3-30-15; Transitional-Light Work Still is Alive in IL WC; Brad Smith, JD Analyzes an Important Pregnancy Discrim Ruling by SCOTUS; Kleptocracy Abounds in IL and more

Synopsis: Transitional/Light Work Programs are Alive and Well in Illinois Workers’ Comp.

 

Editor’s comment: We received an email from a reader at an IL WC insurance brokerage who had been advised by a solid insurance adjuster that an IL employer can’t take any action if an injured worker refused light work a doctor certified was within his/her medical restrictions. With respect to the adjuster, we wholly disagree with the advice being provided. It is our assumption they are misreading the Interstate Scaffolding or Matuszcsak rulings. We encourage all of our readers and anyone you know to send such inquiries/legal requests via email to the defense team at KCB&A and we are happy to provide free legal advice and research as we are doing in this article.

 

In both of the rulings above, injured workers on light duty committed acts that were considered to be criminal in nature. For example, Petitioner Matuszcsak admittedly stole cigarettes from his employer. Neither claimant was convicted of a crime but there was no dispute they did the inappropriate acts. In the contentious and oft-criticized rulings, the employers fired the workers and our courts required them to be paid TTD until they reached maximum medical improvement. This remains a very controversial concept in IL WC because it is felt to reward criminal behavior.

 

However, neither worker “refused light work” and we maintain the legal position any worker who has light work available has to perform the light work or they are subject to normal discipline leading to termination consistent with your normal personnel policies. The workers in the rulings mentioned above were arguably “blocked” from participating in light work due to termination for their criminal actions wholly unrelated to their injuries. In both rulings, the courts consistently maintained the workers would have had to participate in light work if such work were continuously available.

 

Interstate Scaffolding states, in pertinent part:

 

Benefits may also be suspended or terminated if the employee refuses work falling within the physical restrictions prescribed by his doctor. See 820 ILCS 305/8(d) (West 2004); Hartlein v. Illinois Power Co., 151 Ill. 2d 142, 166 (1992); Hayden v. Industrial Comm’n, 214 Ill. App. 3d 749 (1991) (TTD justifiably terminated by the employer, under the Act, when the injured employee was unwilling to cooperate with vocational placement efforts).

 

If this wasn’t a rule, transitional/light work programs in Illinois workers’ comp would have ended. Basically, no IL employer would be able to have an enforceable RTW program. In contrast, thousands of IL employers have them and they are effective in getting folks back to light and then full work. What remains confusing about the legal rule outlined by our highest court is the concept the worker is entitled to TTD until they reach maximum medical improvement or MMI—what if the worker has returned to work prior to MMI? What if the doctors have recommended transitional/light work programs to insure the worker attains MMI as part of the medical protocols? If that happened, it sets up the confusing situation in which TTD might be due until MMI but the employer would be entitled to credit for salary or wages paid.

 

Either way, in any situation where a worker is refusing light work or is blocked from light work due to termination for any reason, as a backup claims position to insure the employer doesn’t have to pay TTD at some later time, it is not a bad idea to informally confirm by doing a weekly web search to document there is other light work at other companies in the labor market around the lead employer—we are happy to discuss that approach further.

 

We appreciate your thoughts and comments. Please post them on our award-winning blog.

 

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Synopsis:  U.P.S. Worker’s Pregnancy Discrimination Suit Reinstated by SCOTUS. Analysis by Bradley J. Smith, J.D.

Editor's Comment: In Young v. U.P.S., a pregnant U.P.S. worker’s doctor recommended she avoid lifting anything heavy due to her multiple miscarriages in the past. When she requested light duties to accommodate those restrictions, U.P.S. was not amenable to those restrictions and placed her on an unpaid leave. 

Thereafter, Peggy Young, sued under the Pregnancy Discrimination Act (“PDA”), which specifies Title VII’s prohibition against sex discrimination applies to discrimination “because of or on the basis of pregnancy, childbirth, or related medical conditions.” The PDA’s second clause says employers must treat “women affected by pregnancy . . . the same for all employment-related purposes . . . as other persons not so affected but similar in their ability or inability to work.” SCOTUS looked at the latter provision to determine whether it applies in the context of an employer’s policy that accommodates many (including, on-the-job injuries), but not all, workers with non-pregnancy related disabilities. 

UPS was granted summary judgment by the Federal District Court holding, inter alia, Young could not make out a prima facie case of discrimination under the landmark ruling in McDonnell Douglas. Particularly, the District Court found Young’s purported comparators (employees with on-the-job injuries, losing licenses under DOT, or ADA accommodations) were too different to qualify as “similarly situated.” Subsequently, the United States Court of Appeals for the Fourth Circuit affirmed the District Court’s ruling. Judge Allyson Duncan of the Fourth Circuit wrote, “One may characterize the U.P.S. policy as insufficiently charitable, but a lack of charity does not amount to discriminatory animus directed at a protected class of employees.”

