Opinion
5-22-0404WC
04-19-2023
HOLLAND TRUCKING, Appellant, v. THE ILLINOIS WORKERS' COMPENSATION COMMISSION, et al. (Guy Martin, Appellee).
This order was filed under Supreme Court Rule 23(b) and is not precedent except in the limited circumstances allowed under Rule 23(e)(1).
Appeal from the Circuit Court of Vermilion County. No. 20 MR 569 Honorable Mark S. Goodwin, Judge, Presiding.
JUSTICE HUTCHINSON delivered the judgment of the court. Presiding Justice Holdridge and Justices Hoffman, Cavanagh, and Barberis concurred in the judgment.
ORDER
HUTCHINSON JUSTICE
¶ 1 Held: The Illinois Workers' Compensation Commission's finding that claimant sustained an accident arising out of and occurring in the course of his employment and its finding that claimant's current condition of ill-being is causally related to his employment were not against the manifest weight of the evidence where the resolution of those issues required the trier of fact-the Commission-to weigh the evidence, draw reasonable inferences therefrom, and resolve conflicts in the medical opinions. Affirmed.
¶ 2 I. INTRODUCTION
¶ 3 Claimant, Guy Martin, filed an application for adjustment of claim pursuant to the Workers' Compensation Act (Act) (820 ILCS 305/1 et seq. (West 2016)) seeking benefits from his employer, respondent Holland Trucking. The arbitrator denied benefits, finding that claimant failed to sustain his burden of proving either an accident arising out of and occurring in the course of his employment or a causal connection between his condition of ill-being and his employment. A majority of the Illinois Workers' Compensation Commission (Commission) reversed the decision of the arbitrator, awarded benefits, and remanded the matter for further proceedings pursuant to Thomas v. Industrial Comm'n, 78 Ill.2d 327 (1980). On judicial review, the circuit court of Vermilion County confirmed the decision of the Commission. In this appeal, respondent argues that the Commission's findings on accident and causal relationship were against the manifest weight of the evidence. We affirm.
¶ 4 II. BACKGROUND
¶ 5 Claimant worked for respondent as a truck driver. On or about June 27, 2017, claimant filed an application for adjustment of claim alleging injuries to his "whole body" as a result of "[d]riving and related repetitive duties" while in the employ of respondent. The application listed an accident date of May 15, 2017. An arbitration hearing on claimant's application for adjustment of claim was held on January 17, 2020, before arbitrator Dennis O'Brien, pursuant to section 19(b) of the Act (820 ILCS 305/19(b) (West 2016)). The issues in dispute included accident, causal connection, average weekly wage, medical expenses, temporary total disability (TTD) benefits, and prospective medical care. The following factual recitation is taken from the evidence adduced at the arbitration hearing.
¶ 6 A. Claimant's Testimony
¶ 7 Claimant testified that he has been employed by respondent for nearly 21 years, both as a "city driver" and a "road driver." Although classified as a driver, claimant testified that his position also encompasses dock work. Claimant drives a long-haul route from Danville, Illinois to Cincinnati, Ohio, sometimes with intermediate stops to drop off or pick up freight. Claimant estimated that each workday he spends between eight and nine hours driving and two or three hours performing dock work.
¶ 8 Claimant testified that upon his arrival at respondent's Danville terminal each workday, he usually finds his trailer preloaded. After claimant puts his belongings in the truck, he performs a pre-trip inspection of the vehicle. This involves examining the truck's lug nuts, tires, lights, air lines, and door seals as well as the undersides of the tractor and trailer. Claimant testified that the pre-trip inspection routine stresses his lower back as he is constantly bending and reaching, especially if he is hauling hazardous materials, which requires him to place placards on the trailer. Claimant testified that if he discovers a major safety issue, he will be assigned different equipment. However, if the problem is minor, he uses the truck, and it is repaired when his shift ends. After the inspection, claimant begins his route. Claimant testified that while driving, he constantly turns and twists to check his surroundings. Claimant testified that the "constant turning and bending, checking [his] mirrors and the vibration with the seats" stress his lower back. When claimant arrives at his final destination and his trailer is empty, he works the dock helping other drivers.
¶ 9 Claimant testified that the dock work he performs includes loading and unloading trailers as well as restacking and rewrapping fallen freight. The fallen freight typically weighs between 25 and 50 pounds. In a typical month, freight would have to be restacked and rewrapped three or four times. Claimant testified that the dock work also involves pulling up dock plates while preparing to unload or reload a trailer. He pulls up the dock plate to enter the trailer and uses a forklift or hand truck to move the freight. The dock plates weigh between 50 and 75 pounds, and claimant handles them three to five times per night. Claimant said that he also does "drop and hooks," which involve "dollying the trailers up and down." Claimant testified that while performing dock work, he bends "hundreds of times [per day]" as he is constantly turning and twisting, getting off a forklift, entering trailers, and loading and unloading freight. Claimant testified that these activities stress his back. At the end of his shift, claimant performs a post-trip inspection. Claimant's pre-and post-trip inspections are documented on a "driver vehicle inspection report" (DVIR).
¶ 10 Claimant testified that prior to 2017, the comfort of his tractor depended on what tractor he was in. Claimant explained that some trucks have "air ride seats" which make the drive "more cushiony" and cause the driver to bounce up and down. Claimant said that some air ride seats are good, some are not. The bad ones "bottom out," causing the driver to "hit the frame" while traversing rough roads. Claimant said he had a few that did not work at all and he would ask respondent to repair them. Claimant estimated that he would "bottom out" two to four times a month. Claimant testified that when he "bottom[ed] out," his low back would hurt, his legs would go numb, and his feet would tingle. When this happened, claimant would move around to try to find a better position.
¶ 11 Claimant testified that in the year before he went to see a doctor, he had pain off and on which would occasionally worsen. In April 2017, claimant began to experience numbness in his legs and tingling in his feet. Claimant testified that he did not have these symptoms before he began working for respondent and that he had never injured his low back or had his low back treated prior to April 2017. On April 21, 2017, claimant consulted his chiropractor, Donald McAskill. McAskill treated claimant for a couple of weeks. During that time, McAskill ordered an MRI and authorized claimant to be off work. McAskill's course of treatment did not provide claimant with any lasting relief, so he was referred to Carle Clinic. According to claimant, the care he received at Carle Clinic did not help. Thereafter, claimant consulted Dr. Rick Sasso upon the referral of his attorney. While under Dr. Sasso's care, claimant underwent a series of injections. Claimant testified the injections provided only temporary relief. Claimant said that while he was feeling better, he felt he could go back to work. Accordingly, he returned to McAskill, who provided him with a release to return to work as of October 29, 2017. Dr. Sasso recommended a surgical procedure. Claimant testified he wanted the surgery proposed by Dr. Sasso because he wants relief from the pain he is experiencing and the ability to walk without hurting.
