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Apparently, it’s time for another workers’ comp reform bill

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Illinois

* Oy…

Illinois’ troubled system for compensating injured state workers hands out money too readily, sometimes without medical evidence to back up a claim and occasionally paying benefits the hurt employee didn’t even seek, according to an audit released Wednesday.

Auditor General William Holland is suggesting awmakers follow up last year’s overhaul of the workers’ compensation system with further improvements in a report that found information about the process “incomplete, inaccurate, and inconsistent.”

State workers claiming injury at work received $295 million on more than 26,000 claims from 2007 through 2010, the report found.

Holland’s report found overworked claims adjustors carrying caseloads several times larger than is practical and negotiating settlements with workers’ lawyers, a job the attorney general should do. They sometimes approved temporary disability payments while a case was under way, even though the worker hadn’t asked for it.

Files on some claims paid were missing medical evidence for the injury. Arbitrators deciding contested cases had no guidelines for deciding compensation and issued wildly inconsistent awards for the same injuries. Some had conflicts of interest in the cases they presided over.

* Oh, man…

Between 2007 and 2010, state workers filed 26,101 workers’ compensation claims with more than half from the state Departments of Human Services and Corrections:

1,180 claims — the highest number from any state agency — from Chester Mental Health Center,

869 claims from Menard Correctional Center in Chester — the most of any corrections facility.

The state paid out a total of more than $295 million during that time frame. Sprains and contusions accounted for three-quarters of all injuries.

The audit identified problems within the Workers’ Compensation Commission and the state’s Central Management Service, or CMS, both of which oversee the workers’ compensation program. Among the findings:

The commission failed to review arbitrators’ performance annually and had no guidelines for how arbitrators were to award compensation for particular injuries, causing inconsistencies.

CMS negotiated settlements with injured employees’ attorneys, made decisions about compensation without appropriate forms and had no policies to address conflicts of interest by those who handle workers’ compensation claims for the state.

Also, the review board that investigates complaints against arbitrators and commissioners did not meet for three and a half years.

posted by Rich Miller
Thursday, Apr 26, 12 @ 10:26 am

Comments

There’s only 550 employees at Chester. How did they have that many claims?

Comment by Jimbo Thursday, Apr 26, 12 @ 10:44 am
Way back when had an employee taking sick time to recover from carpel tunnel surgery. Human Resources called and told me to tell the employee to file workman’s comp claim, “that we were paying on these.” As politely as possible I told HR to make that phone call themselves. They did. WC claim was paid. No clue who signed as approving supervisor.

Comment by Leave a Light on George Thursday, Apr 26, 12 @ 10:47 am
Hrrrmm, maybe whoever is left at CMS and the Worker’s Compensation Commission doesn’t have the knowledge or experience that has recently left state employment due to the threats to employee benefits, and it’s about to get a lot worse with the penny-wise, pound-foolish changes to the pension.

Comment by PublicServant Thursday, Apr 26, 12 @ 10:50 am
Life sure is dangerous in Chester. Maybe they should call in the guard.

Comment by wordslinger Thursday, Apr 26, 12 @ 10:54 am
Good for Holland keeping on this. Nice to see incremental improvements being made as well as people staying on this issue.

Comment by Freeman Thursday, Apr 26, 12 @ 10:54 am
On the other side, there are some claims they should have paid but never did because “they lost the paperwork” and “now the deadline for filing is past”. I never got a penny in WC (my State health insurance picked up the medical bills) and I still limp today from a fall over 20 years ago.

Comment by Retired Non-Union Guy Thursday, Apr 26, 12 @ 10:55 am
For the hometown of Popeye, sounds like some folks aren’t eating their spinach.

Comment by Small Town Liberal Thursday, Apr 26, 12 @ 11:18 am
Thank you Auditor General. Bottom line No Accountability, No Management.

Comment by Just Because Thursday, Apr 26, 12 @ 11:40 am
@wordslinger -

Facilities that provide care for the mentally ill and troubled youth are undoubtedly more dangerous than prisons.

That said, until worker’s comp claim payments are part of the appropriations for every state agency, instead of appearing of budget as a lump sum in CMS’s budget, program and agency heads will have little incentive to make staffing and infrastructure improvements that reduce workplace injuries.

Caterpillar did it, so can state government.

Comment by Yellow Dog Democrat Thursday, Apr 26, 12 @ 11:44 am
Who represents the state in these claims. This is an obvious derilection of duty. Hmm Lisa hasn’t been doing here job or does she get big union donations to ignore fraudulent claims.