On a writ of certiorari, SCOTUS vacated the decision granting new life to Young’s case. The ruling by SCOTUS reasoned a plaintiff may reach a jury on this issue by providing sufficient evidence an employer’s policies impose a significant burden on pregnant workers, and the employer’s “legitimate, nondiscriminatory” reasons are not sufficiently strong to justify the burden, but rather give rise to an inference of intentional discrimination. SCOTUS indicated Plaintiff might use circumstantial proof to rebut an employer’s apparently legitimate, nondiscriminatory reasons for its adverse action. Ultimately, SCOTUS reasoned the record demonstrated Young created a genuine issue of a material fact as to whether UPS provided more favorable treatment to at least some employees whose situation cannot reasonably be distinguished from hers. SCOTUS left the Fourth Circuit to determine on remand whether Young also created a genuine issue of a material fact as to whether UPS’ reasons for having treated Young less favorably than other non-pregnant employees were pretextual.  SCOTUS reinstated the claim with a 6-3 majority and Justice Scalia and Justice Kennedy filed dissenting opinions. Justice Scalia’s dissent cautioned the Court’s opinion blurred the lines between a claim brought as disparate impact versus a disparate treatment. Additionally, he warned the Court’s opinion caused unnecessary confusion with the McDonnell Douglas standard.

Regardless, the Illinois legislature has “spoken” on this topic with its recent amendments to the Illinois Human Right Act. Specifically, Illinois passed the Pregnancy Accommodation Act (a.k.a. the “Pregnancy Fairness Law”). This Act is more inclusive than the federal PDA as it applies to employers employing one or more employees and further applies to full-time, part-time, and probationary employees. Notably, inter alia, the Act provides an employer providing light duty to other types of non-pregnant employees, creates a rebuttable presumption the accommodation does not impose an undue hardship on the employer. In other words, if your employee is injured on the job, and you provide light duty to accommodate that employee, it is presumed that you will do the same for a pregnant employee, and failure to do so will create a presumption of discrimination.  

In order to stay out of the Federal and State Courts under the federal PDA or state PAA, employers need to implement and engage in an ongoing interactive process and also accommodate pregnancy-related conditions if they are accommodating similar restrictions through light duty positions with their on-the-job injured employees. The Young opinion allows an employee arguing she was discriminated under the PDA to look to other employees with on-the-job injuries as comparators to demonstrate a prima facie case under the McDonnell Douglas burden shifting test.

The research and writing of this article was performed by Bradley J. Smith, J.D. Bradley can be reached with any questions regarding the Illinois Pregnancy Accommodation Law, Title VIII, employment law, and general liability defense at bsmith@keefe-law.com.

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Synopsis: Illinois May Be a Land of Kleptocracy Which is Quietly and Surely Bankrupting Our Governments.

 

Editor’s comment: We keep seeing this concept play out over and over. We define ‘kleptocracy’ to occur when government workers legally find methods to use or “game” the system to feather their beds in a fashion that can be shocking to taxpayers. The ‘klepto’ part in the term isn’t truly accurate, as it implies the workers are stealing—we emphasize our position, the workers aren’t stealing, they are just getting very expensive benefits we don’t feel taxpayers should have to pay. We just saw legislation being considered to allow Illinois municipalities to file for bankruptcy—rulings like this are one reason such extreme measures are being considered.

 

In Vaughn v. The City of Carbondale, our IL Appellate Court, Fifth District found a Carbondale police officer bumped his noggin getting into his patrol car to answer the radio. We have no idea how a bump on the head could lead to a lifetime line-of-duty disability pension and the decision doesn’t fully address that issue. However, the patrol officer wanted lifetime family medical coverage asserting his injury occurred responding to an emergency. There is no indication in the record the radio call was due to an actual emergency—the patrol officer was simply answering his radio.

 

The unanimous Appellate Court majority ruled as any typical radio call from police dispatch was one means to notify officers of emergency, it then became the officers' duty to respond to dispatch calls in timely manner in case it is an emergency. Thus, they ruled the officer's injury was incurred as a result of his response to what he reasonably believed was an emergency. With respect to the members of this court, we cannot disagree more. We also point out this ruling provides an enormously expensive lifetime benefit. In our view, this Appellate Court is now ruling basically everything a police officer or firefighter does is in “response to an emergency.” The “emergency” in this one was reaching into his car to answer a dispatch call that clearly wasn’t an emergency. By the theory used in this ruling, a police officer tying their shoes, putting on their hat or buttoning their shirt is acting “in response to an emergency.”

