JUSTICE HOLDRIDGE delivered the opinion of the court:

Alejandro Irizarry filed an application for adjustment ofclaim seeking workers' compensation benefits for an industrialaccident he sustained while working for Dynaweld, Inc. He allegedinjuries to multiple parts of his body, including his left knee. The matter proceeded to a hearing before arbitrator Angelo Caliendounder section 19(b) of the Workers' Compensation Act (820 ILCS305/19(b) (West 2000)). Arbitrator Caliendo awarded medicalexpenses and temporary total disability (TTD) benefits through thedate of the hearing. No appeal was taken from the arbitrator'sdecision.

The matter subsequently proceeded to a second section 19(b)hearing where arbitrator Caliendo awarded additional TTD benefitsfor two periods. The latest period terminated 15 months before thehearing. The arbitrator denied Irizarry's claim for additional TTDbenefits, further medical expenses, and vocational rehabilitation. Irizarry appealed to the Illinois Industrial Commission(Commission), which affirmed the arbitrator's decision. He thenappealed to the Kane County circuit court, which confirmed theCommission's decision.

The matter ultimately proceeded to a final hearing beforearbitrator Peter Akemann, who awarded permanent partial disability(PPD) benefits representing 40% loss of use of Irizarry's left leg. The arbitrator denied all other claims for compensation and medicalexpenses. Irizarry appealed to the Commission, which affirmed thearbitrator's decision. He then appealed to the Kane County circuitcourt, which confirmed the Commission's decision. Irizarry nowbrings this appeal, claiming the Commission erred in threerespects: (1) concluding that injuries to his head, neck, rightshoulder, and back were not causally connected to his industrialaccident; (2) denying additional TTD benefits and medical expenses;and (3) awarding benefits for permanent partial, rather thanpermanent total, disability. We reverse and remand.

Irizarry was working for Dynaweld on January 21, 1991, when hefell and injured himself. The next day he visited Mercy Hospitaland was diagnosed with an acute contusion/sprain of his left knee. He continued treating with Dr. David Clark, and an MRI showedevidence of an injury to the medial collateral ligament in his leftknee. In March of 1991 Dr. Clark performed arthroscopic surgery onthe knee for patellar chondromalacia. Irizarry's postoperativerecovery was slow and marked by left leg weakness. To evaluate theweakness problem, Dr. Clark obtained a lumbar MRI in June of 1991,which revealed minimal degenerative changes with some bulging atL4-L5 and L5-S1. In July of 1991 Irizarry also underwent anEMG/NCV of the left leg, which yielded "essentially normal"results.

Dr. Clark issued a work release on September 12, 1991,stating: "I really feel it would be most important for [Irizarry]to try and get on with it instead of looking for disability whichI am beginning to feel is the major thrust behind all of thissituation." On the following day, Irizarry visited Dr. ThomasTownsend (chiropractor) and received a note describing him as"totally incapacitated" due to pain in his neck, right shoulder,back, and left knee. A cervical MRI revealed normal findings. X rays were interpreted as showing "early degenerative boneproliferation" in the thoracic and lumbar regions, andbiomechanical alterations at all levels.

Townsend referred Irizarry to Dr. Michael Morgenstern for hisleft knee complaints. Both Townsend and Morgenstern renderedsubsequent treatment and authorized him to remain off work. Dr.Morgenstern administered an injection of Depo-Medrol and Marcainein Irizarry's left knee. A lumbar CT scan in October of 1991showed findings consistent with the prior MRI: Schmorl's nodes atL4 and a posterior disc bulge at L4-L5, but no stenosis or facetjoint pathology.

Irizarry remained off work, and his workers' compensationclaim proceeded to a section 19(b) hearing before arbitratorCaliendo on October 11, 1991. The arbitrator awarded TTD benefitscovering the entire period between Irizarry's accident and thearbitration hearing. He also awarded medical expenses totaling$2,504.80. The expenses included bills from Drs. Morgenstern andTownsend.

