7976481519_2f17a2f49cSection 10 of the Public Safety Employee Benefits Act provides that when a covered employee sustains a “catastrophic injury,” the employee is entitled to the additional benefit of having his or her health insurance premiums, as well as those of his or her partner and/or dependent children, paid by the employer. Is Section 10 triggered when a firefighter is held to be entitled to an occupational disease disability pension? The Illinois Supreme Court agreed to decide that issue in the closing days of its January term in Bremer v. City of Rockford, a decision from the Second District of the Appellate Court.

Plaintiff in Bremer began working for the City as a firefighter in 1976. In May 2004, he filed an application with the Pension Board seeking an occupational disease disability pension pursuant to Section 4-110.1 of the Pension Code (40 ILCS 5/4-110.1), arguing that he suffered from cardiomyopathy rendering him unable to work as a firefighter. The Board granted the pension, finding that the plaintiff had completed five years of creditable service and now suffered from cardiomyopathy as a result of exposure to chemicals and toxins on the job and heavy exertion during emergency calls.

One year later, the City informed the plaintiff that it would no longer pay his health insurance premiums. The plaintiff responded by applying for the health insurance benefits under Section 10 of the statute. The City denied his claim, concluding that he had not suffered a catastrophic injury within the meaning of the statute.

The plaintiff filed a complaint seeking a declaration that he had suffered a catastrophic injury within the meaning of the statute and was therefore entitled to have his premiums paid. The parties filed cross-motions for summary judgment, and the trial court granted the plaintiff’s motion and denied the City’s motion. The court subsequently granted the City’s motion for summary judgment on Count 2 of the plaintiff’s claim for an award of attorneys’ fees under the Wage Actions Act. Meanwhile, the court had granted the plaintiff leave to add an additional count, seeking to recover medical expenses incurred and premiums that allegedly should have been paid during the period following the City’s decision to cease payment. In response to a motion to dismiss, the court rejected for the most part the plaintiff’s claim for unpaid premiums. The court also rejected the plaintiff’s claim for medical expenses, finding that the expenses had been paid by automobile insurance.

A divided panel of the Appellate Court largely upheld the plaintiff’s position with respect to the health insurance premiums. The majority explained that the Pension Code defines three types of disability: a line of duty disability under 40 ILCS 5/4-110; an occupational disease disability under 40 ILCS 5/4-110.1; and a non-line-of-duty disability under 40 ILCS 5/4-111.

The Court noted that a line-of-duty pension automatically amounts to a catastrophic injury under the statute. The Court found it significant that the types of injuries justifying a line-of-duty disability and an occupational disease disability are similar. Ultimately, the majority agreed with the trial court that there was no meaningful distinction between a line-of-duty pension based on sickness resulting from cumulative acts of duty and an occupational disease disability pension based upon cardiomyopathy based on years of service. The majority also noted that the both statutes used identical methods of calculating the pensions. The legislature’s methodology supported the conclusion that an occupational disease disability pension was to be treated as a line-of-duty pension under the statute for purposes of Section 10.

That conclusion did not mandate a conclusion that the plaintiff was entitled to the benefits, however. There was still the further requirement of the statute that the injury at issue be incurred as the result of a response “to what is reasonably believed to be an emergency, an unlawful act . . . or during the investigation of a criminal act.” 820 ILCS 320/10(b). Since an occupational disease disability pension could be triggered by “service as a firefighter,” the Court reversed and remanded for further consideration as to whether this standard could be satisfied.

The majority concluded its analysis by briefly affirming the trial court’s rejection of the plaintiff’s claim under the Wage Actions Act, concluding that the health care insurance premiums could not constitute “wages” under the Act since plaintiff’s entitlement to benefits, if any, was triggered only when he was no longer employed by the City.

Justice McLaren dissented from the majority’s conclusion that the plaintiff’s occupational disease disability pension could possibly qualify for a line-of-duty pension (and thereby as a “catastrophic injury” triggering Section 10).

We expect Bremer to be decided in eight to twelve months.

Image courtesy of Flickr by Jack Snell (no changes).