9-19-2016; Wilmette Firm Gets IL WC E-Filing—Will Gov't Efficiency Result in Savings?; Managers, Assume You Are Taped!!, Analysis by Brad Smith; Email Attachment Standard to Boost WC Payment Speed

Synopsis: Wilmette Firm Gets IL WC E-Filing Job—Will Government Efficiency Result in Savings for IL Taxpayers?

Editor's comment: Reliable sources advise WorkComp Strategies of Illinois won the bidding to be the E-Filing Vendor for the IL WC Commission. Their website is http://www.stratag.net/home. IL Secretary of State Jesse White's website indicates this limited liability corporation is based in Wilmette, IL.

One of the two partners is the former program director of Virginia's WC system and this new firm to be the vendor for the first phase of an e-filing program called the digital transformation project. WorkComp Strategies of Illinois, an offshoot of his WorkComp Strategies LLC, will get nearly $807,000 with an option for $574,000 in contract renewals, according to the bid notice. The company appears to be on the cutting edge of e-filing for other states, as they also have a contract with the Kansas Division of Workers' Compensation to shepherd its DigiComp electronic filing system, which is still in the works.

WorkComp Strategies has three employees and their team will determine the steps needed to ascertain needed requirements for the IL WC e-filing system, and then will develop the RFP or request for proposal for the second phase — the development and implementation of the computer systems. Based on how the bidding was set up, WorkComp Strategies of Illinois is not eligible to bid or directly participate in providing services in the second phase. All monies to fund the IL WC e-filing project will come in part from a $44 million settlement obtained through the hard work of Jay Dee Shattuck and others at the Illinois Chamber of Commerce, which filed a lawsuit against inappropriate business fees imposed by former-Gov-now-in-prison Blagojevich's administration.

The Cook County Circuit Court ruled in favor of the State Chamber's lawsuit and confirmed the new business fees violated uniform taxation rules by creating classifications that singled out business groups to bear the cost of operating general government functions. The IL Supreme Court sent the case back to the Circuit Court for more fact-finding, however. At that point, the State agreed to settle for $44M. Part of the $44 million settlement was used to repay loans used to provide Rate Adjustment Fund cost-of-living increases to permanently injured workers and to pay claims owed to others. The bulk of the settlement or $26 million, which is now $30 million was designated for IL WC Commission capital improvements, in particular this new e-filing system. None of the settlement money was designated to cover normal IL WC Commission operating expenses.

The Illinois Chamber, a staunch supporter of e-filing and lots of other things that are good for IL workers' compensation, was the only agency to comment on the proposed e-filing system after WCC rule changes were published July 29 in the Illinois Register. Proposed Section 10B under 50 Ill. Admin. Code 9015, however, could be interpreted to allow only attorneys to use the e-filing system. Every indication is pro se litigants and non-attorney clerks will be given entry to the system.

The digital transformation project will involve several core components, including electronic filing of applications and motions, case management, dispute resolution and workflows, electronic imaging and document management, data interchange, docketing, scheduling, calendaring and reporting, the agency said in its RFP. Other related business functions also will be included, including self-insurance and insurance compliance.

Will IL WC Commission E-Filing Result in Real Savings?

From the Good Gov't folks at KCB&A, we will continue to ask the recurrent question—will this new e-filing effort result in demonstrable savings for IL taxpayers. We point out 100% of the cost of operating the IL WC Commission is levied on business and local governments. There are numerous "special funds" that your editor considers ridiculous and should be ended when and if someone cares about saving IL business money. All IWCC budgets and funds should come under repeat scrutiny to insure IL business and local governments are getting solid value for the money they are spending on the IWCC.

We remember the silliness that happened when TriStar was brought in to "replace" the Central Management Service's WC claims adjusters. Insiders were told the CMS adjusters would either become part of the TriStar claims team or they would be shown the door to save taxpayers money. Instead, we were advised what happened is the cost of the TriStar TPA was added to the WC budget and the various line adjusters with CMS turned into "supervisors" of the outside adjusters. Not a nickel was saved. We vote Governor Rauner take a hard look at the TriStar program and issue an RFP for one of our many in-state WC TPAs, like Cannon Cochran Management Services, IPMG, Gallagher Bassett or many others to openly bid on this needed government service and save money on State WC claims.

We will continue to watch and see what happens with e-filing. If the new computer models result in faster and smoother electronic handling of the claims of injured workers, we assume the money obtained by the IL State Chamber will be put to good use. If it also results in savings for IL State Chamber members and others in IL business and local government, we will strongly salute these efforts. Watch this space for results as we learn of them.