A note from Dr. Morgenstern on October 30, 1991, reads:"Today, the patient additionally states he injured his low back." Irizarry subsequently complained of numbness and tingling in thefourth and fifth fingers of his right hand. An EMG of his upperextremities in November of 1991 revealed normal findings. Shortlyafterward Doctor Morgenstern administered two epidural injectionsinto Irizarry's lower back. In February of 1992 Doctor Morgensternperformed a second arthroscopic surgery on Irizarry's left knee. The procedure involved debriding a partial tear of the anteriorcruciate ligament, and a partial synovectomy of the medial andlateral compartments.

On April 8, 1992, Townsend released Irizarry to work, notingthat he was permanently incapable of performing "heavy and moderatework." Townsend restricted him from bending, stooping, lifting,pushing, pulling, climbing, elevation of the shoulders and arms,and repetitive head or neck movements involving flexion, extension,or rotation. During a functional capacity evaluation in mid-1992,Irizarry demonstrated abilities in the "light to sedentary" workcategory. Dr. Morgenstern issued a light-duty release on July 23,1992, and Irizarry continued to complain of sciatica. A lumbar MRIin August of 1992 revealed disc degeneration at L4-L5 and L5-S1,with mild posterior bulging, but no stenosis or foraminalencroachment.

Dr. Morgenstern reviewed the MRI results and said Irizarry was"certainly not a surgical candidate." On September 3, 1992, thedoctor opined that Irizarry was at maximum medical improvement andcould not return to his usual work as a welder. Dynaweld gave hima referral for vocational rehabilitation services. Three monthslater he returned to Dr. Morgenstern with continued left kneecomplaints and received another injection.

In March of 1993 two rehabilitation consultants (Sylvia Sykesand Louisa Castellanos) issued a report describing Irizarry'sparticipation in vocational rehabilitation. According to thereport, Irizarry failed to contact three employers per week asrequested. He cancelled two interviews with one employer beforefinally appearing. He told another employer he could only work thethird shift and that he could not risk being cut because of a"blood problem." He refused to sit down during an interview witha third employer; instead, he stooped over the interviewer's deskand advised that he could not drive to and from work.

In April of 1993 Irizarry visited Dr. Benjamin Narrajoscomplaining of sharp, shooting lower back pain and dull neck pain. The doctor diagnosed chronic neck and lumbar strains withradiculopathy.

Castellanos prepared a follow-up rehabilitation report inApril of 1993 stating that she had arranged for Irizarry to attenda job fair at Hollywood Casino. Irizarry asked her, "[I]f I getthe job do I have to work it?" He later told Castellanos that heattended the fair and completed a job application. However, shefollowed up and discovered that the casino did not have anapplication on file for Irizarry and that all applicants hadreceived an interview. His rehabilitation file was closed.

The file was reopened in July of 1993, and four interviewswere arranged for Irizarry. At the first interview he appearedwith his shirt undone, held onto the wall as he walked, and neededassistance completing the job application. At the third interviewhe failed to complete the application (providing only his name andsocial security number) and told the interviewer he could notperform the work because of neck pain. He arrived at the fourthinterview over an hour late. His rehabilitation file was againclosed.

Irizarry returned to Dr. Morgenstern in November of 1993 andFebruary of 1994 with complaints of back pain. Both times hisphysical examination was unchanged from 1992.

In June of 1994 Irizarry visited Dr. Leonard Kranzler for anexamination at Dynaweld's request. He complained of lower backpain and bilateral leg pain (worse on the left) radiating into hisheels. Doctor Kranzler conducted a physical examination and opinedthat Irizarry had no objective deficits and could performunrestricted work. Specifically, the doctor noted that noanatomical basis existed for Irizarry's report of numbness on theleft side of his body. The doctor also noted that Irizarrydisplayed positive results during a straight leg test but, atanother point during the examination, he reached within 11centimeters of his toes. According to the doctor, these findingswere inconsistent.

In August of 1994 Irizarry visited Dr. John Martell for a leftknee examination at Dynaweld's request. Dr. Martell found ananterior cruciate deficiency with frequent giving way and earlydegenerative changes. He recommended a knee brace and mentioned apossible reconstruction of the anterior cruciate ligament ifIrizarry did not experience improvement. The doctor advised thatIrizarry could perform work with limited lifting (10 poundsfrequent and 15 pounds occasional).