 

Please start with the fact a police officer or firefighter don’t have to be fully disabled to be entitled to lifetime line-of-duty disability benefits. Our IL Supreme Court ruled “catastrophically injured” means the officer simply has to be disabled from working as a police officer or firefighter. They can have post-employment jobs that make more money than they made while working. We consider that whole approach to be kleptocratic. On top of that, we are now seeing the courts further “bend” the rules to provide not only lifetime benefits for officers who can work but also guarantee lifetime family medical coverage to be paid 100% by taxpayers. The annual added cost of rulings like this is about $30K a year for one officer for this year—that cost continues to climb as health care premium costs rise. The cost of rulings like this to Illinois municipalities is well into the tens of millions and could eventually be into the billions if enough Illinois law-enforcement officials and firefighters claim it.

 

We appreciate your thoughts and comments. Please post them on our award-winning blog.

 

3-23-15; IL Gov't Refusal to Offer Light Work under IL Workers' Comp - A Secret Scandal; Shawn R. Biery on Important Jurisdiction/Lien Ruling; IWCC News/Notices and more

Synopsis: Government Refusal to Offer Light Work Under IL Work Comp – A Secret Scandal for Springfield to Address

 

Editor’s comment: Before we start raising taxes, someone please tell us we are going to first run all IL government(s) better.

 

In brief, we ask legislative action be taken in Springfield to investigate this secret scandal and draft/pass legislation requiring all IL government bodies to have light work programs immediately put into place. Please also note these government bodies are large employers, so the State’s overall workers’ compensation premium measurements are skewed due to their continued mismanagement—on a national level, this projects a poor business environment. Please further note ITLA can’t blame these high WC payouts on “greedy insurance companies”—these monies are misspent by government workers mismanaging return to work issues on accepted WC claims. 

 

Right now, the State of Illinois, City of Chicago, Chicago Park District and Chicago Transit Authority are paying literally hundreds of millions of dollars in workers’ compensation benefits. The State has to be paying over $150M a year in workers’ comp benefits. The City is paying over $100M each year and the Chicago Transit Authority and Chicago Park District are paying over $50M per year. It is not a coincidence all those government bodies are awash in red ink. If light work programs were required for all state and local gov’t bodies by our IL General Assembly we assure our readers the savings to taxpayers would be immense. We further assure you with all the conviction possible, other than California, no U.S. State Government or City the size of Chicago pays anything like the amount we routinely waste on workers’ compensation benefits.

 

Our sources indicate none of those government bodies are providing light work for their injured employees. To our understanding, Cook County started a light work program under their current chairperson—she had to argue with some of the elected county officials to do so. To our further understanding, the long-time alderman in Chicago who runs the City’s WC “defense” system will not provide light work for City employees unless legislation in Springfield requires it. The Chicago Tribune has asked and asked him about this issue and they are routinely ignored.

 

Should Your Tax Dollars Be Used for Funding of Political Work by Former Gov’t Workers Now on TTD and Lifetime TPD?

 

One reason light work isn’t offered to state and local government workers is to insure the workers are indebted and forever beholden to their political patrons. Once on never-ending TTD or lifetime TPD, the workers remain loyal political hacks for the folks endlessly giving them our tax dollars. Would you do sporadic political work for someone who would insure you are paid for years and years not to have to perform real day-to-day work? Could this be a reason there hasn’t been a Republican Party in Chicago in several generations? How can you have a two-party system if the party-in-power can pay former workers the rest of their lives to perform political tasks when the occasional elections occur?

 

There is No Question Light Work is a Major WC Money-Saver; How Can Anyone Dispute That?

 

Light work as a path to return workers to some work and progressing back to their former jobs is an unquestioned money saver in workers’ comp claims across the globe. We know of no reason a business or government wouldn’t provide light work or early return to work for their injured employees—it is a complete no-brainer. As taxpayers, we assure you our money is being thrown away by the barrel. Thousands of articles and books on the topic are out there on the web. If you want samples, send a reply.

 

We also feel light work programs are, to some extent, mandated by the Americans With Disabilities Act—every injured worker we are talking about in this article has permanent restrictions and is kept out of the workplace on an indefinite basis. The ADA requires “reasonable accommodation for qualified individuals with a disability.” An injured worker with restrictions precisely meets that definition but none of these governing bodies offer “reasonable accommodation,” they simply continue to pay tax-free weekly TTD and, as you will read below, weekly total and permanent disability benefits indefinitely. The government workers don’t file EEOC charges because they are being paid so well to do nothing.

