10-10-2016; Arthur O. Kane RIP; Dealing with Closure of Medical Rights in IL WC; IWCC Budget Disappears (?) and more

Synopsis: May God Bless and Keep the Memory of Arthur O. Kane, J.D.


Editor’s comment: Art Kane was licensed as an IL attorney on December 14, 1939. He was an amazing businessperson, legal advocate, philanthropist and mentor. To our understanding, Arthur Kane joined with Irving Greenfield and other top Illinois attorneys in the 1950’s and 60’s to create the Illinois workers’ comp model that we have today.


His lifelong friend was Martin Boyer who formed a claims company that was initially the Martin Boyer Company, later Cambridge Integrated Services. Many of the top execs from those companies are still in the Illinois claims industry today. Art Kane’s firm was named Kane, Doy & Harrington and was considered one of top defense firms in the central U.S. He once said his law firm handled 10% of all workers' compensation claims across Illinois, His former law partner Sam Doy, now deceased, fought on the beaches in Normandy and was wounded in Europe and awarded a Purple Heart. Current IWCC Commissioner Michael Brennan worked at the Kane, Doy, Harrington firm for almost two decades.


The story told about Martin Boyer and Art Kane is they sold the claims company/TPA they owned for a solid value to watch the purchaser do less than well. Martin Boyer and Art Kane bought the company back at a discount to again rebuild the business and sell it again. They again bought it back, rebuilt the business and again sold it and made a lot of money doing so.


Art Kane became famous for handling claims on both sides of the matrix, when there was no conflict of interest. I still remember him appearing at oral arguments before a Commission panel. He argued the first case for the defense side of a claim. Later in the oral docket, he handled another complex case for the Petitioner-side. By the end of the docket, he argued another case for the defense side, each time making it clear to the panel whether he was “wearing a black hat or a white one.”


Art Kane also pioneered the somewhat ethically challenging concept of “appearance-only” handling of defense files. What he would tell the Martin Boyer Co. adjuster to do was send him the Application only and his firm would file just an appearance without having a complete defense file. The adjuster would continue to seek to work out details with Claimant attorney and if they could resolve the claim, Art Kane’s would simply close the file. If not, the file contents would be sent over for “full defense.” The concept highlighted how powerful Art Kane became because no one ever fought about such handling and members of the Claimant bar would always provide some opportunity for his attorneys to get the file and get prepared for hearing. We assure our readers the concept of “appearance only” handling wouldn’t work in the Circuit Courts where the attorneys are less genteel and way more aggressive.


As a philanthropist Arthur O. Kane gave millions to support the University of Chicago: He and his beloved wife, Esther donated $3 million in 1996 for a 10,000-square-foot expansion that became the Arthur Kane Center for Clinical Legal Education, according to a press release by the University of Chicago. In 2015, Kane and his wife made a bequest to support two Law School positions for faculty members who have demonstrated expertise in constitutional law and/or administrative law. He and his wife also donated a significant amount of money to the Rehabilitation Institute of Chicago where they were board members.


Kane was a past president of the Illinois Workers’ Compensation Lawyers Association and Chairman of the Chicago Bar Association’s committee on workers’ compensation. Arthur Kane died on Oct. 1 "peacefully in his sleep," according to an obituary in the Chicago Tribune. He was 98.




Synopsis: Dealing with Unpaid Medical Bills When Settling IL WC Claims.


Editor’s comment: We had a fairly sincere Claimant attorney complain:


We don’t know if work-related medical bills remain outstanding. Bills pop up months and sometimes years after the date of service. This is because bills sometimes sit in limbo with insurance carriers and as long as the treatment provider marks the bill as pending, they often don’t send additional bills. The bill could sit as pending because the WC claims handler wants more info or the WC adjuster doesn’t want to pay but hasn’t denied payment, or WC has denied and the treatment provider resubmit.


These things take months. Treatment providers also change billing companies quite frequently and bills get held hostage. Additionally, treatment providers often sell or turn over the accounts, which can happen multiple times and by the time it gets to a company that works the account, it has been many, many months, and the whole time the bill would show up as 0 with the treatment provider because they do a write off in their accounts. These are just a few scenarios. 


Basically, her message was medical liability has to remain open and infinite in settling a WC claim in this state.


And then you have a very difficult and troubled attorney in central IL He and his defense opponent had “open-ended” medical liability language in the lump-sum contracts following the model above. Then Petitioner’s counsel got the claim settled and waited about ninety days. After all the dust settled and everyone thought the IL WC claim was closed, for the first time, Counsel presented about $40,000 in medical bills for treatment no one on the employer/insurance carrier was aware of. Claimant’s counsel asserted the settlement contract wording was “all medical bills are paid.”


