Opinion
NO. 1-17-1303WC
03-02-2018
CATHERINE PALESE, Appellant, v. THE ILLINOIS WORKERS' COMPENSATION COMMISSION et al. (Touhy Animal Hospital, Appellee).
NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).
Appeal from Circuit Court of Cook County
No. 16L50366
Honorable Ann Collins-Dole, Judge Presiding.
JUSTICE HARRIS delivered the judgment of the court.
Presiding Justice Holdridge and Justices Hoffman, Hudson, and Barberis concurred in the judgment.
ORDER
¶ 1 Held: The Commission committed no error in finding claimant failed to prove that she sustained accidental injuries arising out of and in the course of her employment.
¶ 2 On March 12, 2014, claimant, Catherine Palese, filed an application for adjustment of claim pursuant to the Workers' Compensation Act (Act) (820 ILCS 305/1 to 30 (West 2012)), seeking benefits from the employer, Touhy Animal Hospital. Following a hearing, the arbitrator found claimant sustained an accidental injury to her cervical spine, which arose out of and in the course of her employment on January 27, 2014. She awarded claimant medical ex
penses "with respect solely to [claimant's] cervical injury" and prospective medical care in the form of the cervical spine surgery recommended by one of claimant's doctors.
¶ 3 Both parties sought review of the arbitrator's decision with the Illinois Workers' Compensation Commission (Commission). Ultimately, the Commission reversed, finding claimant failed to establish both accident and causation. On judicial review, the circuit court of Cook County confirmed the Commission's decision. Claimant appeals, arguing the Commission erred in finding she failed to prove accidental injuries arising out of and in the course of her employment. We affirm.
¶ 4 I. BACKGROUND
¶ 5 On December 10, 2014, the arbitration hearing was conducted. Claimant, who was 54 at the time of her alleged work accident, testified she worked for the employer for approximately 10 years as a veterinary technician. Her position was full-time and her job duties included assisting veterinarians and moving, holding, and treating animals. Claimant also had a part-time job as a bookkeeper for Don's Heating and Appliance.
¶ 6 Claimant alleged that on January 27, 2014, she was working for the employer and sustained an accidental injury to her cervical spine when handling a dog and placing the dog into a cage. She described the incident as follows: "I was squatting, I picked the dog up, went to put it in the cage, [and] had to twist to get it into the cage. The dog did not want to go into the cage and was difficult, and as [I] was stretching and twisting, I had like an electrical shock go down my neck to my arms and leg." Claimant testified that her hands had been extended and her torso and neck were twisted "because the dog started like squirming to get out." She estimated the dog weighed 13 to 15 pounds and that its cage was located approximately a foot off of the ground. After experiencing the electric shock, both of claimant's arms "got very very heavy" and she felt
a little unsteady.
¶ 7 On cross-examination, claimant reiterated that the dog she was handling "started to get kind of crazy and decided [it] didn't want to get in the cage." She identified a handwritten statement she prepared that described the incident, which the employer submitted into evidence at arbitration. The statement provided an account of claimant's alleged work accident that was similar to the account she gave at arbitration. However, claimant acknowledged that her handwritten statement did not include a report that the dog struggled or "went crazy" as she attempted to put it in the cage. Instead, the statement notes only that claimant put the dog back in the cage and felt a lightning-bolt type of sensation from her neck to her left hand. On redirect examination, claimant testified that she did not fill out the handwritten statement on the day she was injured and did not remember when it was prepared.
¶ 8 Claimant asserted that, prior to January 27, 2014, she had never experienced neck pain or numbness in her arms. Further, she denied ever previously seeking medical treatment for any neck-related condition, pain in her hands and arms, or numbness and tingling in her arms. Claimant testified she began work at approximately 7:45 a.m. on January 27, 2014, and felt "[p]erfectly fine" prior to the incident with the dog.
¶ 9 Claimant further testified that there were two witnesses to her work accident—Anna Lazarz, a receptionist for the employer, and Iwonna, claimant's manager. (Iwonna's last name does not appear in the appellate record.) She asserted both witnesses were located approximately 20 feet away from her during the incident. Claimant stated she had her head in the cage, made a noise, and one of the witnesses asked if she was okay.
¶ 10 Claimant testified she continued to work after her accident and performed a "laser treatment." Following the laser treatment, Iwonna asked her if she was okay and told claimant
that she did not look well. Lazarz then called an ambulance.