¶ 12 Claimant reviewed respondent's exhibit No. 4, which consisted of DVIRs submitted by respondent dated between January 3, 2016, and May 12, 2017. Claimant testified that the DVIRs document any equipment defects found during the inspections. According to claimant, a DVIR is completed for "every tractor, every load." When asked why respondent's exhibit No. 4 has gaps in the dates for which DVIRs were completed, claimant responded that sometimes they get lost. Nevertheless, he stated that if there was an equipment violation, he would write it up. If given an unsafe tractor, which could happen three to four times per month, then a driver would move on to the next tractor until he or she got one that was safe.
¶ 13 On the date of the arbitration hearing, claimant was 49 years of age and still working for respondent. Most recently, claimant drove a Peterbilt truck that he described as more comfortable, with a better seat, and with an automatic transmission. Despite these features, claimant stated his back had not improved. It had gotten worse. Claimant said that he was alleging an accident date of May 15, 2017, because that was the day when his doctor told him his back was not going to get better and that his back problems were related to his employment.
¶ 14 On cross-examination, claimant testified that he had been a smoker of two packs of cigarettes per day for 19 years, but no longer smokes. Claimant testified that the Peterbilt automatic he currently drives is about a year old. Neither its seat nor its suspension is worn out. Claimant estimated that he had been driving the Peterbilt automatic for about a year, but noted that he would have driven a different truck if there was something wrong with the Peterbilt. Claimant agreed that respondent's trucks get regular maintenance. He said that many of the maintenance requirements are dictated by Department of Transportation (DOT) regulations.
¶ 15 Claimant further testified on cross-examination that when driving, he would look at the mirrors on either side of his truck, and to do that, he would have to twist. He agreed he was basically sitting straight up and turning his head when doing that, with his chest also rotating 15 to 20 degrees in both directions. Claimant testified that prior to unloading freight at a terminal, he would back the truck into the dock. He would then pull a dock plate over the gap between the dock and the trailer and use a forklift or a dolly. He said other workers would help him unload. He usually only manually lifted freight when it fell and needed to be restacked. Stops could take from half an hour to two hours, depending on what was being loaded or unloaded. The longest he has worked a dock was over three hours. With regard to how long he drove, claimant said that per DOT regulations, a driver can drive up to 11 hours a day with a 10-hour break after that. In addition, a driver has to take a 30-minute break before completing 8 hours of driving.
¶ 16 Claimant acknowledged that the DVIRs in respondent's exhibit No. 4 did not indicate that he complained of problems involving a tractor's suspension or defects resulting in the seats "bottoming out." Claimant insisted, however, that over the 21 years he had worked for respondent, he had reported problems with seats "bottoming out" and suspension, although he did not remember when or how often. Claimant agreed he was part of a union and that there were other ways to report a defect or safety condition, but he had not reported such issues to the union.
¶ 17 B. Testimony of Samuel Hogue, Jr.
¶ 18 Respondent called Samuel Hogue, Jr., as a witness. In 2010, Hogue was hired as a mechanic for YRC Freight, the parent entity of respondent and other trucking companies. After several promotions, Hogue became a field equipment process manager. In this position, Hogue manages the people who handle the maintenance for the equipment used by YRC Freight's trucking companies.
¶ 19 Hogue testified that the DVIR is a triplicate form. One copy stays with the truck, one goes to the terminal, and one is retained by the driver. Hogue said that if a driver's pre- or post-trip inspection reveals a safety issue or a DOT violation, the equipment is immediately taken out of service and scheduled for repairs. The equipment is not dispatched again until it is fixed.
¶ 20 Hogue agreed that drivers are supposed to take a lunch break to alleviate the driving time. Hogue added that drivers are required to stop every 200 miles to make sure that they are still DOT compliant and the equipment is still safe to drive. If, at the time of a mid-trip inspection, a problem is discovered, the driver calls dispatch to report the problem. In turn, the call center contacts the closest vendor to repair the equipment. A tractor swap might have to be done and a truck towed back to the yard.
¶ 21 Hogue said only a "city driver" has to unload using a ramp, and if a pallet is heavy, a truck with a lift gate that lowered to the ground would be used so the driver would not hurt his or her back. A "road driver" goes from dock to dock. Drivers also complete "HAZMAT bills" and place placards on the trailers so they are "DOT legal." Hogue said that when making a number of stops, some adjustment of the load may have to be made, and that could involve using bars or straps to secure the load. Generally, such adjustments can be made by one person. However, if there is a "high load," a second worker may assist.
¶ 22 Hogue said that if there is something wrong with a vehicle's seat or suspension, it should be noted on the DVIR because it is considered a safety issue. Hogue said that trucks are taken out of service permanently in certain conditions, such as when there is a frame hole. Hogue said if a driver reports a seat issue, the mechanics will make sure that there are no air leaks (which would cause the seat to "bottom out"), that the base is not rusted out, and that the cushion is in good shape. Hogue noted that the upper or lower seat cushions can be replaced or the entire seat can be swapped out. Some seat repairs can be done in a day. However, if a new seat is required, the repair could take two or three days.
¶ 23 Hogue testified that he is familiar with the suspension systems in respondent's trucks. He explained how the air bag suspension in newer trucks levels the truck when it has a load. He said if the air bag does not level or if it is blown out, it is scheduled for repair. Hogue said the air ride seats and the air bag suspension work together to reduce bouncing. He said seats that were used in the early nineties had the driver jumping up and down in his seat. YRC Freight mandated air ride seats in all trucks by 1999. He said he drove for another company between 2001 and 2009 and used all kinds of trucks with very heavy loads. He said after the air bags came along, the bouncing stopped. According to Hogue, Peterbilt and Freightliner vehicles drove smoothly, and while you will feel a pothole if you ride over one, the impact is worse in a car or any other vehicle that does not have an air ride seat.
¶ 24 On cross-examination, Hogue said he was based in St. Louis, had never been to the Danville terminal, and had never seen any of the trucks there. Hogue said that in older seats, which he called "solid based seats," the driver felt the vibration and road movement. The drivers would move and bounce all of the time. Air ride seats prevent that. Hogue estimated that, during the 21 years claimant had worked for respondent, about 75 to 85 percent of the tractors had air ride seats. If the truck claimant drove did not have a comfortable air ride system, including air suspension, he could have written it up and it would have been repaired.
¶ 25 Hogue said the only DVIRs he had reviewed were those contained in respondent's exhibit No. 4. When asked why there are no DVIRs prior to January 3, 2016, Hogue responded that drivers are supposed to complete the form every day, but not all drivers do. He also said that if claimant reported a major problem with his truck, such as a clutch or transmission, and the truck was down for a long period of time, claimant would have been assigned a new truck. In that case, the DVIR would follow the new truck and he would need to know that truck number.