The matter proceeded to a second section 19(b) hearing beforearbitrator Caliendo on December 12, 1994. In part, thearbitrator's written decision read:

"The Petitioner was a forty-three year old welder whosuffered injuries to his left knee, neck, right shoulder, andlower back on January 21, 1991, the date of accident.

The preponderance of the medical evidence shows that thePetitioner can, in fact, work. ***

*** Dr. Clark, Petitioner's own physician, oncequestioned Petitioner's efforts when he wrote on September 12,1991: 'I really feel it would be most important for[Petitioner] to go back to work and to try and get on with itinstead of looking for disability which I am beginning to feelis the major thrust behind all of this situation.'

The Arbitrator also finds that the Petitioner was not aparticularly credible witness."

After making these observations, arbitrator Caliendo awardedIrizarry additional TTD benefits covering two periods (October 12,1991, through February 17, 1993, and March 8, 1993, throughSeptember 7, 1993). Beyond that award, however, the arbitratordenied additional TTD benefits (leaving a 15-month gap immediatelypreceding the hearing), medical expenses incurred since the firstsection 19(b) hearing, maintenance payments, and vocationalrehabilitation. Irizarry appealed the arbitrator's decision to theCommission.

In April of 1995 Irizarry began treating with Dr. RobertoLevi, who ordered MRI scans of the left knee and lumbar spine. Those studies revealed: a possible low-grade partial tear of theanterior cruciate ligament; a "tiny" disc herniation at L4-L5superimposed on disc bulging; and mild disc bulging at L5-S1. Dr.Levi performed a third left knee arthroscopy in June of 1995,including removal of plica synovial medelias.

On October 25, 1995, the Commission affirmed and adoptedarbitrator Caliendo's decision from the second section 19(b)hearing. Irizarry appealed the Commission's decision to the KaneCounty circuit court.

Irizarry continued treating with Dr. Morgenstern and receivedlumbar epidural injections in July and September of 1995. Dr.Morgenstern also referred him to a pain management clinic, where hereceived treatment through November 20, 1995. He was authorized toperform modified work with restrictions on sustained sitting andwalking.

On September 13, 1996, the circuit court confirmed theCommission's decision affirming arbitrator Caliendo's award fromthe second section 19(b) hearing. In an agreed order, the causewas remanded to the Commission "for further hearing on any othercompensation, benefits or medical expenses that may be awardedconsistent with the arbitrator's previous award."

In June of 1997 Irizarry underwent a lumbar MRI in PuertoRico. The study revealed degenerative changes at L4-L5 and L5-S1. On August 7, 1997, Dr. Morgenstern issued a letter stating thatIrizarry was unable to perform any type of work.

In June of 1998 Irizarry sought treatment from Dr. StevenGoldfarb, complaining of back pain and left leg pain. Irizarry wasapparently living in Puerto Rico at the time. Dr. Goldfarb ordereda myelogram and a CT scan, which revealed no signs of discherniation or spinal stenosis. He diagnosed chronic lower backpain and recommended rehabilitation. Irizarry returned inSeptember of 1998 complaining of left knee pain. Dr. Morgensterndiagnosed "osteoarthritis with no specific injury" and administeredtwo injections into the knee that month.

Also in September of 1998, Irizarry began treating with Dr.Steven Lekah for complaints of headaches and dizziness since hisindustrial accident. The doctor ordered MRI scans of his head andcervical spine. The MRI of his head revealed normal findings. Thecervical MRI revealed mild spurring at C4-C5, suggesting mildnarrowing of the right foramina. There was no disc herniation. Dr. Lekah recommended pain management with trigger-pointinjections. The injections were administered in November andDecember of 1998 by Dr. James Kelly. Dr. Kelly diagnosedmyofascial pain.

