11-12-12; The Day the Republican Party in Illinois Died--What It Means to WC; John Campbell Reviews Religious Discrim Ruling; Sean Brogan analyzes Independent Contractor Claim and much more

Synopsis: The Illinois State Republican Party Died Last Week and is Deader’n a Doornail—What Does It Mean to IL WC?

 

Editor’s comment: One goal in writing this KCB&A Update for our readers is to remain relatively impartial from the perspective of political parties and politics. We represent government bodies on both sides of the political matrix. Our focus is saving such governments and businesses money in the WC arena. However, we have to call ‘em as we see ‘em, folks. In our view, the evidence is irrefutable. While we aren’t happy at all to see the complete lack of options or the protections a two-party system brings, sometimes you may be better served to face reality and try to adjust.

 

Chicago has had One Political Party for Years; Now the Whole State of Illinois Does

 

In taking a bipartisan stance on political issues, we are certain Illinois lost its two-party political situation last week. Most folks know the City of Chicago basically lost any vestige of a two-party system when a crooked Republican political boss named Big Bill Thompson was soundly routed by then-mayoral candidate Anton Cermak. That happened 81 years ago in 1931. Thereafter, Richard J. and Richard M. Daley ascended to the post of Chicago mayor and held the post for about ½ of the 80 or so years of Democrat supremacy in Chicago. Their ascendancy indicates one clear facet or failing of Chicago-style politics that impacts our whole state—our lack of term limits for political posts. Once in power, a smart Illinois politician uses patronage, nepotism, the ability to control government contracts, the capacity to appoint friends/supporters to cushy jobs and control of workers’ compensation/government disability benefits to become entrenched. Once embedded, they can hold the job as long as they like. Please don’t expect the Democrats to bring term limits in to hamstring their potentially unending claim to dominion over this state.

 

From our perspective, the political disaster that befell the Republican party in Chicago generations ago has expanded to a statewide dilemma—in our view, the Illinois Republican Party is smoked, finis, done, over and out. The Illinois “Blue” team hasn’t just won another election, they have thrown the other “Red” side out with the bathwater. How did we get to this point? Why are we sure of this relatively shocking news?

 

Well, IL Democrats now completely dominate within numerous voting blocs. It doesn’t take a rocket scientist to notice there were no African-American or Latino candidates slated by the Illinois Republican party and the party did very little to actively woo such voters. Black and Latino voters in Illinois came out and voted overwhelming for Democratic candidates. In a similar vein, many Illinois women voters have long been upset to consider a State Republican party with an open focus on controlling abortion, even in cases of rape and incest. Women voters were stunned to hear impossibly stupid comments on such topics from Republican candidates in other states and vented their dissatisfaction at our polling places. In our view, when Republicans can’t figure out a workable strategy on such an issue that will make women voters happy, voters will figure it out for you. A vast majority of IL women voters, particularly among young women voted Blue. We don’t see that changing any time soon.

 

The last major group we feel everyone is skipping are “government ghost payrollers.” As we have advised our readers in the past, this group is

 

·         Almost 800,000 eligible Illinois voters receiving or that will be eligible to receive generous government pensions from the five different poorly funded and almost-broke Illinois state pension plans;

·         Thousands of voters who are receiving lifetime “odd-lot” total and permanent disability benefits from State or City of Chicago governments and their impossibly poorly run WC systems;

·         Thousands of former police and firefighters who are now on lifetime line-of-duty disability pensions for things like runny noses where they can have jobs, run businesses and make money but are still considered “disabled” because their condition no longer allows them to be a police officer or firefighter.

 

In our view, hundreds of thousands of government ghost payrollers are supporting, donating and voting for one issue—“keep-my-pension/disability/WC-pay-in-place-and-growing.” Political observers are still laughing about Prop. 49, which would have provided such state and local pensions couldn’t be raised without a 3/5’s vote. The proposition failed miserably. We feel this phenomenon demonstrates the power of this heretofore unknown voting bloc. It is our view “government ghost payrollers” raised a campaign fund of about $500,000 and ran a major media blitz designed to let all of us know they don’t want limits on their current and future “rights” for the major taxpayer-paid benefit they receive. IL state pensions go up 3% each year. “Odd-lot” T&P WC benefits get business-funded COLA increases. Don’t expect either rising cost to slow without a major battle or three.

