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Workers' comp success can hinge on solid medical opinion

Posted on in Firm News

Anyone in Illinois who is injured on the job has a right to expect to have their medical treatments and related health care needs covered by workers' compensation benefits. That's why the system exists. However, the science behind the medicine sometimes can come into question. When it does, the result can be a denial of benefits can result.

Every case is going to be different. That's why a detailed assessment of the facts and the circumstances in any given situation is crucial. The importance of having a skilled attorney working on your behalf can't be overstated.

This may be something on the mind of one man after a recent decision by the Illinois Fourth District Appellate Court's Workers' Compensation Commission Division, based in Springfield. According to a news report, the man has been seeking to obtain workers' compensation coverage for a claim dating back to October 2004.

Court records indicate the man had worked at a Missouri corn processing plant where he says he was exposed to the flavoring chemical diacetyl. This product has been found to contribute to what is known as "flavorings-related lung disease," or more commonly as "popcorn worker's lung."

The plaintiff in this case says he worked at the plant for 30 years and damaged his lungs - developing chronic obstructive pulmonary disease (COPD). However, when he submitted his claim for workers' compensation, it was denied; first by an arbitrator, then by the Illinois Workers' Compensation Commission, and then a Macon County court. Last month, the appeals court also upheld the denial.

The man's argument, which the appeals court agreed with, was that his own doctor's opinion about his condition had not been allowed into the record by previous reviews. However, the appeals court said that the doctor's opinion had no merit because it was "not based on a scientific methodology or principle that has gained general acceptance in the relevant scientific community."

In other words, the doctor's opinion didn't pass scientific and medical muster. The appeals court also agreed with previous findings that the plaintiff wasn't a credible witness about his history of exposure to diacetyl.

The lesson is that the evidence needs to not only back up the claim, but also be credible.

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