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Thursday, December 8, 2016

Illinois Appellate Court Upholds Denial of PSEBA Benefits

In a recent Illinois case, a court affirmed a Village's denial of PSEBA benefits, finding that the firefighter applicant failed to show that he was responding to what was reasonably believed to be an emergency.  Wilczak v. The Village of Lombard, 2016 IL App (2d) 160205 (December 5, 2016).

A firefighter for the Village of Lombard injured his shoulder while lifting a disabled patient.  Following treatment, he had a number of complications and was unable to continue working. He was granted line-of-duty disability benefits the Illinois Pension Code. He then applied for health insurance benefits under PSEBA, but the Village denied his request. The firefighter filed a complaint for declaratory judgment that he was entitled to PSEBA benefits. He argued that he was entitled to PSEBA benefits because his injury occurred during what he reasonably believed to be an emergency.  The trial court granted the Village’s motion for summary judgment, and the firefighter appealed. 

On appeal to the Illinois Appellate Court, the Village acknowledged that the firefighter suffered a “catastrophic injury” under PSEBA.  The main issue then before the appellate court was whether the injury was sustained in response to what the firefighter reasonably believed to be an emergency.  The Illinois Supreme Court held in Gaffney v. Board of Trustees of the Orland Fire Protection District, 2012 IL 110012, that an emergency under PSEBA is an unforeseen circumstance involving imminent danger to a person or property requiring an urgent response.  

In applying that definition to these facts, the Illinois court found that it was not reasonable for the firefighter to believe that he was responding to an emergency and affirmed the denial of PSEBA benefits.  The court noted that the record showed that the injury occurred while dispatched for an invalid assist, which the firefighter should have known did not involve an emergency from the beginning of the call. While the court acknowledged that the firefighter may have subjectively believed there was an emergency initially, once he arrived at the scene, he could have confirmed that it was not an emergency as the patient was not injured and did not require medical attention.  The court pointed out that there was no immediate danger to the patient or the firefighter and that no unforeseen circumstances arose.  

Post Authored by Erin Baker, Ancel Glink


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