8-1-11; Why IL WC claims handlers and risk managers have to be cautious about FCE’s

We were asked why we don’t like FCE’S by a brilliant IL WC risk manager and wanted to provide some thoughts from our veteran defense attorneys. The biggest problem with traditional FCE’s is they have little scientific significance and are based primarily on subjective evaluation of the “effort” of the testee or injured worker. Very few current FCE providers have ramped up their testing to meet scientific standards.

 

Please understand lots of claimants are coached to or just figure out they should act like disabled people in FCE’s and they get “permanent restrictions” as a result of the testing. If that happens on a claim you are handling, you are now stuck with the questionable restrictions that are very hard to rebut in our system. Workers with such restrictions will try to use the permanent restrictions to block return to work and then start what our defense team calls the “wage differential dance.”

 

Unions across Illinois will rely on questionable FCE results to claim the employee can’t do essential job functions and can’t continue membership—they do that to maximize WC recovery for their union member, even though it almost certainly violates ADA. Then workers with the “right” FCE results quickly get low-paying jobs and want you to pay their differential for life.

 

We have seen Illinois hearing officers ask employers to pay $100K-500K and more in wage loss or total and permanent disability claims in reliance on invalid and/or questionable FCE’s. And surveillance results routinely indicate the FCE testing was a sham. We have seen folks who couldn’t lift the equivalent of a gallon of milk in an FCE, lift 50-100lbs. when they don’t know they are being “tested.”

 

Lots of claimant attorneys are now sending their clients for FCE’s because they know the claim becomes worth more money, even though the testing is silly.

 

We have a friend of our firm who has developed a higher-tech FCE, Darrell Schapmire. Schapmire?s work has not been limited to the development and promulgation of testing products and methods. He also published a book, edited by Cairns, titled Forensic Dissection of a Functional Capacity Evaluation. The book provides a blueprint for challenging traditional FCE processes in litigation. Cairns said that traditional FCE methods used for the past 30 to 35 years do not hold up to basic scientific scrutiny. “At least 25 studies published in the past two decades have shown the error rate of the standard grip test (in a typical FCE) is 30 percent or more,” Cairns said.

 

Traditional FCE methods in general can be skewed by the subjective self-limitation of the patient and subjective impressions of tester. “A con man can whine and groan and sweat and act like he is in pain, and if the tester likes him he?ll say he is doing the best he can,” Cairns said. Schapmire likened the traditional FCE testing methods to “1,000 learned scientists 4,000 years ago saying the earth was center of universe. They were in agreement with one another, but they were wrong.” Schapmire said there is not a single FCE in widespread use that is legally defensible. “It doesn?t matter if an expert gives the ?right? answer if he had no way of judging the validity of the subject?s effort,” Schapmire said.

8-1-11; Blowing a Billion in Taxpayers’ Bucks Every Seven Years or So—You have to love and weep about obvious claims-mismanagement by, with and for State of Illinois employees

While the Workers’ Compensation Advisory Board tackles the assignment of Arbitrators that don’t need replacing, we read another block-buster article from the Dynamic Duo with the Belleville-News Democrat, Beth Hundsdorfer and George Pawlacyzk. Turns out they found a story about a State of Illinois worker who apparently mined what we call the “Tunnels of Illinois” after working as a court stenographer for our state for 25 years. Looking at the “accidental injury” in this claim, we point out to our readers there are numerous international studies, one of them from Harvard Medical School which indicates the incidence and prevalence of CTS from keyboarding/typing is no higher than that expected in the general populace. We regularly point out to our readers Harvard Medical School’s findings are not accepted within our state’s “Tunnels which apparently have unique characteristics because we provide so much money for the minimally invasive and non-disabling surgery in our WC system.

A state worker underwent CTS repairs and then could no longer work as a court stenographer. After undergoing and recovering from surgery, this state worker wanted a job back but not a job that involved overuse of her hands. The great reporters at the News-Democrat confirmed this employee applied to numerous Illinois state agencies for any other state job but none responded. Please note the State of Illinois has about 250,000 jobs if you include all state agencies and our colleges/universities. One would have to think there has to be one job out there for someone smart enough to be a court reporter. We further note this claimant holds a master's degree in business administration. While we haven’t done the research, common sense would indicate there has to be at least 5,000 Illinois state jobs that open up and are filled every single year.

