11-18-2022; What Happened During the Election Last Week; Can Walking Now Be An "Accident" in This Nutty State?

Synopsis: What Happened in Illinois During the Election Last Week.

 

Editor’s comment: As I have advised our readers, Illinois is a “one-party” State and will remain same for at least a generation to come. In my view, Illinois is no longer a “democracy” because so many voters have an overridingly strong incentive to maintain their government benefits, in particular the fake and unfundable government pensions that are akin to winning the lottery. It is also truly odd for our Governor to admit he spent about $350 million of his own money to be Governor and do very little, almost nothing, in the office.

 

Along with that, our prior Speaker of the IL House “cooked the books” to gerrymander districts across our State to insure a one-party State was created. The districting will eventually change as the years go on but for now and decades to come, this State is going to be “blue.”

 

What Does It Mean to IL WC?

 

Well, the lack of a presence or any political strength by the IL State Republican party will probably mean our hearing officers will remain liberal. We still feel many of our IL WC Arbitrators bring strong common sense, fairness and perspective to what they do but if you read the “non-published” decision I provided below, as veteran defense counsel(s), we remain challenged on when to fight questionable claims and when to best settle. I feel the Arbitrator and Commission did their job to deny the claim to then have the IL WC Appellate Court flip it and provide six or seven-figure benefits. I am stunned to see a reversal if you understand our IL WC Appellate Court routinely allows the IWCC to make the call on medical issues and causal connection.

 

Most of my readers and I feel our IL State WC system is going to remain uncertain, expensive and unfriendly to businesses, local governments and WC insurers. If you need help with your IL WC defense agenda, send a reply and I assure you I can help.

 

Did They Change the IL State Constitution? Was That Amendment Truly Needed?

 

Please also note the so-called “Workers Rights Amendment” passed, creating another major issue for voters/taxpayers. Along with duplicating the fake pension protections already in the IL “pension clause,” the new Amendment will allow government unions to triple the pay and benefits given gov’t unions across the State. They will now be able to fight for taxpayers to subsidize their housing costs, working hours, travel expense, paid paternity/maternity leave, block layoffs and all sort of other benefits.

 

A New York Supreme Court Justice held:

To tolerate or recognize any combination of civil service employees of the government as a labor organization or union is not only incompatible with the spirit of democracy, but inconsistent with every principle upon which our government is founded. Nothing is more dangerous to public welfare than to admit that hired servants of the State can dictate to the government the hours, the wages and conditions under which they will carry on essential services vital to the welfare, safety, and security of the citizen. To admit as true that government employees have power to halt or check the functions of government unless their demands are satisfied, is to transfer to them all legislative, executive and judicial power. Nothing would be more ridiculous.

 

Trust me, our IL State Government just signed on to have government unions effectively take over. The only thing I am sure that is going to cause is more debt and taxes in a State already awash in red ink.

 

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

 

 

Synopsis: IL WC Appellate Court Awards Benefits for Garbage Truck Driver's Claim for Repetitive Trauma “Injuries” While Walking. Is “Walking” now an IL WC “Accident?”

 

Editor’s comment: As I have advised our readers repeatedly, if Illinois WC goes to a system where accidents cannot be defended, we aren’t going to need lawyers, Arbitrators, Commissioners or most others currently in the IL WC system. Like Group Healthcare, Claimants will be advised to fill out forms and benefits will follow.

 

Please also note my concern about the use of the term “injury” in this Appellate Court decision—With respect to the members of the Court, in my view, Claimant never described an injury and the way the Court uses the term is troubling, in my opinion. If a claimant tore up a shoulder playing baseball away from work but later noticed pain at work, that isn’t an “injury” and the employer should not have to pay for such claims. To keep Illinois a litigation system of resolving work “injuries” or problems, we can’t have “pain at work” translate into “injury.”

 

The Illinois Appellate Court awarded benefits to a garbage truck driver based solely on “repetitive trauma” problems. In Malecki v. IWCC, No. 1-21-0713WC, 09/23/2022, Claimant Malecki worked for Waste Management as a commercial garbage truck driver. His daily duties consisted of collecting garbage along a 75- to 125-stop route during a 10- to 12-hour workday.

Between January 2008 and April 2016, Malecki claimed he experienced pain in his lower back radiating down to his right thigh, for which he sought treatment from Dr. Neeraj Jain. A magnetic resonance imaging scan taken in January 2008 revealed degenerative disc and facet arthrotrocopy at L4-L5 and L5-S1; he also had tiny discs in his back that is typical for folks of his age and habitus.