¶ 11 Claimant testified she was taken to the emergency room at Advocate Lutheran General Hospital (Lutheran General) and then admitted to the hospital for several days. Claimant asserted she underwent various diagnostic tests to rule out a stroke or heart attack. To her knowledge and understanding, she suffered neither a stroke nor a heart attack on January 27, 2014. On cross-examination, claimant denied that she received treatment for a stroke while hospitalized. However, she acknowledged that she was found to have a blockage in her artery and was diagnosed with diabetes and "neck degeneration." Claimant did not recall whether she was prescribed a blood thinner. Further, she testified she did not know if she ever told Lazarz or Iwonna that she had a heart attack.
¶ 12 Lazarz testified for the employer at arbitration, stating she worked for the employer as a receptionist and worked with claimant both at the time of arbitration and on the date of the alleged work accident. She described claimant as appearing "happy" when she came into work on the morning of January 27, 2014. Lazarz then recalled that claimant "went to take the [dog] outside from the cage and *** felt something." She stated claimant looked and acted "kind of different" and she "could tell something had happened." Lazarz clarified that claimant looked tired and pale. Lazarz further testified she observed claimant handling the dog by the cage like she did every day. She denied seeing claimant do anything that she had not done before or that it looked like claimant was struggling to control the dog.
¶ 13 On cross-examination, Lazarz testified she did believe there was cause for alarm after claimant's incident with the dog as claimant "said she felt something." Approximately an hour and a half to two hours later, claimant "was kind of falling over." Lazarz also observed that claimant's left arm appeared to be weak and "was just hanging there."
¶ 14 Additionally, Lazarz asserted that she was "really close" to claimant as claimant was handling the dog. Initially, she estimated the distance between them as "[l]ike 25 maybe, like 10 feet." However, on examination by claimant's counsel, she indicated the distance by using her hands and agreed that she had been approximately three feet away from claimant. Lazarz stated she was talking with claimant and Iwonna at the time of the incident and was in the same room as claimant. Ultimately, Lazarz called an ambulance for claimant. She recalled that claimant was off work for approximately one week. Further, Lazarz testified claimant told her that she had suffered a heart attack and a pinched nerve.
¶ 15 Claimant's medical records show Park Ridge Fire Department responded to the call for an ambulance at the employer's facility. Claimant had a chief complaint of left arm numbness and records documented the following accident history:
"Called for fainting [patient]. Arrived to find [patient] sitting in chair. [Patient] states while lifting a medium sized dog into cage at shoulder height, she felt a strange twinge at base of neck on the left side at shoulder. Took her breath away and she felt lightheaded. After sitting[,] left arm below deltoid became numb with some tingling. [Patient] denies any other symptoms. No facial droop, no slurring pupils PERL, grasp equal but [patient] unable to lift left arm fully. [Patient] states a twinge of pain in the neck where she felt the twinge [sic]."
¶ 16 Claimant was taken by ambulance to the emergency department at Lutheran General. She reported "left arm pain and decreased movement after lifting a dog up into a kennel." More specifically, medical records indicate claimant reported that she had been in her "usual state of health" but lifted a dog at work and experienced "a severe electrical like pain from her neck down her left arm" that resulted in "left upper extremity weakness and hypoesthesia."
Claimant reported that, later, she "had difficulty with ambulation and she felt unsteady." The attending physician made a differential diagnosis of cervical disc disease or carotid/vertebral dissection.
¶ 17 Claimant underwent various diagnostic tests, including an electrocardiogram, chest x-rays, and magnetic resonance imaging (MRI) scans of the cervical spine and brain. Her cervical spine MRI showed "[h]ypertrophic degenerative changes at C4-C5 and C5-C6 with severe spinal stenosis" and "cord edema at C4-C5." The impression from the brain MRI performed without contrast was of an "acute right cerebral hemisphere watershed vascular territory infarction." Claimant was admitted to the hospital and both neurology and cardiology consultations were recommended. On January 27, 2014, Dr. Nayla Chaptini, a cardiologist, examined claimant and found she suffered a "[s]troke with left forearm hemiplegia, associated with severe neck pain."
