Three years ago, officials at a state agency became suspicious when dozens of guards from the Menard Correctional Center filed workers' compensation claims for debilitating injuries from turning keys and manually operating cell locking devices.
Central Management Services, the agency that processes workers' comp claims, brought in an expert to do on-site evaluations of whether those duties could cause repetitive trauma injuries, including the most common -- carpal tunnel syndrome.
A 17-page report by Midwest Rehabilitation Inc. of Springfield, received Sept. 30, 2008, stated that the duties of guards at the Chester prison did not approach even minimal levels on its Stress Index.
The index is a method of measuring the potential for repetitive trauma. A score below 3 is considered safe. None of the Menard guards' duties tested, including operating a crank that opens 24 cells at one time, scored higher than 1.5, according to the report.
But instead of challenging the taxpayer-paid settlements -- which ranged from $20,000 to $100,000 -- CMS continued to approve payments to guards for repetitive trauma. They turned over copies of the 2008 report to the Illinois Department of Corrections and attorney general's office, then filed it with no investigation.
In most workers' comp cases, a state arbitrator gives final approval to claims after a treating physician provides an opinion that the injury exists.
Eventually, more than 230 Menard employees, nearly all of them guards, filed workers' comp claims for repetitive trauma since Jan. 1, 2008. At least half have been settled for a total of about $6.9 million
In all, during the same time period 389 prison staffers filed claims for all types of injuries resulting in nearly $10 million in payouts, including a carpal tunnel settlement of $75,678 for the warden. Millions more in medical fees were billed to the public.
The 2008 report did not raise alarm at the Department of Corrections, even though it accepted the findings that the cell locking apparatus did not cause repetitive trauma injuries.
Department spokeswoman Sharyn Elman said: "The report did not recommend any changes in procedures at IDOC. ... Since the report determined that the injuries were not caused by IDOC workplace procedures, we did not institute any changes."
She said the department did not call for an investigation because "IDOC cannot prevent employees from filing workers' comp claims; this would be violation of the law."
In March, CMS brought in a second expert, a St. Louis hand surgeon, to conduct similar tests. Dr. Anthony Sudekum came to nearly the same conclusion: Menard guards' duties do not cause repetitive trauma. The only difference was that Sudekum also concluded that the duties "could be a possible aggravating factor" for an existing condition.
So far this year, despite four ongoing state investigations and a criminal probe by a federal grand jury in the state workers' compensation system, 27 more repetitive trauma workers' comp cases have been filed from Menard.
Report not heeded
The News-Democrat obtained a copy of the Midwest Rehabilitation report and other documents under the Illinois Freedom of Information Act. But CMS has refused to release other repetitive trauma case files, despite a directive from Illinois Attorney General Lisa Madigan, and has filed suit in Chicago to block the release of those documents to the public.
Natalie Bauer, a spokeswoman for the attorney general's office, said copies of the 2008 report were distributed to assistant attorneys general who represent the public in workers' comp cases brought by state workers. The findings were used to oppose some claims brought by Menard guards, but they did not prove effective, she said.
State lawyers presented "aggressive" defenses for workers' comp claims that they questioned, she added.
The occupational therapist who prepared the report was Tracey Maras, the former occupational therapy supervisor at St. John's Hospital in Springfield. She testified during a pivotal hearing in January 2009 on one of the guards' cases that the duties did not cause repetitive trauma injuries, but her assertion fell apart under cross-examination by Fairview Heights attorney Thomas Rich, who represented many of the Menard workers.
At the 2009 hearing, arbitrator John Dibble rejected Maras' opinion and based his decision on testimony from Dr. David Brown, a St. Louis hand surgeon who was the treating physician in the case. Brown routinely diagnosed Menard correctional officers as having work-related carpal tunnel, Bauer said.
"Based on arbitrator Dibble's decision that the repetitive trauma cases of Menard correctional officers were 'clear cut' in favor of the officers, these cases were extremely difficult to defend," she said.
Dibble, of Freeburg, is on paid administrative leave pending the outcome of the state investigations. Last year he received a $48,790 settlement for a repetitive trauma injury he said resulted from stumbling on steps at a workers' compensation hearing office in Herrin. He has stated he will not comment.
Greg Rivara, a spokesman for CMS, said, "CMS commissioned the (2008) study to support its argument against the repetitive motion injury claims at IDOC facilities. CMS provided the study to the Office of the Attorney General, which used the report in presenting an aggressive defense against the merits of such claims. ..."
No burden of proof
Under Illinois law, workers do not need to prove that a work condition was a significant cause of an injury, only that it could have caused an injury. The recent opinion of Sudekum, the St. Louis hand expert, that a guard's duties could possibly aggravate carpal tunnel syndrome, "is all that's needed under Illinois law," Rich said.
Rich, who adamantly disagreed with Sudekum's finding that a guard's duties were not a "primary" cause of repetitive trauma, said: "Dr. Sudekum is a pleasant person. He just happens to have a different opinion. It mirrors that of many insurance companies, employers and government agencies who want to defend a claim."
The studies conducted by Maras and Sudekum relied on information from on-the-job observation and measurements.
Sudekum's report described a work environment at Menard where duties were performed at a "leisurely and unhurried pace" and where all locking devices tested except one needed only minimal force to operate.
He concluded: "It is my opinion that the job activities of a correctional officer at (Menard) would not serve as a prime etiologic (causal) factor in the development of upper extremity repetitive trauma injuries. However, I feel that these work activities could be a possible aggravating factor in the development and or progression of these conditions."
Sudekum personally tried out many of the locking and unlocking devices. Of the "crank," a metal wheel that unlocks 24 cells at one time, he wrote "there appears to be very little resistance when operating the hand crank." He described sliding open cell doors and working padlocks as "benign."
At one point, Sudekum challenged a guard to show him one of the more difficult cell door locks to open. He tried it himself and reported and wrote that this particular lock and door opened and closed "with minimal difficulty or physical straining." One lock jammed, he reported.
In the 2008 Maras study, she found that a normal, eight-hour shift for a Menard correctional officer "does not present with sufficient risk factors for the development of ... carpal tunnel syndrome."
She added "it was observed that the correctional officers spend the majority of the work activities not actively using their hands, functioning more in an observational/supervisory role." Contact reporters Beth Hundsdorfer at bhundsdorfer@bnd.com or 239-2570 and George Pawlaczyk at gpawlaczyk@bnd.com or 239-2625.
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