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Get a doctor’s note and qualify for workers comp

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Illinois

* More shocking workers compensation coverage from the Belleville News Democrat…

A state, municipal or private worker can get thousands of tax-free dollars through workers’ compensation based primarily on a doctor’s note. All that is needed is a report stating the claimant has a wrist condition known as carpal tunnel syndrome or cubital tunnel syndrome, which can affect the elbow.

Surgery or treatment of any kind is not required. A lawyer isn’t needed.

And the public won’t know anything about it until the money is on the way.

While diagnosis-only settlements pay less, they are part of a little known overall process that takes place primarily out of the public view involving uncontested workers’ compensation claims. According to a database provided by the commission, this procedure allowed approximately 95 percent of 3,500 private and public workers outside Chicago who did not hire lawyers to be given settlements last year without the usual lengthy administrative process, which can include a public hearing. The database did not include awards by any of the 15 arbitrators based in Chicago. There are 32 arbitrators statewide. […]

Of the 3,500 uncontested settlements handled this way in 2010, the News-Democrat found that 117 involved state workers whose total of $2.9 million in awards were paid from the tax supported general revenue fund. Of that amount, approximately $1.9 million involved carpal or cubital tunnel claims or other repetitive trauma injuries.

Oy.

Go read the whole thing.

* Meanwhile, some sobering stats from Crain’s…

The number of people 65 or older in the Chicago area will soar 65% to 1.7 million by 2030, estimates William Frey, a demographer at the Brookings Institution in Washington, D.C.

That’s less than the 78% increase expected nationally, thanks to immigration in Chicago. Still, about 1 in 6 people in the area will be 65 or older in 2030, compared with 1 in 9 today.

From 2020 to 2030, Illinois’ economy is expected to grow 1.4% annually, down from 2.4% this decade and 3% to 3.5% in the 1990s, when the boomers were in their prime, according to Moody’s Analytics Inc.

One reason: Growth in the labor force, necessary to increase output, will slow as boomers leave the workplace. Chicago’s labor growth will decline to 0.24% in 2020 from 1.03% this year, Moody’s estimates.

* Other stuff…

* Second site bows out of high school rodeo rotation

* State incentives for Mitsubishi a needed gamble

* Quinn: Auto jobs latest proof NJ isn’t better: “[In] New Jersey, I think the last auto production was about 2005 in the state,” the governor said. “The lights have been turned out over there. We’re doing very well in Illinois, with Mitsubishi, with Ford, with Chrysler, and with Navistar that makes trucks.”

* Quinn joins hundreds at citizenship workshop

* Quinn blocks hike in Brookfield Zoo admission

* Reform groups hope for more ethics legislation in Illinois: Political scientist and UIS professor emeritus Kent Redfield said those reforms are unlikely to be addressed in the next General Assembly. “Right now, the overwhelming priority is the budget, and in some sense it sort of sucks the air out of everything else,” Redfield said.

* A year after CTA service cuts and layoffs, rehired workers help weather the blizzard - Many laid-off CTA workers are still waiting to be called back

posted by Rich Miller
Monday, Feb 7, 11 @ 5:20 am

Comments

Every story on this workers comp mess paints an ever increasing picture of fraud and abuse. How soon before this crosses into criminal prosecutions? Makes me long for the good old days before the honest services law was watered down.

Gov. Q’s response to all this? From now on every case has to have a case number. BIG DEAL! Heck the arbitrator in the majority of the Menard prison cases was merely reassigned to hear cases at another location. Would it of been too much to ask that he be given some other duties while all this was investigated?

Comment by Leave a light on George Monday, Feb 7, 11 @ 8:01 am
As a creative approach to this problem perhaps well rated state workers who have “enjoyed” a few furlough days and have a strong personal incentive to prevent waste and fraud, should be assigned (as an extra duty apart from their regular jobs) a workman’s comp case or two to monitor and report on. I’m betting the fraud would come to a screeching halt if the effects of this “state on state” crime started being better known by their honest brothers and sisters.