¶ 26 On re-direct examination, Hogue testified that all of respondent's trucks now have air bag suspension, though some of their older trucks still have spring frames as opposed to air bag frames. Hogue further explained that the DOT required the company to hold onto a rolling 90 days' worth of DVIRs, and he believed respondent actually scanned them and kept them for a year. He said that meant that the records showing what trucks claimant drove over the past 15 years probably no longer exist, and even if they did exist, he would have to know the truck number to pull up the DVIRs, records of preventative maintenance, and DOT evaluations.
¶ 27 C. Claimant's Medical Records
¶ 28 On April 21, 2017, claimant presented to chiropractor McAskill with a history of chronic, intermittent low-back pain of about a year's duration. Claimant reported that the pain is exacerbated by sitting and alleviated by lying down and when he is not working. McAskill's records indicate that claimant had some initial improvement with treatment, but eventually plateaued. At McAskill's request, claimant underwent an MRI on May 8, 2017. McAskill interpreted the MRI as showing a three-level disc bulge with effacement of the thecal sac. On May 15, 2017, McAskill took claimant off work. McAskill also referred claimant to Dr. Victoria Johnson of the Carle Clinic's Brain and Spine Institute.
¶ 29 Meanwhile, on May 16, 2017, claimant presented to Steve Jacobs, a physician's assistant at Carle Clinic's Department of Occupational Medicine. At that time, claimant had complaints of low-back pain and bilateral leg numbness with tingling. Claimant indicated that he first noticed some back discomfort a year earlier. Claimant stated that he tried to treat himself with conservative care. However, within the month prior to the visit, the back pain had increased and the numbness and tingling in the legs had intensified. Claimant denied any significant injury to the back or prior back problems. Jacobs noted that claimant had seen a chiropractor, but that treatment was not successful. Upon examination, Jacobs documented that straight-leg raising caused back pain. Claimant was able to forward flex and bend, although he reported back pain with the movement. Jacobs's assessment was back pain, noting that an MRI ordered by the chiropractor suggested encroachment of the nerves. Jacobs prescribed ibuprofen for pain, instructed claimant to avoid bending and twisting at the waist, imposed a lifting restriction of three to five pounds, and prohibited claimant from driving a bus or truck.
¶ 30 On May 17, 2017, claimant saw Dr. Johnson. Claimant told her that he developed back pain a year earlier, but could not recall any particular event or injury associated with the onset of the discomfort. Claimant reported that walking and sitting exacerbated the pain, while lying on his side alleviated it. Dr. Johnson noted that the May 8, 2017, MRI showed mild degenerative disc disease at L2-L3 and L3-L4, broad-based disc bulge with moderate spinal stenosis at L4-L5, and mild disc bulge at L5-S1. Dr. Johnson diagnosed lumbar spondylosis and mild spinal stenosis without radiculopathy. She did not believe that an epidural steroid injection would benefit claimant because he did not report significant leg pain. Instead, she recommended physical therapy.
¶ 31 Claimant followed up with Jacobs on May 22, 2017, and June 5, 2017. Jacobs documented that claimant's leg symptoms had abated but his low-back back pain persisted. Jacobs diagnosed back strain with overlying degenerative disc disease. He authorized physical therapy, gave claimant exercises to do at home, and instructed him to "eat right and watch his weight." Jacobs also directed claimant to avoid bending and twisting the back, imposed a lifting restriction of 10 pounds, and prohibited him from driving a bus or truck. Claimant attended several sessions of physical therapy in May and June 2017, but reported little improvement, so it was discontinued.
¶ 32 Upon a referral by Jacobs, claimant saw Dr. Samatha Tipirneni on July 25, 2017. At that time, claimant reported that he was injured on or about May 15, 2017, when doing his regular work which involved "repetitive bending and lifting." Dr. Tipirneni noted that claimant had preexisting chronic low-back pain, and claimant indicated that his work activities "aggravated his back and leg issues." After conducting a physical examination and reviewing claimant's MRI, Dr. Tipirneni diagnosed chronic lumbar degenerative disc disease, lumbar radiculopathy, preexisting lumbar spinal stenosis, herniated disc at L4-L5, and moderate obesity. She advised claimant that most of his MRI findings "looks more like age-related wear and tear arthritis, degenerative disc disease." She also stated that "the nerve most likely got irritated by his mechanism, especially repetitive type of bending and lifting." She recommended a bilateral epidural steroid injection at L4-L5. Jacobs agreed with Dr. Tipirneni's recommendations and kept claimant off work.
¶ 33 Claimant presented to Dr. Rick Sasso on October 9, 2017. Claimant provided Dr. Sasso with a history of increasing low-back pain with an onset in April 2017. Claimant described the pain as "aching, sharp, shooting and numbness." He stated that it radiates bilaterally to the legs. Symptoms are aggravated by walking, standing, sitting, lying down, coughing, and extension. Symptoms are relieved by rest and flexion. Dr. Sasso's neurological, spinal, and leg examinations were normal. Dr. Sasso ordered X Rays and reviewed claimant's MRI. The X rays showed that the pedicles, sacrum, foramen, and sacroiliac joints were all well delineated. Dr. Sasso interpreted the MRI as demonstrating central stenosis, most pronounced at L4-L5 and L5-S1. Dr. Sasso diagnosed low-back pain, lumbar stenosis, and radicular pain of the lumbosacral region. He referred claimant to a non-spine specialist to better determine the source of claimant's pain.
¶ 34 On October 10, 2017, claimant saw Dr. Kevin Macadaeg. Claimant reported back pain with radiation to the buttocks bilaterally, the posterior legs bilaterally, and both feet. Dr. Macadaeg's physical examination was neurologically normal, but he noted a diminished range of motion in the lumbosacral junction with increased pain and numbness in the buttocks and posterior thighs with back extension. Dr. Macadaeg's impression was degenerative anterolisthesis at L4-L5 with suspected bilateral L5 radiculopathy. Dr. Macadaeg recommended a bilateral L5 selective nerve injection as a confirmatory diagnostic study. Dr. Macadaeg administered the injection on October 16, 2017. As a result of the procedure, claimant's pain level decreased from 6 out of 10 to 1 out of 10. Specifically, although claimant had some residual back pain, his buttock and posterior-thighregion pain had completely resolved. Dr. Macadaeg considered the procedure "a positive study for bilateral L5 radiculopathy."
