TRANSMITTAL LETTER FOR BOARD MEETING OF SEPTEMBER 4, 2025
COMMITTEE ON JUDICIARY
Mr. John P. Murray, Acting Executive Director
Title
Authority to settle the Workers’ Compensation Claim of Dale Polak vs. MWRDGC, Claim number W004106942, Illinois Workers’ Compensation Commission (IWCC), in the sum of $59,637.19, Account 901-30000-601090
Body
Dear Sir:
Dale Polak is a Truck Driver at the Calumet Water Reclamation Plant. On September 11, 2023, he reported that he was standing on the bumper of a truck, adjusting the rear-view camera to hook up a trailer, when he slipped and injured his right arm. Mr. Polak sought treatment at the Industrial Clinic on September 11, 2023, where he was referred to an orthopedic specialist.
An MRI revealed a ruptured distal biceps tendon, and Mr. Polak was off work effective September 14, 2023. He had surgery on October 5, 2023, and was able to return to work on December 18, 2023. Mr. Polak was taken off work again on January 29, 2024, and returned to work on March 4, 2024.
Mr. Polak was paid a total of 18.40 weeks of lost time benefits totaling $20,656.34.
Subject to the approval of the IWCC, this Pro Se case can be settled for $59,637.19, representing approximately 23.0% loss of use of the arm. This settlement will close out any future lost time and medical benefits associated with this injury.
The Director of Human Resources believes this settlement is in the best interest of the District and requests payment of that sum be approved and he be authorized to execute such documents as may be necessary to effect the settlement.
Requested, Thaddeus J. Kosowski, Director of Human Resources, TJK:BLW:DMG
Disposition of this agenda item will be documented in the official Regular Board Meeting Minutes of the Board of Commissioners for September 4, 2025