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Synopsis: Managers, Please Start To Assume You Are Being Taped--Employees Now Secretly Recording Employers: Who Would Consent to That? Carlson Wins $20 Million Settlement Against 21st Century Fox. Analysis by Bradley J. Smith, J.D.

Editor's Comment: Everyone has likely heard of the suit against Fox News brought by former news anchor, Gretchen Carlson. Carlson alleged the network's CEO and President, Roger Ailes, subjected her to harassing comments. Carlson's key pieces of evidence consisted of voice recordings of Ailes making sexually harassing comments. That evidence was taken on Carlson's iPhone for more than a year prior to her exit from Fox News. Ultimately, Carlson's case was in its infancy, but Fox News was more than willing to offer up the substantial sum of $20 million to escape the publicity and negative press that followed the suit. The recordings also cemented Carlson's claims of a hostile work environment at Fox News. Nonetheless, Carlson's workplace was in a state where only one-party consent to recording is required under the applicable eavesdropping laws, similar to Federal eavesdropping laws.

Perhaps a sign of the times, this type of behavior is occurring more and more today. In fact, Carlson's actions are likely to be copied by other employees in similar circumstances. Illinois is not one of those states currently, but employers must remain vigilant to prevent a workplace where every conversation is recorded.

Notably, your place of employment determines if actions like Carlson's are legal. If those actions are not legal, then generally the evidence derived from that illegal act would be subject to exclusion from any finder of fact and could subject the individual recording the conversation to civil and criminal penalties depending on the jurisdiction. In Illinois, all-party consent is required. However, in neighboring Indiana and Wisconsin, only one-party consent is required. All-party consent is required in only 11 states in addition to Illinois: California, Connecticut, Florida, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Pennsylvania, and Washington. A majority of jurisdictions only require one-party consent to record conversations.

As hostile work environment cases generally come down to allegations someone was saying something derogatory or inappropriate, recordings—if legal—are invaluable. This evidence would be extremely beneficial even to employers' managers that fear false allegations of creating a hostile work environment or harassing someone will be lodged against them. Even recording someone in a termination meeting might alleviate the necessity of a witness to sit in on the meeting. However, a precedent of recording can be dangerous. Not only can it subject individuals to severe invasions of privacy. It will be embedded with baiting of individuals. Furthermore, recordings could be taken out of context in an effort to seek out bad publicity against employers.

In Illinois, the requirement of all party consent is an interesting legislative topic fraught with legal implementation challenges. The Illinois Supreme Court struck down the original eavesdropping statute (720 ILCS 5/14-2) in March 2014. In People v. Melongo, 2014 IL 114852 and People v. Clark, 2014 IL 115776, the law was found unconstitutional. Both cases were heard at the same time and both opinions were filed on the very same day. They both held that the Illinois eavesdropping statute as amended in 1994 was unconstitutional, as it was overly broad under the first amendment, in criminalizing the recording of conversations without the consent of all parties, even if they have no expectation of privacy. For example, the original Illinois eavesdropping statute prohibited recording:

1)   A loud argument on the street;

2)   A political debate in a park;

3)   The public interactions of police officers with citizens; and

4)   Any other conversation loud enough to be overheard by others whether in a private or public setting.

In fact, recording of these public conversations were deemed a felony under criminal law. More recently, Public Act 98-1142 amended the statute. Public Act 99-352 again amended the statute in 2015. The amended Illinois eavesdropping statute seeks to follow the Illinois Supreme Court's holdings that struck it down in attempt to make conversations with no expectation of privacy available for recording without repercussions. In other words, public conversations have no expectation of privacy. However, the Illinois eavesdropping statute requires all-party consent—similar to the original statute—for any applicable private conversations.    

Employers will need to implement policies prohibiting workplace recording in Illinois under certain circumstances to avoid any situations where employees are recording conversations meant to be private. Recording conversations at work can only open up a Pandora's box despite the anticipatory use by employers to avoid discrimination claims. One can also see where a determination by an employer to use a recording device in performance and termination meetings would cause the employees to use recordings in everyday disciplinary situations out on the open floor at an employer's place of business. Perhaps an employee would argue—without an applicable restrictive policy in place—that the conversation was recorded and there was no expectation of privacy. Consequently, although at first glance recording workplace conversations with everyone's consent seems like a great way to protect employers, implementing policies preventing any workplace recordings appears to be the better option in the long run.

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

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Synopsis: National Attachment Standard Could Give WC Electronic Medical Billing PAYMENT SPEED a Boost. We recommend all of the doctors, hospitals and healthcare providers among our readers to consider a change.