The BND reporters quote Alka Nayyar, spokeswoman for the State's Office of Workers’ Comp Claims Mismanagement--Central Management Services in a written response: "If and when possible, one of the primary objectives of the state's workers' compensation program is to return employees safely and quickly to productive work." Nayyar also stated: "Re-employment for injured workers is subject to union bidding rights, veteran's preference and other laws, and all hiring must take place within those laws."

Our response to that sentiment is blunt—“balderdash.” We point out the Illinois Workers’ Compensation Act, the Americans with Disabilities Act and common sense are also “laws” which should be considered in re-employment of injured workers. They obviously don’t apply at CMS.

 

In the People’s Republic of Illinois, We Pay a Lot of Money for People Not to Work

It appears this state employee was receiving tax-free TTD at $766 per week. The worker testified before an WC arbitrator she wanted to again work for the state at a job not involving stenography. There appears to be no question she recovered, could lift 45 pounds over her head and was generally in good physical condition. Instead of getting a job and doing something for the taxpayers, she received $248,966 in TTD. Beginning in January, this claimant was awarded the $766 per week for life. If she lives to her normal life-expectancy, that value will be a cool $1,155,128.00.

While we are uncertain as to how it happened, the BND team has also reported claimant was also awarded an additional $122,000. We assume this follows what we feel is the preposterous ruling in Beelman Trucking in which a worker can get total and permanent disability benefits with another “kicker” on top of what is supposed to be lifetime benefits—the State will owe what we call “double permanency” for several years. We are unaware of any state which provides lifetime WC benefits with additional “double” permanency benefits in the fashion this state does. It is our view this was a creation of the courts that has not been addressed by our legislature.

Wouldn’t you think that might be enough? Well, please remember this is Illinois, the state run by convicted felon after convicted felon. In addition to the monies listed above, this claimant will also receive $1,482 per month in occupational disability from the just-about-broke-and-wildly-in-the-hole State Employees Retirement System. Her total for workers' compensation and retirement disability is $57,633 per year, none of which is subject to tax. The projected lifetime cost of the combined benefits is $1,671,357.00. Adding the $122,000 in “double-permanency” and the $248,966 already paid, our State is going to be out about $2,042,323.00 not including medical bills. Hey, it is just taxpayer money and no one cares about that, right? Please note the claim value would drop from over $2,042,323 back to $122,000, a savings of about $1.9 million, if they offered her a reasonable job right now—the State can cut all of this off if and when they ever get the message and offer her a reasonable job.

All of these benefits for a woman who testified under oath she can and will work. Watching this sort of hapless mismanagement, is it any wonder the Chicago Mercantile Exchange is now thinking of pulling up stakes when they have been in this state since 1848?

No One’s Halo is On Straight in Cases Such as This One

·         We continue to assert the whole “odd-lot” or what we call “lazy-lot” total and permanent disability concept is imperfect and needs to be reviewed by our courts that created it and the legislature that ignores it—even a schoolchild can see it greatly rewards malingering. We continue to point out the words “odd-lot” do not appear anywhere in Illinois workers’ comp legislation—it is our view the Illinois Supreme Court “legislated” the concept.

·         Claimant is 54 and may now get lifetime benefits that may continue into her 90’s--when someone who is pension-eligible gets a lifetime benefit to replace work-life lost income, the amount awarded is like winning the lottery. Workers’ comp isn’t supposed to be like winning the lottery.

·         Yes, you are correct, we feel she can and should have found work on her own. As we indicate above, she still can. If she won’t, the State of Illinois or any of our readers can offer her a job this week and seek to terminate the lifetime benefit now being paid by taxpayers.

·         While we haven’t reviewed the record, we also feel it borders on legal malpractice for CMS and the Attorney General to not have provided outplacement services or vocational rehabilitation counseling to demonstrate available jobs outside state employ.

·         Public sector claims poison the private sector--claims like this condition our Arbitrators to give out millions of dollars in questionable circumstances—we assure you they are innocently following the law but in our view, the Arbitrators got put out on the point and are now suffering from public reaction to a wildly flawed system. Our Governor, who we call the “Great Reactor” is simply taking random action to look like he knows what he is doing and may be firing the Arbitrators for simply fulfilling their sworn duties.

·         If the State can’t manage court reporters better than this, they should outsource the services and let private industry manage it.

