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A big reason why our workers’ comp costs are so high in comparison

Thursday, Jul 14, 2016 - Posted by Rich Miller

* Click here to compare Illinois workers’ comp benefit payouts for lost limbs and other appendages to other states. We’re in the top five or six (in most cases, easily so) in just about every single category.

* Related…

* How Much Is Your Arm Worth? Depends On Where You Work - Each state determines its own workers’ compensation benefits, which means workers in neighboring states can end up with dramatically different compensation for identical injuries.

* Five Things I Learned Making a Chart Out of Body Parts - The story behind a graphic on insurance that turned into an unlikely viral hit.

       

55 Comments
  1. - Rober the Bruce - Thursday, Jul 14, 16 @ 9:47 am:

    I wonder what percentage of workers’ comp benefit payments are for lost limbs and other appendages vs. less serious and more temporary injuries.

    The workers comp reform crowd isn’t doing a very good job of stating their case.


  2. - Jim Levelton - Thursday, Jul 14, 16 @ 9:52 am:

    I guess losing a limb is just part of the sacrifice for having a job.

    This is the view of the anti workmans comp reform crowd.

    My limbs matter….


  3. - Illinois Bob - Thursday, Jul 14, 16 @ 9:55 am:

    Please correct me if I’m wrong, but isn’t the fact that Illinois WC also extends to cases where worker loss wasn’t primarily due to work injury in Illinois also a major factor? For example, in Illinois wouldn’t a worker who lost his arm driving to work due to an accident he/she caused get the same payment as someone who lost the arm due to an accident due to faulty equipment or training in a factory?


  4. - Annonin' - Thursday, Jul 14, 16 @ 9:59 am:

    The ProPublica stuff is good and has been out for about a year. Wonderin’ if IL media will ever pick up. There is also a link to OSHA report that shines a slightly difference light on all the “generous benefit”
    BTW Mr/Ms RobertheBruce none of this is “reform” is just jammin’ up the injured workers to benefit the top dogs (AKA Friend of BigBrain)


  5. - 47th Ward - Thursday, Jul 14, 16 @ 10:01 am:

    Well Bob, either way the guy who lost his arm can’t do the same job anymore so whether it cut got off on the job or by his own carelessness on his way to the job, he still doesn’t have an arm. You think taxpayers should pay for his inability to work?


  6. - Dance Band on the Titanic - Thursday, Jul 14, 16 @ 10:05 am:

    Now we know why Governor Rauner holds up Massachusetts as the shining example in workers comp reform. They pay only about 20% of what Illinois does for loss of use for most body parts.


  7. - Frank Selnicio - Thursday, Jul 14, 16 @ 10:07 am:

    @IL Bob:

    So all it takes is for me to get workmans comp is to lose my arm when driving to work?

    You bring the chainsaw, you chop mine off, and I’ll do the same and we split the winnings.

    Seriously?


  8. - @MisterJayEm - Thursday, Jul 14, 16 @ 10:07 am:

    What percentage of workers’ comp benefit payments are for lost limbs and other appendages, and what percentage are for less serious and more temporary injuries?

    I too am curious about the answer to Robert the Bruce’s question. I did some Googling but didn’t find anything.

    Anybody know the answer or where to find it?

    – MrJM


  9. - Anonymouth - Thursday, Jul 14, 16 @ 10:09 am:

    === either way the guy who lost his arm can’t do the same job anymore so whether it cut got off on the job or by his own carelessness on his way to the job, he still doesn’t have an arm. You think taxpayers should pay for his inability to work? ===

    It would probably be more appropriate than a business that had nothing to do with the injury. Why should an employer have to pay for an injury that has nothing to do with the scope of employment?


  10. - Juice - Thursday, Jul 14, 16 @ 10:10 am:

    Bob, in general, that is incorrect. Getting injured during your daily commute is not something that is generally compensable.

    If travel beyond a typical commute is a requirement for the job, that the injured worker would be classified as a traveling employee, and that injury could end up being compensable.