¶ 35 Claimant saw Dr. Sasso on the day Dr. Macadaeg administered the injection. According to Dr. Sasso's notes, claimant "denie[d] complete resolution of his symptoms immediately after the injection" and reported the persistence of "bilateral buttock, posterior thigh, calf, and plantar foot pain." Dr. Sasso interpreted the injection as "negative" and questioned whether claimant had more of a "bilateral S1 distribution." Dr. Sasso's diagnosis was radicular pain of lumbosacral region and lumbar stenosis. He referred claimant back to Dr. Macadaeg for a follow-up evaluation "in determination of [the] exact source of pain."
¶ 36 On October 23, 2017, claimant returned to Dr. Macadaeg. At that time, Dr. Macadaeg administered another bilateral L5 nerve root injection. Dr. Macadaeg noted that claimant's pain level prior to the procedure was 4 out of 10 and that it was 0 out of 10 after the procedure. Dr. Macadaeg opined "[t]his is a positive study for bilateral L5 radiculopathy." Claimant again returned to Dr. Macadaeg on June 27, 2018. Dr. Macadaeg performed a third bilateral L5 selective nerve root injection. Claimant reported that his pre-procedural pain level was 8 out of 10 and his post-procedural pain level was 0 out of 10. Dr. Macadaeg concluded that the injection constituted "a positive study for bilateral L5 radiculopathy."
¶ 37 Claimant saw Dr. Sasso on October 15, 2018. At that time, claimant reported that he experienced several months of relief following the injection administered by Dr. Macadaeg in June 2018, but the symptoms had returned to baseline. Claimant also reported a significant decrease in his overall functional capacity due to his symptoms. Upon examination, Dr. Sasso noted low-back and bilateral lower extremity pain. A radiograph of the lumbar spine taken the day of the visit showed grade one degenerative spondylolisthesis at L4-L5. An MRI also taken the day of the visit showed degenerative changes and disc bulging at L4-L5 resulting in central stenosis and bilateral foraminal narrowing. Dr. Sasso's assessment was spondylolisthesis and lumbar radiculopathy. Dr. Sasso noted that claimant's stenosis was both developmental and congenital. He discussed options, including nonoperative treatment, a laminectomy at L4-L5, and a "Limiflex" trial. Claimant opted to proceed with the laminectomy and enroll in the "Limiflex" trial.
¶ 38 D. McAskill's Evidence Deposition
¶ 39 McAskill testified by evidence deposition on October 25, 2017. McAskill has been a chiropractor for 50 years and specializes in musculoskeletal disorders. He is board qualified in chiropractic medicine, but he is not board certified. McAskill testified that about half of his patients have some level of low-back pain. Claimant presented to McAskill on April 21, 2017, with complaints of chronic low-back pain and occasional numbness in his lower extremities for a year. Claimant denied any previous injuries or treatment to his low back. On the date of the visit, claimant was still working as a truck driver. McAskill and claimant discussed the type of work claimant did as a truck driver. Upon examination, McAskill noted that claimant was in antalgic posture, meaning that he had a lot of lower back spasm which forced his spine into flexion. Extension of the spine aggravated claimant's low-back pain. X rays of the lumbar spine indicated that claimant had some widening of the posterior disc space at L5-S1, which was indicative of a posterior disc bulge. McAskill diagnosed disc bulges at multiple levels, but primarily L4-L5 and L5-S1. McAskill treated claimant with intermittent traction, microcurrent therapy, and ice. McAskill continued to treat claimant conservatively into May 2017. On May 8, 2017, McAskill ordered an MRI. The MRI demonstrated (1) broad-based disc bulging at L5-S1 with intrusion on the right neural foramen abutting the right L5 exiting nerve root, (2) broad disc bulging at L3-L4 encroaching on the entrance of the neural foramina without evidence of neural compression, and (3) broad disc bulging and disc placement at L4-L5 with bi-foraminal encroachment effacing L4 exiting nerve roots. McAskill testified that claimant's symptoms correlated with the findings of the MRI. Claimant did not respond well to treatment, so McAskill referred claimant to Carle Clinic for an orthopaedic evaluation. McAskill took claimant off work on May 15, 2017, his last visit.
¶ 40 McAskill opined that "many issues *** came together" to cause claimant's condition. He explained that claimant has stenosis in his spine-a congenital process which predisposes an individual to disc bulges. In addition, claimant has experienced degenerative changes. McAskill further opined that the work claimant performed as a delivery truck driver was a "contributory" or "aggravating" factor in the development of his lumbar spine condition. McAskill testified that truck drivers "have a 50 percent greater incident of low back pain," that "[a]ny lifting and bending as a dock worker would create further insults to the low back," and that "[accumulative stresses to the spine would likely lead to chronic low back pain." McAskill added that claimant's job, which required constant sitting and performing dock work with bending, lifting, and twisting, aggravated claimant's low-back condition.
¶ 41 On cross-examination, McAskill acknowledged that claimant did not report any specific accident or event contributing to his condition. He testified that claimant was suffering from spinal stenosis and degenerative disc disease. He stated that stenosis is generally congenital and that people typically get degenerative disc disease as they age. McAskill agreed that claimant was obese. He "would imagine" that obesity can contribute to claimant's condition. The following exchange later occurred between respondent's attorney and McAskill:
"Q. So as a chiropractor you would as it relates to the treatment recommended for [claimant] for this condition as it stands, would you defer to the opinion of a spine surgeon?
A. Sure.
Q. And then as it relates to the causation of [claimant's] condition, would you defer to the opinion of a spine surgeon?
A. Well, I would certainly consider it."
¶ 42 E. Dr. Sasso's Evidence Deposition
¶ 43 Dr. Sasso testified by evidence deposition on June 7, 2019. Dr. Sasso is a spine surgeon with a board certification in orthopaedic surgery. In his 27 years in the occupation, he has performed over 12,000 surgeries. Dr. Sasso testified that during his career he has treated long-haul delivery drivers that have developed low-back conditions. He testified that the risk factors to the low back for long-haul truck delivery drivers are the "[s]ame as everybody else."
¶ 44 Dr. Sasso testified that he first treated claimant on October 9, 2017. At that time, claimant complained of low-back and bilateral leg pain. Claimant's physical examination was "relatively normal." Dr. Sasso diagnosed bilateral L5 radiculopathy. Dr. Sasso based his diagnosis on claimant's history, physical examination, and imaging studies. Dr. Sasso recommended a provocation test to verify his diagnosis. To that end, claimant saw Dr. Macadaeg for injection therapy. Claimant followed up with Dr. Sasso on October 16, 2017, just after Dr. Macadaeg administered the injection therapy. Dr. Sasso testified that the injection therapy did not eliminate all of claimant's pain. As a result, Dr. Sasso considered whether claimant had an S1 radiculopathy rather than an L5 radiculopathy. Dr. Sasso referred claimant back to Dr. Macadaeg for another injection. Claimant did not see Dr. Sasso again until October 15, 2018, a year after his previous visit. At that time, Dr. Sasso narrowed claimant's problem down to the L4-L5 level and diagnosed L4-L5 degenerative spondylolisthesis and stenosis. He offered several recommendations, including continued non-operative treatment, decompression of his L5 nerves, and participation in a clinical trial for "Limiflex."
