{ "id": 5782103, "name": "JOEL W. ZIEN, Plaintiff-Appellant, v. THE RETIREMENT BOARD OF THE FIREMEN'S ANNUITY AND BENEFIT FUND OF CHICAGO et al., Defendants-Appellees", "name_abbreviation": "Zien v. Retirement Board", "decision_date": "1992-10-15", "docket_number": "No. 1\u201491\u20140484", "first_page": "499", "last_page": "511", "citations": [ { "type": "official", "cite": "236 Ill. App. 3d 499" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "551 N.E.2d 264", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "194 Ill. App. 3d 573", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 8499008 ], "pin_cites": [ { "page": "585" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/194/0573-01" ] }, { "cite": "505 N.E.2d 1387", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1990, "opinion_index": 0 }, { "cite": "153 Ill. App. 3d 595", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3607394 ], "year": 1990, "pin_cites": [ { "page": "598" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/153/0595-01" ] }, { "cite": "532 N.E.2d 830", "category": "reporters:state_regional", "reporter": "N.E.2d", "opinion_index": 0 }, { "cite": "125 Ill. 2d 489", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5555300 ], "pin_cites": [ { "page": "493-94" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/125/0489-01" ] } ], "analysis": { "cardinality": 990, "char_count": 30536, "ocr_confidence": 0.792, "pagerank": { "raw": 1.672668119173043e-07, "percentile": 0.6962008209745046 }, "sha256": "d4e45b967f970efa1800816c282ef71fc550f2e9bb2c8e79189ac4b5fa4bcf1b", "simhash": "1:b72bc44717d76cd3", "word_count": 5007 }, "last_updated": "2023-07-14T15:50:05.842880+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "JOEL W. ZIEN, Plaintiff-Appellant, v. THE RETIREMENT BOARD OF THE FIREMEN\u2019S ANNUITY AND BENEFIT FUND OF CHICAGO et al., Defendants-Appellees." ], "opinions": [ { "text": "JUSTICE McMORROW\ndelivered the opinion of the court:\nJoel Zien (Zien) appeals from the trial court\u2019s denial of his petition for administrative review of the decision of the Retirement Board of the Firemen\u2019s Annuity & Benefit Fund of Chicago (the Board) that Zien was not entitled to duty-related disability benefits. Because we determine that the evidence of record establishes that Zien sustained a back injury while on duty on August 20, 1987, that has rendered Zien unable to work as a paramedic, we conclude that Zien should have been awarded duty-related disability benefits. Accordingly, we reverse and remand.\nThe record from the Board\u2019s proceedings with respect to Zien\u2019s application for duty-related disability benefits reveals the following. Zien testified at the Board\u2019s hearing that he had been a firefighter for the City of Chicago since October 1, 1975. He stated that on August 20, 1987, while on duty as a city paramedic, he was transporting a patient on a stretcher down a set of stairs, slipped on the stairs, lost his footing, and was pushed into a corner of the stairway. Zien testified that the stretcher fell against him when he was pushed into the corner. Zien stated that he was able to assist his partner in taking the patient to a nearby hospital. At that time, Zien was examined by medical personnel, who informed Zien that he had acute lumbar strain.\nZien was absent from work on August 20, 1987, to September 8, 1987. He testified that he returned to work, but was off work again on September 15, 1987, because of \u201cunbearable pain.\u201d The record reflects that Zien did not return to work until April 1988. Thereafter, he again went on leave because of back problems on December 2, 1988. Zien did not return to active duty. His application for duty-related disability benefits was filed on November 7, 1989, while he was still employed as a paramedic by the City of Chicago.\nThe administrative record of the Board\u2019s proceedings contains extensive medical records and reports regarding the course of Zien\u2019s treatment for back pain following the August 20, 1987, incident. Although the parties\u2019 briefs and the Board\u2019s determination do not restate this evidence in detail, and the documents are not provided in a coherent or chronological order in the record, we will summarize the medical treatments received by Zien as reflected in the record.