¶ 18 On January 28, 2014, claimant underwent a cardiac MRI, which Dr. Chaptini interpreted as follows: "Wall motion abnormality as well as abnormal myocardial delayed contrast enhancement suggestive of a recent myocardial infarction [(MI)] in the basal to mid inferolateral walls—in the circumflex territory." Medical records reflect claimant was diagnosed with (1) a cardiovascular accident (CVA), (2) non-stemi myocardial infarction (NSTEMI), (3) spinal stenosis with edema, and (4) hyperglycemia.
¶ 19 Claimant's medical records further show that, on January 28, 2014, claimant underwent a neurology consultation with Dr. Timothy Mikesell, whose impression was an "acute stroke in R hemisphere watershed area between MCA-ACA intracranial RICA supraclinoid regions with significant stenosis (cannot quantify)." A consultation note authored by Dr. Arvey Stone noted an MRI of claimant's brain "showed what appeared be a right watershed stroke" and
that claimant underwent a coronary angiography that "found complete occlusion of the circumflex artery." Additionally, Dr. Stone noted that an MRI of claimant's heart "showed wall motion abnormality as well as an abnormal myocardial enhancement, suggestive of a recent myocardial infarction ***." Dr. Stone's impression was that claimant "had a non-ST segment elevation myocardial infarction," "an acute right cerebral hemisphere watershed infarct," cervical spinal stenosis, and diabetes. He stated the plan was that claimant would be followed by cardiology and noted she had started various medications, including aspirin.
¶ 20 On January 30, 2014, Victoria Jipping, a nurse practitioner, noted claimant had undergone MRIs showing "an acute right watershed infarction" and a recent myocardial infarction. She further noted as follows: [T]he patient was found to have an occluded OM, but not amendable to stenting and was decided that the patient will be medically managed." During claimant's hospitalization, the presence of either a "watershed" stroke or evidence of a recent myocardial infarction was also noted by Dr. Shetal Patel and Dr. Alexander Jacobs.
¶ 21 On January 30, 2014, claimant saw Dr. Martin Herman, a neurosurgeon. Dr. Herman noted claimant underwent an MRI of the brain and was "found to have a right-sided watershed ischemic stroke." Dr. Herman further noted that the MRI of claimant's cervical spine "demonstrated C4-5 and C5-6 stenosis with cord signal changes, and spinal cord compression." He stated the "stenosis was fundamentally due to disk herniations anteriorly at C4-5, C5-6" but he also found "a component of facet hypertrophy posteriorly." Dr. Herman opined claimant would require cervical surgery for decompression of the spinal cord. However, he stated surgery would "have to take a back seat for now until the ischemic brain issues are improved and resolved."
¶ 22 On February 1, 2014, claimant was discharged from the hospital. Her "[d]ischarge
diagnosis" was identified as "CVA, MI, Newly diagnosed." Further, medical records reflect that, at the time of discharge, claimant was given information and instructions relating to diabetes, strokes/CVAs, smoking cessation, and MIs/heart attacks.
¶ 23 Following her discharge from the hospital, claimant underwent a course of occupational therapy. She testified "[t]hey were just trying to build up [her] strength" after her week-long hospital stay. An occupational therapy evaluation form, dated February 6, 2014, contained the following accident history: "[Claimant] was at work, was picking up a dog, felt a sharp pain in neck and down left arm." Therapy records noted claimant was referred for services "for [e]valuation and treatment of s/p CVA." Records further stated that blood work performed on claimant "showed [a] heart attack" and that claimant was "now a diabetic."
¶ 24 On March 24, 2014, claimant began seeing Dr. Avi Bernstein, a spine surgeon. Her chief complaint was "neck pain and radiating numbness into her arms" and she provided a history of developing neck pain while putting a small dog into his cage at work. Specifically, Dr. Bernstein noted as follows:
"While putting the dog into his cage, [claimant] developed an acute sensation of neck pain and L'hermittes phenomena with [a] shock-like sensation into the upper extremities. She described the incident as awkward requiring extreme positioning of her neck. The left[-]sided shock which was very severe improved immediately, but she had lingering tingling in her upper extremities. She had bilateral pins and needles into her arms. Her left arm was worse than her right arm."
Dr. Bernstein further noted that claimant had been taken to Lutheran General by ambulance and was admitted. His understanding was that claimant "underwent a full cardiac workup" and had "an angioplasty with placement of a stent."
