injuries were caused by the undisputed work accident. There is no countervailing opinion. Therefore, the Arbitrator awards these medial branch blocks.