The matter proceeded to a final arbitration hearing beforearbitrator Peter Akemann on September 22, 1999. At the hearingDynaweld disputed whether Irizarry's condition of ill-being wascausally related to his industrial accident. Irizarry testifiedthat he continued receiving medical treatment and had not receivedany workers' compensation benefits since the second section 19(b)hearing. He had completed his GED but said he could not read orwrite English. He said he moved to his native Puerto Rico in 1997on a doctor's recommendation that he live in a warm climate. Heacknowledged failing to seek any type of work in Puerto Rico. Regarding his symptoms, he said (1) his left knee hurt and wassubject to swelling and giving way, (2) he could not turn his neckto the right, and (3) his lower back hurt with pain radiating intohis feet. He said he could walk the distance between his car andthe hearing room, but not much farther. He also said he could onlysit or stand for 15 to 20 minutes.

After providing a summary of Irizarry's medical treatment,arbitrator Akemann's written decision read:

"The Arbitrator notes that at the prior hearing inDecember of 1994, the Petitioner was denied further medicalpayments, temporary total disability payments, and vocationalrehabilitation. This arbitrator, likewise, is not inclined toaward further payments in these areas as well.

The Arbitrator concludes that the medical records containno evidence that Petitioner ever reported any injury to hishead, neck, right shoulder, or low back to any physician forseveral months following the accident, until after June, 1991. The initial examination of the Petitioner's low back in June1991 was to check for causes for the slow recovery of thePetitioner's left leg. Only thereafter did the Petitionerseek treatment for his back. There is no objective evidenceof neurological or orthopaedic injury to the Petitioner'shead, neck, low back or right shoulder as a result of the ***accident. All of the medical treatment that the Petitionerhas undergone to those areas of the body, is related tosubjective complaints unsupported by any verifiable injury. The Petitioner's continued left knee complaints followinghearing in December, 1994, are similarly related to subjectivecomplaints which no longer are supported by objective evidenceof continuing injury."

After making these observations, arbitrator Akemann denied TTDbenefits and medical expenses for the period following the second section 19(b) hearing. Regarding permanent impairment, he awardedPPD benefits representing 40% loss of use of Irizarry's left leg.

Irizarry appealed to the Commission, which affirmed andadopted the arbitrator's decision. He then appealed to the KaneCounty circuit court, which confirmed the Commission's decision. This appeal followed.

In addition to his left knee, Irizarry alleged that hisindustrial accident caused injuries to other parts of his body. Atthe section 19(b) stage, arbitrator Caliendo found a causalconnection between Irizarry's condition of ill-being (as alleged)and his industrial accident. Such a finding is evident from atleast two facts. First, the arbitrator described Irizarry as "aforty-three year old welder who suffered injuries to his left knee,neck, right shoulder, and lower back on January 21, 1991, the dateof accident." (Emphasis added.) Second, the arbitrator orderedDynaweld to pay medical bills from Dr. Townsend--whose treatmentwas directed at Irizarry's neck, right shoulder, and back. Obviously a finding of a causal connection underlies an award ofmedical expenses. Arbitrator Caliendo's causation determinationwas final and reviewable when he rendered his decision. See 820ILCS 305/19(b) (West 2000) (noting that section 19(b) decisions"shall be conclusive as to all other questions except the natureand extent of [the claimant's] disability"). Since Dynaweld didnot file a petition for review, the arbitrator's decision "[became]the decision of the Commission and *** conclusive." 820 ILCS305/19(b) (West 2000).

But the Commission later adopted arbitrator Akemann'sdecision, which rested on a conclusion that "no objective evidence[existed] of *** injury to the Petitioner's head, neck, low back orright shoulder as a result of the *** accident." (Emphasis added.) In other words, the Commission found that no causal connectionexisted between Irizarry's industrial accident and any injuries tohis head, neck, low back, and right shoulder. Accordingly, theCommission concluded: "All of the medical treatment that thePetitioner has undergone to those areas of the body, is related tosubjective complaints unsupported by any verifiable injury." Theseconclusions are inconsistent with the Commission's section 19(b)decisions. At the section 19(b) stage, the Commission found acausal connection between Irizarry's industrial accident and hisvarious alleged injuries (including injuries to his "neck, rightshoulder, and lower back"). In the final proceeding, however, theCommission found no such connection regarding the alleged injuriesto Irizarry's head, neck, lower back, and right shoulder. Furthermore, in the first section 19(b) proceeding, the Commissionawarded medical expenses for treatment to Irizarry's neck, rightshoulder, and back. Yet in the final proceeding the Commissionstated that all such treatment failed to support an award.