¶ 45 Dr. Sasso opined that repetitive work as a long-haul truck driver contributed to claimant's need for low-back surgery. Dr. Sasso testified that his opinion was based on the fact that claimant's symptoms became exacerbated when engaged in his duties as a truck driver. Dr. Sasso clarified that he did not believe that driving a truck caused claimant's back problems, but driving a truck may have exacerbated his underlying condition. Dr. Sasso testified that as of the last visit, claimant had not reached maximum medical improvement (MMI).
¶ 46 On cross-examination, Dr. Sasso testified that on the date of claimant's first visit, claimant was 47 years of age, 66 inches tall and 238 pounds. Claimant's body-mass index (BMI) was 38.41, qualifying him as obese. Claimant told Dr. Sasso that he smokes. Dr. Sasso testified that smoking increases the incidence of disc degeneration in individuals, regardless of occupation. He also testified that the older one gets, the more likely it is that he or she will develop degenerative disc problems and stenosis. However, there has not been a really good correlation between BMI and degenerative spondylolisthesis. He agreed that a person with those risk factors, i.e., age and smoking, and degenerative disc disease, can become symptomatic on their own, regardless of occupation or specific trauma. Dr. Sasso testified that claimant did not report a history that he suffered a specific trauma and Dr. Sasso did not think that his condition was related to a specific work accident. Dr. Sasso did not recall if claimant gave him a history regarding his job duties.
¶ 47 F. Evidence Deposition of Dr. Timothy Van Fleet
¶ 48 Dr. Timothy Van Fleet, a board-certified orthopaedic spine surgeon, testified by evidence deposition on January 8, 2020. On September 6, 2017, Dr. Van Fleet performed an independent medical examination of claimant at respondent's request. At that time, claimant reported that he was 47 years of age and had been employed by respondent as a long-haul driver since 1998. Claimant stated that he drives approximately 12 hours per day, five days a week. Claimant told Dr. Van Fleet that "some trucks are better than other trucks meaning that their suspension are good [ sic ], some other suspensions are not so good." Claimant further reported that he has to pull dock plates at least four to five times a night and he has to load and unload trailers. Claimant explained that sometimes boxes will fall and he has to reload the boxes, some of which are heavy. Claimant told Dr. Van Fleet that he had "typical back pain in general," but in April 2017 he began experiencing numbness in his lower extremities.
¶ 49 Upon examination, Dr. Van Fleet noted that claimant was 5'4" and weighed 234 pounds. Claimant had a difficult time standing upright and was flexed forward at the waist. Claimant was able to ambulate and had good range of motion in his hips and knees. He had symmetric strength. Claimant did not describe leg pain to Dr. Van Fleet, but noted numbness in the feet which worsened with standing. Dr. Van Fleet reviewed claimant's medical records, including the MRI of May 8, 2017. The MRI showed a combination of congenital canal stenosis as well as some acquired stenosis with facet hypertrophy which resulted in a combination of severe central and lateral recess stenosis at L4-L5. The MRI also showed lateral recess stenosis at L5-S1 and degeneration within the disc space at the L4-L5 and L5-S1 levels. Based on the history of injury, the examination, claimant's medical records, and the diagnostic film, Dr. Van Fleet diagnosed spinal stenosis and degenerative disc disease. He recommended that claimant try an epidural injection. However, based upon the severity of claimant's stenosis, Dr. Van Fleet opined that it was likely that he would eventually require decompression at L4-L5 and L5-S1. Dr. Van Fleet also recommended work restrictions of no lifting greater than 10 pounds and no repetitive bending or twisting.
¶ 50 Dr. Van Fleet did not find claimant's condition to be causally related to his employment. He explained that claimant "didn't really have an accident" and he "didn't describe any particular mechanism that created his condition." Dr. Van Fleet further stated that claimant had evidence of congenital canal stenosis "which is no doubt unrelated to any kind of work activity" and he had acquired changes that had taken place in the spine that occurred over the course of many years. Dr. Van Fleet acknowledged that there are risk factors that can produce or worsen the degree of degenerative disc disease. Among these factors are smoking and genetics. Dr. Van Fleet testified that an individual with degenerative disc disease who is of claimant's age and has his risk factors can become symptomatic on his or her own.
¶ 51 Dr. Van Fleet reviewed claimant's job duties pursuant to a description provided by respondent. He also spoke with claimant about his job duties. Dr. Van Fleet was asked whether he believed that claimant's job duties could have exacerbated his condition. He responded that "under certain conditions there may be activities that can exacerbate a condition such as what [claimant] manifested." He elaborated:
"[I]f you have an underlying condition of spinal stenosis, you can do a lot of different things that may antagonize it. You know, you may feel worse if you're doing a lot of bending and twisting and things like that.
You know, doesn't mean that's the problem. Doesn't mean that's causing the condition. It just means that you've got the condition and it's not something that you're tolerating very well which is part of the reason why we put a restriction on the guy in his workplace because he's not going to tolerate that activity very well.
In fact, he's probably not going to tolerate a lot of activities very well. It doesn't mean that he needs it as a result of a work injury. It just means that he needs it as a result of trying to be functional."
Dr. Van Fleet testified that claimant had not reached MMI because he needs an operation.
¶ 52 Dr. Van Fleet testified that he prepared an addendum report dated April 5, 2018, based on updated medical records and films provided by respondent. The additional documentation included medical notes from Dr. Sasso. Dr. Van Fleet testified that his causation opinion did not change based upon the updated records and films. Dr. Van Fleet testified that he agreed with Dr. Sasso's recommendation for an L4-L5 laminectomy with decompression.
¶ 53 On cross-examination, Dr. Van Fleet testified that the spine can suffer trauma due to repetitive activity. He agreed that an individual with spinal stenosis can suffer an aggravation or exacerbation of that condition. Further, if the trauma is sufficient, it can accelerate the underlying progression of stenosis. Dr. Van Fleet added that degenerative disc disease can also be exacerbated, aggravated, or accelerated. Dr. Van Fleet agreed that a long-haul truck driver who "experiences activities as described" in the job description provided by respondent can experience an exacerbation, acceleration, or aggravation of an underlying condition.
¶ 54 Dr. Van Fleet further testified on cross-examination that he used to deliver appliances in a truck and he did that about eight hours per day and sometimes longer. He stated, however, that he is not a truck expert and that he has never driven a semi-truck. Dr. Van Fleet acknowledged that he did not know what type of seats claimant sat on while driving during the 20 years prior to his accident. He did not know how often claimant drove trucks with a bad suspension system or how much bouncing claimant experienced while driving a truck.
