9-6-11; Why do Illinois doctors continue to find injured workers to be gimps, cripples and special needs?

We understand the terms ‘gimps, cripples and special needs’ are awful discriminatory terms for the folks who require reasonable accommodation to work. However, it is our opinion this is what many Illinois OccHealth doctors/surgeons are effectively doing in constantly setting “permanent restrictions,” effectively barring such individuals from the workplace or their trades for life. We also feel many Illinois labor unions are complicit in the process. We are getting madder and madder to read what has happened with Illinois’ “china doll” construction, medical industry and trucking workers. We are completely sick and tired of hearing doctor after doctor finding Illinois injured workers have permanent restrictions and assure all of you it is our view they are openly or implicitly violating federal law for them to do so. In our view, it is morally and ethically wrong and should be stopped.

 

You may ask what is a “china doll” construction worker, medical industry or trucking worker? Well, if you aren’t sure, the Illinois WC system wildly awards/rewards high-wage workers who learn the ropes and find ways to appear to be looking for work, but magically can’t find a job. We think “un-finding” work is one of the easiest things anyone can do. What is more problematic are the doctors/surgeons who foster this legal concept at its inception by implementing the magical and counterproductive model of so-called permanent restrictions.

 

We have repeatedly told our readers permanent restrictions are a “golden diagnosis” in this state. An injured worker and a politically connected lawyer can make hundreds of thousands or even millions with such a medical finding. One purpose of this article is to let doctors, nurses, CRC, attorneys, Arbitrators/Commissioners and everyone else in the Illinois workers’ compensation system it is our strong view this paradigm runs afoul of federal law—the Americans with Disabilities Act. Following the parameters of the ADA, it is politically incorrect and basically shameful to assess an injured worker with permanent restrictions. In our view, it is the equivalent of medically finding the worker to be an incurable gimp or a cripple—once you find they are gimpy, gosh knows no one else will have them, right? We feel it is wholly negative, discriminatory and wildly unproductive to take that approach to someone with a mild to serious work injury.

 

Right now, as you read this we have:

 

A.    One claim with a physical therapy supervisor who suffered a simple burn to one thumb. A “pain doctor” most of you know found her to be magically but permanently incapable of working for the rest of her life due to non-diagnosable subjective pain—all diagnostic testing is grossly negative. The Arbitrator bought into her silly story and provided total and permanent disability benefits at a projected lifetime cost to an Illinois hospital in the amount of about $2.4 million dollars. Please note all of this is for a burned thumb that healed in about two weeks. Yes, not one but two IME doctors said she is grossly normal and there is nothing wrong with her. Yes, the claim is pending on appeal before the IWCC.

 

B.    Another claim by a construction worker with cubital tunnel syndrome. He has been treating with Dr. A for months and months and months. Dr. A sent him to a “pain doctor” who found equal range of motion in both arms and strength equal. Based on that medical finding, all benefits are cut-off and an emergency petition is expected any day. The settlement demand for a simple elbow surgery is $450,000 based upon a claim this worker is certain to have permanent work restrictions when and if counsel can find a way to get him into an FCE. As we have told all of you, FCE’s are basically hilarious and completely non-scientific as a means to determine if a worker does or doesn’t have “permanent restrictions.” As we have told all of you, lots and lots of claimant attorneys are not sending their claimants to FCE’s themselves—who cares what the doctors might say, let’s get an FCE that will provide permanent restrictions or “gimp-dom.”

 

C.   Another claim by a trucker who is claiming he can’t drive a truck and can’t do basically anything. His next-door neighbor learned of his tale of woe and started to videotape him while he was out and about. She had hours of tape documenting he could literally do hundreds of things, like gardening and riding ATV’s. In our view, there is no question, he can work and might need some reasonable accommodation to do so. Our client paid for computer training to later find out he was running a computer-tuning company. Based upon alleged “permanent restrictions” an Illinois Arbitrator has awarded total and permanent disability benefits. Yes, the matter is pending on appeal.

 

What is wrong with this picture? Well, the Americans with Disabilities Act of 1990 (ADA) is a law that was enacted by the U.S. Congress in 1990. It was signed into law on July 26, 1990 by then President George H. W. Bush and later amended with changes effective January 1, 2009. The ADA is a wide-ranging civil rights law that prohibits, under certain circumstances, discrimination based on disability. In simplest terms, it is against the law to discriminate against folks who might otherwise have “permanent restrictions.” Obviously that simple concept may not apply in what one of our clients aptly calls the “People’s Republic of Illinois.”