Editor's comment: One key to ensuring quick payment of work-related medical bills for injured workers is to electronically submit the attachments unique to the work comp industry. Submitting electronic attachments could become easier following a public advisory board's proposal to standardize this important process. The National Committee on Vital and Health Statistics transmitted the recommendations to U.S. Health and Human Services Secretary Sylvia Burwell earlier this summer. The recommendations could be followed by rule-making on all electronic attachments.

In workers' compensation, the attachments are typically physician notes about an injured worker's recent visit. Unlike group health, workers' comp payers often want to see the physician notes at the same time as the bill. Several states require submission of the physician notes with billing. We feel this concept should be brought to IL WC also.

Concentra has a system to electronically submit bills for workers' compensation services and the attachments at the same time, something the company has been doing since 1998. When they do so, they see much more rapid payment times. But many medical or PT practices aren't following this simple model. Those using a medical billing clearinghouse might submit the bill electronically and then, in an added step, fax the attachment to the clearinghouse, which later matches up the items to send to the payer. Others send paper bills to the payer, where the attachment can easily get separated from the bill.

The problem is that many practice management systems don$B!G(Bt include a way to pair the attachment with the medical bill. That could change if HHS adopts standards for electronic attachments. In a recent white paper on "how to be successful" in the electronic submission of workers' compensation bills, the California Orthopaedic Association lists some of the reasons providers are not yet using electronic billing. California is one of several states that requires workers' comp payers to accept electronic billing, but it is optional for providers. Some orthopedic practice managers told COA they hadn't had a chance to update their electronic billing systems to accommodate workers' comp billing in addition to Medicare and group health. Others said they weren't sure their practice management system could handle electronic workers' compensation billing, or said that their system could bill but wasn't able to send attachments, according to the white paper. Many confirmed electronic billing was too costly to implement, or that their office doesn't have an electronic medical records system. We feel these are the same practices that constantly complain about slow payment in the WC industry.

COA recommended using a clearinghouse as an easy way to submit medical bills, reports and attachments electronically. Alternatively, a practice might need to have custom interfaces written for its practice management system to generate the files in the correct format and to match up billing with attachments. In addition to streamlining the billing process, COA notes a big advantage of electronic billing: getting paid more quickly. "Orthopaedic practices that have moved to the electronic submission of workers" compensation bills/reports/attachments indicate they are commonly getting paid in 10 days or less with fewer bill rejections," the COA report noted.

Texas adopted electronic billing and attachment regulations in 2008, based on standards from the International Association of Industrial Accident Boards and Commissions, or IAIABC. Those were based in part on a federal regulation proposed in 2005 that was never adopted. The Texas system includes an electronic "envelope" for including attachments as well as a transaction to acknowledge receipt of an attachment.

We asked Dr. David Fletcher, the CEO of SafeWorks Illinois about this topic and got this answer from his top staffer Tonya Trice: "We are very lucky. We use Jopari, which will not even submit one of our invoices without an attachment. If for some reason an attachment is not uploaded with our invoice, it takes me a matter of seconds to upload that attachment and continue on with the billing process. I cannot imagine using an electronic system in which we would have to fax or mail in our attachments. I didn't even know some places are billing this way. That is not efficient what so ever. As I have told you before, I wish all of our bills could be submitted electronically. Jopari is adding new payers, and maybe in time it will be that way." For information on Jopari, go to their website at: http://www.jopari.com/. For information about SafeWorks Illinois, go to their website at: http://www.safeworksillinois.com/

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

9-12-16 Worker Can't Sue Employer for Failing to Get Higher UIM Coverage; Brittany Pendry on Discrimination Deadline Ruling; IL County Board Members Can No Longer Be GPP's!! and much more

Synopsis: IL Employers Can’t Be Sued by Injured Employee/Driver for Low Limit Uninsured Motor Vehicle Coverage.

Editor’s comment: The Illinois Appellate Court recently ruled an injured van driver could not maintain a civil action against his employer due to the employer's failure to maintain underinsured motorist coverage with a high enough limit to afford him additional compensation for an on-the-job car accident. Although SCR Medical Transportation allegedly had a contractual obligation to maintain a UIM policy with a $1 million limit, the intermediate appellate court said their injured SCR employee could not sue the company for damages after SCR reduced its UIM coverage.

In James v. SCR Medical Transportation, No. 1-15-0358, the IL Appellate Court reasoned Plaintiff James' complaint wasn't SCR's failure to maintain $1 million in coverage breached the terms of a contract. Instead, the majority decision noted "what James is suing over is SCR’s failure to have and maintain $1 million in UIM coverage with which to compensate him for his injuries." Accordingly, the Court concluded James' suit was barred by the exclusive remedy provision of the Illinois Workers' Compensation Act. The case was

James had worked for SCR, a provider of non-emergency paratransit service serving Wisconsin, Illinois and Indiana. SCR secured a contract with the Pace Bus, the local transit authority for Chicago's suburbs, in the fall of 2008. When Pace Bus solicited bids for the contract, their RFP required interested vendors to have insurance coverage with a limit of $1 million for automobile liability, underinsured motorist and uninsured motorist coverage claims. When it made the bid and got the deal, SCR undisputedly had the required levels of coverage for its fleet of 236 vans but 14 months later, it changed insurance carriers. The new policy SCR obtained from the Empire Fire and Marine Insurance Co. in October 2009 had UIM and UM coverage limits of $50,000.

