Illinois Official Reports

Appellate Court

Sunny Hill of Will County v. Illinois Workers’ Compensation Comm’n,

2014 IL App (3d) 130028WC

Appellate Court 

Caption

SUNNY HILL OF WILL COUNTY, d/b/a Sunny Hill Nursing Home, 

Appellant, v. THE ILLINOIS WORKERS’ COMPENSATION 

COMMISSION et al. (Dalia Mahoney-Tapella, Appellee).

District & No. Third District

Docket No. 3-13-0028WC

Filed June 26, 2014

Held

(Note: This syllabus 

constitutes no part of the 

opinion of the court but 

has been prepared by the 

Reporter of Decisions 

for the convenience of 

the reader.)

The Workers’ Compensation Commission properly awarded claimant 

temporary total disability benefits for a shoulder injury she suffered 

while working as a licensed practical nurse after obtaining a release to 

return to work following her recovery from an earlier shoulder injury, 

since the Commission’s finding that claimant’s present condition of 

ill-being was causally related to the second injury was not against the 

manifest weight of the evidence and there was no evidence of any 

intervening accidents.

Decision Under 

Review

Appeal from the Circuit Court of Will County, No. 12-MR-328; the 

Hon. Barbara Petrungaro, Judge, presiding.

Judgment Affirmed and remanded.
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Counsel on

Appeal

Timothy G. Shelton, Peter H. Carlson, Robert J. Finley, and Starr M.

Rayford, all of Hinshaw & Culbertson LLP, of Chicago, for appellant.

Daniel F. Capron, of Capron & Avgerinos, P.C., of Chicago, for 

appellee.

Panel JUSTICE HARRIS delivered the judgment of the court, with opinion.

Presiding Justice Holdridge and Justices Hoffman, Hudson, and 

Stewart concurred in the judgment and opinion.

OPINION

¶ 1 On July 31, 2009, claimant, Dalia Mahoney-Tapella, filed an application for adjustment of 

claim pursuant to the Illinois Workers’ Compensation Act (Act) (820 ILCS 305/1 to 30 (West 

2008)), seeking benefits from the employer, Sunny Hill of Will County, d/b/a Sunny Hill 

Nursing Home (Sunny Hill). She alleged a work-related injury that occurred while she was 

assisting a patient on December 5, 2008, causing injury to her right shoulder and lower back.

Following a hearing, the arbitrator determined claimant’s condition of ill-being was causally 

related to the accident that arose out of and in the course of her employment, and claimant’s 

presence at a flower shop she co-owned did not constitute a “return to work” or absolve Sunny 

Hill of its liability to pay temporary total disability (TTD) benefits. The arbitrator awarded 

claimant TTD benefits of $596.00 per week for the periods of December 6, 2008, through June 

9, 2009; July 23, 2009, through August 27, 2009; and September 22, 2009, through June 15, 

2011.

¶ 2 On review, the Illinois Workers’ Compensation Commission (Commission) affirmed and 

adopted the arbitrator’s decision. On judicial review, the circuit court of Will County 

confirmed the Commission’s decision.

¶ 3 Sunny Hill appeals, arguing (1) the Commission erred in awarding claimant TTD benefits 

and (2) the Commission’s finding that claimant’s present condition of ill-being is causally 

related to the December 5, 2008, work accident is against the manifest weight of the evidence.

We affirm.

¶ 4 I. BACKGROUND

¶ 5 The following factual recitation is taken from the evidence presented at the arbitration 

hearing on June 15, 2011.

¶ 6 Claimant testified she first began working for Sunny Hill in November 2004 as a licensed 

practical nurse. Her duties included taking care of 25 to 50 patients, including lifting them as 

necessary. In 1996, prior to working at Sunny Hill, claimant suffered an injury to her neck and 

underwent a cervical fusion procedure. In September 2007, while working at Sunny Hill, 
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claimant suffered an injury to her right shoulder. On February 15, 2008, Dr. Paul Trksak 

performed an arthroscopic debridement of claimant’s right rotator cuff and subacromial 

decompression. On October 31, 2008, Dr. Trksak noted claimant had reached maximum 

medical improvement (MMI). Dr. Trksak released her to return to full-duty work at Sunny Hill 

effective November 2, 2008.