 

Basically, the overall legislative package was to forever end the awful concept of calling or even referring to injured workers and prospective workers as gimps, cripples and physically challenged people. The idea was to stop the concept of workers and prospective workers ever having “permanent restrictions.” Basically, the goal is to have U.S. industry employ folks who need help or accommodation to be employed. We truly feel the concept of lifetime permanent restrictions is totally negative and counterproductive.

 

In our view, if a claimant has a medical problem the treating doctor should avoid a negative approach and they should indicate what the patient can do without accommodation and what he/she can do with reasonable accommodation. There should be no hint of the negative concept of “restrictions” as we feel it is the equivalent of shamefully calling the patient a gimp, a cripple or physically challenged. We urge physicians and surgeons to focus on the much more positive concept of focusing on the ability for a worker to get back into the workforce with mild, moderate or significant but reasonable accommodation. We further urge Illinois labor unions to follow the same path and stop barring injured workers from your membership.

 

Following the intent and overall concept of ADA, medical and job discrimination may include, among other things, limiting or classifying a job applicant or employee in an adverse way, denying employment opportunities to people who truly qualify, or not making reasonable accommodations in respect to known physical or mental limitations of disabled employees. It is also discrimination against the arguably disabled to not provide needed accommodations in training. U.S. employers can use medical entrance examinations for applicants, after making the job offer, only if all applicants regardless of permanent restrictions or disability must take it and it is treated as a confidential medical record.

 

We ask all of our readers, if a construction worker breaks an ankle—can the treater indicate the worker is forever barred from climbing a ladder again and therefore forever precluded from his/her lifetime career in construction? Instead, shouldn’t the doctor say the worker with a broken ankle needs reasonable accommodation to include implementation of a better ladder to return to his/her lifetime work by employing a ladder that is effectively a staircase with a railing on both sides. Such “staircase ladders” are available at all major big-box retailers right now. In our view, most Illinois physicians treating injured workers are much more likely to opt for the easy path of granting their patients “permanent restrictions” and almost never think outside-the-box for ways to reasonably accommodate a return to the same job. Similarly, most Illinois labor unions almost never focus on what a carpenter, iron-worker or electrician needs to get back on their job rolls—they would much sooner have that worker be cast to the side as a gimp or cripple and force union contractors to only hire what they feel are arguably “healthy” workers. The concept sounds good to union bosses but it is against U.S. law!

 

Maybe we are going to have to advise our clients to file EEOC complaints against a doctor (or three) or a union (or four) to get them to start implementing ADA concepts in their day-to-day practices to get their attention and move into the 21st Century and stop routinely finding injured workers to be gimps, cripples and physically challenged and bar them from the workforce with accommodation. In our view, doctors and labor unions will only stop the negative concept of “permanent restrictions” when they are forced to do so.

8-30-11; A great thought for IL WC reform, round III

A reader sent us an article about a ruling from Minnesota that might be fodder for future IL WC reform.

In Minnesota, they have a presumption of retirement at age 67 in their WC Act. This presumption cuts off T&P benefits at the time a claimant would normally be able to retire.

The Minnesota Supreme Court in Frandsen vs. Ford Motor Co. reviewed the issue of whether Ford waived the retirement presumption in Minnesota's workers' compensation law simply by failing to expressly reserve the presumption in a settlement agreement. The presumption states that permanent total disability benefits shall cease at age 67 because the employee is presumed retired from the labor market.

Workers can rebut the presumption, court records state. It appears there was no dispute Mr. Frandsen was permanently and totally disabled.

A settlement agreement did not mention Ford potentially discontinuing benefits or the statutory retirement presumption and, in September 2010, Ford petitioned to discontinue paying the PTD benefits pursuant to the retirement presumption.

Ford argued in a hearing Mr. Frandsen could not rebut the retirement presumption because he had stated in a deposition that he planned to retire when he was 66. Mr. Frandsen objected and argued he was entitled to continue receiving the benefits.

In the 2011 Amendments to the Illinois Workers’ Compensation Act, our legislature, in its wisdom, cut wage loss differential benefits at age 67 or five years, whichever is later. We feel the same concept should apply to T&P benefits that currently result in boxcar numbers for settlements.