¶ 55 Dr. Van Fleet testified that claimant has degenerative disc disease with a congenital condition in his back which is "not even remotely related to his occupation. It's related to his genetics and how he was born." Dr. Van Fleet testified that claimant's work as a long-haul truck driver "certainly could have exacerbated the degenerative disc disease," but he was "not sure it's really a contributing feature at all to his spinal stenosis." When asked if repetitive bending and twisting of the spine causes an acceleration of degenerative disc disease, Dr. Van Fleet responded, "[n]ot necessarily" because "that's what your spine does on a regular basis. Bends, twists." Dr. Van Fleet agreed that claimant was credible and did not seem to be exaggerating his symptoms. Dr. Van Fleet testified that he was "not in agreement that the truck driving was a significant contributing factor to [claimant's] underlying illness." He stated that spinal stenosis is mostly congenital but it is also acquired. He stated that claimant is "heavyset, he's short and he's really fat." He stated that claimant's body characteristics are "a huge contributing feature to what he has going on." Dr. Van Fleet opined that claimant could have become symptomatic "no matter what he's doing" and that claimant "just happened to be at work when he started complaining." Claimant's attorney asked Dr. Van Fleet if he agreed that claimant's work "at least forms a minimal factor, even one percent for causing or contributing to his current back symptomology." Dr. Van Fleet responded, "I mean, I could say that maybe one percent but, again, I'm speculating at that. I don't know that I could even say that but it's just-you know, how can I not say it? I'd have to say something."
¶ 56 On redirect examination, Dr. Van Fleet testified that claimant would require an operation regardless of what he was doing based upon the changes in the spine.
¶ 57 G. Arbitrator's Decision
¶ 58 Based on the foregoing record, the arbitrator concluded that claimant failed to prove he sustained a repetitive-trauma injury or that there was a causal connection between his condition of ill-being and his employment. Although the arbitrator found claimant truthful in most respects, he determined that claimant's testimony regarding problems with the trucks' air ride seats and air suspensions was not corroborated by written documentation. Notably, the DVIRs did not mention problems with the seats or air suspension. The arbitrator also concluded that claimant failed to prove that his job "was truly repetitive." The arbitrator determined that the causation opinion of Dr. Van Fleet was more persuasive than the opinions of McAskill or Dr. Sasso. The arbitrator reasoned that Dr. Van Fleet had more personal knowledge of the physical requirements of driving a truck because of his own truck-driving experience. Moreover, Dr. Van Fleet and claimant discussed claimant's job duties. The arbitrator found Dr. Sasso's opinions were "quite limited" because he did not obtain a history from claimant of the specific work duties he performed, he was unaware of claimant's claims regarding inadequate air cushioning or air suspensions, he did not know of claimant's actual duties, and he had did not have personal experience as a truck driver. Further, the arbitrator found that McAskill "said he would defer to a spine surgeon in regards to causation." The arbitrator noted that Dr. Van Fleet acknowledged that claimant's job duties could contribute "maybe one percent" to claimant's back symptomatology. However, the arbitrator also noted Dr. Van Fleet's comment that such testimony was based on speculation. The arbitrator observed that liability cannot rest upon conjecture.
¶ 59 H. Commission's Decision
¶ 60 A majority of the Commission reversed the decision of the arbitrator and remanded the matter for further proceedings pursuant to Thomas, 78 Ill.2d 327. The Commission found that claimant proved he sustained repetitive injuries from his job duties, which manifested on May 15, 2017. In support of this finding, the Commission stated that the lack of written documentation of seat or suspension problems was not conclusive proof that claimant never experienced those problems. The Commission noted that claimant did testify that he gave verbal and written notice of such issues to respondent. He also testified that even in the newer trucks he drove, the vibration and bouncing of the seats would still cause irritation to his back, numbness in his legs, and tingling in his feet. The Commission further observed that Hogue testified that through 2016 only about 75 to 85 percent of respondent's vehicles had air ride seats, meaning 15 to 25 percent of respondent's vehicles lacked them. Hogue admitted that even in the newer trucks with airbag systems, up and down movement occurs. Hogue also admitted that even trucks equipped with air suspension could "bottom out" if the air level in them was not proper.
¶ 61 Regarding causation, the Commission adopted the opinions of claimant's treating medical professionals, McAskill and Dr. Sasso, over that of Dr. Van Fleet. The Commission found that McAskill had knowledge of claimant's job duties and testified that claimant's duties contributed to and aggravated his current spine condition. The Commission disagreed with the arbitrator's finding that McAskill stated that he would defer his causal connection opinion to a spine surgeon. Rather, the Commission observed, McAskill stated only that he would consider doing so. The Commission further noted that Dr. Sasso had experience treating long-haul delivery drivers who had developed low-back conditions. Dr. Sasso found claimant's complaints were consistent with L4-L5 stenosis and opined that while claimant's repetitive work as a long-haul driver did not cause his degenerative conditions, it did exacerbate his symptoms and contributed to his need for low-back surgery. The Commission noted that, under Illinois law, an injury need not be the sole factor, or even the primary factor of an injury, as long as it is "a" causative factor. Sisbro, Inc. v. Industrial Comm'n, 207 Ill.2d 193, 205 (2003).
¶ 62 The Commission noted that claimant saw Dr. Van Fleet only once, on September 6, 2017. Dr. Van Fleet did not believe claimant exaggerated his symptoms, and he found claimant credible. Dr. Van Fleet agreed claimant would likely need surgery to decompress at L4-5 and likely L5-S1, though he did not believe that would be related to claimant's job duties. Nevertheless, Dr. Van Fleet admitted that claimant's duties could have exacerbated his preexisting degenerative disc disease and that repetitive trauma can aggravate spinal stenosis. Dr. Van Fleet acknowledged that he did not know what type of seats claimant sat on while driving during the 20 years prior to his accident. He did not know how often claimant drove trucks with a bad suspension system or how much bouncing claimant experienced while driving his trucks. Dr. Van Fleet admitted he was not a truck expert. The Commission stated that it did not find Dr. Van Fleet's prior experience driving trucks-which he admitted were not semi-trailers like the ones claimant operated on a daily basis-made his causation opinion more credible than McAskill's or Dr. Sasso's.
¶ 63 The Commission awarded claimant 23-6/7 weeks of TTD benefits for the period from May 16, 2017, through October 30, 2017. The Commission further concluded that the care and treatment claimant received for his low back since May 15, 2017, were reasonable and necessary and that he was entitled to prospective medical care, notably the treatment and surgery recommended by Dr. Sasso.