  11. - Thoughts Matter - Thursday, Jul 14, 16 @ 10:13 am:

    –It would probably be more appropriate than a business that had nothing to do with the injury. Why should an employer have to pay for an injury that has nothing to do with the scope of employment?-/

    It’s Insurance, just like auto, homeowners, liability, life. Do those policies pay even when the injured party is partially at fault? Yes, because that is what insurance us for- yo spread the risk of catastrophe. By your logic, life insurance should be void if the insuree wasn’t perfect.


  12. - Hamlet's Ghost - Thursday, Jul 14, 16 @ 10:16 am:

    An excerpt from the Pro Publica article:

    ==> Such decisions are part of a greater rollback in protections for injured workers nationwide. Over the past decade, a ProPublica and NPR investigation found, state after state has slashed workers’ comp benefits, driven by calls from employers and insurers to lower costs.

    In fact, employers are now paying the lowest rates for workers’ comp than at any time since the 1970s. Nonetheless, dozens of legislatures have changed their workers’ comp laws, often citing the need to compete with neighboring states and be more attractive to business.

    The changes have forced injured workers’ families and taxpayers “to subsidize the vast majority of the lost income and medical care costs generated by these conditions,” the Occupational Safety and Health Administration said in a report issued Wednesday that echoed several of ProPublica and NPR’s findings.


  13. - 47th Ward - Thursday, Jul 14, 16 @ 10:17 am:

    ===Why should an employer have to pay for an injury that has nothing to do with the scope of employment?===

    Because it has insurance to pay for this kind of thing while the state would be the insurer of last resort.

    This is what Madigan is referring to when he says he will not support changes to worker’s compensation that force employees to go on welfare. And he’s right.


  14. - Anon221 - Thursday, Jul 14, 16 @ 10:19 am:

    MrJM- This infographic may answer your question

    https://www.nasi.org/sites/default/files/research/WC_Infographic_2014.pdf

    Complete report site is at

    https://www.nasi.org/research/2014/report-workers-compensation-benefits-coverage-costs-2012


  15. - Anonymouth - Thursday, Jul 14, 16 @ 10:20 am:

    === It’s Insurance, just like auto, homeowners, liability, life. Do those policies pay even when the injured party is partially at fault? Yes, because that is what insurance us for- yo spread the risk of catastrophe. By your logic, life insurance should be void if the insuree wasn’t perfect. ===

    That’s just silly. Life insurance is designed to provide compensation in the event that the person covered by the policy dies. Worker’s compensation is designed to provide compensation for worker’s that get hurt in the course of their employment. Is it not designed to be a blanket insurance policy covering all injuries that would prevent an employee from working.


  16. - Illinois Bob - Thursday, Jul 14, 16 @ 10:21 am:

    Folks, I’m not saying that those whose ability to work due to injury should be stiffed, the question is who pays for it and how much they pay. 47th Ward, the much abused Social Security disability program was designed specifically for that purpose. We all pay into it and should be entitled to that benefit regardless of how the injury happened. It’s like disability insurance. The question is whether employers should kick in far more for benefits for which they weren’t responsible, and how much that benefit should cost.

    If the program is “too generous” and liabilities are uncompetitively higher in Illinois, it costs jobs, tax revenues and economic growth in Illinois. There’s a price to pay, and the question is whether the Illinois extra is in the public interest or if it needs to change.

    I think it needs to change and be more comparable to the rest of the nation. Just my opinion.


  17. - Rich Miller - Thursday, Jul 14, 16 @ 10:23 am:

    ===Anybody know the answer or where to find it?===

    Not sure, but we had a real problem after the 05 reforms when permanent, partial disability payout rates were increased (that’s mainly loss of limbs, etc.).


  18. - 612 wharf avenue - Thursday, Jul 14, 16 @ 10:26 am:

    This is a great piece by propublica. The only thing it is missing is a comparison to WC costs in Mexico.

    https://www.theguardian.com/commentisfree/2015/jun/11/lost-hands-making-flatscreens-no-help


  19. - Mama - Thursday, Jul 14, 16 @ 10:26 am:

    The Demolition of Workers’ Comp
    By Michael Grabell, ProPublica, & Howard Berkes, NPR, March 4, 2015

    https://www.propublica.org/article/the-demolition-of-workers-compensation


  20. - 47th Ward - Thursday, Jul 14, 16 @ 10:26 am:

    ===I think it needs to change and be more comparable to the rest of the nation.===

    I feel the same way about housing prices. I wish Chicago real estate was closer to Nebraska prices. Lol. Just my opinion, but unfortunately it doesn’t work that way. Same with this.