8-30-11; WC Cost-Controls for Illinois municipalities/governments/businesses based on the experience of the City of Springfield with added thoughts from KC&A

We recently reviewed a newspaper article in the Springfield State Journal-Register indicating the City of Springfield, IL has paid more than $16 million during the last three fiscal years in medical bills, cash settlements, attorney fees and paid time off to employees who submitted claims for on-the-job injuries. As the costs continue to mount, Springfield Budget Director Bill McCarty is calling for an overhaul of the city’s workers’ compensation claims handling protocols. During the next city council meeting alone, Springfield aldermen will vote on eight workers’ compensation settlements totaling more than $420,000.

In response, Budget Director McCarty wants to hire a comprehensive case manager and require new City employees undergo pre-employment physicals and fill out health history questionnaires. We encourage him to ask the pre-hire questions about prior workers’ comp injuries approved by the Seventh Circuit Federal Appellate Court in Carter v. Tennant Company—if you want the questions, send a reply. The ultimate goal, he said, is to reduce the city’s expenses and the amount of time employees are off work because of injuries. Doing so, he feels, could save millions of dollars each year.

McCarty has suggested a number of changes, including:

·         Hire a comprehensive nurse case management company. Similar to what Sangamon County does, McCarty has suggested hiring a company that would contact an injured employee as soon as a claim is filed and keep in contact until the case is resolved — even attending doctors’ appointments. The company has helped reduce workers’ compensation costs significantly — from $1.5 million in fiscal 2004-05 down to $350,000 in fiscal 2007-08, in addition to lowering the county’s premiums for workers’ comp insurance, he said.

·         Involve city directors in claims. McCarty said the city should become more aggressive in investigating claims. The administration wants to involve directors/supervisors who know their employees but currently aren’t asked for their input.

·         Optimize their Safety Leadership Council. One city department has an 11-member council, which includes upper management, that meets monthly to discuss safety and recommend changes in policy and procedures. Since its inception in June 2007, there has been a steady decline in the number of accidents, Sabin said. McCarty said he wants to see such a council created on the city’s corporate side to work with city employees to find ways to reduce workplace injuries.

·         Pre-employment screenings. McCarty said prospective employees should have to take a comprehensive physical as well as fill out a health history questionnaire so the city knows a worker’s physical condition when he or she begins employment. Employees could be disciplined or terminated if it’s discovered that they lied on the questionnaire, he said.

·         Publish employee claims online. The idea is still being debated, McCarty said, but he wants the names of employees who file for workers’ compensation and the amount they receive to be posted on the city’s website. The city wouldn’t include the injury type or any medical data, he said. The information is already available to the public, but putting it online may increase transparency and potentially discourage employees from filing false claims, he said.

KC&A agrees with many of the above concepts and adds the following for everyone’s consideration.

Ø  Get into a Workers’ Comp PPP. This new tool is going to dramatically change the face of Illinois WC. If you need help with it, send a reply and we can point you to the experts on it.

Ø  Demand Accidents Be Reported Timely—many of our clients now discipline for late accident reporting.

Ø  Aggressively Investigate All Accidents. We have an accident investigation form available for use by anyone who needs it—if you want it, send a reply.

Ø  Use Webcam Questions for interviewing injured workers and witnesses on DVD with a webcam to lock in their stories—if you want it, send a reply.

Ø  Always Pull Surveillance Videos in the area of an accidental event. In work areas where you have high accident incidence rates, set up surveillance cameras.

Ø  Target Return to Work to light and full duty.

Ø  Provide Reasonable Accommodation at all times to facilitate return to work at the earliest but safest interval.

Ø  Target Maximum Medical Improvement or MMI.

Ø  Convey The Targets to the injured worker, the supervisor and your claims handlers.

Ø  Make the Targets a Reality by Staying in Close Touch with the worker on at least a weekly basis whenever they are off work. The goal of staying in touch is to keep the worker on track along with insuring their medical bills and TTD are being paid.

Ø  Consider Making Pro Se Settlement Offers on “hard-tissue claims” to minimize litigation.

Ø  Hire better defense counsel who can provide assistance at every step of the process—KC&A provides 24/7/365 assistance to Illinois government organizations and businesses who want to attack WC costs in every direction.