 

The State of Illinois has been “Gerrymandered” and Will Stay That Way for Ten More Years, Further Blocking a Republican Comeback

 

Gerrymandering is a practice that locks in a political advantage for a particular party or group by manipulating voting boundaries to create slanted, partisan or incumbent-protected districts. On top of getting slaughtered in double and triple-digits in many defined voting blocs, as we outline above, Illinois State Republicans will struggle with another monster mess for the next ten years—IL State Democrats “took advantage of their advantage” and just redistricted the entire state in their image and likeness. They bolstered Democratic strongholds and combined Republican districts to force Republicans to fight and oust other Republicans. This obvious political manipulation of the state’s election boundaries was attacked in IL state courts. Guess what, IL state judges/justices who have to run for election in the same districts quickly and quietly approved the distorted redistricting that helps them and their supporters stay entrenched. Another aspect of gerrymandering is voters start seeing little chance of their candidates winning and stop voting, making the party in power even stronger. We assure our readers this gerrymandering will insure the State Republican party is decimated and powerless in almost all areas of the state for at least the next decade.

 

So Where Is Illinois Going? How Will This One-Party Political System Affect Workers’ Comp Claims?

 

At present, Illinois now has veto-proof Democratic majorities in the state House and Senate. If you aren’t sure, Democratic Governor Pat Quinn just became a figurehead—he can’t stop anything in the legislature as they have the power to overrule him if he doesn’t support a bill. We are sure Senate President John Cullerton and House Speaker Mike Madigan are running things and no one will be able to stop them other than via old age or retirement. Both of them are active, wealthy and healthy men who worked hard to get where they are and appear to want to keep their posts and unsurpassed power.

 

We are predicting you will see one to three new gambling casinos in Chicago, as Mayor Rahm Emanuel sorely needs the cash for his underfunded City payroll and public school system. The only one who was blocking gambling expansion was Governor Quinn—all he can do now is go on the television and whine about it; he has no power to stop it. The veto session that is starting November 27th has lots of “lame duck” legislators on their last laps; odd and unexpected legislation may happen because outgoing legislators have nothing to lose; they are leaving in January no matter what. Often during lame duck sessions, controversial bills are passed. During 2011’s lame duck session the IL General Assembly passed a 67% income tax hike – the largest tax increase in Illinois history. It is possible an additional tax increase may be passed and all wealthy Illinois citizens are worried state legislators may “occupy” their wallets and savings in the same direction our President is taking to turn around his ballooning and massive federal deficit.

 

On the workers’ comp front, everyone on the defense side has our fingers crossed Illinois WC reform and progress in cutting costs will stay at the same levels. About two years ago, Senate President Cullerton took an across-the-board review of workers’ comp costs and supported the 2011 reforms that unquestionably trimmed rising costs. As one prominent Plaintiff/Petitioner lawyer put it, “everyone got a haircut” and WC benefits were similarly clipped. The Arbitrators and Commissioners are now very, very professional and most of the defense bar will affirm they are not issuing shocking, pro-Plaintiff/Petitioner rulings and work to be fair to both sides. We are still the fourth-highest WC state in the United States but things have gotten better since the Blagojevich era. That said, we do predict:

 

·         PPP’s or Preferred Provider Programs are going to be magically and mysteriously tied up in committee for several more years—they were enacted on June 28, 2011 and remain entwined in JCAR or the IL Joint Committee on Administrative Rules 17 months later (if you want our suggestion on what to do about this, send a reply);

·         Impairment ratings will continue to be politely considered but won’t have the impact their proponents wanted in cutting reserves and payouts on permanency;

·         The Illinois Workers’ Compensation Commission’s budget isn’t going to be cut to match the dramatic and continuing drop in new claims;

·         State of Illinois and City of Chicago workers’ comp defense programs will continue to payout hundreds of millions in benefits to political supporters as no one will be able to rein them in.

 

Whatever happens on the One-Party Political Matrix in Illinois, Keefe, Campbell, Biery & Associates will continue to look out for the interests of Illinois business. If you want thoughts, concepts and strategies to cut your WC, GL, EPLI or MVA budgets and free up reserves, send a reply. We appreciate your thoughts and comments. Please post them on our award-winning blog.

 

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Synopsis: Employers must be sensitive to the religious practices of employees, but there is a limit to everything. Thoughts from John P. Campbell, Jr., J.D.

Editor’s Comment: We were comforted by this recent decision from our Seventh Federal Circuit, as it reflects a pragmatic and fact-specific analysis of Plaintiff’s claim of religious discrimination. In  Porter v. City of Chicago our U.S. Court of Appeals for the Seventh Circuit found insufficient evidence for Plaintiff to proceed with her claim of religious discrimination, as the employer, City of Chicago, demonstrated sufficient effort to accommodate the request for accommodation.

Plaintiff Porter worked in data entry for the Chicago Police Department. The position required 24hr/7 day per week coverage by those employees, so of course, Sunday shifts were part of the obligation, utilizing rotating and alternating shifts among all assigned workers. Ms. Porter attended Sunday church services regularly and made a prior request for Sundays off. A few years prior to this claim, her request had been accommodated. However, upon her return from FMLA leave, she was placed on a weekend shift which included Sunday work. She again made the request for accommodation for Sunday off, citing her religious obligation. This time however, her supervisor explained she would have to wait for other similarly situated employees to either

(1)  agree to switch shifts or

(2)  for a position to open up on her desired shift schedule.

