Friday, April 24, 2015

Appellate Court Finds Employee Entitled to PSEBA Benefits

In Vaughn v. City of Carbondale, the Fifth District Appellate Court ruled in favor of the plaintiff Jeffrey Vaughn, finding he was entitled to health insurance benefits under Section 10 of the Public Safety Employee Benefits Act (“PSEBA”).    On June 28, 2005, Vaughn, a City police officer, was on duty when he was stopped by a motorist asking for directions. While Vaughn was outside his squad car assisting the motorist, he received a request from a police dispatcher for him to respond over the radio. He then returned to his vehicle and reached headfirst through his driver’s side door, which he had left open, in an attempt to retrieve his radio from inside the car. As he reached inside the vehicle, he struck the top of his head on the door frame, causing him to “see stars” and experience immediate sharp pain in his arm.  After his shift, Vaughn sought medical attention from his personal physician, who took him off duty as a result of his injury. 

The issue before the court was whether Vaughn has presented sufficient evidence that he was entitled to health insurance benefits under PSEBA. 820 ILCS 320/10.  Section 10 of the Act provides, in relevant part, that injured full-time law enforcement officers and their families are eligible to receive health insurance benefits if two conditions are satisfied.  First, the officer must have suffered a catastrophic injury in the line of duty. Second, the injury must have occurred as the result of the officer’s response to fresh pursuit or the officer’s response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act. 820 ILCS 320/10(b).  The officer must satisfy both of these statutory requirements to be entitled to benefits.

The Act does not define the term “catastrophic injury.” However, the Illinois Supreme Court has concluded that the phrase “catastrophic injury” as used in the Act is synonymous with an injury resulting in the awarding of a line-of-duty disability pension under Section 4-110 of the Illinois Pension Code. Here, Vaughn received a disability pension for his work-related injury. This legal issue was not disputed by the parties.

At issue was whether Vaughn’s injury occurred as the result of one of the circumstances set forth in Section 10(b) of the Act. The court found that the facts established that Vaughn’s injury occurred as the result of his response to what he reasonably believed was an emergency relying on the Illinois Supreme Court’s 2012 decision in Gaffney v. Board of Trustees of the Orland Fire Protection District. The court rejected the City’s argument that there was no evidence that the reason for the call was an emergency situation which involved imminent danger to a person or property that required an urgent response.  The City further argued that the plaintiff’s interpretation of the term “emergency” as used in Section 10(b) of the Act reads the “emergency” requirement out of the Act as any officer injured while answering a dispatch call would be entitled to health insurance coverage regardless of whether the call involved unforeseen circumstance that involved imminent danger to a person or property requiring an urgent response.

Even though there was no evidence presented that this dispatch call resulted in an emergency situation, the Fifth District Appellate Court found it is an officer’s duty to respond to dispatch calls in a timely manner and be prepared for any eventuality.  The court found that an officer cannot know the nature of the call until he responds.  Accordingly, until the officer is able to eliminate the possibility that the dispatch call is an emergency, the officer treats the call as if it were such.  Because the evidence established that Vaughn was engaged in the act of responding to what he believed was a “potential emergency” that could have, based on the fact that a radio call from dispatch was a means of communication concerning an emergency situation, involved imminent danger to a person or property and therefore required an urgent response.  The court concluded that the facts before it established that the plaintiff’s injury was incurred as a result of his response to what he reasonably believed was an emergency.  As a result, the plaintiff was entitled to PSEBA health benefits.

This decision follows the line of recent Illinois PSEBA cases finding in favor of injured employees and awarding them health insurance benefits under the Act. The case is troubling for employers in that it further weakens the emergency requirement in the Act to include “potential emergency calls” which will now make these cases even more difficult to defend.   The time to file a petition for leave to appeal to the Illinois Supreme Court has not yet expired so there may be more to come of this decision.