Opinion
No. 1-15-2049
03-31-2017
MICHAEL P. KLEES, Plaintiff-Appellant, v. VILLAGE OF MOUNT PROSPECT, a municipal corporation; and MICHAEL E. JANONIS and/or DAVID STRAHL, acting in their capacity as "Adjudicator for PSEBA Benefits for the Village of Mount Prospect, Cook County, Illinois, Defendants-Appellees.
NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).
Appeal from the Circuit Court of Cook County
No. 12 CH 30828
Honorable Sophia H. Hall Judge Presiding.
PRESIDING JUSTICE ELLIS delivered the judgment of the court.
Justices McBride and Howse concurred in the judgment.
ORDER
¶ 1 Held: Affirmed. Defendants' administrative decision denying plaintiff's request for health insurance benefits was not against manifest weight of evidence.
¶ 2 The issue in this action is whether plaintiff, Michael P. Klees, is entitled to payment of his health insurance plan premiums pursuant to the Public Safety Employee Benefits Act (PSEBA) (820 ILCS 320/1 et seq.) (West 2012)). The parties do not dispute that plaintiff suffered a "catastrophic injury" under the PSEBA. And this case does not concern whether
plaintiff is entitled to a line-of-duty disability pension; he is, and he has received it, due to the catastrophic injury that rendered him unable to perform his duties as a firefighter. This dispute involves whether plaintiff proved that the injury occurred as a result of his response to an emergency. If he did, then under the PSEBA, plaintiff is entitled to payment of his health insurance premiums for life, in addition to the pension he receives.
¶ 3 Defendant, the Village of Mount Prospect (the Village), ruled that plaintiff did not satisfy the PSEBA requirement and denied his application for benefits. Plaintiff sought a writ of certiorari in the circuit court to overturn that decision. The circuit court initially ruled that the Village's decision was not specific as to the determination of causation and remanded the matter to the Village for a clarification of the basis for its denial of benefits under the PSEBA. After remand, a new adjudicator, David Strahl, issued amended findings of fact and conclusions of law, and again denied plaintiff's application for benefits. Plaintiff filed an amended complaint for certiorari. The circuit court affirmed the administrative decision, and plaintiff filed this appeal.
¶ 4 We affirm the ruling of the circuit court, which affirmed the Village's finding that plaintiff failed to prove that his catastrophic injury resulted from his response to an emergency.
¶ 5 I. BACKGROUND
¶ 6 A. PSEBA
¶ 7 Section 10 of the PSEBA states, in pertinent part:
(a) An employer who employs a full-time law enforcement, correctional or correctional probation officer, or firefighter, who, on or after the effective date of this Act suffers a catastrophic injury or is killed in the line of duty shall pay the entire premium of the employer's health insurance plan for the injured employee,
the injured employee's spouse, and for each dependent child of the injured employee until the child reaches the age of majority or until the end of the calendar year in which the child reaches the age of 25 if the child continues to be dependent for support or the child is a full-time or part-time student and is dependent for support. ***
(b) In order for the law enforcement, correctional or correctional probation officer, firefighter, spouse, or dependent children to be eligible for insurance coverage under this Act, the injury or death must have occurred as the result of the officer's response to fresh pursuit, the officer or firefighter's response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act." (Emphases added.) 820 ILCS 320/10 (2012).
¶ 8 As we noted in the introduction, there is no dispute that plaintiff suffered a "catastrophic injury" and has met that requirement of section 10(a). The question here is whether plaintiff satisfied section 10(b)'s requirement that his injury occurred "as the result of" plaintiff's "response to what is reasonably believed to be an emergency."
¶ 9 B. Evidence of Injuries to Lower Back Suffered by Plaintiff
¶ 10 On May 22, 1972, plaintiff was employed as a firefighter by the Village. During his 25-year career, plaintiff sustained nine work-related injuries to his lower back. Of those nine injuries, the parties agree that three of them occurred while plaintiff was responding to an emergency. At the hearing, they disputed whether plaintiff's fifth injury involved a response to an emergency, but the Village found that it did not. We summarize those injuries below, noting which of these injuries were emergency-related injuries.
¶ 11 1. First injury: January 17, 1974
¶ 12 On "approximately" January 17, 1974, plaintiff was injured while lifting weights in the fire station. According to an injury report not authored by plaintiff, but which purported to have taken information from plaintiff, plaintiff said he suffered a "sore back." The author of the report wrote that plaintiff "notified [the author] on 2/14/74 that the day after lifting weights while on duty his back became sore and progressively got worse. Cause was probably due to overexerting himself." The report indicated that no medical treatment was rendered at the time of the occurrence but that plaintiff "started treatment with a chiropractor on 2/14/74."
¶ 13 2. Second injury: "1983" (emergency-related injury)
¶ 14 Plaintiff states that, sometime in what he estimates was 1983, he was injured while driving a ladder truck on an emergency call. While crossing over train tracks, the impact bounced plaintiff off his seat, and he hit his head on the roof of the truck. He suffered back pain from this incident.
¶ 15 No accident report was filed, and no official claim was made by plaintiff. Plaintiff was not sure the incident occurred in 1983. The fire department chief thought it might have taken place in the late 1970s.
