I. INTRODUCTION

Employer, National Wrecking Company, seeks review of a decision of the IndustrialCommission (Commission) finding that claimant, J. Guadalupe Velasquez, is totally and permanentlydisabled and awarding claimant $1,211.74 in medical expenses. The trial court confirmed theCommission's decision. On appeal, employer argues that (1) the Commission's decision was contraryto the law of the case because it contradicted findings the Commission made in connection with anearlier award of temporary total disability (TTD) benefits, (2) the arbitrator and the Commission erredin admitting claimant's medical and hospital records, and (3) the Commission's decision is against themanifest weight of the evidence. We agree with employer that the arbitrator and the Commissionshould not have admitted claimant's hospital records and certain medical records. Therefore, wereverse and remand the cause for a new hearing on the issues of permanent disability and medicalexpenses.

II. BACKGROUND

On July 15, 1992, claimant was 38 years old and injured his back while working for employer. Claimant and a coworker were using ropes to lift a 300-pound piece of wood from the first floor tothe second floor. Claimant felt a sudden pain in his back and lost sensation in his legs. An MRIperformed on August 21, 1992, was interpreted as normal. Claimant treated with Dr. BenjaminNarrajos from August 1992 until January 1993. Because claimant continued to be symptomatic, Dr.Narrajos referred him to Dr. Jit Kim Lim, a neurosurgeon, in September 1992. Dr. Lim diagnosedsciatic pain and possible median and ulnar nerve entrapment. He prescribed a myelogram and apostmyelogram CT scan, but employer would not authorize it. Claimant testified that he stoppedseeing Dr. Narrajos because he no longer could afford to do so.

In February 1993, claimant saw Dr. John Dwyer at employer's request. Dr. Dwyer opinedthat there was no objective evidence of any disability in claimant's back and legs and that claimantcould return to work without restrictions or further treatment.

In April 1994, the Commission found that claimant was entitled to TTD benefits from August5, 1992, through February 11, 1993, and $6,165 in medical expenses. The Commission based itsTTD award on:

"[claimant's] credible testimony of his complaints and limitations, and on Dr. Narrajos' medicalwork restriction beginning August 5, 199[2]. However, [claimant] has not treated with Dr.Narrajos since January 1993. As of February 11, 1993, Dr. Dwyer opined [claimant] couldreturn to work without restrictions. The Commission finds that [claimant] has failed to provehe is temporarily totally disabled thereafter."

The Commission remanded the cause to the arbitrator to decide whether claimant was entitled tofurther TTD benefits or benefits for permanent disability. In 1997, the trial court confirmed theCommission's decision. Employer did not appeal the trial court's ruling.

After several continuances, the hearing on further TTD benefits and permanent disabilityoccurred over three dates between July 25, 2000, and November 13, 2000. By this time, claimant'sattorney had withdrawn, and claimant, who did not speak English, was pro se. Claimant testifiedthrough an interpreter. The arbitrator questioned claimant, who provided a summary of his medicalrecords and treatment. Claimant was unable to recall the nature of some of the treatment reflectedin his medical bills. He testified that, in October 1993, he sought treatment and physical therapy forhis back problems at Holy Cross Hospital. In February 1994, claimant saw Dr. Phillip Gattas, whoperformed an examination and took X rays. In July and September 1994, claimant saw Dr. AmalHachache, a neurologist, who prescribed medication for the back pain. Claimant visited Universityof Illinois Chicago (UIC) Medical Center a few times between February 1995 and February 1996, andreceived conservative treatment to manage pain in his neck, back, and legs. In May 1996, the SocialSecurity Administration found claimant to be totally disabled. In April, August, and October 1998,claimant treated with Dr. Stanley Bialowas.

Claimant testified that his injuries prevented him from returning to work and that he hassuffered no intervening injuries. He wore a back brace to help reduce his pain. Claimant stillexperienced pain and numbness in his legs and feet and used a cane to walk. Claimant continued tosee Dr. Bialowas to renew his prescriptions. No physician has released claimant to return to work.

Over employer's objection on the grounds of lack of foundation and relevance, the arbitratoradmitted claimant's medical bills. Employer objected to all of claimant's medical and hospital recordson the ground that no foundation had been laid for them. Employer objected to claimant's hospitalrecords because they had not been certified pursuant to section 16 of the Workers' Compensation Act(Act) (820 ILCS 305/16 (West 2000)). Also, employer argued that the physicians' reports wereinadmissible hearsay. The arbitrator allowed these records into evidence as group exhibits.

The medical and hospital records were not supported by any medical testimony. The recordsdo not appear in any logical order and are difficult to follow. The hospital records reveal thefollowing. From December 1995 through January 2000, claimant received treatment at NorwegianAmerican Hospital for his neck, back, and leg problems. A report of a CT scan taken at NorwegianAmerican Hospital on January 24, 1996, concluded that there was mild disc bulging at L4-L5 andpossibly significant disc herniation at L5-S1. CT scans of the cervical and thoracic regions taken onFebruary 14, 1996, were read as normal. The results of an EMG performed on January 11, 1996,were read as normal. Claimant also received treatment for his problems at ProHealth Medical Centerfrom January 1996 through October 1999.