Comment by Responsa Monday, Feb 7, 11 @ 9:37 am
I think this quote sums it all up:

Chicago attorney Gene Keefe, whose law firm has represented employers in workers’ compensation cases for three decades, said of cases he has handled, “In the private sector we don’t pay a dime based on a diagnosis … This state has clearly lost its mind.”

Comment by Bluefish Monday, Feb 7, 11 @ 9:59 am
I would love to comment,but my carpal tunnel prevents me from typing…I am, however, seeking a DOC job in SW Il….

Comment by D.P. Gumby Monday, Feb 7, 11 @ 10:08 am
Once again don’t blame all state employees for the action of a few. Most state employeees will tell they are very concerned about the issues raised on this issue.

Comment by Southern voice Monday, Feb 7, 11 @ 10:13 am
The BND has done some great work on this story.

Comment by wordslinger Monday, Feb 7, 11 @ 10:27 am
The BND, unlike some media, are not afraid to go after the powerful.

Comment by Southern voice Monday, Feb 7, 11 @ 11:00 am
For what it’s worth, I had an ankle injury in an icy State owned parking lot that still affects me off and on today, almost 20 years later. I had a splint / brace on for about 9 months. I got the day off to go to the emergency room and my medical bills paid at the time … but didn’t see dollar one for anything else. Not everyone scams the system …

Having said that, they ought to seriously crack down one the ones that do scam the system.

Comment by Retired Non-Union Guy Monday, Feb 7, 11 @ 11:35 am
wordslinger is so right….

The BND is also the paper that did about 20 articles detailing the boondoggle which is Tamms supermax prison. And they did it persistently and clearly, which is a challenge because there is so much misinformation about this prison.

Most people in the state didn’t even know that Illinois keeps people in indefinite isolation and sensory deprivation for over a decade…with no due process. (amms was supposed to be one year for violent or disruptive prisoners in regular prisons, yet BND proved that half the prisoners there never even committed a crime in a regular prison and have been there indefinitely for years, even a decade.

BND also exposed the fact that it is a dumping ground for mentally ill prisoners, and one that worsens mental illness. No problem, we just pay to put them on meds and hire 9 mental health workers for 250 people.

And we pay the most per capita for this prison, just to damage these guys right before they get released to the community.

Compare the BND coverage to the Tribune hacks who were granted the privilege of going into Tamms and then did a huge photo spread that basically said, “Look, Tribune reporters got the first peek inside a notorious prison where all these murderers are. Wow.” The Sun Times didn’t cover it at all, until recently.

The health of state government depends on good local reporting. The reporting in this state is shameful, and until it gets better, we can’t expect the government to get better.

Comment by tired of press Monday, Feb 7, 11 @ 12:15 pm
-tired of press- I do respect the BND, but on this issue they were completely wrong. Tamms has made the system much safer for the staff and inmates. Maybe you should work in a prison… then maybe you would understand.

Comment by What! Monday, Feb 7, 11 @ 12:38 pm
Carpal Tunnel is THE disease of the computer age. Anybody with a keyboard can get it. You might as well make payments to the entire population above about 20 y.o., and even children are getting it now! Without some investigation — however cursory — there is no way to determine whether the injury is truly work-related. The citizens are being ripped-off by this, and the guards at Menard (paid to watch the criminals) are some of the biggest thieves!

Comment by moby Monday, Feb 7, 11 @ 12:40 pm
=== The BND, unlike some media, are not afraid to go after the powerful. ===

Yep, it takes a real pair of Brass Ones to go after some injured worker who, according to their story, doesn’t even have a lawyer.

The article and the public outcry just prove how ignorant most people are regarding the worker’s compensation system.

Everyone’s glossing over one key word in the story: “uncontested.”

That’s right…in all of these cases, none of the employers objected to the settlement.

That, somehow, is the injured worker’s fault.

Folks are also glossing over this important tidbit, buried halfway through the story:

“Of the 3,500 uncontested settlements handled this way in 2010, the News-Democrat found that 117 involved state workers.”

So, while the story itself focuses totally on public employees, only abut 3% of the settlements were for state workers.