 

Here is How This IL Gov’t Workers’ Comp Catastrophe is playing out:

 

For example, a City Streets and Sanitation worker gets injured—let’s say they have a routine shoulder surgery. They are given a 40lb lifting restriction. They are allowed to stay off work and on temporary total disability (TTD) indefinitely, even though there are numerous well-paid administrative, dispatch or “no touch” truck driving jobs they could be switched to perform. There are workers still on TTD for 3, 5, even 10 years—they are no longer receiving any medical care, they are simply allowed to stay off work  and keep getting paid. Light-duty jobs open up and are filled by other workers when the folks on TTD could be put into such work. In many settings, temporary workers are used in open positions instead of the injured worker on restrictions.

 

After several years on TTD, the governments above then will make a decision on:

 

1.    Total and permanent disability under the goofy “odd lot” theory. This concept was judicial legislation that comes from an IL Supreme Court ruling named E.R. Moore v. Industrial Commission. The main reason we call it judicial legislation is the words “odd lot” don’t appear in the IL WC Act and they are not defined in any legislation. The Supreme Court said an “odd lot” total and permanent disability is someone who is injured at work with restrictions, hasn’t returned to work and can’t find an alternative position anywhere else. When those three factors are present, it is incumbent on the employer to either offer an alternate job or demonstrate the availability of alternate work. The State of Illinois, City of Chicago, Chicago Park District and CTA, never do that. We assure you all governments outlined above have numerous positions open up every year. They could take folks off TTD/TPD, train them and put them in such jobs to save taxpayers money and get their people back to gainful employ. They almost never, ever do so. We are told the State of IL is paying several million in weekly T&P benefits that could be stopped right now, if the workers being paid lifetime benefits with COLA increases were brought back to available light jobs.

 

2.    The other theory is “fake” wage differential settlements. Under Section 8(d-1) of the Act, an employer is required to provide lifetime wage loss differential benefits to someone who can return to lower-paid light work. When a worker is left off work for years, at some point, the government agency or its outside WC administrator agree the employee could locate a minimum wage job and will provide a significant lump sum settlement by discounting the overall lifetime liability. The reason we call it a “fake” wage diff settlement is the worker doesn’t have to actually get a job, the government agency will just assume they can only get a minimum wage job. We were advised the City of Chicago is paying such settlements in amounts like $250K-$350K to workers who haven’t had a single surgical intervention and have been receiving years of TTD. Once the worker settles and gets the giant check, they return to work outside city gov’t wherever they want at the highest pay they can find.

 

Please note this scandal is not common to almost all Illinois governments, just the biggest ones. For a single and exceptional municipal example, the City of Naperville has a very aggressive return to work program and does everything they can to get an injured worker back into some sort of position as soon as they are medically able to do so. Here is a shining example of their long-time and great focus on this issue: http://www.usfa.fema.gov/pdf/efop/efo28156.pdf

 

To investigate and develop the extent of this continuing and secret scandal, we would suggest someone send a FOIA request to the various government agencies to ask:

 

·         How many pending workers’ compensation claims do you have?

·         Do you mandate a light work/return to work program for all agencies? If not, why not?

·         How many of your workers have been on TTD for over a year?

·         How many of your workers are receiving weekly lifetime “odd lot” total and permanent disability benefits?

·         How many new workers were hired by you in the last year?

·         What new or open jobs were filled?

·         Were the injured workers considered for any of the open positions?

·         What current efforts are being made to return all injured workers to modified or limited duty, and/or retraining for other available positions?

·         How many WC settlements over $200,000 were made by your government in the last two years? What was the basis for such settlements?

 

We appreciate your thoughts and comments. Please post them on our award-winning blog.

 

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Synopsis: IL Appellate Court nails another one in confirming IL WC Commission is the proper and exclusive venue to determine questions with regard to workers’ compensation benefits in Illinois. Analysis by Shawn R. Biery, J.D., MSCC.

 

Editor’s comment: The 5th District Appellate Court ruled the Illinois Workers' Compensation Commission, not the Circuit Court, has exclusive jurisdiction to decide whether a claimant who settled a third-party lawsuit resulting from a work related accident may also pursue workers' compensation benefits from his employer after resolving the initial lien.

 

In Bradley v. City of Marion, http://www.state.il.us/court/Opinions/AppellateCourt/2015/5thDistrict/5140267.pdf Plaintiff Bradley had been injured in an automobile accident while working for the City of Marion and initially sought recovery from the motorist who arguably caused the accident. He settled that case for $650,000 and as part of the settlement Bradley reimbursed Marion $190,112.89 for their current workers' compensation benefits it had paid and voluntarily dismissed his workers' compensation claim after Marion and its insurer, the Illinois Public Risk Fund, released the existing lien in writing. Bradley then filed a new workers' compensation claim after the City and its insurer released their lien and the City argued Bradley waived his right to further workers' compensation benefits when he settled the third-party suit and received the lien release.