¶ 7 On December 5, 2008, claimant was working at Sunny Hill, assisting two certified nurse 

assistants who were manually lowering an obese patient from a hoyer lift that was stuck “a 

good 10 feet up in the air.” As they brought the patient down, claimant felt “something just like 

snap and pain down my shoulder and arm.” She also felt pain in her neck and lower back.

Claimant immediately sought treatment from Advanced Physicians, complaining of “pain in 

[her] right shoulder, neck, mid back and low back.” An MR arthrogram of claimant’s right 

shoulder was performed on December 22, 2008. It revealed a full thickness perforation of the 

rotator cuff. On January 6, 2009, an MRI of claimant’s lower back was performed. It revealed 

severe facet arthritis with lateral stenosis in the lower lumbar area. Advanced Physicians 

referred claimant to Dr. Gregory Markarian, an orthopedic surgeon.

¶ 8 Claimant first saw Dr. Markarian on January 15, 2009, at which time he diagnosed a 

recurrent tear of the right rotator cuff (he was unsure whether the MR arthrogram demonstrated 

a partial tear or a full thickness tear), AC joint arthritis and bicipital tendonitis. Based on her 

presentation and the fact she was asymptomatic prior to the accident at issue, Dr. Markarian 

opined claimant’s injuries were causally connected to the December 5, 2008, work accident.

¶ 9 On January 28, 2009, Dr. Markarian performed an arthroscopic debridement of the

partially torn rotator cuff and subpectoral biceps tenodesis. On February 5, 2009, claimant 

underwent an EMG of her lower back which revealed an acute S1 radiculopathy. She 

underwent an EMG of her neck on March 12, 2009, which revealed an acute C7 radiculopathy.

On March 24, 2009, claimant received a lumbar epidural steroid injection by Advanced 

Physicians. On April 14, 2009, claimant received a cortisone injection in her right shoulder by 

Dr. Markarian. On April 16, 2009, Dr. Markarian released claimant to return to light-duty 

work.

¶ 10 On June 9, 2009, Dr. Kevin F. Walsh, performed an independent medical evaluation of 

claimant. Dr. Walsh’s report is not included in the record and was not admitted into evidence at 

arbitration. The only reference to Dr. Walsh’s findings are in Dr. Markarian’s evidence 

deposition and Dr. Anthony Romeo’s (who began treating claimant in 2010) initial report 

recounting claimant’s medical history. According to Dr. Markarian’s evidence deposition and 

Dr. Romeo’s initial report, Dr. Walsh concluded claimant’s injuries were not related to the 

December 5, 2008, work accident and returned her to full-duty work on June 10, 2009.

¶ 11 On July 23, 2009, claimant reported to Dr. Markarian she aggravated her right shoulder 

(she felt swelling and pain) apparently as a result of returning to full-duty work too soon. Dr. 

Markarian restricted claimant from work again and ordered an MRI of her right shoulder, 

which was performed on August 18, 2009. The MRI revealed tendinosis, moderate bursitis and 

minimal subacromial encroachment due to degenerative and inflammatory changes. Dr. 

Markarian testified these injuries were part of the “injury spectrum” and were related to the 

December 5, 2008, work accident. Claimant was released to return to light-duty work effective 

August 28, 2009.

¶ 12 On September 22, 2009, Dr. Markarian gave claimant a cortisone injection in her right 

shoulder and took her off work. He ordered an MR arthrogram which was performed on 
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October 8, 2009. It revealed partial tearing of the rotator cuff. Dr. Markarian explained the 

partial tear of the rotator cuff would not have been evident in the August 2009 MRI results.