\nThe record indicates that Dr. Gregory Palutsis, an orthopedic surgeon who treated Zien extensively following his August 20, 1987, accident, determined that Zien had suffered a compression fracture of the Til and T12 vertebrae. For example, from his examination of Zien on September 21, 1987, Dr. Palutsis recorded in his office notes that Zien had pain in the left paraspinal area at the thoracolumbar junction. The physician\u2019s physical examination revealed marked left thoracolumbar muscle spasm, and that Zien\u2019s pain became worse during right side bending and forward flexion. Dr. Palutsis\u2019 review of X rays led him to believe that it was likely that Zien had sustained a mild compression fracture of the T12 vertebra while lifting. The physician recorded his impression as \u201cprobable compression fracture T12 also associated with a musculoligamentous injury to the low back.\u201d Dr. Palutsis determined that Zien\u2019s activities should be restricted and that he should not return to work. Dr. Palutsis noted that he anticipated Zien would be fully recovered in four to six weeks.\nDr. Palutsis reached similar conclusions from his examinations of Zien throughout October and November 1987. The physician recorded in his office notes for this period that Zien continued to experience lower back pain and spasms. Dr. Palutsis concluded from these visits that Zien\u2019s \u201cprogress is best characterized as being slow, but steady.\u201d\nIn late November 1987, Dr. Palutsis\u2019 office examination of Zien revealed that Zien was still complaining of mid-thoracic back pain and that Zien was \u201cstill showing mild compression of T12.\u201d The physician noted that Zien was still very stiff, that he would bend to his toes very slowly, and that Zien had pain when he came to a standing position. Dr. Palutsis recommended that magnetic resonance imaging (MRI) be undertaken.\nThe record indicates that the MRI for Zien\u2019s lumbar spine and lower dorsal spine was performed at Evanston Hospital on December 3, 1987. The report of the MRI states that the \u201cT12 vertebra showed no evidence of fractures.\u201d Following the MRI, Dr. Palutsis recorded in his office notes from an examination of Zien on December 11, 1987, that the \u201cMRI is totally normal with no evidence of disc or compressive phenomenon.\u201d Dr. Palutsis remarked that Zien still had significant left paraspinal muscle spasm, and that when Zien bent forward, \u201chis thoracolumbar spine is not moving at all really.\u201d The physician recorded that Zien was beginning to do a little bit more at home, and so the doctor felt that some improvement was being made. However, because Zien\u2019s recovery was taking longer than the usual course, Dr. Palutsis recommended a bone scan, and \u201can EMG/NCV of his lower extremities.\u201d\nAccording to Dr. Palutsis\u2019 notes following an office examination of Zien on January 11, 1988, the bone scan and test results were normal. The physician noted that Zien\u2019s lower back spasm had improved, his range of motion had increased, and that his overall movements were a little easier. Dr. Palutsis stated that his plan was to start Zien on a swimming and work-hardening program.\nThereafter, based upon Zien\u2019s participation in a work-hardening program, Dr. Palutsis noticed increased improvement in Zien\u2019s condition during his examinations of Zien in February and March 1988. In late March 1988, Dr. Palutsis found that Zien\u2019s lower back pain was \u201cmarkedly improved.\u201d The physician observed that Zien\u2019s chief complaint was some right buttock pain extending down the thigh, and that Zien had been experiencing this pain for approximately four weeks. Dr. Palutsis recorded that it was his impression that this pain \u201cmay have been related to his physical therapy activities.\u201d The doctor\u2019s physical examination of Zien showed that his muscle spasms in the thoracic spine were markedly decreased and that Zien had good range of motion in this area. Dr. Palutsis also noted that Zien was \u201cpoint tender over the SI joint on the right side\u201d and decided to inject \u201cthis trigger point\u201d with steroids to reduce the pain.