* 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