Why no interview with one of the 3,383 private employers?

Because that would contradict all of the BND’s prejudgments that government needs to be run more like a business.

The worst case scenerio i can see is government is run too much like a business: the worker’s comp system works best if employers offer a fair settlement as quickly as possible on all legitimate claims — regardless of whether they had surgery, because sometimes surgery is the wrong answer — and contests illegitimate claims.

BTW, am I the only one who noticed that the article implies that there are a bunch of doctors out there submitting fraudulent medical records?

Comment by Yellow Dog Democrat Monday, Feb 7, 11 @ 12:50 pm
Ok, now for the other side of the story. First, Gene Keefe is not an unbiased expert in the system. He in an insurance company defense lawyer who has had an inflammatory newsletter and blog where he makes statements that are designed to drive business to him - particularly self-insured businesses who eat up the “read meat” statements that he pushes like the one above. Second, BND has not done any actual reporting. They have looked at some data and made conclusions about it without actually talking to people involved in the system. Talk to some lawyers who have worked in the system for a long time. Cases are paid based upon a doctor’s note because that is the doctor’s opinion. The insurance companies can and do retain their own doctors to rebut what the treating doctors say. Who knows what the state did in these cases. Has BND contacted the claims adjusters for the state that approved these claims? Why did they approve them? Was there medical evidence to support them? Did the state get a doctor to dispute them? The AG would generally only come into the case if it was disputed or at the end when it was settled. They are not the gate keeper - the claims adjuster either at CMS or DOC is. I saw someone on the BND site says every claim should be tried and that doctors should testify in every case. With 50,000 claims being filed every year do you think that the taxpayers or injured workers should bear this expense? So in my opinion BND has done a poor job in actual journalism. Do some reporting - not assumptions made on flawed interpretation of data.

Comment by Marcus Agrippa Monday, Feb 7, 11 @ 12:51 pm
say, What! — that business about Tamms making the prisons safer in untrue. Study after study has shown NO RELATION between the creation of a supermax and the decline in aggregate prison violence. Correlation is not causation, and the factors that reduced violence in Illinois prisons, (a trend that started BEFORE Tamms opened), had to do with a dozen other factors that I could tell you about if you want.

Comment by moby Monday, Feb 7, 11 @ 12:53 pm
Moby-
Carpal tunnel WAS the disease of the computer age. There were a lot of claims filed in the 90s including some by people who work for me. Hardly any are being filed now. Most carpal tunnel cases now are filed by people who work in factories who use their wrists repetitively. Citizens are not getting ripped off because insurance companies will hire doctors to dispute the relationship between work and carpal tunnel and not pay the claim. It’s not automatic.

Comment by Marcus Agrippa Monday, Feb 7, 11 @ 12:59 pm
YDD,
Read the whole BND series on this. The point is that these are NOT helpless “injured workers”–they are theives!!! There is no way that all these AFSCME correctional officers had carpal tunnel, and their warden, and the nurse, and the social worker, and the food service coordinator, and also the examiner who overheard their cases. There is no way the majority of workers at this prison, and this prison only, suffer from this ailment, and must receive huge sums of money for it. It is fraud against taxpayers. Period.

BND is just showing us how easy it is to get these claims. And, as for your suggestion, the cost of a legitimate hearing would be nothing compared to the cost of these tax-free payments Good God, this is the kind of thing that could turn me into a Tea Party candidate…

Comment by tired of press Monday, Feb 7, 11 @ 1:04 pm
Yes, Marcus. Employers and insurance companies got wise to phony carpal tunnel claims. Bit apparently not the state of Illinois and not the IDOC! And doctors started to look closer too, but not the ones employed by Illinois and the IDOC. And if you know your clam wil not be looked at closely at all, the temptation to cheat is great — even if you are the great Roman statesman, Marcus Agrippa!

Comment by moby Monday, Feb 7, 11 @ 1:53 pm
Forget the rantings of Gene Keefe or the unions on this issue. Zero in on some key facts.

