4691710049_73b73e5fdb_zSection 10 of the Public Safety Employee Benefits Act provides that under certain circumstances, police officers receiving line-of-duty pensions are entitled to receive fully paid health insurance coverage for themselves and their families. In the closing days of its September term, the Illinois Supreme Court agreed to decide Vaughn v. City of Carbondale, which poses several related questions about the circumstances triggering a right to insurance coverage, and when – if ever – that coverage benefit may be terminated.

Vaughn arises from an incident in 2005. The plaintiff was talking to a motorist who had asked for directions when he heard a dispatcher calling on his radio. He returned to the car and when he reached inside to retrieve the radio, he struck the top of his head, causing him to “see stars” and a sharp pain in his arm. Nearly two years later, the officer applied for a line-of-duty disability pension under the Illinois Pension Code (40 ILCS 5/3-114.1). The Pension Board rejected his application, but the Circuit Court reversed, finding that he had been injured as a result of his employment. The Fifth District Appellate Court affirmed.

In 2012, the officer requested health insurance coverage pursuant to Section 10 as part of his disability benefits. The City provided the coverage, but that same year, the Board directed the officer to submit to a physical examination. Following that physical, the Board terminated his pension on the grounds that he was fit to return to work as a police officer. The Circuit Court affirmed that decision on administrative review, but the Fifth District reversed, holding that the officer had been denied procedural due process because he was not given notice and an opportunity to be heard.

While that appeal was still pending, the officer filed a complaint seeking a permanent injunction against termination of his health insurance coverage. The Circuit Court declined to enter the injunction, but the officer appealed.

The Fifth District reversed. The Court explained that two prerequisites were necessary before an officer was entitled to the health insurance benefit: (1) he or she must have suffered a catastrophic injury in the line of duty; and (2) the injury must have been received as the result of the officer’s response to fresh pursuit, or to what he or she reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act.

Given that a “catastrophic injury” has been construed by the Supreme Court to mean any injury entitling the officer to a line-of-duty pension, the Court concluded that there was no longer any question that the officer satisfied the first prerequisite, in the wake of the decision reversing termination of his pension.

The Court held that the second prerequisite was satisfied as well, on the grounds that the officer’s injury was received as a result of what he reasonably believed to be an emergency. An “emergency” within the meaning of the statute has been defined as “an unforeseen circumstance involving imminent danger to a person or property requiring an urgent response.” The City argued that this condition was not satisfied, since there was no evidence in the record as to what the nature of the call the officer answered was. But the Court pointed out that an officer was under a duty to respond to dispatchers in a timely manner and to be prepared for any eventuality. Until he or she can eliminate the possibility that the call is an emergency, all calls are treated as one. Therefore, the Court found that the officer was responding to what he reasonably believed was an emergency, and was entitled to health insurance coverage.

Image courtesy of Flickr by Cyro A. Silva (no changes).