Comment by Fed up Thursday, Apr 26, 12 @ 12:01 pm
And what did you all think those union contributions to legislators were for? Just pension largesse? I’m just curious how many state legislator-lawyers are somehow tied into the cashflow for representing allegedly injured state workers.

Comment by Cook County Commoner Thursday, Apr 26, 12 @ 12:07 pm
Has the Commission done anything about the total lack of medical privacy for claimants?

I’m told that because the website lacks a simple “captcha” test to ensure that only humans are accessing the data base, that the medical records in case files are being mined by electronic snoops? Adding “captcha” screening would stop the bots, while still meeting legal requirements for public records.

Mr. Holland, please add this to your audit follow-up.

Comment by anon sequitor Thursday, Apr 26, 12 @ 1:42 pm
“Caterpillar did it, so can state government.”

But first state government would have to break the union, as CAT did a few years ago.

Comment by Springfield Skeptic Thursday, Apr 26, 12 @ 1:52 pm
==Life sure is dangerous in Chester.==

[mental image of hundreds of people limping around, saying, “Mr. Dillon . . . “]

Comment by anonymice Thursday, Apr 26, 12 @ 2:30 pm
anon sequitor: to my knowledge the medical records are not entered as part of any Workers’ Compensation Commission data base. You can physically go to the Commission and inspect the file including medical records, so there is a problem.

The Auditor claims there are no “guidelines” for Arbitrators to follow in rendering awards, yet the Commission has been publishing awards since 1982 and these awards can be used as precedent. WIth the major comp reforms, the section of the Act indicating those prior decisions have presidential value still remains.

After all the shrieking and beating up of every single Arbitrator in the system for the abuses of just one or two, the Auditor found that Arbitrators render awards in just 2% of the cases of State employees, with the rest being settlements between CMS, the claimant’s attorney and the AG office?

Perhaps the legislature will face the big problem, the inability of CMS and the AG to defend these claims in a proper and appropriate fashion? Or will they be looking for more scapegoats again?

Comment by Louis G. Atsaves Thursday, Apr 26, 12 @ 3:12 pm
== Holland’s report found overworked claims adjustors carrying caseloads several times larger than is practical ==
There are consequences to having the fewest state employees per capita of any state. This is one of them.

Comment by reformer Thursday, Apr 26, 12 @ 3:31 pm
great another report by someone who has no idea of how a judicial system, let alone the WC system, works…”guidlines?” how about the fact that the arbitrators follow Commission and apellate court precedent that has be set for the LAST ONE HUNDRED YEARS? Different outcomes in similar cases? ever think that maybe the AG office is so incompetent that in some cases they present no evidence and in others ridiculous evidence so insuring bizarre outcomes? Just what we need more amateurs screwing up the system again..

Comment by stratten Thursday, Apr 26, 12 @ 4:39 pm
I think the worker’s comp situation in the State is completely out of hand. But I will say — when I worked for the state, I was absolutely stunned by the lack of any attempt to make the workplace ergonomic. In one incarnation, I was given an office set-up that required me to torque around so that my hands were facing in one direction while my head faced 90 degrees away. After three weeks of this, my left arm was going numb on a pretty regular basis. I had the resources to go to Staples and buy the stuff I needed to make my workstation minimally wrist-friendly. Not everybody can afford that.

So we cut down on “waste” by putting state employees in horrible offices that were designed to accommodate pencils and paper or manual typewriters, and then we wonder why so many people wind up with hands and wrists that don’t work?

Penny wise, pound foolish…

Comment by soccermom Thursday, Apr 26, 12 @ 4:48 pm
==Perhaps the legislature will face the big problem, the inability of CMS and the AG to defend these claims in a proper and appropriate fashion?==
I’m quite sure speaker Madigan will demand to know why AG Madigan isn’t defending these claims more effectively. (though, truthfully, I’m unclear whose responsibility this is - the AG or the Central Management Service. Clearly whoever is responsible isn’t fighting these excessive claims as agressively as, say, Caterpillar would be)

Comment by Robert Thursday, Apr 26, 12 @ 5:06 pm
This problem should be fixed immediately since it gives state government such a black eye. One more reason for the public to oppose spending and tax increases — since the state is terrible steward of public finances.

Comment by Anon Friday, Apr 27, 12 @ 12:05 am