\nOn April 27, 1988, following the injection, Dr. Palutsis found that Zien was doing very well and that the \u201ctrigger point\u201d that had been injected was \u201cresolved.\u201d The physician noted that Zien\u2019s only complaint pertained to right hamstring pain. Dr. Palutsis determined that Zien should be released to return to active duty and that he would \u201csee him back in about 2 months if there are any residual problems.\u201d\nThe record reflects that a company entitled Rehabilitation Consultations for Industry, Inc. (RCI), in Oak Brook, Illinois, was retained from January to April 1988 to follow Zien\u2019s progress. The pertinent progress reports of this company, written by Cathy A. Mora, a registered nurse employed by RCI, recorded similar observations to those stated by Dr. Palutsis regarding Zien\u2019s treatments during this period. For example, in her progress report dated March 29, 1988, Mora stated that she met with Zien on March 28, 1988, at Dr. Palutsis\u2019 office. According to this report, Zien indicated that his back \u201cfelt significantly improved.\u201d Mora noted in the progress report that Zien had complained of pain in his right hip. Mora stated in her report that she had also met with Dr. Palutsis, who had advised Mora that Zien\u2019s thoracic problem \u201cseem[ed] to be for the most part resolved at this time.\u201d Mora recorded that Dr. Palutsis had advised that Zien was experiencing some pain in the right hip, but that the physician attributed this to Zien\u2019s aggressive physical therapy program. Thereafter, in her progress report for late April 1988, Mora observed that Dr. Palutsis felt that given Zien\u2019s condition, Zien should be able to return to work without restrictions \u201cat this time.\u201d\nAlthough Zien returned to work as a Chicago paramedic on April 28, 1988, he returned to Dr. Palutsis with complaints of back pain. According to Dr. Palutsis\u2019 office notes of August 12, 1988, Zien related to the physician that Zien was experiencing increased discomfort in his lower thoracic spine and also down his right leg. Dr. Palutsis noted that Zien had returned to full-time active duty and that Zien informed him that heavy lifting at work was particularly painful. The physician noted his impression that Zien \u201cmay be having a radicular symptoms [sic] in the right leg.\u201d Dr. Palutsis recorded that he intended to consult with \u201cDr. McMillan\u201d with respect to whether Zien might be a candidate for an epidural steroid injection as a diagnostic maneuver.\nThereafter, an epidural steroid injection was performed upon Zien on October 5, 1988. Following an office examination in late November 1988, Dr. Palutsis stated that the injection provided approximately two to three weeks\u2019 improvement, after which Zien then felt his lower back and buttock pain recur. Dr. Palutsis noted that Zien \u201cstates that his main problems occur when he is lifting\u201d and that as Zien \u201clifts someone on his job, and does any kind of twisting movement, that he experiences pain in the mid back area.\u201d Dr. Palutsis\u2019 notes specifically state that Zien\u2019s \u201clocation of the pain has been consistent throughout his injury. It is in the upper lumbar lower thoracic area.\u201d Dr. Palutsis\u2019 physical examination of Zien revealed tenderness in the lower back. The physician suggested that Zien should perhaps go to Lutheran General Hospital for a second opinion from Dr. David Spencer. It was Dr. Palutsis\u2019 opinion that Zien was \u201cunable to tolerate his work environment.\u201d\nFollowing an examination of Zien on December 15, 1988, Dr. Palutsis found that Zien felt worse. An MRI and bone scan had been performed, but the results were negative. Dr. Palutsis decided to obtain a second opinion after a CT scan had been taken. On December 28, 1988, Dr. Palutsis found that Zien\u2019s CT scan was normal. The physician also determined that Zien had \u201chad an exacerbation of his pain\u201d and that Zien was worse than when the doctor had last seen Zien. Dr. Palutsis noted that the pain was localized in the thoracolumbar junction, and that the pain was worse with flexing, extension, or lifting. The physician again recorded his decision to get a second opinion from Dr. Spencer. Dr. Palutsis stated in his notes, \u201cWe may need to contact his work to get this approved, but I think Joel is heading towards some type of workman\u2019s disability.