We are being constantly bombarded with questions about pending WC reform. We are certain there are about five different bills, all of them confusing and have mild to moderate chances of passing. We are certain the various forces of Illinois labor are fighting to stop whatever change might occur. From our perspective, they are trying to build a horse and more likely will create a camel. On April Fool’s Day, Governor Quinn released his serious outline of a workers' compensation reform package—it sounds good but we don’t see it passing. His staff asserts Illinois WC is the second most expensive state WC program in the nation, after Alaska. We are not sure how we passed Montana who we were told used to be No. 2.
The plucky Governor claims his reforms would reduce magically costs by about $700 million with the vast majority of that savings, almost $500M would come from cutting the current Illinois WC medical fee schedule by 30 percent. Even with that huge medical fee cut, Illinois would retain its high ranking among all states. And the problem with cutting medical costs is the Illinois Hospital Association and Illinois State Medical Association are steadfastly opposed. It is weird to understand Illinois labor unions and the Illinois Trial Lawyers Ass’n have joined ranks with representatives of the Republican-dominated medical community, creating a bi-partisan “plug” on anything the Governor or legislative leaders might want to pass.
We are now advised the forces of Illinois business are fighting hard for a new standard on causation and we being told they want a “standard” requiring work injuries being magically “50 percent related” to the work. As we have advised in the past, there is a major “steam around” factor present, as we expect the most liberal of the Arbitrators and Commissioners will simply find any condition to be at least “50% related.” Unless and until the Commission gets the news, you can pass all the legislation you want, it won’t matter a whit.
Other provisions from Governor Quinn and our thoughts:
* Personal claims made by Arbitrators and Commission employees will be heard by the Illinois Court of Claims, instead of other friendly Illinois Workers' Compensation Commission arbitrators. Yawn—when did the Court of Claims have any idea how to dole out WC benefits? Should CMS claims adjusters who have claims before the Arbitrators still be able to adjust and settle the claims?
* Arbitrators must, by statute, be licensed attorneys, act in an unbiased, impartial manner and adhere to the Code of Judicial Conduct. We recommend this apply to everyone in our WC systems but hard to imagine it will happen as this is Illinois, right? Who is supposed to objectively measure “unbiased, impartial”—the Governor; the Legislature; the reviewing courts; Illinois employers?
* When the six-year terms end for current Arbitrators, they must receive a suitable evaluation in a process to be established under the control of Workers' Compensation Commissioners before they can be reappointed. New terms will be three years. Same “yawn” as above—they are trying to legislative “ideals.” If Governor Quinn wants Commissioners and Arbitrators in his image and likeness, he has the power to locate and appoint them right now.
* Carpal tunnel total disability payments, or weekly tax-free paychecks equal to two-thirds of salary, be capped at 20 weeks. We are back-flipping to hear such a proposal about CTS but the chances we are back-flipping into a pool without any water in it are high—it won’t happen or it will later be magically declared unconstitutional. While you are limiting CTS, limit cubital tunnel syndrome also—our WC benefit system “causes” more CuTS surgery in Illinois than any other state in the U.S.
* Claims by intoxicated workers injured by their inebriation be denied. Again, nice try in “legislating ideals” and we expect a high “steam around” factor following the enactment of such legislation.
* A special assistant attorney general will be assigned to investigate fraud and assist the Department of Insurance, which will be given more authority to investigate and prosecute workers' comp fraud. Sounds fine to us, if it passes.
* Insurers must accept cheaper electronic billing from medical providers. Not sure who cares but if it saves money, go for it.
* Attorneys who appear before the Commission must adhere to the same rules as they do when they appear before a court. No idea what this means or where it came from but if they are trying to say you can’t buy “face-value tickets” for Arbitrators we already thought that was a law or at least a guideline.
* The state can consider the use of outside companies to operate all or part of the state's self-insurance workers' compensation program. See the first article above—we don’t think this has to be in legislation but if it does, we can’t pass it fast enough.