In March 2010, James suffered arguably serious and permanent injuries in a work-related car accident. He filed a work comp claim against SCR and received $8,026 in temporary total disability benefits from SCR before settling his work comp claim for a lump sum of $20,582. Plaintiff James also collected the $50,000 limit from the auto liability insurance carrier for the other motorist involved. We cannot tell if the employer recovered its WC lien. If you need help with recovering/monitoring WC liens, KCB&A knows this very well, send a reply.

Plaintiff James  then requested additional payment under Empire's UIM coverage to SCR. Empire responded its liability was $50,000 and Empire owed him nothing more. In response, James filed suit against SCR, Pace and Empire, asserting they owed him $1 million in UIM coverage pursuant to the terms of the contract between Pace and SCR.

SCR responded to assert Pace Bus approved the reduction in UIM coverage limits, although Pace could not confirm this. The Pace Bus employee who allegedly gave oral authorization for the reduction of SCR's coverage limits died before James filed suit, and Pace has no written records regarding SCR's reduction in UIM coverage limits.

In considering these facts, the Appellate Court confirmed Section 5 of the Illinois Workers' Compensation Act bars a worker from maintaining a civil suit against his employer for the injuries covered by the Act.. While Plaintiff James argued he was suing over SCR's failure to have and maintain the $1 million in UIM coverage according to the contract with Pace Bus, the Appellate Court reasoned his actual complaint stems from "SCR’s failure to have and maintain $1 million in UIM coverage" from which he could have sought compensation.

The majority decision wisely added, when James settled his comp claim, he expressly released SCR, as his employer from further liability related to the car accident.

To read the court's decision, click here.

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Synopsis: Late For A Very Important Date! Discrimination Claims Have Deadlines by Brittany Pendry, J.D.

Editor’s Comment: Plaintiff’s failure to timely file discrimination charge and failure to establish causation for retaliatory discharge claim caused the Court to affirm dismissal for this employer. Recently, the Illinois Appellate Court ruled Plaintiff’s charge of discrimination was untimely, as he failed to file a Charge of Discrimination with the Illinois Department of Human Rights within 180 days after the discriminatory act it derived from, which stripped the Department of subject matter jurisdiction. Additionally, Plaintiff failed to demonstrate any issues of material fact to support a retaliatory discharge claim.

In Vulpitta v. Walsh Const. Co., 2016 IL App (1st) 152203, (issued September 2, 2016), the IL Appellate Court affirmed the trial court’s granting of summary judgment in favor of Defendant-employer. In doing so, the Appellate Court agreed with the trial court in reasoning Plaintiff failed to establish he was terminated within the past 180 days as required by law—divesting the Department and trial court of subject matter jurisdiction, and the trial court further found there were no material issues of fact supporting Plaintiff’s retaliatory discharge claim.

Plaintiff worked for Walsh Construction as a carpenter and carpenter foreman from approximately June 2000 until May 24, 2012, when he was laid off due to a decrease in construction work. During depositions, Plaintiff agreed when an employee was laid off for 30 days or more, they had to re-sign up with Walsh Construction.

On approximately August 15, 2011, Plaintiff sustained a work-related injury to his hip and sought treatment at a hospital, and he returned to unrestricted work the next day. He saw his primary care physician on August 17, and that physician returned Plaintiff to unrestricted work. On October 31, 2011, Plaintiff began working on a construction project for Walsh Construction at a Spring Grove apartment complex. Plaintiff was laid off from this project on May 24, 2012 because the carpentry work was complete. The supervisor on that project testified Plaintiff was the very last carpenter to be laid off that project, and the secretary who handled payroll testified no carpenters were paid for work on that site after that date.

The supervisor for the project did not promise to rehire Plaintiff and did not indicate the layoff was temporary. Plaintiff further admitted he no longer received compensation or benefits from Walsh Construction after May 24, 2012, and he filed for unemployment benefits between May 24 and June 3, 2012. On July 2, 2012 Plaintiff saw a third physician who recommended an MRI of the hip. Plaintiff claimed he then contacted the supervisor’s secretary requesting she forward medical records for his workers’ compensation claim to the doctor, which Plaintiff said the secretary did. The secretary, however, testified she never had this conversation with Plaintiff and it was against company policy. On July 6, 2012, plaintiff filed a workers’ compensation claim for the August 2011 injury.