¶ 25 According to Dr. Bernstein, claimant reported continuing symptoms in her neck, arms, and shoulders. He noted claimant's January 2014 cervical spine MRI showed "severe cervical stenosis with central disc herniations at C4-5 and C5-6 resulting in spinal cord compression, spinal stenosis and signal changes in the spinal cord." Dr. Bernstein assessed claimant as suffering from "cervical myelopathy on the basis of central disc herniations and spinal cord compression." He opined claimant's cervical condition was likely "a chronic pre-existing slowly progressing degenerative condition which was suddenly aggravated as the result of her work accident." Dr. Bernstein recommended surgery in the form of a two level decompression and fusion.
¶ 26 On August 11, 2014, claimant was examined by Dr. Kern Singh, an orthopedic surgeon, at the employer's request. Dr. Singh's examination report shows claimant reported that, while working on January 27, 2014, she put a small dog into a cage and felt "an acute sensation of neck pain and shock-like sensation to her upper extremity." Dr. Singh also noted that claimant was admitted to the hospital and diagnosed with an acute stroke in the right hemisphere and cervical disc herniations and spinal cord compression. He diagnosed claimant with a right cerebral hemisphere transient ischemic attack, severe spinal stenosis at C4-C5 and C5-C6, and cervical myeloradiculopathy. Dr. Singh agreed claimant required surgery on her cervical spine; however, he opined her cervical condition of ill-being was not work related, stating as follows:
"It appears [claimant's] symptoms are global in nature and not consistent with her cervical myelopathy. This would be more correlative with her transient ischemic attack[,] which it appears she has suffered at the time of her original work-related event. With regard to [claimant's] cervical spine condition, she has severe spinal stenosis that is not acute in nature causing cord edema. In essence, this means that
it is a chronic longstanding problem which resulted in spinal cord myelomalacia. I do not believe that the mechanism is plausible as a result of her aggravation of her underlying degenerative condition, as I believe that her condition was critical to begin with prior to intervention.
* * *
[Claimant] has a unique situation in that she has severe spinal stenosis associated with myelomalacia and cord edema. This is very unusual and not commonly found in work-related injuries, as this is a chronic degenerative process, longstanding in nature, that results in spinal cord changes, I do not believe her dog lifting event is a plausible mechanism for the resultant stenosis becoming symptomatic, as I believe that is the natural history and progression of her underlying cervical spinal stenosis and myelopathy. I believe [claimant] is at maximum medical improvement for her work-related injury, and I believe that her symptoms are better explained by her transient ischemic attack as well as her progressive cervical myelopathy."
¶ 27 On March 31, 2015, the arbitrator entered her decision, finding claimant sustained injuries to her cervical spine on January 27, 2014, which arose out of and in the course of her employment. She awarded claimant past medical expenses related solely to claimant's cervical injury and prospective medical care in the form of the two-level decompression and fusion surgery recommended by Dr. Bernstein.
¶ 28 On May 11, 2016, the Commission issued its decision, disagreeing with the arbitrator's findings as to both accident and causal connection. The Commission questioned the ac
curacy of claimant's testimony and recollection of her alleged work accident. Further, the Commission relied on the opinions of Dr. Singh over those provided by Dr. Bernstein, finding the evidence did not support the accident history Dr. Bernstein relied upon to find causation and noting he was unaware claimant suffered a stroke and a heart attack on the morning of January 27, 2014. Thus, the Commission reversed the arbitrator's decision and determined claimant was not entitled to benefits under the Act. On judicial review, the circuit court of Cook County confirmed the Commission's decision.
¶ 29 This appeal followed.
¶ 30 II. ANALYSIS
¶ 31 On appeal, claimant argues the Commission erred finding she failed to prove accidental injuries arising out of and in the course of her employment. Specifically, she contends the Commission erred in finding her testimony was not credible; finding that she suffered either a stroke or heart attack on January 27, 2014; and giving little weight to Dr. Bernstein's causal connection opinion.
¶ 32 "To obtain compensation under the Act, a claimant bears the burden of showing, by a preponderance of the evidence, that he has suffered a disabling injury which arose out of and in the course of his employment." Sisbro, Inc. v. Industrial Comm'n, 207 Ill. 2d 193, 203, 797 N.E.2d 665, 671 (2003). Generally, an injury arises "in the course of employment" if it occurs "within the time and space boundaries of the employment." Id. "The 'arising out of component is primarily concerned with causal connection" and is satisfied if the claimant can show "that the injury had its origin in some risk connected with, or incidental to, the employment so as to create a causal connection between the employment and the accidental injury." Id.