·         We are very sure this is the tip of a very, very big iceberg and there are lots and lots of former State workers quietly and very lucratively living off the taxpayers when replacement jobs aren’t being offered. We urge further investigation be performed.

You may ask how our headline indicates CMS, the Attorney General, our legislative leaders and Governor are blowing a billion in taxpayers’ money every seven years or so?? Well, in grossly mishandling situations like the one chronicled above, they are tossing about $133,000,000 in workers’ comp benefits for state workers into the wind on an annual basis. We don’t think there are three U.S. employers who pay that much on a national basis every year. If you continue to blow $133 million every year, in about 7 years or so, you have blown a billion dollars.

We point out to Alka Nayyar and the staff at CMS, Governor Pat Quinn, Senate President Cullerton and House Speaker Mike Madigan and Attorney General Lisa Madigan, you have got to stop doing the “Who’s on First” comedy bit and stop pointing fingers at everyone else and take ownership of what is happening in our state. Someone has to be accountable for this situation and start to wake up and smell the coffee and do something about it. Firing the Arbitrators as sacrificial lambs to try to look tough isn’t the answer when you can’t and won’t find someone with their brains/guts to replace them. Given the opportunity, the defense team at KC&A is happy to help improve the state’s management and defense of their WC claims in any and every way.

The Belleville-News Democrat article is a must-read and is online at: http://www.bnd.com/2011/07/31/1805797/she-begged-to-go-to-work.html. If you have hot news in the WC industry in this state, you can directly contact reporter George Pawlaczyk at gpawlaczyk@bnd.com or 618-239-2625; you can contact reporter Beth Hundsdorfer at bhundsdorfer@bnd.com or 618-239-2570. We salute their hard work in researching and breaking this story. We also thank the reader who tipped us off to publication of this story.

Read more: http://www.bnd.com/2011/07/31/1805797/she-begged-to-go-to-work.html#ixzz1TmgVsMPj

7-26-11; Surprise! Viewing racy web content on an employer-owned mobile data terminal while on duty as a sworn police officer was in violation of Police Department rules and regulations. Therefore...

The Appellate Court upheld the Circuit Court and the Board of Fire and Police Commission of the City of Clinton order discharging plaintiff police officer. Hurst v. The Board of the Fire and Police Commission, No. 4-10-0964 (July 12, 2011). The chief of police filed written charges with the Board alleging Plaintiff viewed racy materials while on duty on a mobile data terminal owned by the department. Plaintiff filed a complaint against the chief and the Board seeking declaratory relief that the chief obtained the evidence in violation of the eavesdropping statute. (720 ILCS 5/14-1 through 14-9 (West 2008)).

Subsequently the Board held a hearing on the charges and discharged Plaintiff. Plaintiff sought leave to amend his complaint to request administrative review of the Board’s discharge order. The Chief and Board filed respective motions to dismiss which were granted.

On appeal the Court held Plaintiff’s amended complaint filed together with his motion for leave to file the amended complaint were timely and went on to discuss the alleged violation of the eavesdropping statute. Plaintiff argued the Board “unlawfully considered evidence prohibited by the eavesdropping statute.” He claimed the police chief violated the statute by using the employer-owned data terminal, and software thereon, as an eavesdropping device.

The Court noted “under the terms of the eavesdropping statute, in order for a communication to constitute a protected "electronic communication," both the sending and receiving parties must intend it to be private under circumstances justifying such expectation.” 720 ILCS 5/14–1(e) (West 2008). As nothing in the record suggested the sending parties of the various racy images intended to keep them private the Court held the images were not electronic communications under the statute.

The police procedures manual dictated the data terminals were only to be used for law-enforcement purposes and not in any manner which would discredit the police department. The manual further stated any messages sent on the terminal were “retrievable.” As such, the Court determined Plaintiff had no reasonable expectation of privacy or confidentiality with regard to his use of the terminal while performing his work duties.

According to the Court, as there was no violation of the eavesdropping statute the Board’s decision to admit the evidence was affirmed and such evidence overwhelmingly supported the Board’s decision to discharge the Plaintiff.

Quick internet research uncovered several articles which point to an increase in inappropriate content, being viewed by employees at work. This decision indicates the viewing of such content can be grounds for discharge and the gathering of evidence will not violate the eavesdropping statute. This article was researched and written by Matthew Ignoffo, J.D. Please do not hesitate to contact Matt about it at mignoffo@keefe-law.com.