Also, her supervisor offered to place her on the Sunday afternoon shift, allowing her to attend Sunday morning church services. Ms. Porter was dissatisfied with this offer and her EEOC complaint followed.

Drawing from the legal rule cited in the text of the case:

Title VII prohibits employers from “discriminating against any individual with respect to his compensation, terms, conditions, or privileges of employment, because of such individual’s race, color, religion, sex, or national origin.” 42 U.S.C. § 2000e-2(a)(1). Title VII defines “religion” as “all aspects of religious observance and practice, as well as belief, unless an employer demonstrates that he is unable to reasonably accommodate to [sic] an employee’s or prospective employee’s religious observance or practice without undue hardship on the conduct of the employer’s business.” Id. § 2000e-(j).These provisions of Title VII prohibit an employer from intentionally discriminating against an employee based on the employee’s religion, and require an employer to make reasonable efforts to accommodate the religious practices of employees unless doing so would cause the employer undue hardship. See Reed v. Great Lakes Cos., 330 F.3d 931, 934-35 (7th Cir. 2003) (citations omitted).

With the affirmation of the summary judgment for the City of Chicago, our Seventh Circuit explained the employer here made a reasonable attempt to accommodate Plaintiff’s request for accommodation, offering an alternate Sunday (afternoon) shift. This shift would have allowed Plaintiff to attend her Sunday services. Also, evidence the supervisor attempted to get co-workers to switch shifts is further evidence a reasonable accommodation was attempted. Plaintiff on the other hand, refused to accept the form of accommodation offered. Therefore, her decision to elect sick leave or vacation days was her own choice, having refused the option to simply work the Sunday afternoon shift.

Although employers may draw solace from the Porter decision, Human Resource directors and managers everywhere should be mindful of similar such requests by employees wishing to meet their religious obligations. As explained in this decision, a routine dismissal of such an employee’s request may very well be met with a valid charge of discrimination unless the employer makes a good faith effort to accommodate. As always, we strongly recommend you document, document, and  document your efforts to accommodate employees if such a scenario should arise.

This article was researched and written by John Campbell, Jr., J.D. Please direct your thoughts and comments to John at jcampbell@keefe-law.com.

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Synopsis: Illinois trucking company unsuccessful in using signed “independent contractor” agreement to establish that status.

Editor’s Comment: We are regularly asked whether an employer or contractor can establish “independent contractor” status and avoid paying WC benefits for an injured worker simply by having a worker sign such an agreement. Our answer is uniformly “no��—you have to look at the bigger picture of the relationship between the two parties. If you truly want anyone providing services for you to be “independent,” make them buy their own WC insurance to protect themselves or assume you are going to have to pay such benefits, if the unfortunate or unforeseen occurs.

In Labuz v. JKC Trucking, both parties appealed an order from the Circuit Court of Cook County which confirmed a decision of the IWCC awarding claimant benefits for neck, back and left shoulder injuries. Among the more pertinent issues on appeal was whether the Circuit Court should have dismissed claimant’s petition for review for lack of subject matter jurisdiction; whether the Circuit Court erred in finding claimant was an employee rather than an independent contractor; and whether the Circuit Court erred in denying penalties and fees against JKC.

JKC argued Claimant failed to effect proper service of the summons related to his petition for review in the Circuit Court as claimant mailed its summons addressed to the Commission generally and not to a particular member of the Commission. Relying on section 19(f) of the Act which notes “[s]ervice upon any member of the Commission or the Secretary or Assistant Secretary thereof shall be service upon the Commission…”, JKC argued the statutory language indicated service on the Commission may be accomplished only by serving a particular Commission Member or the Secretary or Assistant Secretary thereof. Thus, claimant’s general service to the Commission was insufficient to trigger Circuit Court jurisdiction. 

Reading section 19(f) in its entirety, the Appellate Court, Workers’ Compensation Division noted the statutory language immediately following the quoted language goes on to explain service on the Commission is to be effected by mailing notice “to the office of the Commission.” Thus, the Court rejected JKC’s argument reasoning the quoted language in section 19(f) is not a restriction on proper service but an expansion as it mandates service on the named individuals be considered service at the Commission.

The Court also rejected JKC’s independent contractor argument. In so doing, it assigned no weight to the fact Claimant signed a document indicating he was retained as an independent contractor for JKC. Interestingly, JKC was able to successfully argue against penalties and fees based on the same grounds that proved unsuccessful in its argument that claimant was an independent contractor.

While the Appellate Court found there was sufficient evidence to allow a rational trier of fact to conclude Claimant was an employee and not an independent contractor. The Court’s ruling outlined there were reasonable grounds for JKC’s position he was an independent contractor. In addition to the signed document, it was undisputed JKC did not withhold taxes from claimant’s pay checks and there was evidence claimant exercised control over his routes and over which gas stations he used. Thus, JKC’s basis for withholding payment—its argument he was an independent contract and not an employee—was neither unreasonable nor vexatious. 