 

Bradley filed a complaint for declaratory judgment at the Williamson County Circuit Court with his argument there was no waiver or closure of workers' compensation benefits without approval by the Workers' Compensation Commission—and the IWCC had not approved any waiver.

 

Marion/Public Risk filed a counterclaim and requested declaratory judgment for breach of contract and also argued Bradley waived his right to benefits. The trial court decided there was no jurisdiction to consider the disputes since benefits under the Workers' Compensation Act were the sole function of the Commission who had exclusive jurisdiction and the Appellate Court affirmed there was no jurisdiction for the same reason.

 

Both sides of the bar can understand the frustration of a case where there is a third party issue, and with a settlement for $650,000 which included reimbursement of $190,112.89 for benefits for WC benefits paid, it seems reasonable for Marion and its defense counsel would have considered the WC claim ended with the voluntary dismissal. Realistically, in hindsight they would have been much better with a $1 WC settlement contract along with return of the lien amount. The Act is very clear in Section 23 in noting a claimant “cannot waive the amount of compensation which may be payable to the employee except after approval by the Commission”. 820 ILCS 305/23.

 

There appears to be a strong argument the lien release “contract” has a substantial issue and no proverbial “meeting of the minds” occurred based upon the significant amount achieved over the lien amount and lack of incentive for Marion to leave additional benefits open and it would appear the best result for each party would be for rescission of that agreement and either some final settlement approved by the IWCC or ongoing benefits to be credited at 75% until the third party settlement value is exhausted. We will report on the outcome of the claim as it is determined.

 

One final thought—there have been a plethora of new actions in Circuit Courts in Illinois attempting to circumvent the IL WC Act and directly sue industry components with attempts at

 

Ø  “Assignment of rights” (which is specifically not allowed for certain portions of WC claims) or

Ø  Interest on unpaid medical bills.

 

This is generating anti-business and anti-insurance carrier/TPA litigation outside of the IL WC Commission jurisdiction. For those reasons, it is good to see the Appellate court confirm the exclusive jurisdiction of the Commission for benefits under the IL Workers' Compensation Act.

 

This article was researched and written by Shawn R. Biery JD, MSCC who can be reached at sbiery@keefe-law.com with any comment or question.

 

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Synopsis: IL WC Housekeeping News and Notices.

 

Editors’ comment: Effective April 1, 2015 Arbitrator Friedman will take over the docket previously assigned to now-IWCC-Chair Fratianni in Zone 5 and Arbitrator Hegarty will take over the docket previously assigned to new Commissioner Luskin in Zone 6. All documents and correspondence related to these dockets should be forwarded to their attention effective immediately.

 

Please be advised New Lenox Village Hall will be closed on April 3, 2015 in observance of Good Friday. The status call scheduled for Friday, April 3rd will be moved to Monday, April 6th. All trial dates will remain unchanged. Notices will be mailed to all interested parties.

 

Please be advised the Woodstock hearing site will be closed on April 3, 2015 in observance of Good Friday. The status call will remain on Wednesday, April 1st, and there will be an additional trial day on Thursday, April 2nd.

3-16-15; We Now Need Anti-Assignment Clauses in IL WC Settlement Ks by Brad Smith; Legal Update on Release/Resignations by Brad Smith; Dan Boddicker on Iowa Bad Faith Decision and more

Synopsis: Head Off the Latest IL WC “Sneak Attack” on Settlement Contract Finality—You Now Need an Anti-Assignment Clause! Analysis by Bradley J. Smith, J.D.

Editor's Comment: We recently saw a revoltin’ development where a self-insured IL employer settled a fairly simple IL WC claim for less than $1,000. Having settled the matter, everyone assumed the claim was paid and closed. The next thing we saw was a Circuit Court lawsuit by a medical provider in the settled WC claim for thousands of new dollars against the employer and third party administrator. The medical provider claimed they have “standing to sue” because the patient signed an “assignment of their rights” to allow the provider to try to collect directly from the employer and outside the IL WC system. In our view, on the first office visit, the “pro-assignment” medical providers are giving the patient a bunch of documents to complete and sign like a medical history, HIPAA-GINA release and they sneak in an assignment of the rights of the employee to collect the medical bills in Circuit Court if they remain unpaid at the time of WC settlement. We would assume very few injured workers would have the slightest idea of the legal nature of the document they are signing.