¶ 64 Commissioner Simpson dissented. She would have affirmed and adopted the decision of the arbitrator. She found the opinion of Dr. Van Fleet more persuasive than those of McAskill and Dr. Sasso "due to [Dr. Van Fleet's] clear understanding of [claimant's] job duties and personal experience as a truck driver." Commissioner Simpson also cited a lack of evidence that claimant reported problems with the air ride seats and air suspension systems of the trucks he drove.
¶ 65 I. Circuit Court Decision
¶ 66 On judicial review, the circuit court of Vermilion County confirmed the decision of the Commission. This appeal followed.
¶ 67 III. ANALYSIS
¶ 68 On appeal, respondent challenges the Commission's findings with respect to accident and causation. Because these issues are closely related-and because the parties discuss them jointly in their analyses-we address them together.
¶ 69 An employee who suffers a repetitive-trauma injury must meet the same standard of proof as an employee who sustains an injury arising from a single identifiable event. Durandv. Industrial Comm'n, 224 Ill.2d 53, 64 (2006). The employee must prove by a preponderance of the evidence all elements necessary to justify an award. Quality Wood Products Corp. v. Industrial Comm 'n, 97 Ill.2d 417, 423 (1983). This includes establishing an accident "arising out of' and occurring "in the course of' the employment. Orsini v. Industrial Comm'n, 117 Ill.2d 38, 44 (1987). The phrase "in the course of' refers to the time, place, and circumstances of the injury. Illinois Institute of Technology Research Institute v. Industrial Comm'n, 314 Ill.App.3d 149, 162 (2000). Where a repetitive-trauma injury is involved, a claimant must identify a date within the limitations period on which the injury "manifested] itself." Durand, 224 Ill.2d at 64; Peoria County Belwood Nursing Home v. Industrial Comm'n, 115 Ill.2d 524, 531 (1987). A repetitive-trauma injury is said to manifest itself on "the date on which both the fact of the injury and the causal relationship of the injury to the claimant's employment would have become plainly apparent to a reasonable person." Peoria County Belwood Nursing Home, 115 Ill.2d at 531. For an injury to "arise out of' one's employment, it must have an origin in some risk connected with or incidental to the employment. Navistar International Transportation Corp. v. Industrial Comm'n, 315 Ill.App.3d 1197, 1203 (2000).
¶ 70 Similarly, the employee must establish the existence of a causal relationship between his or her current condition of ill-being and employment. Navistar International Transportation Corp., 315 Ill.App.3d at 1202. An occupational accident need not be the sole or principal causative factor in the resulting condition of ill-being, as long as it was a causative factor. Sisbro, Inc., 207 Ill.2d at 205. Hence, a claimant need prove only that some act or phase of his employment was a causative factor in the resulting injury. Land &Lakes Co. v. Industrial Comm'n, 359 Ill.App.3d 582, 592 (2005).
¶ 71 Both the occurrence of a work-related accident and the existence of a causal relationship are questions of fact for the Commission. Vogel v. Industrial Comm'n, 354 Ill.App.3d 780, 786 (2005) (causation); Pryor v. Industrial Comm'n, 201 Ill.App.3d 1, 5 (1990) (accident). In resolving factual matters, it is within the province of the Commission to assess the credibility of the witnesses, resolve conflicts in the evidence, assign weight to be accorded the evidence, and draw reasonable inferences from the evidence. Hosteny v. Illinois Workers' Compensation Comm'n, 397 Ill.App.3d 665, 674 (2009). This is especially true with respect to medical issues, to which we owe the Commission heightened deference because of the expertise it possesses in the medical arena. Long v. Industrial Comm 'n, 76 Ill.2d 561, 566 (1979); Freeman United Coal Mining Co. v. Illinois Workers' Compensation Comm 'n, 386 Ill.App.3d 779, 782-83 (2008). We review the Commission's factual determinations under the manifest-weight-of-the-evidence standard. Orsini, 117 Ill.2d at 44. A decision is against the manifest weight of the evidence only if an opposite conclusion is clearly apparent. Bassgar, Inc. v. Illinois Workers' Compensation Comm'n, 394 Ill.App.3d 1079, 1085 (2009). The test is whether the evidence is sufficient to support the Commission's findings, not whether this court, or any other tribunal, might reach an opposite conclusion. Pietrzak v. Industrial Comm 'n, 329 Ill.App.3d 828, 833 (2002). Moreover, we may affirm the Commission's decision on any basis supported by the record regardless of the Commission's findings or its reasoning. Dukich v. Illinois Workers' Compensation Comm 'n, 2017 IL App (2d) 160351WC, ¶ 43 n.6.
¶ 72 Respondent asserts that the Commission's finding that claimant suffered an accident arising out of and occurring in the course of his employment and its finding that claimant's condition of ill-being is causally related to his job duties were against the manifest weight of the evidence. With respect to accident, respondent asserts that claimant's testimony about problems with the trucks' air ride seats and air suspension was not corroborated by written documentation. To the contrary, respondent argues that the DVIRs are persuasive evidence that defendant did not report issues regarding defective seats or rough travel during the period of time covered by those documents. As to causation, respondent asserts that Dr. Van Fleet was more credible than McAskill and Dr. Sasso. In support, respondent contends that Dr. Van Fleet reviewed claimant's written job description, discussed with claimant his job responsibilities, previously worked as a truck driver himself, and, as an orthopaedic surgeon, had the experience and expertise to accurately opine regarding causation. In contrast, McAskill was not an orthopaedic surgeon, and he was not familiar with claimant's job duties. Moreover, while Dr. Sasso opined that claimant's job duties could have aggravated claimant's underlying back condition, he never reviewed a written job description, did not discuss job duties with claimant, and was unaware how frequently claimant engaged in repetitive tasks.
¶ 73 Claimant counters that because the Commission's findings on accident and causation required it to weigh conflicting evidence and medical opinions, those findings cannot be said to be against the manifest weight of the evidence.