This article was researched and written by Sean C. Brogan, J.D. He can be reached for questions or comments at sbrogan@keefe-law.com.

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Synopsis: Welcome aboard, Tim O’Gorman.

 

Editor’s comment: Keefe, Campbell, Biery & Associates proudly announce the addition of Tim O’Gorman, J.D. to our legal team. Last week, Tim was sworn in as an IL lawyer and will focus his practice on defense of folks like you who face the enormous challenge of keeping your company’s costs and reserves low in aggressively defending your workers’ compensation, general liability, employment law and motor vehicle defense. Tim is up for the challenge—feel free to contact him at togorman@keefe-law.com.

 

11-5-12; Justice John McCullough RIP; Joe D'Amato, JD reviews "intrusion upon seclusion ruling; Matt Ignoffo, JD reviews new WI ruling expanding WC coverage and more

Synopsis: Last week marked the passing of Illinois Appellate Court Justice John J. McCullough.

 

Editor’s comment: Writing a news article about the passing of this distinguished Justice for a WC business observer and court-watcher is, to say the least, challenging. Justice McCullough proudly served his country in the U.S. Army (1955-57). Following four years in private practice, he was elected county judge in 1962 and Chief Judge of the 11th Judicial Circuit in 1974 and served in that position until his election to the Fourth District Appellate Court in 1984, where he served for the past 28 years.

 

In addition to his regular judicial duties, Justice McCullough served 22 years on the Workers' Compensation Division of the Illinois Appellate Court and acted as the Presiding Justice of the five-member panel for each of those years. Justice McCullough was the longest serving judge in Illinois history, serving 50 years on the bench.

 

Our issue with writing about his passing is he was one of the folks who participated in numerous IL WC Appellate Court rulings considered by Illinois business leaders to be anti-business and mildly to wildly pro-labor. At present, we consider current contested WC appellate rulings to have a ratio of 20-1 or higher for Illinois labor. That said, we assure our readers Justice McCullough was professional, business-like and very honest. He was also the leader of a crucially important judicial panel that led the Illinois workers’ compensation system to where it needed lots and lots of reforms to bring it to remain the fourth most expensive WC system for employers in the entire country. It is our hope the next presiding justice of this important Appellate panel steers the members of the Court closer to the mainstream and takes on a focus of fair/reasonable benefits paid to injured workers by cost-conscious Illinois business and government bodies.

 

For the two decades we have been publishing this Update, KCB&A repeatedly and respectfully criticized the appellate panel Justice McCullough headed for any number of issues we felt were unusual and deserving of comment:

 

  1. This WC appellate panel used to issue many of its decisions in secret. In any ruling of a controversial nature, the Appellate Court, Workers’ Compensation Division could follow Illinois Supreme Court Rule 23 and “non-publish” their rulings, keeping them out of the eyes of the public. Most important, such rulings were kept out of the eyes of the practicing bar. This was supposed to only apply when their ruling was mundane and routine—turns out lots and lots of critically important and lengthy rulings were “non-published.” In our opinion, no one on other side of the bar could tell why or when that might happen.

 

What the “regulars” or lawyers who practiced at the IWCC a lot learned to do was to quietly pass along the secret rulings to each other to allow them to know what the members of the Appellate Court were thinking when faced with an important situation. We also consider it amusing to see the Illinois State Bar Ass’n would “publish” articles analyzing “non-published” Appellate Court decisions; in our view, such publications would openly contradict the Justices’ determination their ruling was to be kept from “publication.” What is also odd is non-published rulings are now posted on the Appellate Court’s website, making them “published but non-published” rulings!

 

  1. Another odd proclivity of the rules governing the Appellate Court, Workers’ Compensation Division was the members’ singular ability to decide when to make the panel’s rulings “appealable.” If you aren’t sure, the panel continues to have that power, although the Supreme Court rules now require not just one but two of the panel members to certify their ruling for further appeal. We always felt this ability presented was to display a pro-labor bias to the rulings of the panel. What one would see was pro-labor rulings awarding benefits left to be non-appealable by the panel while any defense ruling denying benefits would be certified for further appeal in the hope that our highest Court might reverse. We remain chagrined to remember this Appellate panel didn’t have to certify rulings like Sisbro and Twice Over Clean where they wrote brilliant decisions initially denying benefits. We also will always be amazed to note the panel certified the Interstate Scaffolding v. IWCC ruling for further appeal by our highest Court when the total amount at stake was a mere $5,000 in TTD—cases involving hundreds of thousands of dollars wouldn’t be similarly certified for further appeal.