When we first saw this new phenomena, the defense team at KCB&A was able to extricate our client, the TPA from the Circuit Court mess. We understand the employer settled with the medical provider for a substantial amount of money but much less than the actual medical bills being claimed. Their general counsel is a very solid and veteran attorney who immediately understood defending the claim would cost more than the eventual settlement amount. Please note the company still had to pay the Circuit Court appearance fee and other court costs, along with obtaining counsel to defend—we assume there is no one in the IL WC defense industry who would like to defend such a claim after you think you have put the WC claim completely to bed via settlement. We also aren’t sure how the insurance industry is going to handle/cover such claims, as they are only supposed to be insuring for WC exposure at the IL WC Commission and not this new and odd liability in the Circuit Courts.

But the fact the litigation started at all is what we want the IL WC defense community to understand, anticipate and take steps to prevent. In our view, these recent developments should require you to explicitly include a clear anti-assignment clause in your IL WC settlement contracts to protect against direct civil lawsuits by workers’ compensation benefit providers in a post-settlement setting.

We feel all IL workers’ compensation defense attorneys have to become vigilant and insure they are using “air-tight” workers’ compensation settlement contracts. Particularly, the recent issues with Petitioners putatively assigning (whether knowingly or unknowingly) their workers’ compensation benefits has come to the forefront. In our view, these purported assignments of benefits are clearly in violation of the intent and purpose of Section 21 of the IWCA. Nonetheless, to fully protect our clients, KCB&A is now incorporating language in our workers’ compensation settlement contracts confirming there has been no assignment of any workers’ compensation benefits by Petitioner and further requiring an explicit agreement there will be no assignment of any potential current or future payments in violation of the IWCA.

Under Section 21 of the IWCA, “[n]o payment, claim, award or decision under th[e] Act shall be assignable or subject to any lien, attachment or garnishment….” Obviously, due to the clearly delineated provision of the IWCA, workers’ compensation benefits are ostensibly non-assignable. Regardless, it has recently come to light in Illinois the liberal Circuit Court Judges are outlining differing opinions related to the non-assignability of workers’ compensation benefits. Although some Judges agree, others are allowing civil claims from private medical providers to continue against employers, insurers, and/or Third-Party Administrators.

Despite the ostensible invalidity of any procured assignments, we feel language has to be included in IL WC settlement contracts delineating the non-assignability of any past or present benefit, and further to obtain confirmation from Petitioner that they have not and will not assign any of their workers’ compensation benefits in aberration and contradiction of the IWCA. Clearly, as a workers’ compensation settlement is generally reached to close an open claim, or to lock-in any further benefits solely for Petitioner, something must prevent them from assigning their rights under the IWCA. Although it is highly likely Illinois courts will eventually catch on to these arguably subversive tactics, to anticipate and counteract them, your defense attorneys must understand and implement certain provisions into the workers’ compensation settlement contract to seek to protect against these types of collateral civil claims. 

Moreover, to properly protect against any purported assignments in violation of the incorporated anti-assignment clause, there should be further language that in the event an invalid assignment was made and any claim is brought against the employer, insurer, and/or Third-Party Administrator under the arguably void assignment, Petitioner and/or his attorney should have the duty to indemnify, hold harmless, and defend the Employer/Respondent if a Circuit Court claim is filed. These indemnification clauses may help to allocate risks of future lawsuits for the workers’ compensation benefits that were supposedly settled within the workers’ compensation litigation. We have sample language for the IL WC industry to consider.

The research and writing of this article was performed by Bradley J. Smith, J.D. Bradley can be reached with any questions regarding this article, workers’ compensation, employment law, and general liability defense at bsmith@keefe-law.com.

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Synopsis: Getting Rid of Trouble-Makers 101. More Great Legal Analysis by Bradley J. Smith, J.D.

Editor’s comment: We are concerned your Release/Resignation Agreements May Not Be Compliant with OWBPA. Many of our defense clients want us to settle the WC claim and simultaneously make sure Claimant

·         Leaves their employ and

·         Doesn’t file any other claims against the client at the EEOC, Illinois Department of Human Rights, Circuit Court retaliatory discharge claims, union grievances or anything else.

One growing concern as our working population keeps aging are the additional rights and benefits that may be due to workers who are over 40 years of age. Such workers can file age discrimination claims if they feel they were canned/let go due to their age. To obtain a valid release of an age discrimination claim you must comply with certain requirements under the OWBPA. In 1990, Congress amended the Age Discrimination in Employment Act (ADEA) by passing the Older Workers Benefit Protection Act to establish specific requirements for a “knowing and voluntary” release of ADEA claims. Particularly, the OWBPA requires seven factors be present within the release/resignation agreement to be considered a “knowing and voluntary” release of any cognizable ADEA claims.