\u201d\nThe record contains a letter from Dr. David L. Spencer, an orthopedic surgeon at Lutheran General Hospital, dated January 11, 1989, and directed to the Chicago fire department. In his letter, Dr. Spencer noted that Zien\u2019s pain was in the lower back over the right buttock. The physician advised that a physical examination revealed no back spasm or deformity, and that Zien\u2019s neurologic examination was normal. Dr. Spencer related that studies \u201cto date demonstrate a normal bony spine with no evidence of fracture, a normal bone scan with no evidence of a healing or previous fracture, and a normal MRI scan demonstrating no obvious disc herniation in the lumbar spine.\u201d Dr. Spencer stated that in \u201cview of the persistent pain with entirely negative studies to date, one is left with the diagnosis of chronic discogenic back pain.\u201d The physician stated that Zien\u2019s condition \u201cmay not be curable\u201d and that it might be necessary to place Zien on permanent restricted duty because of his disability.\nFrom January 1989 through August 1989, Zien underwent physical therapy and participated in a work-hardening program. Because it would unduly lengthen this opinion, we do not state in detail the medical reports and notes appearing in the record with respect to these treatments. In summary, the reports of the pertinent medical health care professionals consistently reported that Zien suffered lower back, hip, and buttock pain, and that he was tender to lower back palpation. Work capacity evaluations and assessments indicated that Zien was unable to lift the amount of weight required to work as a paramedic, although Zien made some progress in his lifting ability and there was also an alleviation of some of the pain he was experiencing.\nIn October 1989, Zien was examined by Dr. Ivan Ciric, a neurosurgeon with the North Shore Neurosurgeons, S.C., in Evanston, Illinois. In a letter to Dr. Palutsis dated October 14, 1989, Dr. Ciric reviewed Zien\u2019s medical history and stated that in the physician\u2019s opinion, Zien\u2019s \u201cpain is secondary to the persistent fracture at the Til vertebral body.\u201d Dr. Ciric stated that he \u201csuspect[ed] his pain in the lower thoracic area, which is made worse by activities, work, etc., is a consequence of his unhealed fracture.\u201d Dr. Ciric recommended that Zien be fitted with a brace to help heal the fracture and that he stop \u201cany and all forms of exercises involving bending, heavy lifting, etc.\u201d\nZien filed his application for duty-related disability benefits in November 1989. In a report to the Board dated December 13, 1989, the Board\u2019s physician, Dr. George S. Motto, reviewed Zien\u2019s medical history. Dr. Motto advised the Board that he had examined Zien and found that Zien \u201cwas an alert cooperative man who walked holding his back straight and in obvious pain.\u201d Dr. Motto reported that Zien \u201chad difficulty getting into and out of a sitting position\u201d and that there \u201cwas decreased range of motion of the back.\u201d The physician also stated that there was \u201ctenderness where [Zien] was experiencing pain at the level of T-12 thoracic vertebra.\u201d Dr. Motto commented to the Board that Zien was disabled and \u201ccannot and should not perform paramedic duties.\u201d Dr. Motto also advised that Zien\u2019s \u201cinjury dates back to line-of-duty\u201d and that it \u201cdoes appear that Mr. Zien\u2019s disability is a direct result of injuries he sustained while on duty in 1987.\u201d Dr. Motto observed that the \u201cdisability is permanent.\u201d\nDr. Motto also reported to the Board that Zien was scheduled to see another orthopedic surgeon named \u201cDr. McMillen.\u201d Dr. Motto advised that he had asked Zien to have a copy of this physician\u2019s report sent to Dr. Motto. However, the record does not contain any report from Dr. McMillen. It does, however, contained an unsigned, typed memorandum that is undated and bears the initials \u201cRDM.