According to Dr. Markarian, an MRI would reveal “obvious defects where [the tissue is] 

pulled away off the bone and it’s retracted” but tears that are not retracted “can be difficult to 

interpret.” The MR arthrogram reveals more because a dye is injected into the joint. Dr. 

Markarian recommended claimant undergo another shoulder surgery to revise the previous 

repair. Claimant last saw Dr. Markarian on October 15, 2009.

¶ 13 On September 22, 2010, by agreement of the parties, Dr. Romeo, an orthopedic surgeon, 

evaluated claimant. Dr. Romeo diagnosed persistent tendonitis status post previous biceps 

tenodesis. He opined this condition was related to the December 5, 2008, work accident. Dr. 

Romeo noted claimant could either live with her symptoms or undergo additional surgery.

¶ 14 On September 28, 2010, Sunny Hill terminated claimant’s employment because she had 

been off work for more than one year.

¶ 15 On February 24, 2011, Dr. Romeo performed a right shoulder arthroscopy with a revision 

subacromial decompression and a revision open biceps tenodesis. As of the date of arbitration, 

claimant remained in postoperative therapy and continued to treat with Dr. Romeo. She had 

not yet been released to return to work.

¶ 16 In 2007, claimant opened a flower shop with her two daughters following the death of her 

husband and the suicide of her son. She owns a 53% stake in the business, although her 

daughters run it full-time. Following the December 5, 2008, work accident, claimant has gone 

to the flower shop at least three days per week, but does not follow a regular schedule, she is 

not formally employed by the flower shop, she does not draw a paycheck, and she does not 

keep track of her hours. The flower shop first made a profit in 2010 ($2,000), which claimant 

distributed to her daughters who actually work there. When asked what she does at the flower 

shop, claimant responded she answers the phone if it rings (including taking orders over the 

phone), picks up fax sheets, or occasionally her daughters will ask her to “grab *** another 

rose or a daisy or a gerber *** for them” while they are preparing arrangements. Claimant also 

stated she watches over her grandchildren in a babysitting role at the flower shop. She testified 

she does not do anything more physically taxing at the flower shop than she would do at her 

home during this time.

¶ 17 Sunny Hill introduced evidence of surveillance over six days (April 10-11, 2009, August 

10-11, 2010, April 2, 2011, and April 5, 2011), approximately 53 hours in total, of claimant,

including video of claimant at the flower shop while she was off work. Surveillance video, 

totaling approximately 35 minutes in length, was presented by the employer at the arbitration 

hearing. The video depicts claimant walking from her car to the back entrance of the flower 

shop, sometimes carrying bags and/or a laptop case or briefcase, sitting on the back stoop of 

the business, standing and walking around outside of the flower shop, picking wildflowers 

with her granddaughter, holding a baby inside the flower shop, and driving to a park.

¶ 18 The arbitrator found claimant sustained work-related injuries to her right shoulder, neck, 

and lower back, on December 5, 2008. He awarded claimant TTD benefits of $596.00 per 

week for the periods of December 6, 2008, through June 9, 2009; July 23, 2009, through 

August 27, 2009; and September 22, 2009, through June 15, 2011. In reaching his decision, the 

arbitrator noted as follows:

“It is apparent that the [claimant’s] partial ownership interest in a local flower shop 

that is operated on a day-to-day basis by her daughters does not constitute a ‘return to 
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work’ in the sense of disqualifying her from receipt of TTD benefits. The [claimant] is 

a licensed practical nurse by profession. This is her full[-]time occupation. Her trips to 

the flower shop to visit with, and occasionally assist, her daughters are sporadic and 

infrequent. As such, they do not serve to absolve [Sunny Hill] from liability for the 

payment of TTD benefits.”

¶ 19 The Commission affirmed and adopted the arbitrator’s decision. It also remanded the 

matter pursuant to Thomas v. Industrial Comm’n, 78 Ill. 2d 327, 399 N.E.2d 1322 (1980). On 

December 14, 2012, the circuit court of Will County confirmed the Commission’s decision.

