11-12-2018; SB 904 Continues To Loom As a Litigation Disaster--Can The IWCC Provide A Better Path?; Kevin Boyle reports Single Hearing Member (WC Judge) Change in IN, and New 2018 2d Injury Fund

Synopsis: SB 904 Continues to Loom as an IL WC Litigation Disaster—Can the IL WC Commission Provide a Better Path For Docs and Hospitals to Get Paid Timely and in the Right Amount?


Editor’s comment: Under the former Rauner Administration, our IL Legislature passed several anti-business employment law bills for Governor Rauner's desk. Most notable is SB 904 (Hastings/Hoffman). This challenging and unprecedented legislation makes numerous changes to provisions regarding payment of worker's compensation medical bills.


Then-Gov. Rauner agreed with the IL State Chamber’s accurate assessment of SB 904 that Illinois' workers' compensation law needs revision to reduce growing friction and cacophony between IL employers, WC insurers and medical providers. A major class action on this topic is currently pending.


Our concern is SB 904 would further increase litigation and concomitant employer costs in a system where Illinois already has what the Stat-Rats at WCRI opine is the second highest WC medical fee schedule in the entire U.S. Then-Governor Rauner's amendatory veto provided a path to righteousness—give it to the IL WC Commission to provide some reasonable balance between employer, WC insurer and medical provider interests. 


IL Employers and WC insurers have identified numerous problems with SB 904 resulting in the Illinois Chamber's most stringent opposition. For one simple example, SB 904 allows a WC medical provider to pursue collection of their bills before a Circuit Court judge prior to any determination of whether an injury occurs in the workplace by the Arbitrator or Workers Compensation Commission. It is possible the Circuit Court judge assigned would have to hold a mini-WC-arbitration where Claimant, the medical provider, the insurer and/or the employer would have to all appear via counsel and state their claims. Court costs to just to file such claims would be between $200-400 per claim in Cook County. The Sheriff or process servers would also have to be paid. Court appearance fees are at least $200+. There is no limit on what any of the attorneys for the four parties can charge, like there is in a traditional IL workers’ comp proceeding—a Claimant lawyer representing a Petitioner in such a proceeding could charge $300-500 or more per hour.


In my reasoned legal view, if Claimant wasn’t represented and a Circuit Court judge found the claim to be non-compensable and denied the asserted medical bill, “res judicata” or what is also called “issue preclusion” would attach. In short, Claimant’s workers’ comp claim might be barred without the IWCC ever hearing it. Everyone might find the Circuit Court rules aren’t as nice to the parties as the IWCC can be.


If SB 904 is enacted, Illinois would be the only state in the country allowing such a “double-venued” WC hearing procedure. I firmly believe this change alone will add dramatically more WC litigation into an overly litigious system. I am also sure SB 904 would slow down claim adjudication for injured workers and make all of it confusing and uncertain—the IWCC exists to streamline WC issues and disputes. Finally, I assert SB 904 would cause IL workers' compensation costs to spiral.

Please Remember I Want/Demand IL Doctors and Hospitals Who Provide WC Care to be Paid Timely and in the Correct Amounts—I just want that adjudicated where it has been adjudicated since 1909—the IL WC Commission.


Take a look at this link from ISMS or the IL Medical Society: https://www.team-iha.org/files/non-gated/advocacy/workers-compensation-payments.aspx


It does accurately outline their valid concerns and demand for overriding then-Governor Rauner’s amendatory veto. I join with ISMS in wanting answers and solutions to their many appropriate issues. I have already openly written and asked the IWCC managers and consultants and everyone to rapidly come up with a plan to parrot Indiana or Wisconsin or some other WC system that insures doctors and hospitals are timely paid and paid in the right amounts. I remain amazed to hear nothing is being discussed at the many boards that consult with the IL WC Commission members and interested legislators. Please get going, slowpokes!!!


What is happening in this State is shameful when I hear of approved care by an insurer that is then cut and cut and paid in amounts considered comical by our great doctors and similarly situated medical care-givers. I join with the august and knowledgeable members of the IL Appellate Court in castigating those who are responsible for such actions.


I am sure the gurus at the Illinois Chamber have communicated to the proponents of SB 904 their strong willingness and commitment to negotiate changes to IL WC law to address their concerns in a manner that will not adversely impact Illinois employers and WC insurers. To date, their offer has been rejected without any consideration of finding solutions at the IWCC and in the IL WC Act and Rules. The State Chamber’s exhaustive and accurate analysis can be found at this link: State Chamber on IL SB 904.


Please consider joining the IL State Chamber that is out on the point for IL business. For information, go to www.ilchamber.org.


Please contact your legislative rep on this debate over IL SB 904—the veto session starts TOMORROW!!


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Synopsis: “Here Comes The Judge.” Article and analysis by our IN WC Defense Team Leader, Kevin Boyle, J.D.


Editor’s comment: Kevin Boyle reports there is a Single Hearing Member (WC Judge) Change in Indiana, and New 2018 Second Injury Fund Status Report and Forms Available.

The Indiana WC system will soon have a new Single Hearing Member (aka “judge”), replacing Krysten LeFavour, who handled the southeastern part of Indiana.

IN WC Judge replacements don’t happen very often here, and we only have six judges anyway, so this change could be very important.

Please note the “judges” handle both hearings and combine to handle appeals—IN doesn’t have lots of hearing officers, unlike many other states.

No replacement has been named yet and the southeast region is being temporarily handled by Single Hearing Members/judges Dan Foote and Diana Parsons. I’ll keep you posted when the new person is named.

We join with others to thank Judge LeFavour for your time at the IWCB.

Also, the IWCB just posted the new IN 2018 Second Injury Fund Status Report and the Second Injury Forms are now available.

The 2018 Assessment, certificates for insurers and self-insureds have been updated. If you’d like copies, let me know.

IN WC remains efficient and effective.

If you want an IN defense lawyer who covers the entire State and knows the system and works hard to close your files, contact Kevin Boyle at kboyle@keefe-law.com