¶ 33 In cases that involve an employee with a preexisting condition of ill-being, recov
ery under the Act depends upon "the employee's ability to show that a work-related accidental injury aggravated or accelerated the preexisting disease such that the employee's current condition of ill-being can be said to have been causally connected to the work-related injury and not simply the result of a normal degenerative process of the preexisting condition." Id. at 204-05, 797 N.E.2d at 672. "Accidental injury need not be the sole causative factor, nor even the primary causative factor, as long as it was a causative factor in the resulting condition of ill-being. (Emphasis in original.) Id. at 205, 797 N.E.2d at 673.
¶ 34 "As a general rule, the question of whether an employee's injury arose out of and in the course of his employment is one of fact for the Commission." Bolingbrook Police Department v. Workers' Compensation Comm'n, 2015 IL App (3d) 130869WC, ¶ 38, 48 N.E.3d 679. "With respect to factual matters, it is within the province of the Commission to judge the credibility of the witnesses, resolve conflicts in the evidence, assign weight to be accorded the evidence, and draw reasonable inferences therefrom." Id.; see also Land & Lakes Co. v. Industrial Comm'n, 359 Ill. App. 3d 582, 592, 834 N.E.2d 583, 592 (2005) ("It is the Commission's duty to resolve conflicts in the evidence, particularly medical opinion evidence.").
¶ 35 On review, the Commission's determination on a question of fact will not be overturned unless it is against the manifest weight of the evidence. Bolingbrook Police Department, 2015 IL App (3d) 130869WC, ¶ 38, 48 N.E.3d 679. "A decision is against the manifest weight of the evidence only if an opposite conclusion is clearly apparent." Id. "The appropriate test is not whether this court might have reached the same conclusion, but whether the record contains sufficient evidence to support the Commission's determination." Kawa v. Workers' Comp. Comm'n, 2013 IL App (1st) 120469WC, ¶ 78, 991 N.E.2d 430.
¶ 36 Initially, we note that claimant argues a de novo standard of review should apply
to this case because the facts are undisputed and susceptible to only a single inference. See Brais v. Illinois Workers' Compensation Comm'n, 2014 IL App (3d) 120820WC, ¶ 19, 10 N.E.3d 403 ("[W]hen the facts are undisputed and susceptible to only one single inference, the question is one of law and is subject to de novo review."). However, we disagree with claimant's position and find the facts necessary to resolving this appeal are very much in dispute. In particular, the parties dispute facts related to how claimant's alleged accident occurred and her subsequent medical treatment and diagnoses. Given the disputes as to these important factual matters, we apply the manifest-weight-of-the-evidence standard of review.
¶ 37 As discussed, in this instance, the Commission found claimant failed to prove that her cervical spine injury arose out of and in the course of her employment. We find the record contains sufficient support for the Commission's decision and an opposite conclusion from that reached by the Commission is not clearly apparent.
¶ 38 Here, the Commission's decision first indicates that it found claimant's arbitration testimony was not credible. Specifically, it noted its concern that, "after suffering a stroke and a heart attack, [claimant] did not accurately recall the events of January 27, 2014." To support that determination, the Commission pointed to inconsistencies between claimant's arbitration testimony and the other evidence presented. The record supports the Commission's findings.
¶ 39 Claimant testified at arbitration that her work accident occurred as she struggled with a dog while attempting to put it in its cage. She stated her torso and neck were twisted because the "dog did not want to go into the cage," the dog was "squirming to get out," and the dog "went crazy." However, as noted by the Commission, neither the accident histories contained in claimant's medical records nor her handwritten statement referenced a struggle with the dog. Claimant's assertion on appeal that "[t]here are simply no inconsistencies in [her] account of
how her injury occurred," is, in fact, incorrect and unsupported by the record.