The “reform” of insisting upon a case number before settlement was in place in the past, and then later abandoned when the Blagojevich administration took over and started changing things at the Commission. Ask former Chairman Hallock.

Settlement requires the consent of three individuals or entities: (1) the employee, (2) the employer (usually through an claims adjuster) and (3) the Illinois Workers’ Compensation Commission (through settlement contract approval).

It is a pretty transparent system, far more than personal injury and other types of cases out there.

Someone at CMS, the jail system, the AG’s office, or a combination of all them, have been busy resolving all these cases. What are their names? Who was in charge? Who made these decisions? Funny how that information never quite gets into these stories.

Yet the venom is trained upon the individual Arbitrators who approve the ultimate settlements that are sent to them for that purpose. The real venom should be trained on all those who settled the cases, signed off of them and then sent them on for Arbitrator approval.

But that would step on a lot of big important toes.

Throwing Arbitrators under the bus won’t fix a system that will continue to send settlement agreements to them for approval. Better claims handling by the State would be an excellent start. You can’t legislative better claims handling. Some professional and competent claims examiners should be replacing the ones who created this nightmare. Reassigning Arbitrators to different territories solves nothing other than to create a distraction from the real problem. The replacement Arbitrator will still be handed a stack of settlement contracts for approval. And God help him/her if he/she refuses to approve them.

Comment by Louis G. Atsaves Monday, Feb 7, 11 @ 3:24 pm
=The “reform” of insisting upon a case number before settlement was in place in the past, and then later abandoned when the Blagojevich administration took over and started changing things at the Commission. Ask former Chairman Hallock.

You can’t legislative better claims handling. Some professional and competent claims examiners should be replacing the ones who created this nightmare.=

You mean to say there should have been some fumigation of Blago hacks?

Comment by Leave a light on George Monday, Feb 7, 11 @ 3:33 pm
Maybe someone should check at pontiac and stateville as they have the same cell locks that menard has. How many are off hurt at these two prison BND?

Comment by Question? Monday, Feb 7, 11 @ 4:44 pm
@tired of the press -

It sounds to me that the worst case scenerio is that ONE bad claims adjuster in ONE jurisdiction either doesn’t know what they’re doing or they’re a crook.

But since we have only the sprinkling of facts, its hard to say.

One thing is pretty clear though. 250 cases out of 50,000 per year are suspect: one half of 1%.

I’m not saying it shouldn’t be fixed…just that we shouldn’t treat it as earth shattering.

Its not a clarion call for radical reform…its a statistical anomaly.

Comment by Yellow Dog Democrat Monday, Feb 7, 11 @ 6:48 pm
I might have to take back some of the stuff I’ve said about Gov. Christie poaching Illinois business.

If you’re an Illinois business, you might want to take a look. The guy is throwing around millions, and I’m not talking Monopoly money — even if it’s in Atlantic City.

Christie has committed $261 million in state money to hopefully attract another $1.5 billion in private investment to complete the Revel, a half-built white elephant on the boardwalk.

Morgan Stanley has already written off their investment as a billion dollar loss. Yet, conservative Christie comes in with state money to try and complete the casino — although the owners and workers at the 11 private casinos on the boardwalk are pretty honked off they’re competing against their own tax dollars.

Christie says its good for workers. It’s certainly good for Morgan Stanley, which is trying to get out from under and attract new suckers to complete this monstrosity in a dying market.

But it begs the question: what’s the function of state government? Putting people to work building a public tunnel under the Hudson to facilitate commerce with the largest economy in the United States? Or bailing out a private investors with public money for a project to compete against private money in a shrinking industry — East Coast casinos?

It seems these days, all you have to do is call yourself a “conservative,” and you can get away with all sorts of wacky socialism.

Illinois business — it might be worth to see what it takes to put up hotels on Boardwalk and Park Place — Gov. Christie is the bank.

The google will help, but below is pretty good.

http://www.trentonian.com/articles/2011/02/03/opinion/doc4d4b7ffc5163d539451871.txt

Comment by wordslinger Monday, Feb 7, 11 @ 9:08 pm