Capitol Fax.com - Your Illinois News Radar » Behind the workers’ comp fracas

Monday, Apr 4, 2011 - Posted by Rich Miller

* The biggest political problem with Gov. Pat Quinn’s new workers’ compensation reform plan is that it cuts fee schedules for doctors by 30 percent, but doesn’t get rid of what is essentially a no-fault system…

But the plan does not include a key element of workers’ compensation reform backed by some Republicans in the legislature. This would be changing Illinois law to require that before an award or settlement can be made, a worker must show that an accident or condition resulting from employment was a “significant” or “primary” factor that caused disability. Under current law, all that it must be shown is that a workplace accident or condition was a “possible” factor.

“The issue is not causation, the issue is fairness,” McRaith said, adding that older workers often are more affected by on the job injuries than younger workers and that adopting the “significant cause” clause would be unfair to them.

But Sen. Kyle McCarter, R-Lebanon, said the workers’ compensation law needs to change so the workplace accident must be the primary cause of the injury. […]

“I wouldn’t vote for it,” McCarter said. “What would be the point?” […]

“The first paragraph of any reform story related to workers’ compensation is primary cause,” [Rep Dwight Kay, R-Glen Carbon] said.

Quinn’s failure to take on the primary cause issue doesn’t address the real concerns of business, such as Caterpillar, who are considering leaving the state in search of more hospitable environments, Kay said.

Actually, the Illinois Manufacturers’ Association - of which Cat is an important member - is realistic about the causation issue. It’s not an absolute must-have-or-we-walk-away for the IMA. Why is it for so many Republicans? Because by making this causation demand - which they know cannot pass a Democratic-controlled General Assembly - they have a ready-made excuse not to vote for a plan that rolls back physician reimbursements. The docs, of course, give Republicans a whole lot of campaign money. They’re essentially protecting their allies while they push the other side to give up even more.

This is a very basic, quite well-known fact of Statehouse life. Yet, you almost never see it covered in the media. Why? Heck if I know. Back in January, the IMA came out for a compromise plan which didn’t include causation, but it died because only three House Republicans were willing to vote for it.

* The docs are very much in battle mode…

(T)he Illinois State Medical Society was quick to push back.

“There’s no way,” society president Dr. Steven Malkin said when told of Quinn’s proposed cut in payments to health care providers. Malkin said treating workers’ compensation cases was time consuming for doctors because it requires a lot of paperwork and was often a more complex process because lawyers typically are involved.

Yes, a 30 percent fee schedule cut is pretty darned steep. But Illinois would still have the second highest workers’ comp medical fee schedule in the nation even if this passed. You’d have to cut the fee schedule in half before we’d move into third place - and then, just barely. Ponder that for a bit. Also, that one cut would save $500 million in a $3 billion program.

* The Illinois Chamber wasn’t all that happy in January when causation was left out, and it still isn’t…

Illinois Chamber of Commerce head Doug Whitley agreed. Otherwise, he said, “we’re still going to have thousands of questionable claims being filed.”

McRaith said Quinn’s proposals didn’t include definitions of injuries or accidents.

“Any proposal is going to be too much for one side or not enough for the other side. The governor said identify the problems, target the problems and that’s what we’ve tried to do,” said McRaith

It’s still possible that business may get more than they think they can achieve, mainly because of the Caterpillar uproar. The reforms were likely unveiled Friday because Quinn is meeting with Caterpillar’s CEO tomorrow. We’ll see what he has to say. If he pushes back hard, that would likely blow up the whole ballgame and force Democrats to consider whether they will have to alienate their union allies even more.

The way things stand now, this is an anti-union vote. Finding Democratic votes is extremely tough in an environment like that, so Republican votes are absolutely required.

* There are some other reforms in Quinn’s proposal that are much-needed…

* Carpal tunnel total disability payments, or weekly tax-free paychecks equal to two-thirds of salary, be capped at 20 weeks.

* Claims by intoxicated workers injured by their inebriation be denied.

Carpal tunnel complaints are getting way out of hand. They were at the heart of the problems at Menard prison. Several other reforms targeted at that sorry mess were also proposed.

* Related…

* CS-T Editorial: Share the pain in workers comp plan

* Whitley: Worker’s comp system needs reform

* Some towns bring in business without incentives

* State Farm CEO says businessmen must address state spending

22 Comments

- Mark Buerhle - Monday, Apr 4, 11 @ 8:32 am:
The House Committee on Comp heard extensive testimony on causation in December. Missouri has a proximate cause standard. It created a litigation gap between things going to the comp commission and things going to circuit court, which is a significant unintended consequence. The reason the Chamber and the IMA backed down is because utilization review, sort of an automatic 2nd medical opinion that is binding, was in the bill.