 

  1. We remain intrigued to recall a lengthy and thoroughly analyzed ruling where the five-member panel decided to issue a “non-published” ruling indicating the decision was somehow routine but all five members of the same Appellate panel certified the same ruling for appeal as critically important for further consideration by our Illinois Supreme Court.

 

  1. Another ruling where Justice McCullough and the appellate panel might be subject to criticism was William G. Ceas & Co. v. Industrial Commission, issued in 1994. The Appellate Court initially issued an initial favorable decision for the defense, resulting in denial of a death claim. For reasons no one may ever know, the members of the Court quickly withdrew it. If you aren’t sure, it is very, very rare for an Appellate Court panel to withdraw a ruling they take the time to vote on, research, write up and then issue for public review. By very, very rare, your editor will assert in more than thirty years of practice and having read literally every published ruling by Justice McCullough’s panel, we can only recall this single ruling where a final decision of the panel was recalled and the majority completely reversed itself. In Ceasthe Court issued a “corrected decision” and a majority of the panel overturned its original denial and awarded full benefits to Petitioner. The only three reasons we can think of for the 180-degree turn around by all the members of the Court would be politics, politics and more politics.

 

  1. Finally, we recall the article written by your editor and Shawn R. Biery, our brilliant law partner in 2008. We analyzed the odd ruling in Smalley Steel Ring where a claimant made a claim for injuries on unquestionably fraudulent grounds—he filed the WC claim in the name of a dead person and the insurance carrier/employer did not learn of the fraud until after the time to appeal had run. The defense side screamed for justice confirming the IL WC Act says the Commission’s ruling is not supposed to be conclusive unless it is issued “in the absence of fraud.” Most observers, including my parents feel it might be fraud to come into court and raise your hand and swear an oath to tell the truth all while using a dead person’s name—do you think that is fraud? Does the legislature have to pass a law stating it is fraud to do so?

 

The Appellate panel headed by Justice McCullough made the reasoned determination to adhere precisely to the “English language” version of the IL WC Act and allowed the lower court ruling to stand. Shawn and I chronicled how the “English language” was arguably and repeatedly “bent” by our justices in various pro-labor rulings such as DurandGeneral Tire and Rubber and First Assist. In Smalley Steel Ring, Justice McCullough adhered to a strict construction of the law and wrote “[s]uch deficiencies in the Act should be remedied by the legislature.” With respect to this long-time hearing officer, we feel it would have been easy to openly affirm this august Court and its members shouldn’t have allowed benefits for an unquestioned swindler who clearly had an attorney appear for him, as part and parcel to his unquestioned deceit on the Commission and our courts. With respect to the members of the Court, we wouldn’t metaphorically defer and deflect the duty of dealing with such fraud as the job of the legislature and not the courts.

 

In closing, we want our readers to understand Justice John McCullough brought his best to the bench every day of his 50-year-career. While we didn’t always agree with him, we remain confident he didn’t always agree with us—that is what creates the need for our judicial system. We had the highest respect for Justice McCullough as performed his sworn duties and handled his post. The lawyers and staff of Keefe, Campbell, Biery & Associates extend our deepest condolences to Justice McCullough’s family and friends across our state.

 

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Synopsis: Illinois Supreme Court recognizes the tort of “intrusion upon seclusion” and holds an employer liable for acts of an outside private investigator; analysis from Joseph D’Amato, J.D.

 

Editor’s Comment: We consider this a very important ruling for all Illinois employers and risk managers to be aware of. We are also confident surveillance operatives and investigators across the state should read this case. On October 18, 2012, the Illinois Supreme Court handed down what we believe to be an important decision for Illinois employers who use surveillance to investigate their workers.

 

In Lawlor v. North American Corporation of Illinois, 2012 IL 112530, issued October 18, 2012, Plaintiff Lawlor filed a claim against Defendant North American Corporation of Illinois (North American) for “intrusion upon seclusion” (more generically known as “invasion of privacy”), alleging her former employer hired investigators to obtain her private phone records.

 

The ruling indicates in 2005, Plaintiff Lawlor was working as a salesperson for Defendant North American when she accepted a position with Shamrock Companies, a North American competitor. North American became concerned Plaintiff was contacting its customers, possibly violating a non-competition covenant.

 

In order to investigate whether Plaintiff was communicating with its customers, North American hired a private investigator to obtain her phone records. North American provided the investigative firm with Plaintiff’s phone number, date of birth, social security number and other unique identifiers. The private investigator then engaged in a course of behavior the Court termed “pretexting.” In short, the private investigative firm used the unique identifiers provided to it by North American and pretended to be Lawlor in order to obtain her home phone records from AT&T and her cell phone records from U.S. Cellular. North American then used that information to determine whether Plaintiff had, in fact, contacted its customers.

 

Plaintiff asserted she “vomited,” suffered “anxiety,” changed her locks and installed an expensive home security system when she learned her phone records were accessed without her authorization. None of these facts were disputed at trial.