¶ 16 In any event, plaintiff entered into the record several documents to substantiate this injury, including:
• A letter dated August 9, 2007, from a fellow Mt. Prospect firefighter named Larry Bazaar, who wrote that, "I do remember an incident, at the time I was a Mt. Prospect firefighter (1972 - 1985), in which Firefighter Michael Klees hit his head on the interior cab roof of our then existing ladder truck while crossing the Village railroad tracks." (Parenthetical in original.)
• A 1998 letter from Dr. Michael Fragen to the deputy fire chief concerning a different injury plaintiff later suffered in 1998. The letter mentions, in discussing plaintiff's history, that "[i]n 1983, he had a work injury to his low back from a spinal load that occurred when his head bumped the cab ceiling while riding in a rig."
• An injury report dated October 1993, where plaintiff, in answering whether he had suffered any other injury involving back pain, wrote: "Mild herniated disc while driving ladder truck."
• An August 2007 letter from Dr. Stanley Zydlo, who wrote a letter on his stationery that he was asked if he recalled this 1983 injury to plaintiff. Apparently, plaintiff was in the emergency department at Northwest Community Hospital in Arlington Heights, having transported a patient there. "This incident occurred in the 1970s and was not presented to me as an official line of duty complaint by [plaintiff] so no written documentation was made." He continued:
"All I can recall of the incident, due to his concern, is that he did strike the top of his head on the roof of his vehicle while going over [an] uneven part of a roadway. He was concerned because he was experiencing mid low back pain when he got to our hospital E.D. and didn't correlate his back discomfort with his head impacting the interior roof of his vehicle, nor did he wish a report be made.
I reviewed with him the axial load mechanism of his injury and its forces most likely being transmitted to the musculoskeletal lordodic curvature of his back, causing a sudden strain or sprain to his lower back.
I believe I advised him to take anti-inflammatory pain medication (aspirin) and to follow up with his personal physician if his symptoms were not relieved, worsened, or new symptoms occurred." (Parenthetical reference to aspirin in original.)
¶ 17 When asked at the hearing whether this injury ever resolved itself, plaintiff responded, "I want to say yes," and indicated that the injury basically resolved itself within about two weeks. But he also said, "I don't remember not having back pain on and off from about that time going forward at different times ***."
¶ 18 3. Third injury: July 24, 1986 (emergency-related injury)
¶ 19 Roughly three years later, plaintiff injured his lower back while on an emergency ambulance call, as he was lifting a stretcher carrying a 300-pound patient. Plaintiff states that he was treated by a Dr. Kruger, who appears to be a chiropractor. In an injury report for consideration of benefits, plaintiff described his injury as being to the "lower back right side."
¶ 20 Plaintiff testified that he thought he went to work the next day but had to go home due to the pain in his back. He does not recall if he missed any duty days after that.
¶ 21 4. Fourth injury: June 27, 1990
¶ 22 Approximately four years later, plaintiff injured his back while on a training exercise. He was carrying two fire extinguishers across an open field and stepped into a small hole. The record contains various records verifying the incident, including from an eyewitness, as well as injury reports showing that plaintiff was treated at the hospital and by a chiropractor, and that he was advised to have three days' rest following the injury. Plaintiff described his injury as being to his "lower back."
¶ 23 Plaintiff missed two duty days as a result of this injury. After that, his back was "well enough" to return to work, though he did not equate that phrase with "pain-free."
¶ 24 5. Fifth injury: December 14, 1992
¶ 25 Roughly 2½ years later, on December 14, 1992, plaintiff was injured on an emergency ambulance call when he "bent over to pick up medical bag & O2 kit." He described his injury as to the "lower back." When asked whether he had suffered any previous injury to this body part, he wrote: "minor hernia to lower disk." A supervisor's report dated two days later stated that plaintiff had suffered a "possible strain to lower back" when he "bent down to pick up a medical bag and a small CO2 bottle and regulator." Plaintiff does not recall if he missed any duty days as a result of this injury.
¶ 26 Again, the parties disputed whether this injury was a response to an emergency. The Village found that it was not.
¶ 27 6. Sixth injury: August 28, 1993
¶ 28 About nine months later, plaintiff injured his lower back, and suffered pain in both legs, while walking down stairs and missing a step. In his injury report, plaintiff described the incident as "[w]alking through door onto apparatus floor + forgetting the additional step down." He reported being treated by a chiropractor. In describing any prior injuries to his back in the injury report, plaintiff referenced his 1983 emergency-related injury to his back while driving the ladder truck, his 1990 back injury while carrying the fire extinguishers in the training drill, and his 1992 injury while putting the medical bag into the locker. He referenced another injury not pertinent to this appeal and ended by writing, "there may have been others but I don't recall."
¶ 29 Plaintiff testified that a fellow firefighter, Ken Stahl, cracked his back, and plaintiff felt "somewhat better," returning to work to complete his shift.
¶ 30 Plaintiff testified generally that during this time period that we have discussed thus far—roughly 1983 through the early 1990s—his general method of treatment included chiropractic visits, muscle relaxants, intermittent (not consistent daily) pain medication, and rest.