¶ 20 II. ANALYSIS

¶ 21 On appeal, Sunny Hill argues the Commission erred in finding that: (1) claimant was 

entitled to TTD benefits due to its failure to apply what it refers to as the “stable labor market 

test”; and (2) claimant’s current condition is causally related to the December 5, 2008, work 

injury.

¶ 22 “The time during which a worker is temporarily totally disabled is a question of fact.” City 

of Granite City v. Industrial Comm’n, 279 Ill. App. 3d 1087, 1090, 666 N.E.2d 827, 828 

(1996). The Commission’s decision to award TTD will not be disturbed unless it is against the 

manifest weight of the evidence. Archer Daniels Midland Co. v. Industrial Comm’n, 138 Ill. 2d 

107, 118-19, 561 N.E.2d 623, 627-28 (1990). A decision is against the manifest weight of the 

evidence only if the opposite conclusion is clearly apparent. Dolce v. Industrial Comm’n, 286 

Ill. App. 3d 117, 120, 675 N.E.2d 175, 178 (1996).

¶ 23 “It is a well-settled principle that when a claimant seeks TTD benefits, the dispositive 

inquiry is whether the claimant’s condition has stabilized, i.e., whether the claimant has 

reached maximum medical improvement.” Interstate Scaffolding, Inc. v. Illinois Workers’

Compensation Comm’n, 236 Ill. 2d 132, 142, 923 N.E.2d 266, 271 (2010). “Once an injured 

employee’s physical condition stabilizes, he is no longer eligible for TTD benefits ***.” 

Archer Daniels, 138 Ill. 2d at 118, 561 N.E.2d at 627. This court has held, “[t]he duration of 

TTD is controlled by the claimant’s ability to work and his continuation in the healing 

process.” City of Granite City v. Industrial Comm’n, 279 Ill. App. 3d 1087, 1090, 666 N.E.2d 

827, 829 (1996).

¶ 24 Sunny Hill argues the Commission’s failure to apply what it terms the “stable labor market 

test” (ostensibly derived from language in E.R. Moore Co. v. Industrial Comm’n, 71 Ill. 2d 

353, 361-62, 376 N.E.2d 206, 209 (1978)) in determining whether claimant was entitled to 

TTD benefits was error and requires reversal. The issue in E.R. Moore was whether the 

claimant should have been awarded total permanent disability benefits because there was no 

“reasonably stable market” in which claimant could be employed. Id. at 359-60, 376 N.E.2d at 

208-09. The claimant in E.R. Moore was 58 years old and her work injury (contact dermatitis) 

prevented her from returning to domestic service work–the only type of work she had ever 

performed. Id. at 364, 376 N.E.2d at 211. Based on the claimant’s work-related injury, age, 

work experience, training and capabilities, the court found it was reasonable for the 

Commission to determine “there existed no reasonably stable market in which claimant could 

be employed,” and therefore its award for total permanent disability was proper. Id. at 362-64, 

376 N.E.2d at 210-11. Sunny Hill cites a string of cases that reference the “stable labor market”

language in E.R. Moore, but which apply it to TTD benefits instead of permanent disability 

benefits. See, e.g., J.M. Jones Co. v. Industrial Comm’n, 71 Ill. 2d 368, 375 N.E.2d 1306 
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(1978) (working approximately 11⁄2 hours per day as a hot dog vendor did not preclude a TTD 

award); Zenith Co. v. Industrial Comm’n, 91 Ill. 2d 278, 437 N.E.2d 628 (1982) (driving a bus 

for a few hours per day did not preclude a TTD award); Mechanical Devices v. Industrial 

Comm’n, 344 Ill. App. 3d 752, 761-62, 800 N.E.2d 819, 828 (2003) (driving a shuttle bus 10 to 

15 hours per week did not preclude a TTD award); Dolce v. Industrial Comm’n, 286 Ill. App. 