    And Social Security Disability pays a max of what, $3000 a month? It is woefully insufficient, which is why we have workers compensation insurance in the first place, to compensate injured workers.


  21. - CrazyHorse - Thursday, Jul 14, 16 @ 10:27 am:

    A big problem and cost driver has to be the down time lost waiting for the insurance company to approve treatment. Several people I know waited months for treatment (both conservative and surgical) to be approved. Eventually the approvals were given but the months of getting paid to simply sit idle have to be a considerable cost. I guess that’s on the Insurance Companies which is why you seldom hear about improving that aspect of WC. Once again the avenues toward solution involve reducing benefits to the injured workers or enacting much tougher causation standards. I do agree with some improvements to the causation as cases such as the man who slipped on HIS driveway before going to work are just flat out ridiculous.


  22. - Anon221 - Thursday, Jul 14, 16 @ 10:31 am:

    Here is the latest NASI report-

    https://www.nasi.org/sites/default/files/research/NASI_Work_Comp_Year_2015.pdf


  23. - Anonymouth - Thursday, Jul 14, 16 @ 10:32 am:

    From the Illinois Workers Compensation Commission Handbook (http://www.iwcc.il.gov/handbook.pdf):

    “4. What injuries and diseases are covered under the law? The Workers’ Compensation Act provides that accidents that arise out of and in the course of employment are eligible to receive workers’ compensation benefits. This generally means that the Act covers injuries that result in whole or in part from the employee’s work.”

    I don’t think I am being extreme here. I am not one of these conservative business types by any stretch of the imagination. I think it is reasonable to only pay benefits to those injuries that are related to the job.


  24. - Anon221 - Thursday, Jul 14, 16 @ 10:38 am:

    The most recent Illinois stats do not appear to be updated on the IDPH site (when is that upgrade coming???). Go here to see the most recent by state on the US Bureau of Labor Statistics site-

    http://www.bls.gov/iif/oshstate.htm#ia


  25. - DuPage - Thursday, Jul 14, 16 @ 10:42 am:

    @Illinois Bob9:55==Please correct me if I’m wrong, but isn’t the fact that Illinois WC also extends to cases where worker loss wasn’t primarily due to work injury in Illinois also a major factor? For example, in Illinois wouldn’t a worker who lost his arm driving to work due to an accident he/she caused get the same payment as someone who lost the arm due to an accident due to faulty equipment or training in a factory?==

    It does not cover driving to or from work. It does cover if you are driving your own car as part of your work.


  26. - thoughts matter - Thursday, Jul 14, 16 @ 10:50 am:

    anonymous, - I’m not saying that the employer should pay for things that happen at home, or on a normal commute. I’m saying that 1:the employer doesn’t pay the claim, the work comp policy does, just like health insurance. I’m saying 2:that the worker deserves to be paid even if he was partially at fault, just like any other insurance would pay if the insured was partially at fault. Should an auto insurance policy refuse to cover damage to your car or injury to anyone in your car if you got a ticket for the accident? Maybe the health insurance policy shouldn’t pay the claim if your injury happened while playing softball and you tripped over your own two feet?


  27. - My button is broke... - Thursday, Jul 14, 16 @ 10:52 am:

    Something that is often not mentioned as part of this debate is that work comp limits damages that the employer has to pay. Let’s say I’m an employee in a warehouse and I’m walking. There are a stack of boxes which the employer told employees to stack, and its higher than it should and not stable, and we agree its negligent. The boxes fall on me as I’m just walking by. I am limited to work comp. I can’t sue my employer for negligence and get punitive damages or actual damages that I suffer. Just what the work comp system provides. This is a benefit to the employer. If it was a customer, the company would be out a lot more money. When work comp was first established the agreement was, the employer’s damages would be limited, but they would cover injuries they wouldn’t generally cover.