On July 11, 2011, Plaintiff and the Walsh supervisor of the Spring Grove project met for lunch. Plaintiff claimed the supervisor made statements he had to let plaintiff go, and the supervisor did not want to do this. The supervisor denied making these statements under oath.

Plaintiff recalled that around June 2008, he had learned the supervisor was going to terminate a different foreman because the foreman got “hurt a lot” and had become a “liability.” However, Plaintiff admitted he was not in the room during this conversation and did not actually hear these statements.

Plaintiff filed a charge of discrimination with the Illinois Department of Human Rights on December 28, 2012. The Department dismissed the charge for lack of subject matter jurisdiction, finding the charge was filed 218 days after Plaintiff was discharged from work. On October 15, 2013, plaintiff filed a three-count complaint alleging retaliatory discharge for seeking benefits under the Workers’ Compensation Act, and unlawful discharge/refusal to accommodate based upon an actual or perceived disability in violation of the Illinois Human Rights Act.

Defendants moved for summary judgment, which was granted by the trial court, and affirmed by the Appellate Court. Under Section 7(A)-102 of the Act, “charges of civil rights violations must be filed with the Department within 180 days after the date of the commission of the alleged violation.” 775 ILCS 5/7A–102(A)(1) (West 2012). “Compliance with the statutory time limit is a condition precedent to the right to seek a remedy and is a prerequisite to the Commission's acquisition of subject matter jurisdiction.” Weatherly v. Illinois Human Rights Comm'n, 338 Ill.App.3d 433, 437 (2003).

In reasoning Plaintiff’s charge of discrimination was untimely, the Court looked to the “undisputed facts” which gave “ample support to the trial court’s conclusion that [plaintiff] was terminated on May 24, 2012, for the purpose of determining whether his charges were timely.” The facts the Court found compelling were the supervisor’s testimony Plaintiff was laid off because the carpentry work was complete; Plaintiff was the last carpenter to work on the job and received no pay after May 24; the supervisor’s testimony Walsh had no other work for carpenters for the remainder of the year in 2012; and the fact Plaintiff filed for unemployment benefits immediately after he was laid off work on May 24. Furthermore, Plaintiff also admitted if an employee was laid off for more than 30 days, Walsh Construction employees had to “re[-]sign up” with Walsh.” Therefore, Plaintiff could no longer consider himself an employee as of June 23, 2012, and would have had to have filed his claim no later than December 20, 2012. However, he filed his claim on December 28, 2012.

In ruling on the retaliatory discharge claim, the court looked to the following three elements that must be established in order for a plaintiff to state a claim for retaliatory discharge: (1) he was an employee of the defendant at or before the time of the injury; (2) he exercised some right under the Workers' Compensation Act; and (3) his discharge was causally related to the exercise of his rights under the Workers' Compensation Act. The court stated, however, that the element of causation is not met if “the employer has a valid, non-pretextual basis for discharging the employee.” The court cited Clemons v. Mechanical Devices Co., 184 Ill.2d 328, 336 (1998).

The Court stated in this case, Plaintiff “failed to establish a causal connection between his exercise of his rights under the Worker's Compensation Act and his discharge.” Plaintiff reported his first work injury in March 2008, returned to work in August or September of the same year with work restrictions, was never denied a work break, and Walsh Construction consistently accommodated work restrictions. Further, Plaintiff never challenged that he was continuously employed on nine different construction projects between the date he filed his workers’ compensation claim on August 20, 2009 and the date he was laid off on May 24, 2012.

As such, plaintiff failed to establish causation and did not file in timely manner.

This article was researched and written by Brittany Pendry, J.D. You can reach Brittany at any time for questions about IDHR charges, employment law, general liability defense, and workers’ compensation at bpendry@keefe-law.com.

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Synopsis: New IL County Board Members Can No Longer Be GPP’s or Ghost Pension Payrollers!! Can We Hope the Trend Will Spread?

Editor’s comment: We salute IL Governor Bruce Rauner and IL State Rep Jack Franks for a new law that simply makes financial, government and common sense. As we told our readers a couple of weeks ago, literally thousands of former government workers become GPP’s or Ghost Pension Payrollers when the hilariously low fake gov’t pension contributions they make while working are rapidly used up in retirement. After they use up every penny contributed during their work, they go back on lifetime compensation with guaranteed annual raises without the annoyance of having to do any further work for taxpayers.

