Court Opinion

ID: 9520005
Source: CourtListenerOpinion
Date Created: 2023-08-07 01:29:04.998477+00
Date Added: 2024-06-11T12:45:25.637775
License: Public Domain

PRESIDING JUSTICE BOWMAN, dissenting: I respectfully dissent. I disagree with the majority’s opinion for several reasons. Some of the factors the majority includes in its totality of the circumstances test are ill-advised because they will invite trial courts to substitute their judgment for that of the medical experts whose opinions are at issue. Additionally, even if I agreed with the majority’s test, I would still disagree with the majority’s conclusion that the trial court erred in admitting Dr. Cicmanec’s permanency opinion. Last, I would allow the jury’s award for future pain and suffering to stand. In fashioning its totality of the circumstances test, the majority emphasizes the trial court’s “gatekeeping” responsibility to insure that the expert opinions the jury hears are reliable. While I agree that trial courts must prevent unreliable expert testimony from reaching the jury, the majority goes too far and improperly inserts the trial court into the role of expert. This approach is just as inappropriate as the unquestioning acceptance of expert opinion the majority wants to guard against. By including such factors as the nature of the patient’s injuries or condition and the type of treatment the patient received, the majority requires trial judges to make medical distinctions that are properly left to medical experts. I fail to see how a trial judge is qualified to determine that an expert’s opinion on permanency is unreliable because the patient received chiropractic manipulation, for example, as opposed to surgery, or because a patient sustained a sprained back as opposed to a broken back. If a party wishes to challenge an expert’s opinion on such bases, the proper way to do so is through a rebuttal expert, not by asking the trial court to question an opinion a medical expert holds to a reasonable degree of medical certainty based on the expert’s experience and expertise. The majority’s explanation of why it found Dr. Cicmanec’s testimony unreliable provides a good example of the problems with the majority’s test. The majority reasoned, “plaintiff in this case had pain symptoms of a highly subjective nature, for which she was treated by a chiropractor for less than one year. Her treatment consisted of noninvasive therapies designed primarily to loosen her muscles and alleviate pain. *** Dr. Cicmanec’s last examination of the plaintiff was approximately 30 months prior to trial ***.” 313 Ill. App. 3d at 148. The majority thus concludes that given the facts of this case it was not possible for Dr. Cicmanec to form a reliable opinion on whether plaintiff’s condition was permanent. However, the majority, not being a medical expert, does not know what facts are necessary in order for Dr. Cicmanec to be able to render such an opinion to a reasonable degree of chiropractic certainty and, consequently, is not qualified to make such a determination. A trial court is similarly unqualified. The majority’s totality of the circumstances test, however, will inevitably result in trial courts drawing such conclusions. The majority may characterize them as legal conclusions of reliability, but they are in fact medical conclusions. I find it significant that no other case has established such an intrusive approach. There is no support in the case law for expanding the trial court’s inquiry into the basis of expert opinions to the extent the majority suggests. Further, the majority offers no explanation as to how the type of treatment a person received or the nature of a person’s injuries will help trial courts determine whether an expert’s opinion is reliable enough to be admitted. The majority also fails to address how trial courts, which lack the medical experience and expertise of medical experts, can make .such inquiries without substituting their judgment for that of the experts. In my view the majority’s totality of the circumstances test is inappropriate and unnecessary. Unlike the majority, I do not think trial courts need to be told what factors to consider when determining whether to admit an expert opinion on permanency of injuries. I would follow this court’s approach in Molitor v. Jaimeyfield, 251 Ill. App. 3d 725 (1993). In Molitor, we held that a chiropractor’s trial testimony that the plaintiff would most likely continue to experience pain and to require treatment was admissible even though the chiropractor last examined the plaintiff 18 months before trial. Molitor, 251 Ill. App. 3d at 729. We concluded that the date of the last examination went only to the weight of the evidence, not the admissibility. Molitor, 251 Ill. App. 3d at 729. In my view the factors the majority sets forth in the present case, including the nature of the injury and the type of treatment received, go to the weight, not the admissibility, of the evidence. In Molitor, we further noted that an expert’s opinion need not be based on absolute certainty, but on a reasonable degree of medical certainty. Molitor, 251 Ill. App. 3d at 729. Any medical expert’s opinion on permanency that is not held to a reasonable degree of medical certainty should be excluded. However, when a medical expert testifies that he holds an opinion on whether a patient’s condition is permanent to a reasonable degree of medical certainty, as Dr. Cicmanec did here, the appropriate course is to admit the opinion. Dr. Cicmanec testified to a reasonable degree of chiropractic certainty that “[i]f the [plaintiff] continues to have problems in the same areas, similar complaints after this long of a period of time I think it would be reasonable to assume that it was a permanent condition.” Thus, Dr. Cicmanec’s opinion was based on plaintiffs current condition, not her condition when he last saw her in 1996. Dr. Cicmanec treated plaintiff regularly for a period of several months. Plaintiff testified that there was no substantial change in her condition between the date of her last exam and the time of trial. Notwithstanding my belief that the nature of plaintiffs injuries and the type of treatment she received are inappropriate factors, I believe these factors do not affect the reliability of Dr. Cicmanec’s opinion one way or the other. Consequently, applying the majority’s factors, I still would affirm the trial court’s decision that Dr. Cicmanec’s opinion was admissible. Last, I disagree with the majority’s remittitur of the jury’s award for future pain and suffering on the ground that it was based on Dr. Cicmanec’s testimony regarding permanency. In my opinion the trial court properly admitted Dr. Cicmanec’s opinion on permanency, and that opinion provided a basis for the jury’s award for future pain and suffering. Even without Dr. Cicmanec’s testimony, there was sufficient evidence of future pain and suffering to allow the jury’s award to stand. Expert testimony is not a prerequisite to instructing a jury regarding future pain and suffering when future pain and suffering can be objectively determined from the nature of the injury. Neyzelman v. Treitman, 273 Ill. App. 3d 511, 518 (1995). The majority incorrectly states that Dr. Cicmanec’s “improper” testimony “comprised the basis of the award for future pain and suffering of $3,200.” 313 Ill. App. 3d at 148. The evidence in this case was that plaintiff was rear-ended by a car traveling 45 miles per hour and, as a result, suffered sprain/strain of her neck and low back. Plaintiff testified that she continued to have discomfort in her neck and lower back at the time of trial. I believe this evidence provided a sufficient and objectively reasonable basis for including a future pain and. suffering component in the jury’s instructions.