A February 2010 scan revealed degenerative changes and spinal stenosis at L4-L5. A November 2015 scan revealed a grade 1 anterolisithesis at L4-L5, spondylosis changes at L4-L5, mild arterolisthesis, severe spinal and bilateral recess stenosis at L4-L5, and multilevel neural foraminal stenosis. Claimant Malecki received chiropractic adjustments from September 2014 through June 23, 2016.

Malecki claimed he started to feel his right foot get “heavy” while walking to his truck during his route on July 6, 2016. He completed his work shift and went home, where he claimed he continued to have difficulty moving his right foot.

The next day, Malecki alleged he completed an incident report with Rich Sarac, a district manager. Sarac later denied filling out the report with Malecki or that Malecki reported any “injury.”

On July 12, 2016, Malecki saw Dr. Hamidanti, his primary care physician. The doctor’s notes state that Malecki was complaining of leg pain that started three weeks prior. Hamidanti also noted that Malecki was walking with a limp and had decreased sensation on the lateral leg and dorsum of the right foot and thigh. Malecki saw Dr. Darwish on Aug. 5, 2016. He completed a patient assessment form in which he recorded that his symptoms occurred on July 6, 2016, and that it was a work-related “injury.” Darwish made an initial diagnosis of spondylolisthesis.

On Aug. 25, 2016, Darwish diagnosed Malecki with right foot drop and recommended a transforaminal lumbar fusion of L4-L5 and L5-S1. Darwish performed the surgery a week later. He opined Malecki’s job duties have “some causal connection” to the condition for which he was treated.

Malecki filed a workers’ compensation claim, asserting he had suffered repetitive trauma injuries that manifested on July 6, 2016.

An arbitrator denied the claim and found Malecki failed to prove he sustained a compensable injury, did not provide notice of an injury to Waste Management, and that his current condition of ill-being was causally related to a work accident. The arbitrator specifically found Malecki was not credible as well.

The Workers' Compensation Commission affirmed, as did a circuit court judge.

The Illinois Appellate Court said the arbitrator erred in finding Malecki was unable to provide any specific testimony relating to the actual route or activities he was engaged in on July 6, 2016, when he noticed an increase in symptoms.

“Contrary to this finding, the record reflects that the claimant testified to his daily duties as a garbage truck driver and specifically stated that, on July 6, 2016, when midway through his route and after dumping two yard containers filled with cardboard, he started to feel his right foot get ‘heavy’ as he walked to his truck,” the court said.

The Court further said the discrepancy in evidence between whether Malecki worked on July 7, 2016, was not relevant to the issue of whether he had sustained an injury or gave proper notice.

“The arbitrator also relied upon the fact that the claimant did not demonstrate any increased risk of harm to which he was exposed which contributed to his symptoms while walking to his truck,” the court noted. “The finding is based upon the incorrect assumption that walking was a claimed contributing cause of the claimant's symptoms.”

The Court outlined Malecki’s testimony was that he started to feel his right foot get heavy walking to his truck, not that his symptoms were caused or contributed to by walking to his truck. The Court also said Dr. Darwish also testified that, to a reasonable degree of medical and surgical certainty, Malecki’s job duties have “some causal connection” to the condition for which he was treated.

The Court further said the causation opinion was insufficient to support a finding that Malecki failed to prove that his condition of right foot drop is causally related to his employment, since he never offered an opinion as to whether Malecki’s job duties on July 6, 2016, contributed to his condition.

The Court went on to find the commission’s determination that Malecki failed to give timely notice of an injury was against the manifest weight of the evidence.

“In this case, there is no disputing the fact that the claimant gave notice of his July 6, 2016, injury at the very latest on July 25, 2016, when he gave the completed employee report of injury form,” the Court said, noting this date fell within the 45-day notice period provided by Illinois law.

To read the court’s decision, click here.

10-30-2022; Please, Please Vote Against Amendment 1, the so-called "Workers Rights Amendment"; IL State Chamber WC Seminar This Wednesday--Still Time to Register and much more

Synopsis: Unless You Like Wildly Higher Taxes and Overpaid IL Government Workers, Please, PLEASE Vote Against Amendment 1, the so-called “Workers’ Rights Amendment.”

 

Editor’s comment: I assure you the State of Illinois is wildly in debt, to the tune of billions and billions of dollars. Our State government got a one-year reprieve from its financial misery because the Democrats in Washington borrowed trillions of dollars and spread it out among the States in a fashion that allows those States, like Illinois, to falsely claim they had a good financial year.