Those factors are:

1.    A waiver must be written so it can be clearly understood by individuals at the level of comprehension and education of the average individual eligible to participate. In addition, the waiver must not mislead, misinform, or fail to inform participants and must present any advantages or disadvantages of agreeing to the waiver.

2.      A waiver must specifically refer to rights or claims arising under the ADEA by name. 

3.      A waiver must advise the employee in writing to consult an attorney before accepting the agreement.

4.      A waiver must provide the employee at least 21 days to consider the offer.  The 21-day consideration period runs from the date of the employer’s final offer. If material changes are made to the final offer, the 21-day period starts over.

5.      A waiver must give an employee 7-days to revoke his or her signature. The 7-day revocation period cannot be changed or waived by either party for any reason.

6.      A waiver must not include rights and claims that may arise after the date on which the waiver is signed.

7.      A waiver must be supported by consideration in addition to anything to which the employee is already entitled. 

Unfortunately, if a waiver of an ADEA claim fails to meet any of the aforementioned requirements, it is invalid and unenforceable. Consequently, it is recommended to include appropriate language in the release/resignation agreement compliant with the requirements of the OWBPA so that you can obtain a full release of a claimant’s potential ADEA claims. Unfortunately, an individual cannot waive his or her right to file a discrimination charge with the EEOC or to participate in an EEOC investigation. Consequently, an executed release/resignation agreement cannot validly prohibit an individual from exercising his or her rights to file a charge or to participate in the investigation. 

Even when the release/resignation agreement is acquiescent with the OWBPA, a waiver of ADEA claims, like waivers of Title VII and other discrimination claims, will be invalid and unenforceable if an employer used fraud, undue influence, or other improper conduct to coerce the employee to execute the waiver. Numerous courts have found ADEA waivers invalid for failing to meet just one of the many statutory requirements, especially when groups or classes of employees are involved. 

The professionals at Keefe, Campbell, Biery & Associates, LLC recommend our clients consider OWBPA compliant language when seeking a release/resignation agreement. Missing one of the 7 factors outlined above could be fatal to obtaining a valid waiver of any potential age discrimination claims. The research and writing of this article was performed by Bradley J. Smith, J.D. Bradley can be reached with any questions regarding employment law and general liability defense at bsmith@keefe-law.com.

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Synopsis: Iowa WC Insurers take notice! Multi-Million Dollar Bad Faith Verdict Resulting from an Iowa Workers’ Compensation Denial. Analysis by Daniel J. Boddicker, JD. who is open for our KCB&A defense business across the great State of Iowa!

Editor’s Comment: On February 11, 2015 a Pottawattamie County, Iowa jury returned a verdict including $25 million in punitive damages in a bad faith claim. In Thornton v. American Interstate Insurance Company, Plaintiff Toby Thornton (“Thornton”) filed to recover damages against American Interstate Insurance Company (“American”) for bad faith and abuse of process following American’s actions in defending Thornton’s Iowa workers’ compensation claim. Thornton was working as a truck operator for Clayton County Recycling on June 25, 2009 and he was injured when his truck rolled and crushed the cab with him inside. Among his injuries Thornton suffered several vertebral fractures, leaving him paralyzed from the chest down, entirely without the use of his left hand and with only minimal use of his right hand. Soon after the date of accident American set aside a lifetime reserve based on permanent total disability (“PTD”) for Thornton’s claim. American calculated maximum statutory weekly benefits and began weekly payments dating back to June 26, 2009. Weekly payments continued until June 6, 2014, when American paid Thornton’s partial commutation in a lump sum.

In Iowa an insurer acts in bad faith when it (1) has no reasonable basis for denying an insured’s claim and (2) knew or had reason to know its denial or refusal was unreasonable. The parties disagreed over whether Thornton’s claim was denied. American accepted the claim and paid weekly benefits, without designating Thornton as a PTD, and without agreeing to stipulate to a partial commutation of Plaintiff’s benefits. Before the Commissioner in the workers’ compensation claim, American denied Thornton’s PTD petition, moved to reconsider the adverse finding, and later denied a partial commutation of Thornton’s benefits was in his best interests.

Thornton identified four different instances of denial: (1) failure to classify Thornton as permanently totally disabled even while providing weekly payments, (ii) failing to agree to a partial commutation of benefits, (iii) denying both PTD and a partial commutation at the workers’ compensation trial, and; (iv) moving for reconsideration of the Commissioner’s adverse finding. On summary judgment the court found American took a course of action which first challenged and ultimately denied Thornton’s PTD status and eligibility for partial commutation, and if successful would have reduced or cancelled Thornton’s benefits. The court held Thornton’s claims were denied.