¶ 74 Applying the deferential standard applicable to the issues raised on appeal, we cannot conclude that the Commission's findings on accident and causation were against the manifest weight of the evidence. Regarding accident, the Commission concluded that claimant proved that he sustained repetitive-trauma injuries from his job duties, which injuries manifested themselves on May 15, 2017. The evidence of record supports this finding. Claimant has worked for respondent as a truck driver for nearly 21 years. Claimant testified that his position involves dock work in addition to driving. Claimant estimated that each workday he spends between eight and nine hours driving and between two and three hours performing dock work. Claimant further testified that his job duties require repetitive activities that stress his back. For instance, claimant testified that each workday he has to perform a pre-trip inspection, which involves repeated bending and reaching. Further, claimant testified that while driving, he constantly turns and twists to check his surroundings and he experiences "vibration with the seats." In addition, claimant testified that the trucks have "air ride seats" which cause the driver to bounce up and down. Claimant reported that if a driver is assigned a truck with a bad "air ride seat," he or she will "bottom out," thereby causing the driver to "hit the frame" while traversing rough roads. Hogue confirmed that a driver will bounce even in trucks with air ride systems and that these trucks can "bottom out" if the air level in the seats is not correct. Claimant estimated that he "bottoms out" two to four times a month. Claimant stated that when this happens, his low back hurts, his legs go numb, and his feet tingle. Claimant testified that, over the 21 years that he had worked for respondent, he had reported problems with seats "bottoming out" and with the trucks' suspensions, although he did not remember when or how often. Claimant also testified that while performing dock work, he is constantly turning and twisting and he bends "hundreds of times [per day]." Claimant testified that in the year before he sought treatment, he experienced intermittent pain. In April 2017, claimant's symptoms worsened, so he sought medical care. Claimant testified that on May 15, 2017, his chiropractor told him that his back was not getting better and that his symptoms were attributable to his occupation. Given this evidence of record, we cannot say that the Commission's finding that claimant sustained repetitive injuries from his job duties, which injuries manifested themselves on May 15, 2017, was against the manifest weight of the evidence.
¶ 75 Despite the foregoing evidence, respondent insists that the DVIRs are persuasive evidence that claimant's occupation did not contribute to his back problems. According to respondent, 211 DVIRs were admitted into evidence. Of those, claimant noted defects on 18 of the forms, but never reported a "rough ride" or a defective seat. Respondent reasons that if claimant's complaints of back pain were accurate, "it is logical to believe he would have identified the seat as being defective and would have noted in his many inspections that the seat had to be replaced immediately." We are unpersuaded by respondent's contention for multiple reasons. First, it ignores the fact that claimant had other job duties which required repetitive bending, reaching, turning, and twisting. Respondent does not address these other activities. Second, the DVIRs admitted into evidence are incomplete. Although claimant worked for respondent for 21 years, the DVIRs do not begin until January 3, 2016. More significantly, there are several large gaps in the dates of the DVIRs admitted. The date range of the DVIRs is from January 3, 2016, through May 12, 2017. However, there are no reports at all for the period from January 4, 2016, through March 29, 2016. In addition, there are other unexplained gaps, including ones from (1) May 13, 2016, through May 22, 2016; (2) June 10, 2016, through June 15, 2016; (3) July 9, 2016, through July 17, 2016; (4) July 30, 2016, through August 9, 2016; and (5) August 31, 2016, through September 15, 2016. Further, we note that some of the DVIRs submitted were completed by other drivers. As such, we agree with the Commission that the DVIRs are not conclusive proof that claimant never reported seat or suspension problems with his truck. Rather, they show only that claimant did not make a complaint regarding seat or suspension problems on the days for which there are DVIRs from claimant in the record. Clearly, the Commission considered the DVIRs, but, as was its province, accorded them limited weight due to their incompleteness. See Hosteny, 397 Ill.App.3d at 674.
¶ 76 Similarly, we cannot conclude that the Commission's finding on causation was against the manifest weight of the evidence. The Commission was presented with conflicting medical opinions as to whether claimant's current condition of ill-being is causally related to his occupation. In this regard, we note that McAskill opined that claimant's job, which required prolonged sitting and performing dock work with bending, lifting, and twisting, aggravated claimant's low-back condition. McAskill explained that truck drivers "have a 50 percent greater incident of low back pain," that "[a]ny lifting and bending as a dock worker would create further insults to the low back," and that "[accumulative stresses to the spine would likely lead to chronic low back pain." Likewise, Dr. Sasso opined that while claimant's work as a truck driver did not cause claimant's back problems, it exacerbated his underlying condition. Dr. Sasso testified that his opinion was based on the fact that claimant's symptoms worsened when claimant engaged in his duties as a truck driver. Dr. Sasso also testified that claimant's repetitive work as a long-haul truck driver contributed to his need for low-back surgery. In contrast, Dr. Van Fleet opined that claimant's low-back condition was not causally related to his employment, but rather to congenital canal stenosis and acquired changes that had taken place in the spine over the course of many years. The Commission adopted the opinions of McAskill and Dr. Sasso over the opinion of Dr. Van Fleet. The Commission noted that McAskill and Dr. Sasso treated claimant. The Commission further noted that McAskill had knowledge of claimant's job duties and Dr. Sasso has experience treating long-haul delivery drivers who have developed low-back conditions. The Commission placed less weight on Dr. Van Fleet's opinion because he saw claimant only once, he admitted that claimant's duties could have exacerbated claimant's preexisting degenerative disc disease, and he acknowledged that repetitive trauma can aggravate spinal stenosis. Given the conflicting medical opinions presented and in light of the Commission's role as fact finder, we cannot say that an opposite conclusion is clearly apparent. Hence, the Commission's determination is not against the manifest weight of the evidence.
¶ 77 Respondent nevertheless insists that Dr. Van Fleet was more credible than McAskill or Dr. Sasso because Dr. Van Fleet: (1) reviewed claimant's written job description, (2) took a thorough history of job duties from claimant, and (3) previously worked as a truck driver. In contrast, respondent posits that McAskill was less credible than Dr. Van Fleet because he was not familiar with claimant's job duties and he testified that he would consider deferring his opinion to a spine surgeon. Respondent further posits that Dr. Sasso was less credible than Dr. Van Fleet because he never reviewed claimant's written job description and he did not discuss with claimant the nature of his job duties. Essentially, respondent asks us to reweigh the evidence. As noted above, however, it is the function of the Commission, as the trier of fact, to assess the credibility of the witnesses, resolve conflicts in the evidence, assign weight to be accorded the evidence, and draw reasonable inferences from the evidence. Hosteny, 397 Ill.App.3d at 674. Where, as here, there is sufficient evidence in the record to support the Commission's findings, we will not reweigh the evidence or substitute our judgment for that of the Commission merely because other reasonable inferences may be drawn from the evidence. Berry v. Industrial Comm'n, 99 Ill.2d 401, 407 (1984). Thus, we decline respondent's request to reweigh the evidence.
¶ 78 In sum, the Commission's findings that claimant proved that he suffered an accident arising out of and occurring in the course of his employment and that his condition of ill-being is causally related to his employment were not against the manifest weight of the evidence in light of the testimony presented at the arbitration hearing, the conflicting medical opinions presented by the parties, and the Commission's role as fact finder.
¶ 79 IV. CONCLUSION
¶ 80 For the reasons set forth above, we affirm the judgment of the circuit court of Vermilion County, which confirmed the decision of the Commission. This cause is remanded for further proceedings pursuant to Thomas, 78 Ill.2d 327.
¶ 81 Affirmed.