- wordslinger - Monday, Apr 4, 11 @ 8:47 am:
Maintaining status quo in worker’s comp is the one thing that the docs and the lawyers can get together on. That’s a tough alliance to crack.

The Dems and GOP are going to have to hold hands and stick it to both of them. If not now, with the scandals and federales, when?

- Fed up - Monday, Apr 4, 11 @ 9:43 am:
Why is it impossible for the deems to vote for a plan that requires the claim to be from an injury caused at work. I understand the unions control Quinn and the deems they paid good money to buy them but it not asking to much for it to be shown that it is a workplace injury you are claiming workers comp for.

- Fed up - Monday, Apr 4, 11 @ 9:47 am:
I noticed stories over the weekend of the Feds investigating workers comp abuse and the abuse of state grants handed out by Hollywood Hendon. I for one am glad our Attorney General never let’s all this corruption get in the way of her photo ops and press releases.

- ghost - Monday, Apr 4, 11 @ 10:03 am:
The causation issue is ripe for a middle ground.

Have the totl award reduced by the percent not attributable to the employer. BUT I would note two points with that:
First, under regualr injury law, you take a person as you find them. If somone is more susceptiable to an injury, but is uninjured (symtom free) and you injure them., you are 100% resposible. If they are not uninjured, you are just responsible for the aggravation of the pre-existing condition (however much you made it worse).
Secondly, the reason for the strict liability in work comp is because damages are capped. A work comp award is capped at 500 weeks salary, capped at whatver the current cap is. medical expense from the injury are not capped.

So if an employee gets killed, a broken back or other severe occurence, outside of the medical expenses, instead of millions in economic damages the employer is looking at less then 100k. Thats a huge protection to employers.

We could throw out the work comp act and let employers fend for themselves in the civil system, whih would cost them a lot more then the current work comp payouts… or balance there capped damages against some of the causation issues.

Asking that they get the benefit of damage caps, but the open ended reductions of civil causation seems unfair.

- Anonymous - Monday, Apr 4, 11 @ 10:12 am:
I love how Quinn is willing to share this proposal with the press, but not with his strongest supporters.

- cassandra - Monday, Apr 4, 11 @ 10:22 am:
Have the unions agreed to any changes in the current law. Otherwise, I don’t see other than cosmetic changes. The unions own Quinn and Caterpillar’s backpedaling on the leave-the-state-with-our-jobs rhetoric suggests that perhaps this is not a top priority issue for the corporate sector. Otherwise, why not leave the implied threat out there.

This could be partly due to the weakness of the Republicans. The private sector no doubt has seen the weakness of the Repubs and know that a threat to support them politically isn’t going to cause much fear among the Dems or Quinn. The Repubs may
call for reform but they have little ability to actually bring it about. They can’t obstruct everything just for workers’ comp reform. And if they do, the Dems and the union pals can wait them out.

Union-controlled Dems and very weak Republicans–adds up to fiscal disaster for us ordinary folk, but really, in Springfield, who cares.

- wordslinger - Monday, Apr 4, 11 @ 10:27 am:
Cassy, you obviously did not read Rich’s post at all. Illinois doctors, big GOP contributors, are strong backers of the status quo.

- Marcus Agrippa - Monday, Apr 4, 11 @ 10:40 am:
Rich-
Do you have any statistics to back up your statement on carpal tunnel? My bet is that carpal tunnel cases peaked in the 90’s when computers came into being. I had three staff people have claims from keyboard use back then. I know of quite a few offices that had them as well. None recently. In addition factories have retooled to use more modern and ergonomically improved equipment leading to fewer claims.

On causation, the insurance companies have plenty of doctors who preform “independent medical examinations” who will state that the injury had no role in the origin of the medical problem. Unfortunately many of them have no credibility with the Commission. If they were truly independent they might be believed. The hundreds of thousands of dollars they make every year doing exams obviously is a factor.

As ghost says, it has long been a tenet of British and American law that you take the person as you find him/her. Overturning that would be changing centuries of Anglo-American common law.

The real question is what is driving premiums. Don’t guess - do a detailed analysis. A few years back we were in the middle of the pack nationally for premiums. Whats caused it to go up so dramatically in the last two years (losses in the stock market?)