¶ 31 7. Seventh injury: November 20, 1997 (emergency-related injury)
¶ 32 Over four years later, plaintiff was injured while responding to a call, where he assisted paramedics by immobilizing the neck of an unconscious victim who was inside a vehicle and not breathing. He was injured when he angled himself into an awkward position to perform the immobilization. In the injury report, plaintiff described it as follows: "Lifting patient from driver's seat across console to passenger side while support[ing] her head." He described the injury as "lower back." When asked about prior injuries involving his back, he wrote: "many times over the course of 25 yrs of employment." In his written submission to the Village, plaintiff also claimed that he "began to feel tingling and pain in his legs."
¶ 33 The evidence showed that plaintiff did not miss any duty shifts as a result of this injury.
¶ 34 Plaintiff testified that, after this injury, the treatment "became more severe. It was more drastic. It was invasive procedures with the steroid shot in the back, which was not a comfortable thing to go through." Plaintiff estimated that he had three epidural steroid shots.
¶ 35 8. Eighth injury: October 7, 1998
¶ 36 Just under a year later, on October 7, 1998, plaintiff injured his lower back while performing training exercises, namely carrying large amounts of hose, dragging and "pulling up heavy objects," and rappelling. An investigation report corroborated this incident and described the training drills as "physically demanding." In his injury report at the time, plaintiff described the incident leading to injury as "[f]ull turn out gear + 2 lengths of 3" shoulder load." When
asked if he had recovered, he wrote: "Unable most of time to stand erect constant pain." He missed one or two duty days as a result.
¶ 37 9. Ninth injury: June 25, 1999
¶ 38 Approximately nine months later, plaintiff was injured while lifting a Halmatro tool power unit, resulting in lower back and leg pain. In an injury report at the time, plaintiff described the task as "[r]eplacing power unit" and described the body part affected as the "lower left side of back." Although there were no witnesses to the occurrence, an investigation report described the tool plaintiff was lifting as "an extremely heavy piece of equipment" that plaintiff was lifting alone.
¶ 39 At the hearing, plaintiff's counsel asked the following questions of plaintiff regarding the pain he had suffered over the years:
Q: So you've been in some kind of pain since 1983 when you hit your head on the ladder truck; is that correct?
A: Yes.
Q: It would come and go?
A: On and off. It was more constant after the '97 incident. On and off up until then. I could function. I didn't need pain medication all the time.
¶ 40 C. Medical Records and Treatment
¶ 41 No physicians or medical experts offered live testimony at the hearing. The record includes several letters from doctors, including those from three doctors who were charged with determining whether plaintiff was permanently disabled and thus entitled to a duty-disability pension.
¶ 42 1. Doctor Fragen
¶ 43 In a letter date October 22, 1999, Dr. Michael Fragen, MD, FACSM, and Medical Director of Endeavor Plus, opined that plaintiff had "an NFPA Category B condition: Spinal Stenosis" and that plaintiff's "physical examination findings today are consistent with past evaluations." Our review of this letter shows that Dr. Fragen reported on the results of a CT-Myelogram that plaintiff had had eight days earlier and stated that it "showed evidence of spinal stenosis at L4-5 >L3-4 that is unchanged from July of 1996."
¶ 44 2. Doctor Loseff
¶ 45 In a letter dated May 19, 2000 to the Mount Prospect Firefighters Pension Fund Board, Doctor Herbert S. Loseff of the Illinois Bone & Joint Institute, Ltd. wrote that he examined plaintiff on May 17, 2000. Dr. Loseff summarized plaintiff's medical history, noting that plaintiff had had numerous complaints of recurrent back problems dating back many years as a firefighter and that plaintiff had been treated by various modalities, including chiropractic manipulations and standard orthopedic treatment. He noted that, in June 1999, plaintiff had an attack of low back pain which was caused by doing something "on duty" such as lifting a stretcher, but that plaintiff did "not specify the specific injury which caused the low back condition."
¶ 46 Dr. Loseff opined that plaintiff was "unable to pursue his duties as a firefighter-paramedic because of his back condition" and would be "permanently disabled."
¶ 47 3. Doctor Vatz
¶ 48 In a letter dated May 25, 2000 to the Mount Prospect Firefighters Pension Fund Board, Doctor Kenneth A. Vatz, M.D., S.C., wrote that he had conducted an independent medical examination of plaintiff.
¶ 49 Dr. Vatz stated that plaintiff gave a history of multiple injuries (plaintiff estimated eight injuries in 27 years) since 1972 incurred in the performance of his duties as a firefighter. Dr. Vatz stated that plaintiff's problems with his lower back dated back to the mid-1990s, and that plaintiff had been evaluated initially by Dr. Quinn Regan in 1996. In 1998, plaintiff presented with "significant symptoms" in his lower back following an episode in which he had been carrying a 100-pound fire hose along with his regular gear during a drill in a building that was about to be torn down.
¶ 50 Dr. Vatz further noted that, in November 1998, "an MRI scan of the lumbar spine showed mild stenosis at L-3-L4, L4-L5, with facet hypertrophy at these levels and slight foraminal narrowing." In February 1999, plaintiff was "seen in follow-up by Dr, Regan and found to have an abnormal SSEP at the S1 level." Plaintiff's "MRI scan was again noted to show a fracture at the L4-L5 level, and he was said to have more problems with his lumbar radiculopathy when standing and sitting for prolonged periods." Dr. Vatz further described plaintiff's injury of June 1999.