3d 117, 675 N.E.2d 175 (1996) (consistent work selling real estate precluded claimant from a 

TTD award).

¶ 25 Sunny Hill’s argument notwithstanding, we doubt the existence of a separate “stable labor 

market test” to determine TTD benefits. While it is true cases such as J.M. Jones, Zenith, 

Mechanical Devices, and Dolce refer to the “stable labor market” language in E.R. Moore, the 

essence of the TTD determination is as set forth by our supreme court in Interstate 

Scaffolding–whether the claimant’s condition has stabilized. The existence or nonexistence of 

a “stable labor market” for a particular job simply is not germane to the determination of 

whether an individual’s condition has stabilized. However, the fact a claimant has returned to 

work in some capacity may be relevant to whether and to what extent the claimant’s condition 

has stabilized. To this extent, it may well be appropriate to consider the type of work being 

performed, hours worked, and any income earned, all in order to ascertain whether the 

claimant’s condition has stabilized. See Freeman United Coal Mining Co. v. Industrial 

Comm’n, 318 Ill. App. 3d 170, 178, 741 N.E.2d 1144, 1150 (2000) (“The factors to be 

considered in determining whether a claimant has reached maximum medical improvement 

include a release to return to work, with restrictions or otherwise, and medical testimony or 

evidence concerning claimant’s injury, the extent thereof, the prognosis, and whether the 

injury has stabilized.”). The courts in J.M. Jones, Zenith, Mechanical Devices, and Dolce 

considered the claimants’ earnings and “work” as one factor–not necessarily the dispositive 

factor–in determining whether they were entitled to TTD benefits.

¶ 26 Thus, in determining TTD benefits in this case, the Commission’s focus was properly 

directed to whether claimant’s condition had stabilized and she had reached MMI, and not 

whether she was working in a “stable labor market.” Claimant’s presence at the flower shop, 

and whether it constituted a “return to work,” was but one factor for the Commission to 

consider in its analysis. Sunny Hill argues the Commission erred in awarding TTD. We 

disagree.

¶ 27 Claimant’s “work” at the flower shop did not establish her condition had stabilized.

Claimant opened the flower shop with her daughters as a way of grieving the loss of her 

husband and son. Although she is the majority owner, her daughters run the business. Claimant 

is present at the flower shop approximately three days per week. Her presence at the flower 

shop was the same both before and after the December 5, 2008, work injury. While at the 

flower shop, she primarily watches her grandchildren in a babysitting role. On occasion, 

claimant answers the phone, retrieves faxes, and assists customers if her daughters are 

occupied. At times, she may provide minor assistance to her daughters when they are making 

flower arrangements and may make an occasional delivery if it is a “light one.” Claimant does 

no more at the flower shop than she would do at home. She does not draw a paycheck, have a 

regular schedule, or track her hours. She has received no income from the flower shop 

business. The surveillance records and video submitted by Sunny Hill do not contradict 

claimant’s testimony about her activities at the flower shop.
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¶ 28 We take this opportunity to address this court’s statement in Granite City, that “[t]o show 

entitlement to TTD benefits, claimant must prove not only that he did not work, but that he was 

unable to work.” Granite City, 279 Ill. App. 3d at 1090, 666 N.E.2d at 829. Here, claimant’s 

activities at the flower shop could arguably be characterized as “work.” A literal application of 

the preceding language in Granite City might therefore dictate a denial of TTD benefits, a 

result we do not believe was intended by Granite City. We believe the quoted language in 

Granite City should not be interpreted to mean a return to any work will result in the denial of 

TTD benefits, but rather evidence of such work may be probative of whether the employee’s 

condition has stabilized which, according to the supreme court in Interstate Scaffolding, is the 

proper focus of the TTD analysis. In the present case, we do not believe claimant’s activities at 

the flower shop demonstrated her condition had stabilized.