\u201d This document stated that the writer \u201cstrongly doubt[ed]\u201d that there was \u201cin fact any pathology what so ever that would be related to [Zien\u2019s] continued back pain.\u201d The writer related that he believed Zien had \u201ca painful back syndrome but we do not have a specific diagnosis and he has been extensively evaluated for this and I have no additional thoughts over a soft tissue injury to the back which in some fashion is being maintained.\u201d It was the writer\u2019s opinion that Zien had \u201cno structural abnormalities in his back and as such does not require fusion or operative intervention.\u201d The writer recorded that he had suggested \u201crepeat ct [sic] scan in view at our facility to see if there\u2019s any interval change since the previous ct and to characterize this region better with bone windows. This perhaps might give us a more specific diagnosis.\u201d\nThe Board held its first hearing on Zien\u2019s application for duty-related disability benefits on January 17, 1990. At this hearing, Dr. Motto testified that Zien\u2019s back injury was related to the accident that had occurred while Zien was on duty on August 20, 1987. Dr. Motto also noted that he had received a report from Dr. McMillen, and suggested that Zien be sent to another doctor for an additional evaluation. The Board\u2019s hearing was continued to a later date.\nIn a letter to Zien dated January 30, 1990, the Board informed him that it had decided to defer his application for duty-related disability benefits \u201cfor the reason that there was not sufficient evidence to sustain your disability resulted from an act or acts of duty.\u201d The Board advised Zien that it sought further medical evaluation at the Board\u2019s expense. The Board stated that when the additional medical records and evaluations were made available, the Board would reconvene its hearing on his application.\nThe record reflects that Zien was sent to Mayo Clinic in Rochester, Minnesota, at the Board\u2019s expense for the additional evaluation. The report of the Mayo Clinic, dated March 7, 1990, and signed by Dr. Sherwin Goldman, noted that X rays of Zien\u2019s thoracic and lumbar spine were normal. Dr. Goldman\u2019s report also related that neurologic consultation of Zien found no neurologic cause for pain, and that Zien\u2019s central nervous system was normal. The physician\u2019s report diagnosed Zien\u2019s condition as chronic dorsal lumbar strain and musculoskeletal deconditioning. It further noted that a pain clinic consultation felt that Zien had muscle attachment pain and chronic strain and that Zien would benefit from local injections and rehabilitation.\nAt the Board\u2019s resumed hearing on March 21, 1990, Dr. Motto testified that Zien\u2019s problems with pain precluded him from ever performing paramedic duties. In response to a question of what chronic dorsal lumbar strain is, Dr. Motto explained as follows:\n\u201c[ajnywhere where there are muscles with an acute stretch or trauma, the muscles and the ligaments that attach the muscle to the bones can be injured. Weakened, if you will. And when you do x-rays there is no obvious fracture, but yet the weakness and the strain or the problem with the inflammation or whatever is there. So, the person can have a persistent problem especially in *** extreme measures of lifting and twisting heavy loads, etc., and really not have a tremendous amount of objective evidence in the form of say nerve root compression or in the form of fractures.\u201d\nDr. Motto testified that he considered the report from Dr. Goldman of the Mayo Clinic to be a \u201creaffirmation of the initial evaluation.\u201d Dr. Motto stated that Zien had a strained back, in layman\u2019s terms, and that this injury was duty-related from Zien\u2019s accident on August 20, 1987. Dr. Motto related that because of the injury, Zien can no longer work as a paramedic. Dr. Motto testified that \u201cwhat the Mayo Clinic letter is saying here is that *** this is a permanent diagnosis.\u201d\nIn a letter to Zien dated March 31, 1990, the Board informed Zien that it had denied his application for duty-related disability benefits, because his disability was not the result of a specific injury, or of cumulative injuries, incurred in or resulting from an act or acts of duty. The Board did grant Zien ordinary disability benefits for the period December 2, 1989, to December 2, 1994, \u201cwithout prejudice of pursuing any of the rights that you may have for the duty disability benefit.