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Then and now on workers’ comp reform

Saturday, May 28, 2011 - Posted by Rich Miller

* There’s been much consternation at the Statehouse over the fact that the Illinois Chamber’s claimed “neutrality” on the workers’ compensation reform bill is more than a little shaded toward opposition

“It doesn’t go far enough to give us true reform,” said Doug Whitley, president of the Illinois Chamber of Commerce, which has declared itself “neutral” on the bill because the measure doesn’t harm businesses. “Yes, there will be some savings, but when the dust settles three years from now, we’ll still be a high-cost state.”

Whitley’s absolutely right about the fact that we’ll still be a high-cost state if this bill passes. This is an effort at reform, but it’s not a fix. Our workers’ comp costs are so far out of whack that only draconian, radical measures would’ve gotten us in line with everyone else. For instance, medical provider rates were cut 30 percent. A 50 percent cut would have moved us out of our rank as second highest in the nation, but we’d still just barely be in third place.

* However, Whitley also said this

“If we support (HB 1698) than it would give the impression that we fixed workers’ comp. And we don’t think that’s true,” Whitley said.

* Hmm. Back in January, Whitley testified at the House Executive Committee about a workers’ comp reform bill which cut only about half as much from employer costs as the current one

“The Illinois Chamber is here today to say we support the changes that are being offered and we encourage the members of the General Assembly to approve this bill. But the legislation pending before this General Assembly does not go nearly far enough to satisfy the objectives of employers who are looking for extensive reforms in our State. But there is no question that the legislation presented by Representative Bradley embodies improvements over the existing law.”

The difference between now and back in January is some believed that the reform process would continue in the spring. Whitley, himself, made some mention of that in his January testimony

“What I heard today is that that people said we got issues but for some reason a lot of these people here with issues don’t recognize that this is an ongoing process.”

So, I can see where the current legislation is viewed as the more “permanent” legislation and should, therefore, be taken more seriously. But if that bill had passed back then, I doubt that the GA would’ve taken it up again in May because the legislative plate is so darned full right now. It would’ve most likely been checked off the list. And Whitley also closed with an implied call for continued work in the years to come

“We are not here to suggest that this is the panacea or that this is perfect. In fact, we are here to say that we will recommend that you pursue what you’ve got in front of you and for gosh sakes let’s keep at it. Let’s continue to work on this issue going forward for an extended period of time. There is no quick fix, there is no silver bullet, it’s complicated, there are many people with interest in this subject area and we need to listen to them and we need to adapt. But there is no such thing as okay this is it, walk away, wash your hands we have fixed workers compensation and the problems in Illinois. We will improve the situation in Illinois if Representative Bradley’s legislation is passed. Are we done with it . . . Not at all, Thank you very much.”

* Meanwhile, the Chicago Tribune is exectedly disappointed with the workers’ compensation reform proposal

But it falls so far short of what’s needed, we can’t join in the celebration. This issue presented an opportunity for the state to improve its troubled business climate. Instead of providing a competitive advantage, the proposed reforms merely stand to make Illinois less uncompetitive.

Disappointment No. 1: “Causation.” In principle, any successful claim must be related to an injury caused by the job. Illinois has a lax standard for proving that, and as the negotiations unfolded, plaintiff’s lawyers fought any effort to tighten it. Many of their cases, we suspect, would become non-starters if they had to connect the injury to the workplace in a common-sense way. Stricter causation rules have cut a fortune from work-comp costs in neighboring Missouri. In Illinois, no such luck.

The reform also includes built-in loopholes that enable lawmakers to pretend they tackled big problems while actually changing very little. One measure, for instance, establishes a network of providers with the goal of screening out doctors who would support illegitimate claims. Sounds good, but it contains a wide-open escape clause. Same goes for a proposal to follow American Medical Association guidelines when determining the level of impairment from an injury or condition. Lawyers eager to get around those potential obstacles no doubt will appreciate the roadmaps that legislators have conveniently included.

* Related…

* House OKs bill that would dump workers’ comp; but will system be scrapped altogether?

* Dueling workers compensation reform proposals pushed in Springfield

* Measure to repeal workers compensation OK’d

* Illinois House votes to change state’s workers’ comp system

       

11 Comments
  1. - Worker Comped - Saturday, May 28, 11 @ 12:28 pm:

    Weird - Doug4Gov does something to boost his organization’s fundraising efforts over the interests of the state’s businesses?