  28. - Mama - Thursday, Jul 14, 16 @ 10:55 am:

    I bet this dept. is short handed since this report only goes up to 2012.
    Illinois Epidemiologic Report Series
    http://www.idph.state.il.us/about/epi/cfoirpt.htm


  29. - Anonymous - Thursday, Jul 14, 16 @ 10:56 am:

    Where does Illinois rank for Worker’s Comp attorneys and judges?


  30. - APerson - Thursday, Jul 14, 16 @ 10:57 am:

    The more common situation that drives costs for IL work comp is co-morbidity. The classic example is diabetes.

    A worker’s foot is injured by a falling object, but due to the worker’s diabetes this becomes an amputation case instead of surgery + PT. In states like Texas the worker will only be compensated based upon the injury itself, not the actual outcome (amputation) due to co-morbidity.


  31. - Anon221 - Thursday, Jul 14, 16 @ 11:01 am:

    Mama- they are required to submit the Federal report. They should update the State site at the same time. Short handed, maybe. But this is not the only site where the State info lags behind what they have to report to Federal agencies. If Raunet wants to tout transparency and efficiencies, as well as pay out a lot for IT improvements , then it doesn’t seem unreasonable to me to start getting it done. Otherwise, it appears that the State agencies are out of touch.


  32. - Anonymouth - Thursday, Jul 14, 16 @ 11:02 am:

    I was simply responding to the hypothetical of the worker losing his arm in an auto accident on his way to work. I don’t think that should be covered.

    But in response to your point about costs: “I’m saying that 1:the employer doesn’t pay the claim, the work comp policy does, just like health insurance.”

    The company pays for the policy, and guess what happens if there are a significant number of claims made against a policy? The cost of the policy goes up. That is just like auto insurance. If you get into a lot of car accidents, your insurance company will probably drop you or jack up your rates to unaffordable amounts. I’m not saying that claims of injured workers shouldn’t be paid. All I am saying is that, even though the employer doesn’t “pay the claim”, they do experience some real costs by the fact that claims are getting paid out. That is partially the reason for my point above that I do not think that employers should be on the hook for injuries that do not occur on the job.


  33. - illinois manufacturer - Thursday, Jul 14, 16 @ 11:03 am:

    Wow Alabama looks like Mexico


  34. - WCD - Thursday, Jul 14, 16 @ 11:04 am:

    The vast majority of WC claims are not for the loss of a body part. They are for a percentage of the loss of use. PPD is a percentage of wks the part is worth x 60% of the average weekly wage. The AWW is capped. Also the employee may not sue the employer in civil court. It is a trade off.


  35. - Juvenal - Thursday, Jul 14, 16 @ 11:05 am:

    @DuPage -

    I believe WC does cover driving to-from work if your employer requires you to bring your own car to work every day to do your job. That makes the injury work-related.

    If employers find this requirement onerous, they merely need to provide company cars for the folks they require to drive to do company work.

    To the post:

    Looks like employers are getting off pretty cheap in America when it comes to workplace injuries. Unless there is someone who would be willing to have their arm ripped off their body for $50,000 on this post?


  36. - Poolside - Thursday, Jul 14, 16 @ 11:08 am:

    Why does the reform discussion and high cost discussion focus on workers and not the fees charged by the medical community or the profits of the insurance industry?


  37. - TrumpsSmallHands - Thursday, Jul 14, 16 @ 11:08 am:

    The real driver for Illinois work comp costs is not injury away from work. That sort of thing is not covered, that doesn’t mean workers don’t try, but that is fraud.

    The real driver is co-morbidity, with the most common one being diabetes.

    In states like Texas the employer only pays for the injury itself and can/will reduce or deny compensation for injury exacerbated by the underlying disease.

    Example:
    Work with diabetes injures his foot on the job (heavy object falls on it), the standard course of treatment is surgery, pharmaceuticals, and then PT/OT. Lets say the expected return to work time for this type of injury in 4 months.

