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Overcoming the “Pre-existing” Trap: A Strategic Victory

When a 58-year-old food manufacturing worker in Chicago reported shoulder pain in 2019, his employer initially dismissed it as a simple sprain. What followed was a complex medical battle involving massive rotator cuff tears in both shoulders and advanced arthropathy. Despite aggressive insurance denials claiming his injuries were "pre-existing," our firm fought to secure two life-changing surgeries and permanent workplace protections.
man sitting on floor

In this case result

The Reality of Repetitive Motion Injuries

In March 2019, the client—a right-handed production line worker—began experiencing severe pain while lifting heavy loads and performing repetitive tasks. In the food manufacturing industry, the cumulative stress of these movements can be just as damaging as a sudden fall.

Initially, he was diagnosed with a minor sprain. However, as the pain became nocturnal and his mobility vanished, advanced imaging revealed a much grimmer reality: massive, chronic rotator cuff tears and significant muscle atrophy.

The Strategy: Navigating Disputed Causality

This case was a classic example of insurance “causality disputes.” The employer’s insurance carrier argued that because the client had signs of arthritis and bilateral issues, his condition was due to age or pre-existing conditions, not his work.

To counter this, the legal strategy led by Jack Epstein, with 30 years of experience in the Illinois legal market, focused on “aggravation.” Under Illinois law, if a workplace task makes a pre-existing condition worse, it is compensable.

Our intervention included:

  • Challenging the IME: We aggressively reviewed the Independent Medical Exams that provided unfavorable opinions to minimize the client’s claim.
  • Evidence-Based Causality: We utilized orthopedic evaluations to prove that heavy lifting at 58 years old directly exacerbated his arthropathy.
  • Coordinating Complex Care: We managed the authorization process for two distinct, high-level surgeries that the insurance company initially refused to link to the workplace.

A Life-Changing Medical Resolution

Despite the legal hurdles, our firm successfully secured the following medical benefits for the client:

  • Right Shoulder: Arthroscopic debridement to address the initial tear.
  • Left Shoulder: A highly specialized Reverse Total Shoulder Arthroplasty to restore function where a standard repair was no longer possible.

By the end of the case, the client’s mobility significantly improved and his chronic pain was finally managed. Recognizing that he could no longer perform the heavy physical labor of a manufacturing line, we secured permanent work restrictions to protect his health and safety for the remainder of his career.

Proven Experience in Every Illinois Case

  • “Jack Epstein, with 30 years of experience in the Illinois legal market, personally oversaw the case.”
  • “The client paid nothing until we won the case.”

The Final Word on Perseverance

An “old injury” isn’t an excuse for an employer to ignore a new problem. This Chicago worker proved that even with a history of arthritis, you are entitled to a safe recovery and the best medical technology available. By securing a reverse shoulder replacement and permanent job protections, we didn’t just win a case; we gave a 58-year-old worker his quality of life back.

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