Irizarry argues that the causation determination from thefinal proceeding violated the doctrines of res judicata andcollateral estoppel. Since arbitrator Caliendo had already decidedthe causation issue, Irizarry asserts, Dynaweld was barred fromraising it again before arbitrator Akemann. We agree that a barexisted, but not under res judicata or collateral estoppel. Thosedoctrines are invoked by final judgments in separate, prioractions. Although Irizarry's claim has proceeded through variousstages, it still comprises only a single action. Under suchcircumstances, the bar Irizarry seeks stems from the "law of thecase" doctrine. See Heller Financial, Inc. v. Johns-Byrne Co., 264Ill. App. 3d 681 (1994).

That doctrine has been explained as follows:

"The rule of the law of the case is a rule of practice,based on sound policy that, where an issue is once litigatedand decided, that should be the end of the matter and theunreversed decision of a question of law or fact made duringthe course of litigation settles that question for allsubsequent stages of the suit." McDonald's Corp. v. VittorioRicci Chicago, Inc., 125 Ill. App. 3d 1083, 1086-87 (1984).

At the section 19(b) stage, arbitrator Caliendo determined that acausal connection existed between Irizarry's industrial accidentand the alleged injuries to his left knee, neck, right shoulder,and back. The determination became a final judgment from whichDynaweld did not appeal. The determination thus became the law ofthe case, and Dynaweld was barred from raising the causation issueagain during the final proceeding. Accordingly, arbitrator Akemannand the Commission erred in revisiting the issue.

Our holding does not apply to Irizarry's claim of a headinjury. The record does not indicate that arbitrator Caliendofound a causal connection regarding such an injury.

During the final proceeding, the Commission denied TTDbenefits and medical expenses for the period since the second 19(b)hearing. The Commission also evaluated Irizarry's permanentimpairment at 40% loss of use of his left leg. As noted above, theCommission erroneously considered that the requisite causalconnection never existed between Irizarry's accident and theinjuries to his neck, right shoulder, and back. We do not know howmuch, if any, impact that error had on the Commission's decisionsregarding TTD benefits, medical expenses, and permanent impairment. We thus remand for new determinations in these areas.

According to the dissent, there is no need to remand becausethe Commission "has already found there is no objective evidence ofneurological or orthopedic injury to the head, neck, lower back, orright shoulder." Slip op. at 19. But the dissent omits a key partof the Commission's statement: the qualifying words, "as a resultof the *** accident." The Commission discounted the aforementionedinjuries by finding that they were never causally connected toIrizarry's industrial accident, not by finding that their formerconnection to the accident had ceased at some point without laterresuming. Only the latter finding could sustain the result theCommission reached.

For the foregoing reasons, we reverse the circuit court'sjudgment confirming the Commission's decision. The cause isremanded to the Commission for determinations consistent with thisopinion.

Reversed and remanded with directions.

HOFFMAN, O'MALLEY, Jack, and GOLDENHERSH, JJ., concur.

PRESIDING JUSTICE McCULLOUGH, dissenting:

I disagree that arbitrator Caliendo's second decision andarbitrator Akemann's findings and decision are inconsistent. Ofutmost importance is to point out arbitrator Caliendo's decisionconcerns temporary disability while arbitrator Akemann's decisionaddresses permanency.

With respect to the majority's reliance upon arbitratorCaliendo's "description" of claimant, that is exactly what itappears the arbitrator stated, a "description." The one statementreferred to by the majority should not be taken in isolation.

As that decision states, "At issue is the extent ofPetitioner's temporary disability." Arbitrator Caliendo's decisiondoes address the extent of claimant's temporary disabilityconcerning his left knee, neck, right shoulder, and lower back.

In his second decision, Caliendo found that on September 12,1991, Dr. Clark released claimant to return to work; that on July23, 1992, Dr. Morgenstern released claimant to return to work; andthat the preponderance of the medical evidence shows thatpetitioner can, in fact, work.