¶ 51 Dr. Vatz also discussed an EMG and nerve conduction study performed on April 9, 1997, by Dr. Livia Hantos, which had been interpreted as showing bilateral L5 and S1 radiculopathies. Dr. Vatz opined that he interpreted the data as more consistent with a polyneuropathy than with multiple lumbosacral radiculopathies. Dr. Vatz opined that plaintiff had "a chronic low back syndrome with pain and sensory symptoms" and that he had "had a lumbar laminectomy at L4-L5 that [had] not eliminated these problems."
¶ 52 He further opined as follows: "It is more likely than not, based on a reasonable degree of medical certainty, that his low back problems have resulted from the cumulative injuries incurred
while performing the duties of a firefighter." Dr. Vatz considered plaintiff to be "totally and permanently disabled in terms of performing the duties of a firefighter."
¶ 53 4. Dr. Fahey
¶ 54 In a letter dated May 22, 2000, to the Mount Prospect Fire Department, Doctor Thomas J. Fahey reported on the results of his independent disability evaluation of plaintiff. He concluded that plaintiff was "permanently disabled for service in the fire department on a permanent basis and that it is duty incurred secondary to the accumulative effects of acts on duty."
¶ 55 In view of Dr. Fahey's opinion that plaintiff's duty-related career-ending disability, i.e., the catastrophic injury, was caused by the accumulative effects of acts of duty, we believe it is important to note that earlier in his letter, Dr. Fahey referenced plaintiff's history of "seven or eight workman's comp related injuries through the years involving his lumbar spine with progressive pain and disability." Dr. Fahey additionally opined that "the current condition emanates from workman's comp related injuries that I presume are substantiated in your file." (As noted earlier, one of those workers' compensation injuries was plaintiff's emergency-related injury of November 20, 1997.) Dr. Fahey further noted that plaintiff had undergone a lumbar laminectomy and decompression, but did not get satisfactory relief of symptoms.
¶ 56 D. Line-of-Duty Disability Pension
¶ 57 On June 30, 2000, based on these evaluations by Drs. Loseff, Vatz, and Fahey, the Board of Trustees of the Mount Prospect Firefighter's Pension Fund awarded plaintiff a "duty-related disability pension," pursuant to section 4-110 of the Illinois Pension Code (40 ILCS 5/4-110 (West 2000)). Section 4-110 states, in relevant part: "If a firefighter, as the result of sickness, accident or injury incurred in or resulting from the performance of an act of duty or from the cumulative effects of acts of duty, is found, pursuant to Section 4-112, to be physically or
mentally permanently disabled for service in the fire department, so as to render necessary his or her being placed on disability pension, the firefighter shall be entitled to a disability pension." (Emphasis added.) 40 ILCS 5/4-110 (West 2012). The board found that plaintiff had adequately demonstrated that his back injury was both disabling and incurred in the course of duty.
¶ 58 E. Workers' Compensation Settlement Order
¶ 59 Many of plaintiffs' back injuries resulted in workers' compensation claims. These were settled in 2007 by the Illinois Workers Compensation Commission Settlement Contract Lump Sum Petition and Order, which referenced injuries occurring on seven different dates. Three of those injuries are not back injuries and have no bearing on this case. Four of the injuries were back injuries, including those occurring on December 14, 1992 (injury while bending over and lifting the medical bag and O2 kit), August 28, 1993 (injury while missing a step down on the apparatus floor), November 20, 1997 (emergency-related injury to back while reaching into a car to immobilize unconscious patient), and June 25, 1999 (injury while lifting Halmatro tool power unit).
¶ 60 F. First PSEBA Application
¶ 61 About 5½ years after receiving his pension, in December 2005, and by addendum in September 2007, plaintiff applied for health insurance benefits under the PSEBA—the request that is under review in this case. As we have explained, plaintiff's burden was to show that he suffered a catastrophic injury (which was uncontested) and that his injury "occurred as the result of *** the firefighter's response to what is reasonably believed to be an emergency ***." 820 ILCS 320/10(b) (2012).
¶ 62 The hearing was held on December 17, 2007. Plaintiff requested a continuance to provide additional information, which plaintiff sent by facsimile a good 4½ years later, on May 15 and
May 30, 2012. We have recited above the documentary evidence of plaintiff's injuries and plaintiff's testimony from that hearing.
¶ 63 On July 9, 2012, defendant, Michael E. Janonis, acting in his capacity as the adjudicator for PSEBA Benefits for the Village of Mount Prospect, denied plaintiff's application. Among Janonis's conclusions was that "[n]either PSEBA nor any Illinois court decision ha[d] provided guidance regarding what or how much of an 'injury' must satisfy the Section 10(b) restrictions that the injury occur while responding to an emergency." Janonis noted that the "final" injury that required surgery and ended plaintiff's career as a firefighter was "a non-emergency related injury" and that "of the nine (9) total injuries claimed by [plaintiff], only three (3) occurred while [plaintiff] was responding to an emergency, and of these three (3) injuries, [plaintiff] missed only a total of four (4) duty shifts, as compared with three and a half (3.5) months missed total for non-emergency related injuries." Janonis found that "the large majority and most serious of [plaintiff]'s injuries did not occur while he was responding to [an emergency]."