¶ 29 Similarly, the medical evidence in this case does not demonstrate claimant’s condition had 

stabilized. Claimant underwent surgery on her right shoulder on January 28, 2009. She 

remained off work until April 16, 2009, when she was released to light-duty work by 

Dr. Markarian. Effective June 10, 2009, Dr. Walsh returned claimant to full-duty work 

apparently after having determined claimant’s injuries were not related to the December 5, 

2008, work accident. On July 23, 2009, claimant reported to Dr. Markarian she had aggravated 

her right shoulder. Dr. Markarian restricted her from work again effective July 23, 2009.

Following an August 2009 MRI and a cortisone injection, Dr. Markarian returned her to 

light-duty work effective August 28, 2009. On September 22, 2009, claimant still had pain in 

her right shoulder and Dr. Markarian restricted her from work again. Following an October 

2009 MR arthrogram, Dr. Markarian diagnosed a partial tearing of the rotator cuff and 

recommended surgery. On February 24, 2011, Dr. Romeo performed surgery on claimant’s 

right shoulder. As of the June 15, 2011, arbitration hearing, claimant was still in post-operative 

therapy and continued to treat with Dr. Romeo. He had not released her to return to work. This 

evidence does not necessarily indicate claimant’s condition had stabilized.

¶ 30 The arbitrator found TTD benefits were appropriate because (1) claimant’s presence at the 

flower shop and occasional assistance to her daughters there did not constitute a “return to 

work” and (2) she had not yet reached MMI nor had she been released to return to work. The 

Commission adopted the arbitrator’s decision. Based on this evidence, we find the 

Commission’s award of TTD benefits is not against the manifest weight of the evidence. (We 

note the record contains evidence claimant was working light-duty at Sunny Hill from 

approximately April 16, 2009, to June 9, 2009. The claimant was awarded TTD benefits during 

this time. However, Sunny Hill does not assert this as error and any such claim is therefore 

forfeited.)

¶ 31 Next, Sunny Hill asserts the Commission’s decision that claimant’s current condition (full 

thickness rotator cuff tear) is causally related to the December 5, 2008, accident is against the 

manifest weight of the evidence. Specifically, Sunny Hill contends claimant failed to establish 

(1) the December 5, 2008, work accident caused a change in her preexisting rotator-cuff 

condition or (2) that an intervening, aggravating event occurring after her June 2009 surgery 

caused her current injury.

¶ 32 “To prevail on a claim for benefits under the Act, the employee must establish, among 

other things, that his or her current condition of ill-being is causally connected to a 

work-related injury.” Elgin Board of Education School District U-46 v. Illinois Workers’

Compensation Comm’n, 409 Ill. App. 3d 943, 948, 949 N.E.2d 198, 203-04 (2011). Where the 
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claimant suffers from a preexisting condition, she must “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 be causally connected to the work-related injury.” Id. at 

949, 949 N.E.2d at 204. “The accidental injury need neither be the sole causative factor nor the 

primary causative factor, as long as it was a causative factor in the resulting condition of 

ill-being.” (Emphasis in original.) Id. Whether a work-related injury aggravated a preexisting 

condition such that the injury is compensable under the Act is a question of fact which we 

review under the manifest weight of the evidence standard. Id.

¶ 33 Here, the record contains sufficient support for the Commission’s causation finding.

Although claimant suffered a previous shoulder injury and underwent an arthroscopic 

debridement of the right rotator cuff and subacromial decompression in February 2008, she 

reached MMI and was released to return to full-duty work on October 31, 2008. Claimant 

performed her job duties without difficulty or the need for further medical treatment until the 

second injury on December 5, 2008, when she felt “something just like snap and pain down 

[her] shoulder and arm,” as well as pain in her neck and lower back. She immediately sought 

treatment and shortly thereafter underwent an arthroscopic debridement of what turned out to 

be a partially torn rotator cuff and subpectoral biceps tenodesis. Claimant received 

postoperative physical therapy for the shoulder injury. In March 2009, she received a lumbar 

epidural steroid injection as treatment for her back injury. In April 2009, claimant was still 

experiencing pain in her right shoulder and was given a cortisone injection and released to

light-duty work by her treating physician. Following a June 2009 independent examination by 

Dr. Walsh, he returned claimant to full-duty work after apparently concluding she was at MMI 

and her injuries were not related to the December 5, 2008, work accident.