  2. - DOC - Saturday, May 28, 11 @ 2:40 pm:

    1. More misrepresentation of fee schedules. Only 1. Illinois Boerder state has a work comp fee schedule to my knowledge. Those without a fee schedule charge usual and customary rates and actually collect more than Illinois physicians for the same treatments. That is why there is such concern over access to care for injured workers in southern Illinois becuase many Missouri docs now treating those folks may opt out of the system.

    2. Using the 6th edition AMA Guides as a sole means is inappropriate as the Guides book itself states it is not to be used to determine disability but only impairment (2 totally different terms).

    3. Be careful what you wish for because Missouri is now seeing some claims pursued in civil court. According to the Constitution, a person cannot be denied access to the court system. If a claim is flat out denied, the immunity to tort business currently enjoys under the work comp act cannot be claimed. There have recently been a few rather large settlements in Missouri due to this issue of overly strict causation. Like it or not, there is no way to eliminate tort liability. If you don’t believe me, talk about tort with any Illinois doctor.

    There seems to be a double standard in this state with regards to different businesses. If you are in manufacturing, every effort in the world is made to restrict liability exposure. If you run a healthcare business such as a medical practice or hospital you are on your own. Most docs I know would love to have the current tort protections Illinois Businesses currently enjoy.

    At the end of the day, costs will simply be shifted elsewhere. Injured workers will be treated under personal health insurance or Medicaid thereby shifting that cost. Quality docs will simply avoid dealing with all the red tape. Hello ER visits and social security disability. Rather than solve anything, this bill shifts costs and I believe we will be here again in a couple years. In reality, the max money saved would occur if there was an express line put in for these cases so dispositions could be made immediately. Patients would know who is responsible for the bill and could be made whole quickly and re-enter society as producers instead of dependents.


  3. - wordslinger - Saturday, May 28, 11 @ 3:34 pm:

    Anyone who won’t take half a loaf ain’t really hungry.

    Seriously, how can the Illinois Chamber of Commerce be “neutral” on the bill?


  4. - Louis G. Atsaves - Saturday, May 28, 11 @ 4:06 pm:

    Doc, you are making too much sense. Unfortunately, the powers at play want to pass a “comp reform bill” which is little more than putting a new set of curtains to cover a leaky, stuck window, instead of repairing the window.

    And a bunch of political hires to be hired based on a return to a system found flawed 40 some years ago instead of professional Arbitrators will decide your bills based on the fee schedule.

    Sleep well tonight. The medical industry is getting screwed as badly as the Arbitrators to be fired are getting. Both of you are scapegoats for the failure to properly administer the system the past 8 years.


  5. - melawman - Saturday, May 28, 11 @ 5:13 pm:

    Having practiced law for 37 years in Illinois, undoubtedly the Workers Compensation system is run for LAWYERS who somehow are “entitled” to 20% of the settlement for a person’s injuries. Like personal injury, there are multiple lawyers ON BOTH sides of the case who benefit. Meanwhile, the employees who are seriously injured have their cases continued indefinitely while (literally) thousands of “carpal tunnel”, “back strain”, and similar claims clog the system. The system should be simplified by developing forms which can be easily completed, releases for medical records which are then to be timely produced, and medical payment conditioned upon timely compliance. The records can be submitted to an appointed medically trained reviewer who can then assess the case based on those records objectively without the white men with suits and ties being involved. It could work like the unemployment system which is far more efficient and involves lawyers only tangentially. Employers could accept the assessment or reject it, in which event the employee would then have recourse to legal assistance. In addition, the redundancy with third party personal injury claims and federal disability claims should be resolved practically without multiple recoveries for the same injuries. The policy for any workers compensation system should be to fairly compensate responsible employees who are injured as a result of employment risks, to make certain that medical personnel are timely and fairly compensated to assure treatment, and to further assure that employers are not held hostage to lawyers and insurance claims agents. This will never happen in Illinois since we have so many lawyers in the General Assembly who benefit either from direct involvement in the system or by “referral” of cases from which they receive kickback fees of as much as 50%.


  6. - Someone who knows - Saturday, May 28, 11 @ 5:47 pm:

    @ Louis G, You are right that a return to political appointments of arbitrators won’t be good for the system. However,assuming you’re the same Louis G. Atsaves married to arbitrator Fratianni your comments are disingenuous. It was republican administrations that loaded the arbitration staff with non-attorney politically connected arbitrators (republican state senator’s brother,republican states attorney’s brother,wife of county republican chairman,etc, etc)All the arbitrators hired the last 8 years were experienced workers’ comp professionals. You should blame the current “crisis” on CMS and DOC who appear to have been assleep at the switch as to state employee claims.