On the issue of whether a reasonable basis existed for denying Thornton’s claims, the court noted to avoid bad faith liability an insurer may only challenge those claims that are “fairly debatable,” and may only delay commencement of benefits for a period that is “necessary for the insurer to investigate the claim.” The court noted either will establish a reasonable basis for denial or delay, but that reasonable basis must exist at the time of the denial. American contended its denial of Thornton’s claim for PTD benefits was reasonable because: it paid weekly benefits while investigating and later challenging the claim; it had a right to file an answer; it was investigating the possibility of vocational rehabilitation for Thornton; no bad faith penalty benefits were awarded at the underlying workers’ compensation trial and it wished to force a reasonable settlement. The Court held none of the arguments established a reasonable basis for challenging Thornton’s claim.

The court took notice American was made aware of the nature of Thornton’s catastrophic injuries almost immediately. American investigated whether its liability could be offset by training Thornton to perform new or modified job tasks. American sought the advice of three practitioners none of whom indicated Thornton was a candidate for vocational rehabilitative services. The court further noted American was informed by its counsel Thornton was both clearly eligible for PTD benefits and a partial commutation of his benefits would very likely be found to be in his best interests. Prior to trial, American learned Thornton would not be released for vocational rehabilitative services by his insurance-assigned physician. American chose to go to trial because it “wanted its day in court” in order to make a favorable settlement more likely. The court held American put off granting Thornton’s PTD and partial commutation requests as long as possible in order to force a settlement at less than the full policy amount despite knowing Thornton’s claim was not “fairly debatable”. The Court held there was no reasonable basis for denying Thornton’s claims.

The Court also held given the severity of Thornton’s injuries and the lack of any factual basis in the record upon which “reasonable minds could differ,” American knew or had reason to know it had no reasonable basis to deny Thornton’s claim for PTD and partial commutation once its counsel advised it of such. After granting summary judgment on liability, the Court returned the matter for trial on damages only. The Iowa jury in Pottawattamie County gave a resounding message to Iowa insurers the actions taken by American are not welcome, finding $284,000 in compensatory damages and $25,000,000.00 in punitive damages.

It is important to follow this and other similar rulings that affect Iowa insurers. We recommend contacting our firm to discuss your potential liabilities and/or defense of any litigation. This article was researched and written by Daniel J. Boddicker, JD. Dan can be reached with any of your questions or concerns regarding Illinois or Iowa workers’ comp, municipality defense and or general liability defense at dboddicker@keefe-law.com. Our new Iowa office address is 1103 Buckeye, Suite 104, Ames, IA 50010.

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Synopsis: With Our Deepest Respect to a Great Jurist, Here is Our Answer to Your Pension Question, Justice Thomas.

Editor’s comment: We listened to the arguments made before the IL Supreme Court last week about the viability of government pension reform. Our Attorney General is trying to keep the government pension reforms in place to protect IL taxpayers and avoid chaos. Justice Robert Thomas appropriately asked how there could be an “emergency” about our spiraling gov’t pension problem when our state income tax just decreased.

Our answer is there wasn’t a true “emergency” when the RMS Titanic hit an iceberg. By that we mean, the contact with the large iceberg didn’t cause any injuries or require anyone to get immediate care. What actually happened when the iceberg struck the side of the ship was to set things in motion so the great ship and many of its passengers and crew would be on the bottom of the ocean in rapid course. That was the true emergency.

Right now, IL taxpayers have awoken to learn our State Government is on its way to the bottom of the financial ocean. We pay lots more to our state workers after they are done working for us than when they were actually doing their jobs. No government or business can do that—it is a financial model that is certain to sink and it is just a matter of time for that to occur. IL government pensions are similar to a Ponzi scheme—they are doomed to fail. Please note we owed about $52B in debt in 2009 and the amount has more than doubled to what is now a shocking $110B in debt. Like other credit card junkies, we now owe both enormous principal and interest and still have to keep borrowing to make payments. As our leaky financial boat keeps taking on more debt, the State may soon be over $150B, $200B, $250B or more in debt in five more years. At some point, someone in the financial markets is going to “pull the plug” on more borrowing. That is what happened to the City of Detroit where they borrowed and borrowed until their ship sank. Unless we change IL law either through the legislature or by amending the Constitution, that is where IL Government is certain to go. We consider that state of affairs an awful future for every Illinois citizen to contemplate.

We don’t think our legislators can tax their way out of this looming financial cataclysm. The fake government pension system has to be changed and we hope our highest court allows the changes to stand. We appreciate your thoughts and comments. Please post them on our award-winning blog.