The physicians' reports reveal the following. On February 8, 1994, Dr. Gattas diagnosedlumbar intervertebral disc syndrome, cervical radiculitis, displacement of the thoracic intervertebralsegment, cervicobrachial syndrome, lumbar paravertebral myospasms, cervical, thoracic, and lumbarmyofascitis, lumbago, and dorsal paravertebral myospasms. He opined that claimant's conditionswere the result of his work-related accident.

On February 27, 1996, claimant saw Dr. W. Charles Kennedy of the neurosurgery departmentat UIC Medical Center. Dr. Kennedy summarized his findings in a letter to Dr. Bialowas. Dr.Kennedy's impressions were thoracic and lumbar spine pain with radiation into the right leg and apossible disc protrusion at L5-S1. He recommended an MRI of the thoracic and lumbar regions ora complete myelogram including the cervical region. Dr. Kennedy believed that, because of hisfindings and the extensive evaluation claimant had undergone, a more aggressive approach might bejustified.

On March 15, 1996, at the request of claimant's attorney, Dr. Bialowas wrote to anadministrative law judge of the Social Security Administration. He reported that a January 24, 1996,CT scan showed soft tissue density at L4-L5 and L5-S1 indenting the ventral surface of the thecalsac. A January 11, 1996, EMG was normal, thus ruling out significant nerve root impingement. According to Dr. Bialowas, despite the normal EMG, claimant's disc pathology caused him a greatdeal of lower back pain and stiffness. He did not believe that claimant could walk without using acane or sit or stand for extended periods.

At employer's request, Dr. Dwyer examined claimant on May 26, 1998. He concluded thatclaimant demonstrated no objective evidence of disability or impairment about his lumbrosacral spine. Claimant could resume his normal occupational and daily living activities without restriction or furthertreatment.

The arbitrator found that claimant was permanently and totally disabled as of February 27,1996, the day he saw Dr. Kennedy. The arbitrator assigned more weight to the reports of Drs.Gattas, Kennedy, and Bialowas than that of Dr. Dwyer. Also, the arbitrator awarded claimant $1,661 in medical expenses.

The Commission likewise found that claimant was permanently and totally disabled butreduced the medical expenses award to $1,211.74. The Commission relied on Dr. Kennedy's opinionthat claimant was unable to work and Dr. Bialowas's opinion that claimant needed a cane. Employersought judicial review, and the trial court confirmed the Commission's decision. Employer timelyappealed.

III. DISCUSSION

A. Law of the Case Doctrine

Employer argues first that the Commission's decision to award permanent total disability(PTD) benefits is contrary to the law of the case established by the Commission's 1994 decision toaward TTD benefits only until February 11, 1993. According to employer, because the Commissionfound that claimant was not temporarily and totally disabled after that date, it was improper torelitigate during the second arbitration hearing whether claimant was totally disabled. We disagree.

Under the law of the case doctrine, the unreversed decision of a question of law or fact madeduring the course of litigation settles that question for all subsequent stages of the suit. Irizarry v.Industrial Comm'n, 337 Ill. App. 3d 598, 606 (2003). The second arbitration hearing involveddifferent legal and factual issues, and the law of the case doctrine did not prohibit the litigation ofthose new issues. The first arbitration hearing addressed claimant's entitlement to TTD benefits andthe extent of claimant's disability at the time of the first arbitration hearing. The second arbitrationhearing addressed claimant's entitlement to PTD benefits and the extent of claimant's disability afterthe first arbitration hearing.

Contrary to employer's assertion, the Commission did not decide in 1994 that claimant wasnot totally disabled after February 11, 1993. The Commission merely ruled that claimant "failed toprove he is temporarily totally disabled thereafter." As the Commission noted, claimant last saw histreating physician in January 1993. In February 1993, Dr. Dwyer opined that claimant could returnto work without restrictions. Claimant failed to produce any medical evidence to rebut this opinion. Any deficiency in claimant's evidence regarding his entitlement to TTD benefits beyond February1993, however, did not preclude him from subsequently attempting to prove that he was permanentlyand totally disabled. The Commission did not relitigate the TTD issue or make any findings that wereinconsistent with its earlier decision. Instead, it considered entirely new evidence to find that claimantwas entitled to PTD benefits. Therefore, the law of the case doctrine does not apply here.

B. Admissibility of Medical Reports

Employer argues second that the reports of Drs. Gattas, Kennedy, and Bialowas were hearsayand should not have been admitted. Except when the Act provides otherwise, the Illinois rules ofevidence govern proceedings before the Commission or an arbitrator. 50 Ill. Adm. Code