¶ 64 Plaintiff filed a complaint for administrative review and declaratory judgment in the circuit court. The circuit court found that Janonis's decision was not specific as to the determination of causation and remanded the matter for further clarification on the issue of causation.
¶ 65 G. Second PSEBA Application
¶ 66 On remand, a new hearing officer, David Strahl, acting in his capacity as the adjudicator for PSEBA Benefits for the Village, again denied plaintiff's application for benefits. Strahl found that plaintiff failed to prove that his previous emergency-related injuries contributed to, or had a role in causing, his catastrophic injury.
¶ 67 H. Circuit Court Decision
¶ 68 Plaintiff filed an amended complaint for certiorari. The circuit court affirmed defendants' administrative decision denying plaintiff's application for PSEBA benefits. Plaintiff filed this appeal.
¶ 69 II. ANALYSIS
¶ 70 A. Applicable Law
¶ 71 "[I]t is well established that a disability may result from multiple causes." (Internal quotation marks omitted.) Scepurek v. Board of Trustees of Northbrook Firefighters' Pension Fund, 2014 IL App (1st) 131066, ¶ 27 (quoting Luchesi v. Retirement Board of the Firemen's Annuity & Benefit Fund, 333 Ill. App. 3d 543, 550 (2002)); accord Wade v. City of North Chicago Police Pension Board, 226 Ill. 2d 485, 505 (2007) (disability pension may be based on line-of-duty aggravation of preexisting physical condition and there is no requirement that duty-related incident be originating or primary cause of injury). "This court has repeatedly held that [a] 'plaintiff need not prove that an injury received on duty was the sole cause of his disability; the injury need only have contributed to the disability.' [Citations.]" Scepurek, 2014 IL App (1st) 131066, ¶ 27.
¶ 72 In Richter, we gave a detailed analysis of causation in the context of section 10(b) of the PSEBA. There, we explained that the plaintiff could "recover under the PSEBA so long as the injury he sustained *** during an emergency response was a contributing cause of his disability, even if it was not the sole cause of that disability." Richter v. Village of Oak Brook, 2011 IL App (2d) 100114, ¶ 21. Under Illinois law, "[i]t need not be the only cause, nor the last or nearest cause. It is sufficient if it combines with another cause resulting in the injury.' [Citation.]" Id.
¶ 73 B. Collateral Estoppel
¶ 74 Preliminarily, plaintiff argues that defendants are collaterally estopped from arguing that plaintiff's emergency response injuries were not a contributing cause of his disabling back condition. Plaintiff relies on the Illinois Workers Compensation Commission Settlement Contract Lump Sum Petition and Order, dated June 25, 2007.
¶ 75 Plaintiff claims the Commission's order resolved the issue of causation. Plaintiff notes that among the four back injuries settled by the Commission was plaintiff's "emergency response" injury of November 20, 1997. Thus, plaintiff contends that the Commission's order was determinative of causation of his career-ending disability, and that the disability was caused, in part, by the November 20, 1997 emergency-related injury.
¶ 76 We would first note that we find no indication in the administrative record that plaintiff raised collateral estoppel before the administrative agency. "It is quite established that if an argument, issue, or defense is not presented in an administrative hearing, it is procedurally defaulted and may not be raised for the first time before the circuit court on administrative review." Cinkus v. Village of Stickney Municipal Officers Electoral Board, 228 Ill. 2d 200, 212 (2008); see also Faulkner-King v. Department of Human Rights, 225 Ill. App. 3d 784, 793 (1992) (finding estoppel argument forfeited where not raised at administrative level). It is no answer that the circuit court considered this argument, as "raising an issue for the first time in the circuit court on administrative review is insufficient" to avoid forfeiture in the reviewing court. Cinkus, 228 Ill. 2d at 213.
¶ 77 Regardless, as the issue has been fully briefed before this court, we agree with defendants and the circuit court that, even if plaintiff's argument had not been forfeited, plaintiff's collateral estoppel argument would fail in any event.
¶ 78 Collateral estoppel is a branch of res judicata that bars the relitigation of an issue actually decided in an earlier proceeding between the same parties. Richter, 2011 IL App (2d) 100114, ¶ 17. For collateral estoppel to apply: " '(1) the issue decided in the prior adjudication must be identical to the issue in the current action; (2) the party against whom estoppel is asserted must have been a party or in privity with a party in the prior action; and (3) the prior adjudication must have resulted in a final judgment on the merits.' [Citation.]" Id.
¶ 79 We begin with the first requirement, whether the issue decided by the Commission was identical to the issue before Strahl. Plaintiff contends that this court has clearly stated that "a workers' compensation settlement award is a conclusive finding regarding causation of the injury which cannot be relitigated later by either party in another proceeding." See, e.g., id. ¶ 24 (commission's order collaterally estopped defendant-Village from relitigating issue of whether plaintiff-firefighter's emergency-related shoulder injury was contributing cause of plaintiff's disability); Thurow v. Police Pension Board, 180 Ill. App. 3d 683, 688-89 (1989) (settlement agreement may be res judicata as to causation but may not be res judicata as to the nature and extent of the disability). Whether the identical issue was actually decided in the first action depends on the facts of the case.