\u201d\nZien filed his complaint for administrative review on April 17, 1990, arguing that the Board\u2019s decision was against the manifest weight of the evidence. The trial court denied Zien\u2019s request for relief, and this appeal followed.\nUpon review, Zien argues that the Board\u2019s decision should be reversed because it was against the manifest weight of the evidence. Zien contends that the evidence of record established that his back injury, which rendered him unable to work as a paramedic, was caused by the accident that occurred on August 20, 1987, when he slipped on a set of stairs as he was carrying a stretcher to transport a patient to a nearby hospital.\nUnder the firefighters\u2019 pension fund act, an active firefighter (including a paramedic) who becomes disabled \u201cas the result of a specific injury, or cumulative injuries *** incurred in or resulting from an act or acts of duty, shall have the right to receive duty disability benefit.\u201d (Ill. Rev. Stat. 1989, ch. 1081/2, par. 6 \u2014 151.) This statutory provision serves an equivalent purpose to the objectives of worker\u2019s compensation. (Mitsuuchi v. City of Chicago (1988), 125 Ill. 2d 489, 493-94, 532 N.E.2d 830.) The terms of the statute should be liberally construed in favor of the applicant to achieve its beneficent purpose. (Olson v. City of Wheaton Police Pension Board (1987), 153 Ill. App. 3d 595, 598, 505 N.E.2d 1387.) Although the Board\u2019s factual determination is entitled to deference upon review, its decision should be reversed where it is against the manifest weight of the evidence. Kellan v. Board of Trustees (1990), 194 Ill. App. 3d 573, 585, 551 N.E.2d 264.\nThe Board claims that the evidence supports its determination that Zien failed to prove that his back injury was duty-related. Initially, the Board argues that its decision was proper because there was insufficient evidence to prove that Zien suffered from back problems. The Board notes that \u201c[a]ll objective tests regarding Zien\u2019s injury were determined to be normal.\u201d The Board also observes that although Dr. Palutsis diagnosed Zien\u2019s injury as a compression fracture of the T12 vertebra, the \u201cother physicians treating Zien found no compression fracture.\u201d The Board also points out that Dr. Motto testified that \u201cthere was no definite physical cause for Zien\u2019s back pain.\u201d\nThe record does not support the Board\u2019s claims. Dr. Motto specifically testified that there was a definite physical cause for Zien\u2019s back pain. Dr. Motto confirmed the diagnosis of Dr. Sherwin Goldman, of the Mayo Clinic, that Zien suffered chronic dorsal lumbar strain. Dr. Motto additionally testified that this had occurred because Zien\u2019s back muscles and ligaments had suffered an \u201cacute stretch or trauma.\u201d Dr. Motto explained that \u201cwhen you do x-rays there is no obvious fracture, but yet the weakness and the strain or the problem with the inflammation or whatever is there.\u201d According to Dr. Motto, a person \u201ccan have a persistent problem especially in *** extreme measures of lifting and twisting *** and really not have a tremendous amount of objective evidence in the form of say nerve root compression or in the form of fractures.\u201d Based upon this testimony, we cannot accept the Board\u2019s claim that Dr. Motto testified there was \u201cno definite physical cause for Zien\u2019s back pain.\u201d\nWe also note that the record does not support the Board\u2019s contention that Dr. Palutsis was the only physician who diagnosed Zien\u2019s condition as a compression fracture of the thoracic vertebra. For example, Dr. Ivan Ciric, a neurosurgeon who also examined Zien and his medical records in October 1989, similarly concluded that Zien had suffered a \u201cpersistent fracture at the Til vertebral body.\u201d Moreover, virtually all of the health care professionals who treated Zien following his August 1987 injury found that Zien suffered lower back pain, and often was point tender to palpation of the lower back.