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Workers’ Compensation FLASHPOINTS August 2019

August 15, 2019Print This Post Print This Post

Joseph P. Basile | E-mail Joseph Basile

This month features a review of a case involving a claim for death benefits by a minor child who was legally adopted subsequent to the death of his biological father in a work-related accident. The Workers’ Compensation Commission Division of the Illinois Appellate Court unanimously found the child was entitled to death benefits. This was the focal issue in the case in which the court interpreted §7(a) of the Workers’ Compensation Act, 820 ILCS 305/1, et seq. The other issues are also reviewed.

Minor Child Was Entitled to Death Benefits Although Legally Adopted Subsequent to Death of His Father

The Workers’ Compensation Commission Division of the Illinois Appellate Court issued a decision affirming the Commission’s determination that a minor child who was adopted after his father’s death in a work-related accident was entitled to death benefits under §7(a) of the Workers’ Compensation Act in Ravenswood Disposal Services v. Illinois Workers’ Compensation Commission, 2019 IL App (1st) 181449WC. The case involves other issues, including employer-employee, liability for medical expenses, and penalties and attorneys’ fees.

Raul Laguna died on September 15, 2013, as a result of a work-related accident that occurred on September 14, 2013. He married Maria Diaz on June 4, 1996. Their son, Sergio, was born on November 9, 2001. They divorced on August 18, 2010, and Maria married Isidro Delgado on October 17, 2010.

Maria testified Raul complied with court orders to pay child support. He made those payments until he died and would give Sergio a weekly allowance. After Raul died, Isidro adopted Sergio. Maria and Isidro changed Sergio’s last name from Laguna to Delgado. Maria paid all of Sergio’s health and welfare expenses, and at times Isidro would contribute a little less than 30 percent of Sergio’s expenses.

The president of Ravenswood Disposal Services (RDS) testified Raul began working for them a few years before his death. A spreadsheet showed payments adding up to $37,674.70 between September 8, 2012, and September 11, 2013. The president testified RDS initially paid Raul by sending checks to a staffing company but later, at Raul’s request, paid him in cash. Raul asked to “do work differently” by working at only one of RDS’s premises and setting his own hours. 2019 IL App (1st) 181449WC at ¶5. The president testified he told Raul what to do and agreed that he controlled how Raul did his job. He also testified that Raul was doing the work employees do when the accident occurred.

Sergio testified that he considered Maria and Isidro his parents, that Isidro brought him things after marrying Maria, and that he spent most of his time with them. He did not see Raul often, but Raul would pick him up from school two or three days a week and give him some money.

At the arbitration hearing Maria’s counsel introduced into evidence a notice from the Department of Healthcare and Family Services (HFS) to RDS, stating HFS was subrogated to Raul’s right to recover medical expenses paid on his behalf. The attorney also tendered medical bills. RDS’s counsel objected to the admission of the bills on the basis that many had been reduced. The arbitrator inquired if RDS’s counsel had any other basis for objecting, and RDS’s counsel replied “no.” 2019 IL App (1st) 181449WC at ¶9. The arbitrator asked Maria’s counsel if the bills were certified. He replied that they were but that the certifications were not attached and that he could represent to the court they had been obtained by subpoena. The arbitrator admitted the bills.

Following the hearing, the arbitrator found that RDS employed Raul on the date of accident, found the accident compensable, determined Sergio was Raul’s survivor for purposes of §7(a) of the Act and that RDS unreasonably argued that no employment relationship existed. The arbitrator ordered RDS to pay medical bills subject to the fee schedule, awarded Sergio accrued death benefits and weekly benefits, granted RDS a credit for payments made, and awarded penalties and attorneys’ fees pursuant to §§19(k), 19(l), and 16.

The Commission affirmed and adopted the decision. One commissioner dissented, noting that although §7(a) does not terminate benefits for dependent minors upon adoption in the same manner as surviving spouses who remarry, that provision should be construed based on the intent of the Adoption Act, 750 ILCS 50/1, et seq.) to terminate all parental rights and responsibilities of a biological parent in lieu of the adoptive parent. The dissent reasoned that Sergio’s adoption “terminated his dependency on his late father and therefore his entitlement to survivor benefits.” 2019 IL App (1st) 181449WC at ¶11.

The appellate court first addressed the Commission’s finding that RDS employed Mr. Laguna. Although the record did not specify what Mr. Laguna’s duties were, it was undisputed he was crushed between a dump truck and a front loader. RDS’s president testified that Raul was doing the work employees do and that he told him what to do and controlled how the work was done. The cash payments were not sufficient to create an inference that he was paid as an independent contractor. The evidence, as a whole, supported the finding that he was an employee, and the Commission’s finding was not against the manifest weight of the evidence.

