Employee’s Reasonable Self-Care of an Injury is not an Injurious Practice

Dunteman v. Illinois Workers’ Compensation Commission (Caterpillar, Inc.)

By: Conor P. Desmond - Associate - Nyhan, Bambrick, Kinzie & Lowry

Synopsis: Petitioner lanced a blister on his foot, leading to a severe infection. Employer stipulated to the fact that an accident occurred at work, leading to the blister, but disputed the infection was casually related due to Petitioner’s actions. On review, the Appellate Court concluded that but for the accident, Petitioner’s infection would not have occurred and therefore Petitioner has a compensable claim.


Facts: Petitioner, who had a previous medical history of type II diabetes and was under the care of a physician, worked as an “outside driver.” In May 2011, the automatic truck he usually drove was replaced with a 10-speed manual transmission model; over the course of a shift, Petitioner forcefully struck the clutch about 200 times with his left foot and also got in and out of the truck approximately 30 times, putting pressure on the same area of his foot. On June 21, 2011, Petitioner noticed pain on the bottom pad of his left foot; striking the clutch worsened the pain and he began walking with a limp. The parties stipulated Petitioner had sustained an accidental injury that arose out of and in the course of his employment on June 21, 2011. On June 25, 2011, Petitioner observed a “water blister” under the callus on the bottom of his left foot; he lanced the blister with a sterilized needle and applied peroxide to the area. On July 4, 2011, Petitioner reported to an emergency room with chills and left foot pain. Petitioner underwent three surgeries, resulting in the amputation of his left third toe. After treatment, Petitioner returned to work full duty on September 5, 2011.


On August 8, 2013, the Arbitrator found the self-treatment was not an injurious practice. On December 10, 2014, the Commission reversed the award, finding the Petitioner’s actions led to the infection.


On April 29, 2016, the Appellate Court concluded Petitioner’s infection and subsequent amputation would not have occurred but for the accident at work. Citing to National Freight Industries v. IWCC, the court reiterated that once an injury is shown to be compensable, every “natural consequence that flows from the injury … is compensable absent the occurrence of an independent intervening accident.” Further, even if Petitioner lancing the blister was the direct cause of the infection, the infection would not have occurred but for the work-related blister. Therefore, Petitioner’s work-related injury was a cause of Petitioner’s state of ill-being and therefore is compensable.


Impact on Illinois Employers: Employers must carefully weigh the advantages and disadvantages of stipulating to the existence of an accident due to cases such as this. A close reading of the Appellate Court’s reasoning shows the court felt this lancing fell into the “natural consequences that flow” from an injury, or that it was normal for a worker to lance a blister in this manner. Such a case has a potential to limit what could reasonably be classified as an injurious practice where accident is not at issue. While this decision does not steer employers towards always denying accident, it does reveal that stipulating to an accident limits potential future defenses to compensability.

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