Please note Illinois has 102 counties. For one example, Madison County that is the eight biggest IL county in size has 29 county board members. IMRF or the IL Municipal Retirement fund says there are about 927 county board members across this state getting this pension. The average payout is $1,800 a month. Most members only contribute 4.5 percent of their salary, and can get paid up to 75 percent of their final salary, plus 3 percent annual increases for life. The average recipient gets about $1,800 on a tax-free basis each month. The guaranteed 3% annual increases that will double the take every 23 years someone participates. If you make several thousand county board members into GPP’s or Ghost Pension Payrollers, you are certain to be spending millions upon millions of our tax dollars each year without any return.

A controversy that arose in McHenry County led to a new law that abolishes gov’t pensions for future county board members statewide. Consistent with existing IL law, existing county board members will have to document their work hours to reach a required minimum to qualify for a public pension. The changes mean taxpayers might save a significant chunk of the approximately $10 million each year on county board member fake government pensions in Illinois. Like most things with IL fake government pensions, there is no true “reason” for the 1,000 hour minimum and we feel everyone’s cousin’s brother’s uncle will be closely watching their buddies on the county board to insure  they write down enough hours to go on the dole when they quit.

The new limits received bipartisan support but were prompted by a political fight in conservative McHenry County that pitted Democratic state Rep. Jack Franks against mostly Republican board members. Franks, the son of Herb Franks, a long-time WC lawyer, is now running for county board chairman in November against Republican board member Michael Walkup, got pension fund officials to investigate whether McHenry board members were improperly claiming the pensions despite not working the required 1,000 hours a year. Eighteen of the 24 board members signed sworn affidavits saying they had worked enough hours to qualify. But when IMRF pension fund Executive Director Louis Kosiba asked to verify their claims, board members said they could not go back and document whether their claimed hours were real or made-up, noting they all seem to claim their work occurs outside of the public eye, making it easy to conjure up what is needed. As a result, Kosiba last week said his investigation was "inconclusive." By then, Gov. Bruce Rauner signed the new pension measure into law.

Franks objected to the plan where county board members were trying to get a full-time taxpayer benefit for part-time work. "We need to protect local taxpayers from having their money siphoned off by elected officials who are gaming the system," he said. In response, McHenry County board members voted to opt out of the pension plan entirely starting Dec. 1. However, members who are already vested will begin receiving their fake pensions immediately thereafter.

We remain firmly against all fake government pensions in this state. The fake gov’t pension that just ended is a perfect example of goofy government in the People’s Republic of Illinois—no one knows why part-time county members would get cushy lifetime retirement benefits with annual increases for contributing a random and small amount of money for a random and short number of years. We assure our readers these fake gov’t pensions eventually pay out millions of our dollars for retirees who live long enough.

We hope the State of Illinois, Chicago and all local governments move to a 401K or other plan where people that work in government receive retirements where they get back only what they and their employer put into the plan while working. It is preposterous to have to pay a secretary, park ranger, prison guard, state trooper or other government workers billions upon billions of tax dollars they did literally nothing to earn.

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9-5-2016: The IL WC Community Says Goodbye to Arb. Bob Williams and 11 Great Arbs Reappointed; WCRI Notes Wide Variances for WC Hospital Costs and more

Synopsis: IL Governor Rauner Reappoints 11 Arbitrators, Says Goodbye to 20-Year Veteran Arbitrator Bob Williams. Let’s Hope IL WC Costs Continue to Drop.

Editor’s comment: Illinois Gov. Bruce Rauner on Wednesday reappointed 11 Arbitrators to the IL Workers’ Compensation Commission and thanked outgoing Arbitrator Robert Williams for his nearly 20 years of service.

Former Arbitrator Bob Williams, of Cook County, has practiced law for more than 30 years in government and in the private sector, and was a solid IL workers’ comp arbitrator starting in 1997. He previously served as chief of the Chicago Industrial Commission Bureau of the Office of the Illinois Attorney General, as legal counsel for the Illinois Office of the Comptroller and as corporate counsel in the City of Chicago’s law department. He also was an associate at Washington, Kennon, Bryant & Hunter, and holds an MBA from the University of Illinois, a JD from Loyola University and a BS from Le Moyne-Owen College.

Bob Williams was the only sitting IL WC Arbitrator who played competitive volleyball against your editor and other WC attorneys in the Chicago Bar Ass’n league. His departure doesn’t do much for the concept of “diversity” among the 40 hearing officers at the IWCC along with the Circuit and Appellate Court judges/justices across this state. We have no reason why Former Arbitrator Williams was not reappointed and hope it was as much his decision as it was the Governor’s. Bob was a solid and knowledgeable hearing officer who we are sure wanted to keep IL WC costs both reasonable, affordable and fair.

