## Illinois Official Reports

Appellate Court

Sunny Hill of Will County v. Illinois Workers ’ Compensation Comm ’ n , 201 4 IL App ( 3d ) 130028 WC

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 shoulde r 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.- 2

-

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 Dece mber 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

p resence 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 Decembe r 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 causall y 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 tes tified 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,- 3

-

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 ar throgram 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 steno sis 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 injur ies were causally connected to the December 5, 2008, work accident.
¶ 9 On January 28, 2009, Dr. Markar ian performed an arthroscopic debridement of the

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

underwent an EM G of her lower back which reveale d 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 evalu ation 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 claiman t 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 h er 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 fr om 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- 4

-

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 A ugust 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 bec ause 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, a n orthopedic surgeon,

evaluated claimant. Dr. Romeo diagnosed persistent tendo nitis 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 symp toms 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

subacromia l decompression and a revision open biceps tenodesis. As of the date of arbitration

, claimant remained in post operative 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 leas t 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

dis tributed 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 t o “ 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 e ntrance 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, t hrough 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- 5

- 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. H er 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 arbi trator ’ 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 confir med 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, w ork 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 dist urbed 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 conclusi on 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 c ondition 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

proc ess. ” 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 permanen t 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

Commissi on 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- 6

-

(1978) (working approximately 1 1⁄2 hours per day as a ho t 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 i n 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 g ermane 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 ma y 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 17 0, 178, 741 N.E.2d 1144, 1150 (2000) ( “ T he 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 disagre e. ¶ 27 Claimant ’ s “ work ” at the flower shop did not establish her condition had stabilized.

C laimant 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 busi ness. 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 bab ysitting 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 de livery if it is a “ light one. ” Claimant doe s no more at the flower shop tha n she would do at home. She does not draw a pay check, 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.- 7

- ¶ 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 character ized 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 interpre ted 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. Cl aimant 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 aft er 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, 20 09. 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. Foll owing 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, claima nt 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 be cause (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 pre existing 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- 8

-

claimant suf

fers 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 injur y. ” 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 Commissi on ’ 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 o n 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 i n 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 ten odesis. Claimant received

post operative 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 accide nt. ¶ 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

ten d in osis, moderate bursitis and minimal subacromial enchroachment due to de generative 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 th e tear would not have been visible on the August 2009 MRI. He recommended surgery.
¶ 35 In September 2010, Dr. Romeo evaluated claiman t and diagnosed persistent tendo nitis

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 i nto 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 su pporting 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

propone nt of expert testimony must lay a foundation sufficient to establish the reliability of the- 9

-

base s 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 claiman t 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. M arkarian 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 s tated, 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 circui t 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.