- Demoralized - Monday, Apr 4, 11 @ 10:51 am:
What people on this board and elsewhere fail to realize is that you are not going to get everything you want. There is a little word in politics called COMPROMISE. It’s a must if you want to get anything accomplished. Stomping your foot b/c you don’t get what you want is not going to get you anywhere.

- Marcus Agrippa - Monday, Apr 4, 11 @ 11:19 am:
Doctors use comp to make up for the cuts in their charges they take from Medicare, Medicaid and PPOs. The probably get between 25% to 45% on their charges from those payors. The get 80% from work comp.

The statement that work comp is more expensive because of paperwork is a bunch of crap. There’s no paper to fill out - they just have to send their medical records to the insurance company. Their staff might have to call the adjuster to get authorization for treatment, but that is no different than regular medical insurance. They fill out more papers in short term and long term disability claims.

- mokenavince - Monday, Apr 4, 11 @ 11:23 am:
Any change has to be an improvement on our present plan. Insurance companies have to be brought in for their recommendations on how we can
cut premiums. Our present plan is a major job killer. P.S. I had a serious injury,a few years ago and I was well taken care of by workers comp.

- cassandra - Monday, Apr 4, 11 @ 11:37 am:
I read it. The GOP, a weak bunch at best, has a choice of opposing reform at the behest of the docs or supporting it at the supposed behest of the corporate/private sector. Meanwhile, the unions will presumably side with the docs and the status quo. Why would private sector interests bother trying to gin up the Republicans when they are 1) weak and 2) owned by the docs and their contributions. Could they pry a few away with big contributions.Maybe, but why bother- what Democrats would go against the unions. I see no path to substantive reform here–I think any changes will be cosmetic. And do corporate interests care that much? I’m not getting that outrage feeling from press reports. Even Cat has been going around downplaying the infamous letter. Doesn’t seem like a huge deal to this particular company.

- Insider - Monday, Apr 4, 11 @ 11:51 am:
Another huge place for savings is prescription drugs. BUT that presents another problem for those wanting reform since one of the main proponents of comp reform is IRMA who would not want the Walgreens and CVS’s to take the hit on that. Next to the Doc’s that is the place most ripe for savings.

- Seriously??? - Monday, Apr 4, 11 @ 12:27 pm:
Workers who are drunk on the job and get injured can still collect on claims? Really?

- Small Town Liberal - Monday, Apr 4, 11 @ 3:21 pm:
- Workers who are drunk on the job and get injured can still collect on claims? Really? -

Hey, sometimes Illinois journalists have to knock a few back to cover these clowns in Springfield. It’s a required risk.

- Old Timer - Monday, Apr 4, 11 @ 4:59 pm:
i am interested in knowing how much worker’s comp claims escalated after 2003. The administration complains about the lowest paid employee earning overtime to get the job done. Yet, the number of positions receiving 8% temporary assignment pay goes unnoticed.

- Rich Miller - Monday, Apr 4, 11 @ 5:07 pm:
===i am interested in knowing how much worker’s comp claims escalated after 2003.===

The important date is six years ago, after the last round of reforms, which the biz lobby signed off on.

- 4 percent - Monday, Apr 4, 11 @ 7:53 pm:
The biz community signed off in 2006 but Dennis Ruth and the IWCC did not fully implement the fee schedule that was supposed to cut costs.

- Bo Hart - Monday, Apr 4, 11 @ 7:59 pm:
Rich - The Commission publishes the number of wc claims filed per year statewide. I’m sure its on their website somewhere. Claim numbers have consistently fallen each year for quite some time, although the Commission budget has gone up quite a bit.

- Bo Hart - Monday, Apr 4, 11 @ 8:05 pm:
Here you go: http://www.state.il.us/agency/iic/annualreport.htm

I stand corrected on the number of claims. If anything they’ve remained fairly stagnant since 2003.

- No Competition - Tuesday, Apr 5, 11 @ 5:08 pm:
It’s not just about Cat moving (too expensive) or Unions having too much power, what ever happened to fair play and competition. Is it really right for an employee to hurt his back over the weekend and come in Monday, bend over and pick up a tool, and writhe in pain from the work-caused accident.
We are competing with other states to attract new business to Illinois. How can we do that with such laws - the other states have to be laughing all the way to the bank. IL is just short-sighted due to “leadership” in Springfield.

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