 

Right now, I feel confident Illinoisans are paying the highest tax load in the entire country. We have ever-higher income, real estate, sales, estate, gas and other taxes unlike any in the 50 states. Our road tolls were increased four times and by as much as 90% in the decade ending in 2019. On January 1, 2022, truck/trailer toll rates were again increased, supposedly to improve things—no one has any idea what those “improvements” might be.

 

I am sure the County of Cook and City of Chicago also have gigantic debt and spiraling taxes unlike any other governing bodies of like size.

 

Why are Illinois taxes skyrocketing?

 

Well, www.OpenTheBooks.com wants us to consider the Illinois government employee $100,000+ Club. They are sure this “club” is comprised of 132,000+ public employees and retirees who earned a new 'minimum wage' of $100,000 or more. These workers cost Illinois taxpayers $17 billion a year, every year with more raises to come.


They point out while crime skyrockets in your neighborhoods, test scores plummet in our public schools, and inflation decimates private-sector paychecks, the Illinois public “worker” class is living the good life. They found nearly 500 educators in the public schools with salaries between $200,000 and $439,000. In small Illinois towns, city managers made up to $341,300. Three doctors working in Illinois government at the University of Illinois at Chicago earned incomes between $1 million and $2.1 million.

 

How Are Folks in Illinois Government Wasting Your Tax Money?

 

I have advised my readers in the past, there are 88 Illinois State Agencies. Many of these agencies are duplicative and there are lots and lots of workers whose jobs are unclear and hard to pinpoint. Hundreds of overpaid jobs could be eliminated if State government would use what are called “computers” to eliminate government waste.

 

As an example, about a decade ago, the late Judy Baar Topinka confirmed the IL State Treasurer and Comptroller’s offices do exactly the same thing—they are duplicate agencies, performing duplicate work with no value to taxpayers. Judy told everyone this more than ten years ago and nothing has been done to cut the fat.

 

Feel free to ask yourself, “why is there an Illinois Department of Transportation and an Illinois State Toll Authority?” Don’t they both manage our roads? Couldn’t they be consolidated to eliminate duplication and waste?

 

Please also note Illinois State government has at least six overlapping police departments, many of them tied to IL State agencies. Does anyone have any idea why there is a “Secretary of State Police Department” and what those sleuths do to justify their existence? Does our IL Commerce Commission need its own do-nothing police department?

 

So What is this New IL Workers’ Rights Amendment?

 

In short, it is another hoax being foisted on Illinois taxpayers, this time by government union bosses. Naming it the “Workers’ Rights Amendment” is the first hoax—the law only applies to IL Government Union Workers. As I have outlined above, hundreds of thousands of Illinois government workers make over $100K while working and get hefty fake gov’t pensions after retirement. If you want to know why I call them “fake” gov’t pensions, send a reply and I will expand on that thought.

 

The two main concepts these government union bosses are seeking is to

 

  • Block any chance our State may take the “fake” out of our unquestionably fake and unfundable government pensions. The amendment will prevent the Illinois legislature, governor, city councils, county boards and every other elected official or governing body to create any law or ordinance now or in the future that is designed to reform Illinois’ public pension systems.

 

  • The amendment will also permit any public union to negotiate and receive whatever it wants at the bargaining table. This would include police, fire and other public safety employees who are currently unable to walk off their job to do so. The amendment will allow such public safety employees to bargain over the “right” to strike. Additionally, the amendment will prevent the state or local units of government the ability to create any law or ordinance that prevents unlimited giveaways at the bargaining table --- allowing public sector unions to demand and receive an unlimited amount of pay and benefits (with dues going back to the labor unions, of course). If this isn’t clear enough, perhaps think about this way: what current Illinois politician who controls the state’s finances will want to say “no” to the very labor unions supporting them politically? Can you imagine paid maternity and paternity leave for a year or two years or three years for government union workers? If you can’t imagine it, I promise they can and may do so.

 

In short, this fake and stupidly named “Workers’ Rights Amendment” will insure we are beholden to Illinois government union bosses and our State taxes are unquestionably going to continue to rise, rise and rise again.

 

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

 

 

Synopsis: Great WC Seminar this Wednesday—Register ASAP!!

 

 

Join us November 2, 2022

3003 Corporate West Drive, Lisle, IL 60532

8:00 am - 3:30 pm | In Person Conference

 

11:10 am–12:00 pm Workshop #2:

Shawn Biery, John Campbell, and Jim Egan

Keefe Campbell Biery & Assoc.