¶ 80 In Richter, the plaintiff-firefighter had five work-related injuries, four related to diesel-induced rhinitis and an emergency-related shoulder injury. The plaintiff contended that the Commission's settlement contract and order conclusively established that the shoulder injury was a proximate cause of his eventual disability. Richter, 2011 IL App (2d) 100114, ¶ 17. The court agreed that, for purposes of the plaintiff-firefighter's PSEBA claim, the Commission's order had resolved the issue of whether the plaintiff-firefighter had suffered an emergency
related injury, and that the defendant-Village was collaterally estopped from re-litigating causation.
¶ 81 But the court in Richter based its decision on statements in the Commission's order that "necessarily establish[ed] that the [emergency-related] shoulder injury was among the causes of the disability that was the subject of the order." Id., ¶ 17. Significantly, the defendant-Village had stipulated "that the pension board's grant of a line-of-duty pension to the plaintiff was 'based on his shoulder injuries.' " Id., ¶ 24. Also, as the court in Richter acknowledged: "Although it is possible for a settlement contract to include an express disclaimer of liability on the part of the defendant and such a provision may under some circumstances prevent the application of collateral estoppel [citation], no such language was included here." Id. ¶ 24.
¶ 82 In this case, the language contained in the Commission's order disclaims liability. As defendants note, the Commission's order states that: "Issues exist as to whether any of these injuries are compensable, and the settlement is made to settle these issues." Thus, we do not believe that the order necessarily established causation for purposes of plaintiff's PSEBA claim. We agree with defendants that the settlement made no factual findings on causation.
¶ 83 The Illinois Supreme Court has explained that "[a]pplication of the doctrine of collateral estoppel must be narrowly tailored to fit the precise facts and issues that were clearly determined in the prior judgment." Nowak v. St. Rita High School, 197 Ill. 2d 381, 390-91 (2001). The supreme court has also stressed the importance of an "identical issue" to the application of collateral estoppel:
" '[I]t is absolutely necessary that there shall have been a finding of a specific fact in the former judgment or record that is material and controlling in that case and also material and controlling in the pending case. It must also
conclusively appear that the matter of fact was so in issue that it was necessarily determined by the court rendering the judgment interposed as a bar by reason of such estoppel. If there is any uncertainty on the point that more than one distinct issue of fact is presented to the court the estoppel will not be applied, for the reason that the court may have decided upon one of the other issues of fact.' " Lange v. Coca-Cola Bottling Co. of Chicago, Inc., 44 Ill.2d 73, 75 (1969) (quoting Hoffman v. Hoffman, 330 Ill. 413, 418 (1928)).
Accord Prospect Development, LLC v. Kreger, 2016 IL App (1st) 150433, ¶ 34.
¶ 84 The Commission's role was to determine whether plaintiff's injuries arose out of the course of his employment, but there is no dispute here that the November 20, 1997 emergency-related injury did. The issue here is whether that injury (or either of the other two emergency-related injuries) caused or contributed to plaintiff's eventual 1999 permanent disability. That causation issue was not before, nor decided by, the Commission, let alone did it consider how the emergency-related injuries figured in with the six other non-emergency related injuries of 1974, 1990, 1992, 1993, 198 and 1999. Thus, we agree with defendants, and the circuit court, that collateral estoppel does not apply here.
¶ 85 C. Standard of Review
¶ 86 The standards of review under a common-law writ of certiorari are essentially the same as the standards under the Administrative Review Law. Pedersen v. Village of Hoffman Estates, 2014 IL App (1st) 123402, ¶ 48. We review the final decision of the administrative agency, not the decision of the circuit court. Id.
¶ 87 The parties disagree on which standard of review this court should apply to the Village's decision denying PSEBA benefits to plaintiff. Plaintiff says our standard of review is either de
novo or clearly-erroneous review. Defendants argue that the correct standard is whether the Village's findings were against the manifest weight of the evidence.
¶ 88 The applicable standard of review depends upon whether the question before the court is a question of fact, a question of law, or a mixed question of law and fact. Kouzoukas v. Retirement Board of Policemen's Annuity & Benefit Fund of City of Chicago, 234 Ill. 2d 446, 463 (2009); Marconi v. Chicago Heights Police Pension Board, 225 Ill. 2d 497, 532 (2007). An agency's findings of fact are given considerable deference and will be reversed only if they are against the manifest weight of the evidence. Kouzoukas, 234 Ill. 2d at 463. Questions of law are reviewed de novo. Id. Cases involving mixed questions of law and fact are reviewed under the clearly-erroneous standard of review. Id. Where the historical facts are undisputed and the issue is whether the established facts satisfy a statutory standard, that issue is a mixed question of law and fact subject to the clearly-erroneous standard. Pedersen, 2014 IL App (1st) 123402, ¶ 52.