  7. - Louis G. Atsaves - Saturday, May 28, 11 @ 8:22 pm:

    Somebody, I’ve made it very clear who I’m married to the past 6 months on this site.

    Bottom line is no one is speaking up for those Arbitrators who performed admirably in their jobs, took a month of furlough days the past two years, didn’t game the system, and acted honestly and ethically in their positions.

    They are being fired for the sins or perceived sins of one or two of their fellow Arbitrators. Would a business fire every single employee because one was dishonest or perceived to be so? Politics isn’t business.

    So I have elected to speak out. Strongly. A few “power broker” attorneys are angry with me with speaking out over this travesty inserted into a so-called “reform” bill, but so what. Perhaps they have some pals or designs on those 1, 2 or 3 year term seats. Whatever. I’ve always been pretty blunt and to the point over the years. My wife has never been fired from any job she had held in her entire life, and who worked hard at all of them.

    Her reward? Her reputation trashed and she will be fired.

    If you have been paying attention, I have been a strong critic of CMS, DOC and the AG over the defense of the Menard claims. And please don’t tell me with a straight face that no non-lawyers have been appointed Arbitrator these past 8 years.

    Funny thing about those non-lawyer Arbitrators. Most of them perform so well in their positions that some lawyers are unaware that they don’t hold law licenses.


  8. - jodyfaulk - Sunday, May 29, 11 @ 1:18 am:

    You may look at the premium amount and think that there is no way that you can afford it. You cannot afford to be without health insurance! shop around you may find it easy to find an affordable premium, I always find health insurance through “Penny Health Insurance” network.


  9. - Ill PT - Sunday, May 29, 11 @ 8:29 am:

    Doc you got it right. This bill does nothing to fix the system. With a 30% cut in reimbursement for Work comp and recent cuts in Medicaid, Illinois will start losing hospitals and start seeing medical professionals leave the state. The problem isn’t the fee schedule, there can be more done with catching false claims. During the last reform there was a committee put in place to investigate false claims, however they have seen their budget cut and do not have the resources it needs. More could be done to investigate false claims, which is the real problem with the system. Why are we lowering our standard of care to the same level as other states? This bill does nothing for Illinois workers….


  10. - wordslinger - Sunday, May 29, 11 @ 8:54 am:

    –With a 30% cut in reimbursement for Work comp and recent cuts in Medicaid, Illinois will start losing hospitals and start seeing medical professionals leave the state.–

    Why’s that? Are that many medical professionals incomes dependent upon worker comp claims? Are they worker comp “specialists,” so to speak. That’s interesting.

    Rich notes that even with a 30% cut, Illinois’ medical provider rates would still be the second highest in the country. If their incomes are tied up in workers comp, why would they leave that?


  11. - Bill - Sunday, May 29, 11 @ 1:05 pm:

    I’ve got to agree with Lou Atsaves on this. I’ve been in front of virtually every Arbitrator in the state and have found them to be far more professional and competent then they are being given credit. The system has problems - all systems do - but to blame all the Arbitrators for all the problems of the system because of the reported indescretions of one or two is painting with too broad a brush. And, to replace them with new Arbitrators or judges isn’t going to elminate political bias that is at the heart of any adjudicative selection process. In fact, the two non-lawyers who are Arbitrators that I know of are pretty good. They both work hard and the decisions I have gotten from them - both have ruled againt me - were well reasoned and supported by the evidence.

    I get the impression there is a lot of “blaming it on the refs” going on. It’s alwasy easier to say “we lost because the Arbitrator was an idiot” than to tell your client the weakness of their case and the likely outcome.

    With resepct to the Menard cases, one has to wonder why the state hasn’t fixed the problems found to be casuing the CTS. With that many men developing carpal tunnel in such a high concentration one of three things is going on, either the EMG/NCV machines aren’t working properly, the neurologist is reading the findings incorrectly, or, most likely, work is contributing to their condition. (By the way, two of Dibble’s decisions on the Mendard’s cases were affirmed by the Commission were affirmed, and if you read the decisions they are correct under existing standards and would be compensable even if the causal connection standard was raised.)Were I a state representative or Senator, I’d want to know why the problem causing the CTS hadn’t been addressed.


Sorry, comments for this post are now closed.


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