¶ 40 The Commission also relied on Lazarz's observation of claimant at work on January 27, 2014, noting she was standing close to claimant and "did not notice anything unusual when [claimant] put the dog into the case." Claimant argues the Commission misstated Lazarz's testimony because she actually reported that claimant looked different after the dog incident and stated she could tell "something happened." We disagree that the Commission misstated the evidence. At arbitration, Lazarz testified she was in the same room as claimant and conversing with her and another employee when the incident at issue occurred. She stated she observed claimant handling the dog by the cage and stated claimant was performing her "everyday" activities. Lazarz testified she did not see claimant doing anything she had not done before and denied seeing her struggling to control the dog. Thus, Lazarz's testimony contradicts claimant's description of a struggle. We find the Commission was clearly referencing these contradictions when discussing Lazarz's testimony in the context of claimant's credibility.
¶ 41 In finding claimant was not credible, the Commission also noted her denial that she suffered a stroke or heart attack on January 27, 2014. We can find no error in the Commission's determination that such a denial further reflected negatively on her credibility. In particular, claimant's medical records make several references to the diagnosis of both conditions during her hospitalization.
¶ 42 On appeal, claimant argues there is no medical evidence that she suffered a stroke or heart attack and, instead, the testimony and medical evidence indicated only that she suffered an acute cervical injury. This argument, however, is contradicted by the record. Claimant was taken to the emergency department at Lutheran General on January 27, 2014, and then admitted to the hospital. Initially, the precise cause of her symptoms and nature of her condition was un
known. However, after undergoing various diagnostic tests, including brain, cervical spine, and cardiac MRIs, claimant was found to have "[h]ypertrophic degenerative changes at C4-C5 and C5-C6 with severe spinal stenosis" and "cord edema at C4-C5," as well as an "acute right cerebral hemisphere watershed vascular territory infarction," and an "abnormal myocardial delayed contrast enhancement suggestive of a recent myocardial infarction." Claimant's medical records—including the notes of various doctors who examined her during her hospitalization—were replete with references to both a stroke and a heart attack. Ultimately, it is clear from the record that claimant was diagnosed with both conditions after being admitted to the hospital.
¶ 43 Additionally, the record contains medical opinions relating claimant's symptoms on January 27, 2014, to the occurrence of a stroke rather than her cervical condition. Specifically, Dr. Chaptini found claimant had suffered a "[s]troke with left forearm hemiplegia, associated with severe neck pain" and Dr. Singh opined claimant's symptoms were "correlative with her transient ischemic attack." As noted by the Commission, Dr. Singh did not believe the mechanism of injury reported by claimant could plausibly aggravate or accelerate her preexisting, cervical spine condition of ill-being.
¶ 44 Claimant argues Dr. Bernstein provided a conflicting medical opinion and points out that he causally related claimant's cervical spine condition to her work activities on January 27, 2014. However, as discussed, it was within the province of the Commission to resolve conflicts in the medical opinion evidence. In this instance, the Commission relied on Dr. Singh's opinions over those provided by Dr. Bernstein and we can find no error in the manner in which it resolved the conflicting medical evidence.
¶ 45 The Commission first found fault with Dr. Bernstein's opinion due to his reliance on claimant's description of the dog "incident as awkward [and] requiring extreme positioning of
her neck." As indicated by the Commission, such a description was not otherwise supported by the evidence as it was not contained in the accident histories claimant reported to her medical providers or in her handwritten statement. The history relied upon by Dr. Bernstein was also contradicted by Lazarz's description of the incident. Second, the Commission noted that Dr. Bernstein "evidently was unaware that [claimant] suffered a stroke and a heart attack the morning of January 27, 2014." Although Dr. Bernstein's notes referenced claimant's hospitalization, he never mentioned either her diagnosis of a stroke or a heart attack. This omission by Dr. Bernstein indicates he was unaware of either condition and did not consider them in forming his opinions.
¶ 46 On review, claimant argues the testimony and evidence at arbitration conclusively establish that she suffered a work accident as she was placing a dog in a cage. However, while the record may support a finding that claimant began experiencing symptoms for which she was subsequently hospitalized at that time, it does not necessarily follow that those symptoms were attributable, either in whole or in part, to her cervical spine condition. Rather, the record contains evidence contradicting claimant's testimony regarding how her alleged accident occurred and attributing her symptoms on January 27, 2014, to a stroke rather than her cervical spine condition. Ultimately, there is sufficient evidence in the record to support the Commission's denial of benefits and its decision was not against the manifest weight of the evidence.
¶ 47 III. CONCLUSION
¶ 48 For the reasons stated, we affirm the circuit court's judgment, confirming the Commission's decision.
¶ 49 Affirmed.