 

Prior to this decision the Illinois Supreme Court had never formally adopted the tort of intrusion upon seclusion, although all five Illinois Appellate districts adopted the theory of liability. In recognizing the tort, the Court adopted the definition given to it by the Restatement (Second) of Torts § 652B (1977). §652B states "One who intentionally intrudes, physically or otherwise, upon the solitude or seclusion of another or his private affairs or concerns, is subject to liability to the other for invasion of his privacy, if the intrusion would be highly offensive to a reasonable person."

 

North American did not argue Plaintiff’s privacy had not been violated. Rather, North American asserted it could not be held liable for the actions of its private investigative firm, as it was unaware how Plaintiff’s phone records were obtained. Furthermore, North American argued it had no control over the way its investigators obtained the material.

 

The Illinois Supreme Court agreed there was no direct evidence North American knew exactly how its investigators obtained Plaintiff’s phone records. However, the Court held by providing investigators with non-public information about Plaintiff (including her social security number and other unique identifiers) and asking them to obtain her phone records, a jury could reasonably infer North American was exercising control over the actions of its private investigators, thus creating a principal-agent relationship. As such, the Court reasoned North American could be held vicariously liable for the admittedly tortious actions of its private investigators.

 

We think this ruling holds important lessons for any Illinois employer utilizing the services of a private investigating firm, lest they face liability for the actions of their investigators.

 

      Be cognizant of giving out personal and sensitive employee information such as social security numbers and telephone numbers;

 

      Clearly consult with your investigators as to what types of activities they can lawfully engage in. Although it may seem obvious, make sure your investigators know it is now actionable to impersonate an employee in order to obtain their personal information, as doing so inevitably leads to a clash between your legitimate need for information and an employee’s protected privacy rights and

 

      Confirm your instructions and discussions with your investigative team in writing. Clear and concise written instructions may help shield you from liability in the event an investigator violates your explicit instructions and unreasonably infringes on the privacy rights of your employees. 

 

This article was researched and written by Joseph D’Amato, J.D. He can be reached for questions or comments at jdamato@keefe-law.com.

 

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Synopsis: Watch out employers with Fitness for Duty requirements!!! Wisconsin Appellate Court affirms an award of workers’ compensation benefits to an off-duty police officer injured doing push-ups in his basement.

 

Editor’s Comment: We consider the theory and ruling in the claim to be shocking and misguided. In a government WC setting, such cases again demonstrate how poorly governments continue to be treated in the WC arena—we assure our readers “global WC coverage” of any injury occurring while off work is going to greatly increase WI WC costs and may cause taxes to rise to pay for the new unexpected costs.

 

In City of Appleton Police Department v. LIRC and Nofzinger, No. 2011AP2008, Patrol Officer Michael Nofzinger alleged a rotator cuff injury as a result of performing push-ups while off-duty and at his own home. There was no true “accident,” the officer just felt a pull in his shoulder. He argued he was preparing for a mandatory physical fitness test which required him to perform this specific exercise. The Wisconsin WC Commission concluded the injury occurred in the course of Nofzinger’s employment as required by WIS. STAT. §102.03(1)(c).

 

This section of the Wisconsin Workers’ Compensation Act contains limited guidance regarding what constitutes “service growing out of and incidental to …employment”, but one of the few areas in which the statute provides additional guidance is in reference to an employee’s participation in “well-being” programs, events, or activities:

 

An employee is not performing service growing out of and incidental to employment while engaging in a program, event, or activity designed to improve the physical wellbeing of the employee, whether or not the program, event, or activity is located on the employer’s premises, if participation in the program, event, or activity is voluntary and the employee receives no compensation for participation.

 

§102.03(1)(c)3. (emphasis added). The WI Appellate Court noted the logical corollary is an employee is performing services growing out of and incidental to employment if the employee’s injury occurs while participating in a well-being program, event, or activity that is not voluntary or for which the employee is receiving compensation. The Court cited previous case law and noted when the applicability of this section is in question there is a three-part test and the court must ask if:

 

v  The employee is engaged in an activity designed to improve [the employee’s] physical well-being,

v  [The employee’s] participation is voluntary, and

v  [The employee] receives no compensation for participation.

 

Only if all three elements are met will the employer prevail. There was no serious dispute element one was satisfied as Office Nofzinger was participating in a well-being program or activity. The issue on appeal involved whether participation was voluntary. The Court upheld the Commission’s decision where it concluded Nofzinger’s push-ups were not voluntary and as such did not address whether he was compensated as all three of the elements must be met for the employer to prevail.

 

The pertinent facts which were not disputed are as follows:

 

v  Nofzinger was required to undergo a physical fitness test twice per year;

v  The test included a component measuring how many push-ups he could perform;

v  He received points for each component and a cumulative score;

v  If he failed to maintain an adequate score, he could be subject to disciplinary action; and

v  He was injured while performing a twelfth or thirteenth successive push-up in preparation for one of the tests.