In my view, this was classic sandbagging—I feel he knew he was going to get a fight over the unpaid medical bills and hid them until he cashed the settlement check and disbursed the proceeds. Once that was complete, he then started the second fight.


We don’t mean the worker treated at ABC Hospital starting in the emergency room and then being admitted for surgery. We understand many times, some but not all of the bills get paid and fell through the cracks. In our view, that isn’t an issue when we know the worker treated at ABC Hospital.


Our problem starts when the worker treated at ABC Hospital and the surgical and follow-up medical care was with four different medical providers our side knows of. In our view, the defense side has to pay for such care whenever the bills are presented for treaters we are aware of.


We get mad when work-related medical care occurs that no one on the defense side knows about with a cost of $40K and there was literally no presentation, defense or denial of those bills. What if the bills were $140K or $440K? Under the theme presented by counsel in the quote above, the exposure for unpaid medical bills is infinite.


Our rule is we pay for medical bills for work-related medical care of which the defense is aware. Our lump sum settlement contracts say that. If there is a beef, we assert Petitioner or their attorney have to plead and prove we were aware of the care and/or the bills. We don’t ever use language in lump sum settlement contracts that says “all medical bills are paid” as that creates unlimited and infinite medical liability.


We don’t have to settle but if we do, we can’t have infinite post-settlement liability. If we try the claim, medical rights remain open but we have the ability to dispute bills and care.


We ask our readers—if you have a better approach to reasonably cutting off medical liability when settling/closing an IL WC claim—send it along, on or off the record.


We appreciate your thoughts and comments. Please post them on our award-winning blog.



Synopsis: IWCC Budget and Fund-Spending Disappears?? JCAR to Examine WCC Rules on FOIA, Filing, Judicial Review

Editor’s comment: We recently learned two things of interest to WC readers in Illinois.

First, one of our readers noticed the IL WC Annual reports for years have reported the IWCC’s budget along with how much of Illinois’ business’ money is wasted, we mean spent on the various funds run by the IWCC. For the first time anyone can remember, the last or 2015 IWCC Annual Report dropped/skipped/deleted the budget and the levies and expenditures on the funds. No reason for the deletion is outlined.

In our view, the goal of doing so is to hide the budget from everyone and not allow simple but important analysis or monitoring. We are sure the information is contained somewhere in the IL State Budget that might be about twenty volumes of other stuff. No, we don’t want to go through all of that to find out what this one state agency is doing with our tax dollars and levies.

We find it particularly galling to see this is happening under Republican leadership. The math is there, why not let us know? Maybe we should send an FOIA request for them—see below.

Second, a bipartisan legislative oversight committee will review several Illinois Workers' Compensation Commission rules during its coming meeting.

JCAR or the Joint Committee on Administrative Rules will look at regulations concerning access to records, electronic filing, pre-arbitration, arbitration, review, oral arguments, judicial review, settlement contracts and lump sum petitions, the discipline of attorneys and insurance regulations. The proposed rule on access to records would bring the IL workers' compensation system into compliance with Illinois' updated Freedom of Information Act. It would require the Workers' Compensation Commission to respond to records requests within five business days from receiving a FOIA request. It would also make public all records dealing with payrolls, public funds, and settlement and severance agreements, unless exempted by statute.

The Illinois General Assembly delegates the power to oversee the rule-making process to the Joint Committee on Administrative Rules. The committee ensures that each agency's rules meet the requirements of the Illinois Administrative Procedure Act and that they do not exceed the agency's authority.

The committee requires people who wish to speak about a rule to mail their written comment to: Joint Committee on Administrative Rules, 700 Stratton Office Building, Springfield, Illinois 62706. View the agenda for the meeting, which links to each proposed WCC rule, on the third and fourth page, here.

We appreciate your thoughts and comments. Please post them on our award-winning blog.



Synopsis: You Can Vote Today!!!


Editor’s comment: Voting is one of our most fundamental rights as Americans. It is the cornerstone of our democracy and our civic duty. Early voting is officially underway in Illinois. You can vote early using a mail-in ballot or at a local polling place.

Some people think their vote doesn’t matter. That’s just not true. Elections - especially those at the state and local levels - are often decided by just a few hundred votes. Your vote matters. 


Get out there and VOTE!!!