¶ 89 The appropriate standard of review in this case is the manifest-weight standard, because the question before us is a purely factual one. This case does not concern the interpretation of a statute or whether the historical facts fall within or outside a statutory definition. Rather, this case concerns one and only one thing—causation. And this court has explained that whether a work-related incident is a cause of a claimant's disability is a purely factual determination which we review under the manifest-weight standard. See Carrillo v. Park Ridge Firefighters' Pension Fund, 2014 IL App (1st) 130656, ¶ 22; accord Rose v. Board of Trustees of Mount Prospect Police Pension Fund, 2011 IL App (1st) 102157, ¶ 94 (where parties did not dispute definition of causation, issue of whether on-duty accident contributed to police officer's disability was purely factual determination to be reviewed under manifest-weight-of-evidence standard); Phalin v. McHenry County Sheriff's Department, 381 Ill. App. 3d 185, 192 (2008) (reversing grant of
summary judgment because issue of whether injury was causative factor in plaintiff's disability was "question of fact").
¶ 90 If we were being asked whether the circumstances of certain injuries fell within or outside the definition of an "emergency" under section 10(b) of the PSEBA, we would be applying historical facts to determine their applicability to a statutory provision, and we would apply the clearly-erroneous standard. That was the case, for example, in Pedersen, 2014 IL App (1st) 123402, ¶ 58, where we were asked to determine whether the circumstances of the plaintiff's injuries qualified as responses to an "emergency" under the PSEBA. That case involved a mixed question of law and fact because "the question of whether an emergency exists is not categorical, but depends on the circumstances of the moment. An event or incident that is not initially an emergency may become an emergency as the circumstances change." Id.
¶ 91 An example of an issue invoking the clearly-erroneous standard in this case, had plaintiff properly raised it, would have been the issue of plaintiff's fifth injury in 1992, which the Village found was not an emergency-related injury, while plaintiff insisted it was. Had we been asked to determine whether the circumstances of plaintiff's fifth injury satisfied the statutory definition of a "response to what is reasonably believed to be an emergency" under the PSEBA (820 ILCS 320/10(b) (2012)), that question would have been a mixed question of law and fact, as it was in Pedersen.
¶ 92 But plaintiff has raised no specific argument before this court that the Village erred in finding that this fifth injury was not emergency-related. Instead, he has merely assumed throughout his brief that it was an emergency-related injury. He has thus forfeited the issue. See Ill. S. Ct. R. 341(h)(7) (eff. Jan. 1, 2016) ("Points not argued are waived ***."); Wilson v. County of Cook, 2012 IL 112026, ¶ 25 (claims supported by "little or no argument" forfeited
under Rule 341(h)(7)); Cwik v. Giannoulias, 237 Ill. 2d 409, 421 (2010) ("a court of review is entitled to have the issues on appeal clearly defined with pertinent authority cited and reasoned, cohesive legal argument."). Absent that mixed question, we are considering purely factual questions.
¶ 93 The circuit court, relying on Pedersen, applied the clearly-erroneous standard in this case. But as we have noted, the issue in this case is distinguishable. Unlike in Pedersen, the only question before this court is whether any of the three admittedly emergency-related injuries caused or contributed to plaintiff's eventual disability. We are reviewing a purely factual finding by the Village, and we will apply the manifest-weight standard to our review.
¶ 94 "An administrative agency's findings and conclusions on questions of fact are deemed prima facie true and correct." Cinkus, 228 Ill. 2d at 210. In examining the factual findings of an administrative agency, a reviewing court does not reweigh the evidence or substitute its judgment for that of the agency; the court is limited to ascertaining whether such findings of fact are against the manifest weight of the evidence. Id.
¶ 95 "An administrative agency decision is against the manifest weight of the evidence only if the opposite conclusion is clearly evident." Wade v. City of North Chicago Police Pension Board, 226 Ill. 2d 485, 504 (2007). This highly deferential standard has been described by the Illinois Supreme Court as follows: "Only if, after reviewing the evidence in a light most favorable to the [administrative agency], we determine that no rational trier of fact could have reached the conclusion reached by the [administrative agency] are we able to overturn a decision under this standard." Chief Judge of the Circuit Court v. American Federation of State, County & Municipal Employees, Council 31, 153 Ill. 2d 508, 514 (1992); accord Holden v. Police Board of City of Chicago, 324 Ill. App. 3d 862, 868 (2001). Thus, the " 'mere fact that an opposite
conclusion is reasonable or that the reviewing court might have ruled differently will not justify reversal of the administrative findings.' " Marconi v. Chicago Heights Police Pension Board, 225 Ill. 2d at 534 (quoting Abrahamson v. Illinois Department of Professional Regulation, 153 Ill. 2d 76, 88 (1992)).
¶ 96 The Village found that plaintiff "did not meet his burden [of] establishing by a preponderance of the evidence that his catastrophic injury was as a result of responding to an emergency." The question before us is whether the opposite conclusion is clearly evident.
¶ 97 D. Analysis of Village's Causation Finding
¶ 98 Initially, plaintiff argues that the Village applied the wrong legal standard in determining whether plaintiff had demonstrated causation. Plaintiff claims that the Village required that plaintiff prove that one or more of his emergency-related injuries was the sole cause of his career-ending disability. The record shows otherwise. The hearing officer's decision stated that "[c]ase law has established that the emergency related injury does not need to be the sole cause of an injury" and that plaintiff "was required to prove that his previous emergency-related injuries contributed to his catastrophic injury." (Emphasis added.) As we previously explained, this was a correct statement of the law, as was the hearing officer's citation to Richter, 2011 IL App (2d) 100114, ¶ 21.