\nIn addition, we cannot accept the Board\u2019s claim that Zien\u2019s pain was \u201cwholly subjective.\u201d There is nothing in the record before us to indicate or infer that Zien\u2019s back pain was feigned or exaggerated. We find nothing in the record to warrant an inference that Zien was fabricating a continuing back pain in order to receive duty-related disability benefits.\nNext, the Board claims that its decision was supported by the evidence of record because this evidence demonstrates that Zien had completely recovered from his back injury when Zien was released for work in April 1988. The Board notes that \u201c[f]ive months after the alleged injury, Dr. Patutsis [sic] found that Zien has recovered from the compression fracture of the T-12 vertebrae and Zien was released for work without restriction.\u201d The Board contends that \u201cDr. Patutsis [sic] determined that Zien at that point only had a pulled hamstring\u201d and that Zien \u201chad full motion, full strength, and normal function.\u201d The Board further observes that the \u201cphysical therapy report of March 29, 1988, noted that Dr. Patutsis [sic] found Zien\u2019s thoracic problem was resolved and that he should be able to return to work.\u201d According to the Board, \u201cDr. Patutsis [sic], at that time, found that Zien had some trouble point irritation in the right hip which he attributed to physical therapy not to his injury.\u201d\nAgain, the Board\u2019s arguments are founded on misstatements of the evidence of record. According to the record, Dr. Palutsis determined in April 1988, almost nine months after Zien\u2019s accident, that Zien had recovered sufficiently that Zien should be allowed to return to work. However, in his office notes, Dr. Palutsis specifically observed that Zien would return in two months \u201cto see if there were any residual problems.\u201d Also, in the reports of RCI by Cathy Mora, the registered nurse who was reviewing Zien\u2019s progress, Mora noted in March 1988 that Zien continued to complain of pain in the right buttock. Thus, the record indicates that these health care professionals had determined that Zien was well enough that he could return to work, not that Zien was completely and finally recovered from the back injury.\nThe Board additionally argues that although Dr. Palutsis resumed treatment for Zien\u2019s back pain in August 1988, there was no \u201ccausal connection between the alleged injury and the disability.\u201d The Board suggests that there were \u201cintervening causes\u201d that precipitated Zien\u2019s continued back pain after he returned to work in April 1988. In this regard, the Board contends that \u201cDr. Patutsis [sic] did not state his conclusions as to the cause of Zien\u2019s new alleged back pain.\u201d According to the Board, \u201cDr. McMillan [sic] and Dr. Goldman, likewise, did not attribute Zien\u2019s painful condition to his alleged duty injury.\u201d\nHowever, the Board\u2019s claims mischaracterize the evidence of record. Dr. Palutsis specifically stated his conclusion that the cause of Zien\u2019s back pain in August 1988 was Zien\u2019s accident in August 1987 while Zien was on duty as a city paramedic. Dr. Palutsis recorded in his office notes in August 1988 that Zien\u2019s \u201clocation of the pain has been consistent throughout his injury. It is in the upper lumbar lower thoracic area.\u201d Dr. Palutsis also recorded his opinion that Zien was \u201cunable to tolerate his work environment.\u201d Later, in December 1988, Dr. Palutsis recorded that he thought Zien was \u201cheading towards some type of workman\u2019s disability.\u201d It is rather apparent from these remarks of Dr. Palutsis that the physician believed Zien\u2019s resumed back pain in August 1988, and thereafter, was causally connected to Zien\u2019s August 1987 accident in which Zien initially hurt his back.\nMoreover, we are unable to rely on a report from Dr. McMillen, as no report from this physician appears in the record. Although the record contains a memorandum from \u201cRDM,\u201d we cannot ascertain who was the drafter of this memorandum. Furthermore, even assuming arguendo that this document constituted the report of Dr. McMillen, the document indicates no more than the writer\u2019s conclusion that there was no \u201cpathology\u201d to Zien\u2019s back pain that would require surgical intervention.