Reappointed as IL WC Arbitrators were:

• Kurt Carlson, of Cook County, a workers’ compensation attorney and arbitrator starting in 2004. Previously he represented both employers and injured workers at the law firms of Macey, Chern and Diab; Teplitz & Bell; and Power & Cronin. He served in the U.S. Army Medical Corps before earning his BA from the University of Wisconsin and a JD from the John Marshall Law School in Chicago. I consider Arbitrator Carlson to be fair and a solid hearing officer who always listens to both sides.
• Brian Cronin, of Cook County, a finance and business professional and an arbitrator beginning in 1996. Previously he was an independent and head trader, broker, trading floor manager and options specialist for several firms, including the Chicago Board of Trade, Barclays Bank and O’Connell & Piper Associates. He holds an MBA in finance and business policy from the University of Chicago, and an MBA in management and finance from the University of Notre Dame. Arbitrator Cronin is also a knowledgeable, professional and fair hearing officer with high ethical standards..
• Carolyn Doherty, of DuPage County, who has worked in workers’ compensation, insurance law and as an attorney with the IWCC. She has served as an arbitrator in the Cook and DuPage county mandatory arbitration systems on a rotational basis. She holds a JD from the John Marshall Law School and a BA from Marquette University, and previously worked as an associate at the law firms of Sedgwick, Detert, Moran and Arnold; Hanson & Peters; and Schoen & Smith. Arbitrator Doherty is brilliant in pretrials and we consider her to be a strong mediator of difficult disputes.
• Greg Dollison, of Cook County, a review coordinator for the IWCC for more than 20 years. He has moderated negotiations between employers and union representatives, and served as an arbitrator for the IWCC starting in 2004. Dollison has a BS in city and regional planning from the Illinois Institute of Technology and attended Roosevelt University. To our understanding, Arbitrator Dollison may be the last “non-attorney” Arbitrator in our state. He has a legal understanding he learned the hard way and does a solid job running his hearing room.
• Barbara Flores, of Cook County, who has worked as corporate counsel of Alden Management Services and previously in the labor and employment law department at the U.S. Postal Service. She also worked as an assistant attorney general in the labor and employment unit at the Office of the Attorney General and at the firm Rock, Fusco and Garvey, and the AIDS Legal Council of Chicago. She holds a JD from Chicago-Kent School of Law at the Illinois Institute of Technology, and a BS from the University of Illinois. Arbitrator Flores is both knowledgeable and fair to both sides.
• William R. Gallagher, of St. Clair County, who has more than 35 years of legal experience, including as a solo practitioner specializing in workers’ compensation law in Illinois and Missouri. He also worked as in-house counsel at the Kemper National Insurance Co., and specialized in workers’ compensation and products liability cases, and as an attorney at the Harry J. Nichols Law Office, working on workers’ compensation claims in Illinois and Missouri. Gallagher has a BA in political science and economics, and a JD from Southern Illinois University. We feel Arb. Gallagher does great work and brings top-notch professionalism to the job every day.
• Christina Hemenway, of Lincoln, who worked as an attorney specializing in workers’ compensation claims for more than 20 years. Hemenway has worked for Country Financial as a workers’ compensation claims attorney, and managed catastrophic claims and employer liability and coverage lawsuits. She is a member of the Illinois Chamber of Commerce’s Workers’ Compensation Committee, the Property Casualty Insurers’ Workers’ Compensation and Medicare committees, and the Illinois Advisory Committee for the Workers’ Compensation Research Institute. Hemenway is a graduate of Missouri State University and earned her law degree from the University of Missouri. Arbitrator Hemenway has a great legal mind and, as a claims manager, was behind many of the Appellate and Supreme Court rulings that define IL WC law.
• Edward Lee, of DuPage County, who as more than 30 years of workers’ compensation law experience. He served as a U.S. Army armor officer, representing soldiers or the Army in court martial cases. Lee worked in private practice specializing in workers’ compensation law, representing both respondents and petitioners, and was named an IWCC arbitrator in 1997. He holds a law degree from John Marshall Law School and attended Tulane University for his undergraduate studies. Arbitrator Lee is a quiet, knowledgeable and hard-working man who carefully considers all sides and makes his best judgment.
• Molly Mason, of Cook County, who has more than 25 years of workers’ compensation law experience. She served as a commissioner with IWCC starting in 2007 and as a staff attorney beginning in 2003. Mason previously worked at the law firms Corti, Freeman & Aleksy, and Burke & Burke, and has published several articles in the Illinois Bar Journal. She holds a JD from Loyola University and a BA from Harvard University. When she started at the IWCC, we feel Arb. Mason learned every single minute on the job; she is now brutally honest to the lawyers and a very solid mediator and hearing officer.
• D. Douglas McCarthy, of Macon County, who has more than 30 years of legal experience. At McCarthy, Rowden and Baker, McCarthy specialized in workers’ compensation and Social Security disability law, and has appeared before the IWCC, state circuit and appellate courts, and in federal administrative hearings. He graduated from Illinois State University with a BA in communications, earned an MA in public affairs reporting from Sangamon State University, and a JD from Southern Illinois University. Arbitrator McCarthy had such a strong background as a Petitioner attorney, many attorneys were concerned he would be biased—to the contrary, he is professional, careful and fair to both sides.
• Deborah Simpson, of Kane County, who as more than 25 years of government and law experience, including in the Office of the Illinois Attorney General’s administrative review/civil prosecutions unit. Simpson also was an attorney at the State’s Attorney’s Offices for Kane, Vermilion and Cook Counties, and was a part-time instructor at the Danville Area Community College. She holds a JD from the John Marshall Law School and a BA from DePaul University. Arbitrator Simpson is unsurpassed in ethics, professionalism and hard work.