Arbitrator Caliendo also found that as a result of anexamination by Dr. Kranzler on June 30, 1994, Kranzler did notelicit:

"any objective findings to substantiate the petitioner'scurrent complaints of pain to his back. Dr. Kranzler notedseveral inconsistencies and found 'no reason to limit[petitioner's] work activities on the basis of his backexamination.' Dr. Kranzler's findings are credible whentaking into consideration prior diagnostic studies of the backwhich have resulted in essentially normal findings."

Additionally, Caliendo found that claimant refused tocooperate with respondent's vocational rehabilitation program:

"Dr. Clark, Petitioner's own physician, once questionedPetitioner's efforts when he wrote on September 12, 1991: 'Ireally feel it would be most important for [Petitioner] to goback to work and to try and get on with it instead of lookingfor disability which I am beginning to feel is the majorthrust behind all of this situation (PX3).' "

Although the majority accepts claimant's testimony that he couldnot speak English, Caliendo found claimant "not a particularlycredible witness" including his ability to speak "basic English."

Arbitrator Caliendo's second decision refers in severalparagraphs to the inconsistencies in the claimant's testimony,found him not credible, found that he would not cooperate with therehabilitation consultant, found that his own physician, Dr. Clark,questioned his efforts to work, and found that, as Caliendo stated,the doctor indicated he should try to go back to work instead oflooking for disability, which, the doctor stated, he was "beginningto feel [was] the major thrust behind all of this situation." Withrespect to the back injury, arbitrator Caliendo found that Dr.Kranzler examined the claimant and did not elicit any objectivefindings to substantiate the claimant's complaints of pain to hisback. The doctor noted several inconsistencies and found no reasonto limit the claimant's work activities on the basis of his backexamination. Since claimant's move back to Puerto Rico in 1997, heacknowledges he has not sought any type of work.

Contrary to claimant's argument and the majority decision,there is no inconsistency between arbitrators Akemann and Caliendoinsofar as the second decision of Caliendo is concerned. In hissecond decision, October 25, 1995, Caliendo stopped the TTD at adate prior to the hearing date, stating that "the petitioner isable to secure employment and is not entitled to maintenance orfurther vocational rehabilitation from the respondent." I do notunderstand how Caliendo and Akemann, as arbitrators, wereinconsistent in their decisions.

As the majority states, arbitrator Akemann found " 'noobjective evidence [existed] of *** injury to the Petitioner'shead, neck, low back or right shoulder as a result of the ***accident.' " Slip op. at 12. This finding by arbitrator Akemannis consistent with arbitrator Caliendo's second decision whenCaliendo found "the Petitioner is able to secure employment and isnot entitled to maintenance or further vocational rehabilitationfrom the Respondent." TTD was stopped by Caliendo on September 7,1993.

The majority determines that because the Commission awardedmedical expenses for claimant's neck, right shoulder, and back, theCommission is inconsistent in determining "such treatment failed tosupport an award." Slip op. at 13. This logic escapes me. Thatthe arbitrator described the injury and authorizes the payment ofmedical bills does not foreclose a finding of no permanent injury. The Commission has simply awarded expenses for medical treatmentbut did not find permanency.

The majority cites Heller Financial Inc. v. Johns-Byrne Co. inadopting the law of the case doctrine. The issue here, the extentof claimant's injuries as "described" by arbitrator Caliendo, isnot the law of the case. A review of his second decision makes itclear the statement was not and is not the law of the case.

Even if we accept the "description" statement as law of thecase, that isolated sentence does not determine the permanencyquestion. The detailed findings of Akemann concerning the medicalevidence and his findings as affirmed by the Commission andconfirmed by the circuit court make it clear the issues of TTD,impairment and medical expenses have been addressed. As to TTD,Caliendo's 1995 decision terminated TTD on September 7, 1993.

Finally, the majority remands this case to the Commission. Iam at a loss to know what the Commission should do on remand. Ithas already found there is no objective evidence of neurological ororthopedic injury to the head, neck, lower back, or right shoulder. The Commission decision affirming the award of arbitrator Akemannof 40% loss of use of the left leg as confirmed by the circuitcourt should be affirmed.