The next issue concerned the award for medical bills. RDS argued the bills were admitted into evidence without proof they were certified or obtained pursuant to a subpoena under §16. Section 16 relaxes the foundational requirement for the admission of hospital records, provided that “records, reports, and bills kept by a treating hospital, . . . certified to as true and correct by the hospital . . . shall be admissible without any further proof as evidence of the medical and surgical matters stated therein.” 2019 IL App (1st) 181449WC at ¶19. When a proper objection is made it is necessary to show compliance with §16. The only objection raised by RDS was that the bills had been reduced and, therefore, were inaccurate. The arbitrator did ask petitioner’s counsel if the bills were certified or obtained by subpoena; however, RDS did not raise that as an objection. As a result, RDS’s claim of error based on lack of certification was forfeited.

The third issue was the Commission’s determination that Sergio qualified as Mr. Laguna’s dependent under §7(a). RDS argued as a matter of law death benefits are not due to a decedent’s child who has been adopted. It relied on §17 of the Adoption Act (750 ILCS 50/17), which relieves the natural parents of a child sought to be adopted of all parental responsibility for the child. RDS argued that Sergio’s adoption severed any liability for death benefits under the Workers’ Compensation Act.

To resolve this issue, the court interpreted §7(a) of the Workers’ Compensation Act. Its purpose is to provide compensation to persons who were dependent on the deceased employee for support or as to whom a legal obligation to support existed. In regard to a child or children, death benefits must be paid to “any surviving child . . . until . . . the age of 18,” or if the child is “enrolled as a full time student in any accredited educational institution, the payments shall continue until such child has attained the age of 25.” 2019 IL App (1st) 181449WC at ¶23, quoting 820 ILCS 305/7(a). The term “child” refers to “a child whom the deceased employee was legally obligated to support or a child to whom the deceased employee stood in loco parentis.” 2019 IL App (1st) 181449WC at ¶23.The phrase “legally obligated to support” does not create a “statutory requirement for benefits” under §7(a). Id. It serves as a catch-all for those children not covered by the other enumerated categories in the statute.

The opinion cites Drives, Inc. v. Industrial Commission of Illinois, 124 Ill.App.3d 1014, 464 N.E.2d 1142, 80 Ill.Dec. 159 (4th Dist. 1984), which held that a surviving child enrolled full time in graduate school could not be denied benefits because she married after her father’s death. Section 7(a) contemplates that a child may qualify for benefits based on one statutory ground but not another, and the fact that a child does not qualify under a particular ground will not prevent benefits under a different ground, if one exists.

While Sergio’s adoption after his father’s death may have precluded him from ongoing benefits on the basis that his father was “legally obligated” to support him, it did not restrict him from claiming benefits on a different basis, viz, that he was under age 18 when his father died. The court observed that, while there are limitations applicable to the benefits available to a surviving spouse who remarries, §7(a) contained no such limitation terminating Sergio’s rights to benefits by reason of his adoption when he was otherwise qualified for them by reason of his age when the accident occurred.

The court rejected RDS’s position that the outcome was irreconcilable with §17 of the Adoption Act (750 ILCS 50/17), which concerns the duties of a natural parent owed to a child and not the child’s rights vis-à-visthe natural parent. It is also not necessary to establish that a child was completely dependent on the decedent to recover benefits under §7(a) of the Workers’ Compensation Act. What is required is that a legally enforceable basis for the dependency exists at the time of the accident. Inventory Service Corp. v. Industrial Commission, 62 Ill.2d 34, 338 N.E.2d 377 (1975). Although Sergio received some support from his adoptive parent, that did not defeat his entitlement to benefits when he was also dependent on his biological father when the accident occurred. The court found there was sufficient evidence supporting the Commission’s determination that Sergio was dependent on his biological father at the time of Mr. Laguna’s death.

The final issue to resolve was the awards for additional compensation under §§19(k) and 19(l) and attorneys’ fees under §16a. Here the court determined that the Commission’s finding that RDS’s dispute that Mr. Laguna was not its employee was unreasonable was supported by the evidence. While RDS’s argument that Sergio was not Mr. Laguna’s dependent was reasonable, that did not preclude the awards of penalties and fees. The Commission determined that RDS lacked a reasonable basis for challenging the existence of an employment relationship, and that relationship gave rise to the obligation to pay medical expenses; therefore, it was not irrational to impose penalties despite the fact that RDS’s unrelated challenge to Sergio’s status as a dependent was reasonable. In fact, on appeal RDS had not challenged the Commission’s imposition of penalties and fees for its failure to pay benefits predicated on its argument that Mr. Laguna was not its employee. Consequently, that issue was also forfeited. Despite the forfeiture, the Commission could reasonably determine the failure to pay medical expenses was deliberate and in bad faith, such that it did not abuse its discretion in imposing penalties and fees.

For more information on workers’ compensation, see WORKERS’ COMPENSATION PRACTICE (ILLINOIS) — 2015 EDITION. Online Library subscribers can view it for free by clicking here. If you don’t currently subscribe to the Online Library, visit www.iicle.com/subscriptions.facebooktwittergoogle_pluslinkedinrssyoutube

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