    But because this worker has poor circulation recovery time is extended and and infection sets in causing an amputation to be necessary. In Illinois the WC coverage will continue to pay for all medical costs related to the injury and the worker will probably receive a settlement based upon the actual outcome (lose of a foot) instead of just the injury (broken foot).

    Personally I am against the way other states do this because it becomes a tool to use any negative medical issue the worker has as a reason to deny coverage and reduce payment.


  38. - Joe M - Thursday, Jul 14, 16 @ 11:15 am:

    =====I think it needs to change and be more comparable to the rest of the nation.===

    No I think the federal rate needs to be the standard, and states would be allowed to have more generous payments, but not lower than the federal standard.


  39. - Chicagonk - Thursday, Jul 14, 16 @ 11:19 am:

    Where Illinois struggles compared to other states is the percentage of claims that result in time off from work. I don’t know if it is a product of work culture, the types of work being done, or the ease with which employees can obtain benefits for injuries, but it is a huge driver of high severity of claims in this state.


  40. - Illinois bob - Thursday, Jul 14, 16 @ 11:38 am:

    @47th ward

    =I feel the same way about housing prices. I wish Chicago real estate was closer to Nebraska prices. Lol. Just my opinion, but unfortunately it doesn’t work that way. Same with this.=

    Since I’m selling my last Illinois property now, I wish it was closer to California!LOL Overall, Illinois real estate is down and will stay down overall, at least partially due to loss of working, prosperous population.

    I do agree that payouts should reflect that cost of living in a state. The last time I checked the Illinois cost index was only 98% of the national average, so payouts about the national average would seem to make sense.

    I agree with some others here that believe that much of the cost is due to gouging by the medical community. I’d pay far more for medical services at Loyola than at Mayo clinic in Scottsdale/ Phoenix for far inferior service.

    I don’t have a problem with paying out proportionately


  41. - illinois Bob - Thursday, Jul 14, 16 @ 11:50 am:

    @Joe M

    =No I think the federal rate needs to be the standard, and states would be allowed to have more generous payments, but not lower than the federal standard.=

    You’re incredibly generous with OTHER people’s money, Joe. The fair thing to do is make it commensurate with cost indices in the different states, with payouts taking ability of a state’s economy to support it taken into account.

    One size does NOT fit all here, which is why amny of those living on SSC and fixed incomes go to lower cost states.


  42. - pundent - Thursday, Jul 14, 16 @ 12:18 pm:

    =I think it needs to change and be more comparable to the rest of the nation.=

    Absent a meaningful understanding of workers’ comp in Illinois and each and every state this is a meaningless statement. WC is regulated on a state by state basis. The main drivers in every state are how wages and medical costs are treated under the system. There are many nuances to these issues. Co-morbidity which was mentioned above is one, rates established by insurers is another. There are many, many others. But as has also been pointed out narrowing the scope of wc only shifts the burden and costs to others. So this is what underlies the issue. Making the system more cost effective for businesses only places more of a burden on society. It’s no different than paying employees minimum wage and making them whole by providing welfare. What’s good for business isn’t always necessarily good for the rest of us.


  43. - Earnest - Thursday, Jul 14, 16 @ 12:25 pm:

    Rauner chose the deliberate destruction of human services and higher education over developing a stable, balanced budget and actually improving the work comp situation. Every day the hole gets deeper and more and more people depending on state services keep getting cut away from them.


  44. - pool boy - Thursday, Jul 14, 16 @ 1:04 pm:

    Carpal tunnel is a big one. I have had employees that were paid $25,000 plus medical.


  45. - steve schnorf - Thursday, Jul 14, 16 @ 1:07 pm:

    One of the purposes of UC is to help replace wages (income) lost because of the injury. Since income (per household or per family or per capita) is relatively high in Illinois, it makes perfect since to me that our pay-outs, and therefore employer costs, are relatively high. As I looked further into it, income in Illinois, no matter how you look at it, tends to be around 13th to 16th highest in the nation. If our UC cost to employers is 5th, it seems reasonable to me that there is some room to contain payouts and therefore costs, without driving employees onto the welfare rolls. Perhaps that analysis is too simplistic.