 

It was held the act of performing push-ups was precisely the type of activity he was required to be tested on and failing to prepare would subject him to discipline. The Court further noted Nofzinger was required to participate in a physical fitness program and it was reasonable to conclude he was complying with this requirement when he was injured.

 

Please remember the challenge of an “at-home” injury is investigation. In this claim, we do not feel most folks would suffer a rotator cuff tear doing standard push-ups. Risk managers have to carefully investigate and document any claim where the event occurred in the home or away from the workplace.

 

We find the decision unsettling considering exercising at home or in one’s spare time is something each and every one of us should be doing for our general health. We point to the specific facts of this case and the particular section of the Wisconsin WC Act to hopefully avoid a ripple effect in expanding WC coverage for all injuries which may be found compensable. We assert Officer Nofzinger would make the same claim bowling, playing golf, shooting pool, any off-duty activity where he had a physical problem could possibly be alleged to now be compensable. If you are an employer requiring Fitness for Duty testing you should consider on-duty test preparation time and on-site preparation facilities to limit liability for off-site injuries when preparing for such tests.

 

This article was researched and written by Matthew Ignoffo, J.D., M.S.C.C. licensed in IL and WI who can be reached at mignoffo@keefe-law.com.

 

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Synopsis: Welcome aboard, Tim O’Gorman.

 

Editor’s comment: Keefe, Campbell, Biery & Associates proudly announce the addition of Tim O’Gorman, J.D. to our legal team. Last week, Tim was sworn in as an IL lawyer and will focus his practice on defense of folks like you who face the enormous challenge of keeping your company’s costs and reserves low in aggressively defending your workers’ compensation, general liability, employment law and motor vehicle defense. Tim is up for the challenge—feel free to contact him at togorman@keefe-law.com.

 

10-29-12; IL WC Reforms Help Premium Costs a Bit; New IL WC Dental Fee Schedule Posted; WARN May Be Needed to Change to Staffing Co and much more

Synopsis: Illinois WC Reform Results Not So Great but Hope for the Future Remains When PPP’s Start.

 

Editor’s comment: The State of Oregon WC Premium Rankings are out. Illinois is ranked as the 4th highest premium in 2012 rankings, pegged at 151% of the median states of Georgia & New Mexico. If you are keeping score, we moved from No. 3 in 2010 down to No. 4 and are now better than wildly expensive Alaska, Connecticut and California. Many of our readers are happy to hear things didn’t get worse and we have to work for more improvement in the future.

 

If you care about cutting WC premium costs, we invite you to attend the IL State Chamber’s Annual WC Conference on October 25, 2011 and see what President Doug Whitley and his top-notch staff and sponsors like KCB&A are doing to help improve our state for WC costs—send a reply for details on registration or surf to their website at: http://ilchamber.org/illinois-chambers-4th-annual-workers-compensation-conference/

 

One motivating factor for the 2011 Reforms to our IL WC Act was the annual WC premium rankings from the State of Oregon. Illinois law actually included a provision for our state to create competing rankings—doesn’t appear that is going to happen any time soon. Oregon’s every-other-year Workers’ Comp Premium Ranking by State is out and can be located on the web at:

 

http://www.cbs.state.or.us/external/dir/wc_cost/files/report_summary.pdf

 

This biannual report ranks the WC premiums of all 50 states and the District of Columbia. The workers' compensation premium rates used for the study are from January 1, 2012, or late 2011 depending on the state, so they do not appear to include any of NCCI's current recommended rate changes for various states.

 

Texas is by far most improved, jumping 26 spots to finish in the top 15. Many observers feel they will make the Top 10 best in 2014. Their WC premium improvement has been remarkable, and puts them on another level compared to the other big population states/centers.

 

Illinois WC made some changes last year but the biggest and best should have been the WC Preferred Provider Program or WC PPP option. Right now, the WC PPP option for Illinois employers is sort of like looking through the glass at the candy in a candy store—it is nice and shiny and smells great but you can’t touch it. Despite the fact our Governor signed the 2011 WC Reforms last June, they still haven’t approved the rules to allow implementation. We expect the final approval of PPP’s to hit your WC program in mid-December 2012 but certainly no later than January 2013.

 

IL Department of Insurance Terminology Changed

 

When the IDOI submitted its proposed WC PPP regulatory modifications, it updated or clarified the preferred provider program terminology.

 

Health Care Preferred Provider Program (HC PPP) Administrator

 

Formerly referred to as the Preferred Provider Program Administrator (PPA). The HC PPP is a new term for the current/traditional PPOs and PPAs, which applies to both group health and workers’ compensation without WC employer direction networks.