¶ 34 In July 2009, Dr. Markarian again restricted claimant from work after she reported pain 

and swelling in her right shoulder. An August 2009 MRI on her right shoulder revealed 

tendinosis, moderate bursitis and minimal subacromial enchroachment due to degenerative 

and inflammatory changes. She was returned to light-duty work. In September 2009, claimant 

still had right shoulder pain, and in October 2009 she underwent an MR arthrogram which 

revealed a partially torn rotator cuff. Dr. Markarian explained the tear would not have been 

visible on the August 2009 MRI. He recommended surgery.

¶ 35 In September 2010, Dr. Romeo evaluated claimant and diagnosed persistent tendonitis 

status post previous biceps tenodesis related to the December 5, 2008, work accident.

Dr. Romeo performed a right shoulder arthroscopy with a revision subacromial decompression 

and a revision open biceps tenodesis.

¶ 36 The Commission noted, “[a]ll of the petitioner’s physicians–Advanced Physicians, Dr. 

Markarian and Dr. Romeo–have identified the accident of December 5, 2008[,] as the causal 

factor for the petitioner’s ongoing right shoulder problems.” In opposition, Sunny Hill 

suggests Dr. Walsh’s opinions were somehow more persuasive. First, Sunny Hill did not even 

introduce Dr. Walsh’s report into evidence, let alone provide his testimony. Other than a brief 

mention in the initial report of Dr. Romeo and in Dr. Markarian’s deposition, Dr. Walsh’s 

causation opinion appears nowhere else. Moreover, the record is barren of any basis or 

foundation supporting Dr. Walsh’s opinion. See Gross v. Illinois Workers’ Compensation 

Comm’n, 2011 IL App (4th) 100615WC, ¶ 24, 960 N.E.2d 587 (“ ‘Expert opinions must be 

supported by facts and are only as valid as the facts underlying them.’ ” Further, “[t]he 

proponent of expert testimony must lay a foundation sufficient to establish the reliability of the 
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bases for the expert’s opinion.” (quoting In re Joseph S., 339 Ill. App. 3d 599, 607, 791 N.E.2d 

80, 87 (2003))). Second, it is the province of the Commission to determine the credibility of 

witnesses and the weight to be accorded their testimony. O’Dette v. Industrial Comm’n, 79 Ill. 

2d 249, 253, 403 N.E.2d 221, 223-24 (1980). The record does not support Sunny Hill’s 

contention that Dr. Walsh’s opinion deserved to be given more weight than it was apparently 

accorded by the Commission.

¶ 37 Sunny Hill also argues claimant’s current injury (full rotator cuff tear) could have been the 

result of an intervening, aggravating event. Specifically, Sunny Hill notes that claimant 

reported she aggravated her shoulder in late July 2009. However, according to Dr. Markarian, 

claimant aggravated her shoulder because she was forced back to full-duty work while still 

undergoing physical therapy and without Dr. Markarian’s consent. Dr. Markarian testified the 

exact “mechanism” by which she aggravated her shoulder was not important because she 

should not have been working. Therefore, we agree with the Commission that “[t]here is no 

evidence of any intervening accidents.”

¶ 38 For the reasons stated, the Commission’s finding that claimant’s present condition of 

ill-being is causally related to the December 5, 2008, work accident is not against the manifest 

weight of the evidence.

¶ 39 III. CONCLUSION

¶ 40 For the reasons stated, we affirm the circuit court’s judgment, confirming the 

Commission’s decision, and remand the cause for further proceedings pursuant to Thomas, 78 

Ill. 2d 327, 399 N.E.2d 1322.

¶ 41 Affirmed and remanded.