  46. - steve schnorf - Thursday, Jul 14, 16 @ 1:08 pm:

    Obviously I mean WC. I continue to show signs of aging, because I twice reviewed that comment before posting it.


  47. - DuPage - Thursday, Jul 14, 16 @ 1:14 pm:

    @Juvenal 11:05 ==If employers find this requirement onerous, they merely need to provide company cars for the folks they require to drive to do company work.==

    Yes, that is correct! If the job requires you to bring a car then driving it there would be “part of the job”. Just to be on the safe side, a teacher I know always takes a school district car when she has to drive to Chicago or Springfield to attend meetings. It would be more convenient to use her own car, but if you are in a employer owned car, it helps verify you are on employer related business.


  48. - Bigtwich - Thursday, Jul 14, 16 @ 1:37 pm:

    Thank you for the link to the ProPublica graphic. Found it compelling. Not paying a lot of attention to this subject I had assumed there was a reason to try to consider standards in other states. After looking at the graphic I have no interest in joining the race to the bottom. Worker’s comp provides protection to the employer as well as the employee. If an employer wants out I would be willing to leave them to the personal injury system in court to sort things out. But as for matching other states, the graphic does show one body part that is not available in most states.


  49. - pundent - Thursday, Jul 14, 16 @ 1:53 pm:

    Steve - the method of calculating payments for lost time is fairly straightforward and consistent from state to state. WC payments typically represent 66% of the employees average weekly wage. To the extent that pay is higher in a given state these numbers will reflect that. There are however minimum and maximum payments amounts that can vary from state to state.

    Permanency awards are calculated on a similar basis (a percentage of AWW). Again these are subject to min/max calculations. Higher wages mean higher awards. One of the key differences that exists in IL is the way that permanency award percentages are calculated. In IL it’s much more art than science. It usually involves a battle amongst employer and employee attorneys over how “disabled” an injured worker truly is. A doc aligned with an employee will argue for a higher figure while the employer doc aims lower. The attorneys and occasionally arbitrators argue over the final number which ultimately just drives up the cost of the system.

    In states with lower permanency awards objective “impairment ratings” are more of the norm. The employee is seen by a designated physician who in turn assigns an impairment rating to the injury. The settlement is based on this assignment. In most instances attorneys aren’t involved. Settlements are paid more quickly and the overall cost of the system is far less because there are few mouths to feed.


  50. - jimk849 - Thursday, Jul 14, 16 @ 2:30 pm:

    At this time wc is a no-fault system. I think most injured workers would rather get the case in front of a jury. Thats the trade-off, industry you can’t have the best of both worlds.


  51. - James Knell - Thursday, Jul 14, 16 @ 2:36 pm:

    Seems to me that higher workers comp awards leads to greater attention to and more spending on health & safety.


  52. - Juvenal - Thursday, Jul 14, 16 @ 3:22 pm:

    === If our UC cost to employers is 5th, it seems reasonable to me that there is some room to contain payouts and therefore costs, ===

    Schnorf -

    Your statement ignores the profiteering by the insurers.

    Before we cut compensation for doctors, we ought to make sure that the insurance industry profits aren’t unreasonable first.


  53. - Anon - Thursday, Jul 14, 16 @ 4:19 pm:

    “Big reason” is incredibly misleading

    Very few claims involve losing limbs where these numbers are applicable

    IL’s issues beyond the aggravation standard is that they will call a lumbar surgery where a person has no restrictions following surgery a 20-25% loss of a man as a whole

    Too often the permanent partial disability focuses on whether the person has had surgery, and if so, awarding a far too high minimum % of PPD without taking into account whether the person has any actual permanent issues


  54. - Anonymous - Thursday, Jul 14, 16 @ 5:00 pm:

    juvenal, business are supposed to make profits. If not they wouldn’t be in business


  55. - JimO - Thursday, Jul 14, 16 @ 5:09 pm:

    No Anonymous @5:00. Businesses DO NOT need to make profits. Have you ever hear of non-profits? Thousands upon thousands of these exist. The only thing a business must do is cover the costs of labor, materials, and equipment. NOTHING more is need by ANY business. Business do NOT need to expand, they only need to satisfy their customer’s need.


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