 

The IDOI already updated its website to reflect this change in terminology:

Approved Health Care Preferred Provider Program Administrators; if you click on this link you will find all of IL HC PPP Administrators.

Provisionally Approved Health Care Preferred Provider Program Administrators--"Provisionally approved" refers to previously approved companies with renewal applications submitted to the IDOI.

 

Workers’ Compensation Preferred Provider Program (WC PPP) Administrator

 

Created by HB 1698/Public Act 97-18. This term refers to the new workers’ compensation designation that allows employer direction into an IDOI-Approved WC PPP network. Please note simply by offering an approved WC PPP network, employers will cut their employees’ choice of healthcare providers in half.


Approved Workers’ Compensation Preferred Provider Program Administrators; if you click on this link, you will find all of the IL WC PPP Administrators.

IWCC’s WC PPP Notification Form

 

For any employer with a designated IDOI-approved WC PPP, an employee must receive the IWCC’s official Notice of Preferred Provider Program for Workers’ Compensation Medical Care. That official form is available on the IWCC website in either English or Spanish. All IWCC forms, including optional WC PPP notification forms, are located in the Forms Section of the IWCC website.

Our recommendation for the top HC PPP or WC PPP source is Guy Swanson or Dave Kolb at HFN, Inc. They have been using a similar WC PPO concept for 25 years or more and they should be able to ramp that up quickly and smoothly to provide WC PPP services for your organization, once the rules are approved. If you need contact information, send a reply or simply surf to their great website at www.HFNInc.com.

 

We appreciate your thoughts and comments. Please do not hesitate to post them on our award-winning blog.

 

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Synopsis: IL WC Dental Medical Fee Schedule now posted—IL WC adjusters should note the effective date for covered dental services starts on 6-20-12.

 

Editor’s comment: In the new tradition of globally controlling WC Medical costs, we salute our IWCC for posting a new dental schedule for folks who injure their teeth at work and require related dental care.

 

The IWCC updated its website this week with the effective date of the new schedule. The IWCC dental fee schedule will apply for all dates of service on or after June 20, 2012. 

Their fee schedule for dental services covers work-related dental services provided on or after June 20, 2012. Bills should be paid at the lesser of the actual charge or the WC dental fee schedule amount.

As part of the changes instituted by HB 1698/PA 97-18, the Illinois legislature directed the Illinois WC Commission to create this dental fee schedule. It is our understanding the schedule came together due to the combined work of the

 

      IL Workers' Compensation Medical Fee Schedule Advisory Board and

      Illinois State Dental Society who obtained and analyzed needed data.

 

We are certain attorneys on both sides will want to bring dental fee schedule-coded dental bills to disputed hearings. If you need assistance in getting dental bills coded, send a reply.

 

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Synopsis: Be Fore-“WARN”-ed; Proper WARN Notices may be a Prudent Choice for HR Managers Switching to Staffing Companies.

 

Editor’s comment: We recently saw this class-action lawsuit while looking up other things and wanted to share it with our readers who may be considering changing your workforce.

 

On July 16, 2012, workers at Progressive Gourmet in Wilmington DE were told they had to reapply for their jobs through a temporary employment agency that would not provide health insurance and other benefits they received as former employees of the specialty food-distribution company. Those who refused to agree were quickly let go. In all, more than 70 workers or about one-third of the company's workforce lost their jobs due to their refusal to re-apply.

 

These claims are now part of a class-action lawsuit filed in U.S. District Court in Boston, alleging Progressive Gourmet violated the federal Worker Adjustment and Retraining Notification Act or WARN by not giving employees 60 days' notice of the layoff. The workers also filed a complaint with the National Labor Relations Board saying Progressive Gourmet's move was aimed at thwarting employees' efforts to form a union.

 

The Worker Adjustment and Retraining Notification Act of 1988 (WARN) is a United States labor law which covers employees by requiring most employers with 100 or more employees to provide sixty-calendar-day advance notification of plant closings and mass layoffs. Employees entitled to notice under the WARN Act include managers and supervisors, hourly wage, and salaried workers. The WARN Act requires notice also be given to unions, if any,  the local chief elected official (i.e. the mayor) and the state dislocated worker unit. Damages can be significant but are avoidable if the appropriate notices are provided. Our readers should also understand the cost and uncertainty of defending these actions in Federal Court can be moderately high.

 

The claims in the lawsuit may represent a trend in which many employers have increasingly used staffing companies to cut costs. This may be one of the first times a U.S. company has required all existing employees to reapply as temporary workers in such a transition. In other similar settings, workers who were asked to reapply with the staffing company were guaranteed a job for stated period with comparable salary and benefits. This may be a strong alternative to avoiding the raucous litigation and public relations impact of such a change.

 

KCB&A has no interest in the lawsuit reported above and we do not intend to affect its outcome. We appreciate your thoughts and comments.