¶ 99 In deciding that plaintiff had failed to prove that any of his three emergency-related injuries played a role in, or contributed to, his eventual career-ending disability, the hearing officer, Strahl, noted that plaintiff had suffered nine back injuries over the course of a 25-year career, only three of which were emergency-related, and that plaintiff had failed to present sufficient evidence that specified how any of the three emergency-related issues played a particular role, if any, in his ultimate disability.
¶ 100 Strahl acknowledged that Dr. Fahey wrote to the pension board that plaintiff's "low back problems in part resulted from the accumulative effects of acts on duty." But Strahl found that "Dr. Fahey did not provide any detail or analysis as to which or how [plaintiff]'s nine injuries affected or caused the eventual disabling injury."
¶ 101 Strahl also acknowledged that Dr. Vatz wrote to the pension board that plaintiff's "injury was a cumulative injury." But Strahl noted that "in describing the injuries, [Dr. Vatz] only mentions two of the non-emergency related injuries as causing pain." (Emphasis in original.) Strahl found that none of the letters contained "any findings as to the specific impact of any of [plaintiff]'s injuries or whether they contributed at all to the disabling injury." Strahl noted that, although the letters contained the doctors' opinions that the injuries were work-related, they did not focus on "emergency or non emergency related activities or injuries." Because the letters "did not make a finding as to whether the specific emergency-related injuries caused or contributed to the disabling injury," Strahl gave them "little weight." (Emphasis in original.)
¶ 102 Simply put, Strahl found that "[t]he complicated and dense medical history of [plaintiff] require[d] more than a brief, conclusory statement that previous injuries had a cumulative effect." Absent more specific medical documentation or expert testimony specifically linking any of the particular emergency-related injuries to plaintiff's ultimate disability, and with no evidence "as to the severity of each injury or any lasting effects of the injuries," Strahl found that plaintiff "did not meet his burden [of] establishing by a preponderance of the evidence that his catastrophic injury was a result of responding to an emergency."
¶ 103 The record shows that plaintiff suffered three emergency-related back injuries—one at an undetermined time that plaintiff estimates as 1983, one in 1986, and one in 1997. Plaintiff missed a total of four duty shifts for those injuries. Interspersed before, between, and after those injuries
were six other back injuries for which plaintiff missed 3½ months of work. Several of these injuries were spaced out by several years. And we would agree with the hearing officer that the relative severity and lasting effect of each injury was not particularly well-supported.
¶ 104 It would not strike us as irrational that emergency-related back injuries incurred in "1983" or 1986 might have played a role in the injury that ultimately ended plaintiff's career in 1999, but neither would it be irrational to suppose that the lengthy passage of time, and the intervening occurrence of several other back injuries in the interim, broke the causal chain between those old back injuries and plaintiff's disability in 1999. The emergency-related injury in 1997 is, to be sure, closer in time—18 months—to plaintiff's ultimate disability. But it is fair to note that plaintiff missed no work after that injury. And while plaintiff did testify that his back pain became more intense after that injury, the hearing officer was not required to believe that testimony.
¶ 105 Nor can we fault the hearing officer for his assessment of the doctors' letters to the pension board. Those doctors found a disability, and they found that the cause of that disability was injuries plaintiff incurred in the course of his duties as a firefighter. Whether the injuries were incurred in the course of plaintiff's firefighting duties was the relevant issue before the pension board. The doctors' reference to "cumulative" injuries did not put a finer point on it—they did not specify that any of plaintiff's emergency-related injuries contributed to his disability. The hearing officer did not draw that favorable inference, and he was not required to do so. Plaintiff did not bolster that evidence with more specific letters from these doctors or with live expert testimony of any kind.
¶ 106 Our review is deferential. The question is not whether we would have reached the same result as the hearing officer. The question is not whether it would be reasonable to reach the
opposite result. Our question is whether the opposite conclusion is clearly evident, after reviewing the evidence in the light most favorable to the Village. Marconi, 225 Ill. 2d at 534; Chief Judge of the Circuit Court, 153 Ill. 2d at 514. We cannot say that no rational trier of fact could have reached the conclusion the Village reached. The opposite conclusion is not clearly evident.
¶ 107 Finally, we would note that, although the hearing officer found that plaintiff's fifth injury was not an emergency-related injury, while plaintiff insists that it was—an argument that we found to be forfeited above—our decision would not be different even if we included plaintiff's fifth injury in the class of emergency-related injuries. The hearing officer's findings spoke generally to the failure of proof in plaintiff's case: that plaintiff failed to provide sufficient medical evidence or testimony as to the severity or lasting impact of any particular injury, and that plaintiff failed to provide any evidence directly establishing that any of the emergency-related injuries contributed to plaintiff's ultimate disability. That criticism holds no less if we included one additional injury under the "emergency-related" category.
¶ 108 For all of these reasons, we affirm the circuit court's ruling upholding the Village's decision.
¶ 109 III. CONCLUSION
¶ 110 The Village's decision denying plaintiff's request for health insurance benefits pursuant to the PSEBA was not against the manifest weight of the evidence. We affirm the judgment of the circuit court, which upheld that determination.
¶ 111 Affirmed.