\nAlso, the report of Dr. Sherwin Goldman, from the Mayo Clinic, stated that Zien suffered from chronic dorsal lumbar strain. Dr. Motto testified that this report from the Mayo Clinic confirmed Dr. Motto\u2019s own diagnosis that Zien suffered from a strained back because of Zien\u2019s August 1987 accident. There is nothing in the Mayo Clinic report that contradicts the testimony of Dr. Motto, or the conclusions of Dr. Palutsis, that Zien\u2019s continued back problems were caused by his August 1987 accident.\nLastly, the Board claims that the \u201cbasis of both Dr. Motto\u2019s and Dr. Goldman\u2019s conclusion that Zien was disabled was Zien\u2019s own subjective assertion that he suffered pain.\u201d The Board contrasts these physicians\u2019 observations with those of Dr. Palutsis. According to the Board, \u201cDr. Patutsis [sic] stated [Zien] recovered and could return to work. Dr. Patutsis [sic] found that Zien had full motion, full strength and normal function.\u201d However, as we have noted previously, Dr. Palutsis explicitly recorded his opinion that Zien\u2019s disabling back injury was causally related to Zien\u2019s slip on a set of stairs in August 1987. In addition, both Dr. Motto and Dr. Goldman reached the medical conclusion that Zien suffered chronic dorsal lumbar strain. It was the opinion of both Dr. Motto and Dr. Palutsis that Zien\u2019s back problems were caused by his August 1987 accident.\nBased upon our review of the record, and the arguments of the Board on appeal, we find that the Board\u2019s denial of Zien\u2019s application for duty-related disability benefits was against the manifest weight of the evidence. According to the evidence of record, Zien slipped on a set of stairs as he was carrying a patient on a stretcher while Zien was on duty as a city paramedic. Zien was advised after the incident that he had suffered lumbar strain. Dr. Palutsis, the orthopedic surgeon who treated Zien for his back injury, determined that Zien has suffered a compression fracture of the T12 vertebra. Zien was required to undergo approximately nine months of physical therapy and work hardening until, in late April 1988, Dr. Palutsis determined that Zien had made sufficient recovery to return to work as a paramedic. However, Zien\u2019s back problems recurred, and Dr. Palutsis, as well as Dr. Ciric, concluded that Zien\u2019s continued back problems were caused by the compression fracture he sustained at his August 1987 accident. Moreover, Dr. Motto and Dr. Goldman determined that Zien suffered from chronic dorsal lumbar strain. Dr. Motto explained at the Board\u2019s hearing that this condition was caused by Zien\u2019s August 1987 accident. All of the medical personnel were in agreement that Zien\u2019s disability is permanent and will prevent him from resuming his employment as a paramedic for the City of Chicago. In light of this evidence, we conclude that Zien should have been awarded duty-related disability benefits.\nFor the reasons stated, the decision of the Board is reversed, and the cause remanded to the Board for further proceedings consistent herewith.\nIn light of this disposition, we need not and do not address the parties\u2019 remaining arguments.\nReversed and remanded.\nJIGANTI, P.J., and JOHNSON, J., concur.", "type": "majority", "author": "JUSTICE McMORROW" } ], "attorneys": [ "Steven M. Levin, of Steven M. Levin & Associates, of Chicago, for appellant.", "Fagel & Haber, of Chicago (Maynard B. Russell, Steven J. Teplinsky, and James A. Roth, of counsel), for appellees." ], "corrections": "", "head_matter": "JOEL W. ZIEN, Plaintiff-Appellant, v. THE RETIREMENT BOARD OF THE FIREMEN\u2019S ANNUITY AND BENEFIT FUND OF CHICAGO et al., Defendants-Appellees.\nFirst District (4th District)\nNo. 1\u201491\u20140484\nOpinion filed October 15, 1992.\nSteven M. Levin, of Steven M. Levin & Associates, of Chicago, for appellant.\nFagel & Haber, of Chicago (Maynard B. Russell, Steven J. Teplinsky, and James A. Roth, of counsel), for appellees." }, "file_name": "0499-01", "first_page_order": 519, "last_page_order": 531 }