As we approach the publication of the 2016 Oregon WC Premium Analysis, we are confident the IL WC Arbitrators reappointed by our Governor “get it” and are working to have IL WC reach a middle ground among the U.S. workers’ compensation programs. We will continue to watch and vet them every day we are working as defense attorneys and reporting their strengths and any concerns to our readers.

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

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Synopsis: WCRI Report Shocks Lots of State WC Systems Due to Wide Variances in Work Comp Hospital Costs.

Editor’s comment: As we have advised, IL WC doesn’t have high medical costs compared to our sister states.

In their recent study, WCRI found rapidly rising hospital costs in the treatment of injured workers receives attention from public policymakers and system stakeholders in many states. To assist in better understanding these costs, the Workers Compensation Research Institute (WCRI) released their new national study, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 5th Edition, that compares hospital outpatient payments across states and monitors the impact of fee schedule reforms.

“This report found that hospital outpatient payments per surgical episode varied significantly across states, ranging from 69 percent below the study-state median in New York to 142 percent above the study-state median in Alabama in 2014,” said Dr. Olesya Fomenko, co-author of the study and economist at WCRI. Variation in the difference between average workers’ compensation payments and Medicare rates for a common group of procedures across states was even greater—reaching as low as 27 percent (or $631) below Medicare in New York and as much as 430 percent (or $8,244) above Medicare in Louisiana. We have included a comparison of workers’ compensation hospital outpatient payments and Medicare rates,” said Ramona Tanabe, executive vice president and counsel at WCRI. “Medicare rates capture payments to hospital outpatient providers for similar services by a large payor, and the report offers an additional benchmark that helps states better understand their hospital payments.”

The following are some major findings from the study:

·         States with no workers’ compensation fee schedules for hospital outpatient reimbursement had higher hospital outpatient payments per episode compared with states with fixed-amount fee schedules—63 to 150 percent higher than the median of the study states with fixed-amount fee schedules. Also, in non-fee schedule states, workers’ compensation paid between $4,262 (or 166 percent) and $8,107 (or 378 percent) more than Medicare for similar hospital outpatient services.

·         States with percent-of-charge-based fee regulations had substantially higher hospital outpatient payments per surgical episode than states with fixed-amount fee schedules—32 to 211 percent higher than the median of the study states with fixed-amount fee schedules. Similar to non-fee schedule states, workers’ compensation payments in states with percent-of-change based fee regulations for common surgical procedures were at least $3,792 (or 190 percent) and as much as $8,244 (or 430 percent) higher than Medicare hospital outpatient rates.

·         Most states with fixed-amount fee schedules and states with cost-to-charge ratio fee regulations had relatively lower payments per episode among the study states. In particular, for states with fixed-amount fee schedules, the difference between workers’ compensation payments and Medicare rates ranged between negative 27 percent (or -$631) and 144 percent (or $2,916).

The hospital outpatient payment indices compare payments (per surgical episode) for common outpatient surgeries under workers’ compensation from state to state for each study year and the trends within each state from 2005 to 2014. The analysis captures payments for services provided and billed by hospitals, and it excludes professional services billed by nonhospital medical providers (such as physicians, physical therapists, and chiropractors) and transactions for durable medical equipment and pharmaceuticals billed by providers other than hospitals. The analysis also excludes payments made to ambulatory surgery centers.

The 33 states included in this study represent 87 percent of the workers’ compensation benefits paid in the United States. The states are Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin. Note the 2014 workers’ compensation and Medicare comparison is conducted for 31 states.

To purchase this study, visit http://www.wcrinet.org/studies/public/books/hci_5_book.html.