 

Working Remotely and Workers Compensation Claims

 

The Illinois Chamber of Commerce along with attorneys from Keefe, Campbell, Biery & Associates will present a workshop regarding Working Remotely & Workers’ Compensation Claims in the Covid Era. The workshop will provide an overview of some of the pitfalls and strategies with remote workers in this new Era as well as tips for utilizing various combined approaches to investigate claims, deal with subrogation issues, and tools to effectively manage employee expectations as well as determining when and where to implement protocols for claim management. As applicable, we will discuss HIPAA compliance, outside insurance issues, and managing injured workers remotely to effectively move toward closing claims and day-to-day injured worker management. The presentation is conducted in format where the audience is welcome to participate with questions to drive the discussion to areas of specific concern.

 

Register Here

 

 

Our Speakers

 

 

Shawn Biery received his JD from Thomas Jefferson School of Law in 2001. He was a founding member of Keefe, Campbell, Biery & Associates in 2003 after practicing in employment law and patent law firms prior. Shawn utilizes strategies similar to those he developed while an active duty member of the US Marines conducting desert warfare training. In addition to his work as a courtroom litigator, Shawn is also an adjunct law professor and regular speaker regarding workers’ compensation and employment law issues.

 

John Campbell received his John Campbell received his JD from Chicago-Kent College of Law in 1999 and co-founded the Keefe, Campbell, Biery & Associates firm in 2003. John’s area of concentration is in workers’ compensation as well as employment and OSHA citation defense. John enjoys teaching as an adjunct professor of workers’ compensation law as well.  JD from Chicago-Kent College of Law in 1999 and co-founded the Keefe, Campbell, Biery & Associates firm in 2003. John’s area of concentration is in workers’ compensation as well as employment and OSHA citation defense. John enjoys teaching as an adjunct professor of workers’ compensation law as well. In addition to his work as a courtroom litigator, John is also an adjunct law professor and regular speaker regarding workers’ compensation and employment law issues.

 

 

Jim Egan received his JD from John Marshall Law School in 1988. He is a thirty-year practitioner with extensive civil practice throughout the State of Illinois. Formerly managing partner of James F. Egan and Associates, Ltd., Jim was recruited to merge his practice with Keefe & Associates as of January 1, 2004.  He has lectured frequently on the Illinois Workers’ Compensation Act and is a contributing lecturer for Rosecrance Legal Considerations of Marijuana in the Workplace presentations and podcast. 

 

To register to attend or for any questions, contact Pam Holleman,

at (855) 239-6150 or pholleman@ilchamber.org

8-8-2022; Big Mac Gets Whacked with Penalties/Fees; IRS Increases Mileage that Changes IL WC IME's and more

Synopsis: Big Mac Gets Whacked for IL WC Penalties/Fees. Your Editor is not sure why this set of facts needed an appeal to the IL Appellate Court and a reported ruling.

Editor’s comment: The Illinois Appellate Court, WC Division upheld an award of full benefits, including Claimant’s attorney fees and other penalties for a long-time McDonald’s employee for an unreasonable contest to her IL WC claim. We are fairly sure this was a franchise store and not a company-owned location.

In my view and as a veteran defense attorney, this is a classic example of frustrating IL WC overtreatment by physician after physician. Again, and in my view, UR (or utilization review) should have been implemented early and often to block what I feel was obvious unnecessary care—if you aren’t sure how and why KCB&A recommends UR in such settings, send a reply.

In McDonald’s v. IWCC, No. 1-21-0928WC, issued 06/24/2022, Claimant worked for McDonald's for approximately 21 years. On Oct. 3, 2012, Claimant went to a refrigerator to get a box of meat. She claimed she grabbed a box from the top shelf, which was above the height of her eyes and forehead. She asserted she placed the box on her left shoulder, and it began to fall. She claimed she twisted her lower back and tried to stop the box from falling, using her right hand, and she felt pain in her right shoulder.

Claimant told two supervisors what had occurred. She continued working until she was advised to stop. She then went to Trinity Hospital. That same day, one of Claimant’s supervisors completed a report of incident and faxed it to McDonald's main office. The report states Claimant suffered a back injury handling a box of meat. I feel there is an incident report issue with calling this event an “injury”—if you aren’t sure why, send a reply.

Trinity Hospital’s records indicate Claimant complained of low back pain lifting heavy boxes of meat and she was diagnosed with a back strain. Claimant returned to work on two days after this occurrence on Oct. 5, 2012.

On Oct. 8, 2012, the insurance carrier for McDonald's sent a letter to Claimant advising it received notice of her "work-related injury.” On Oct. 16, 2012, Claimant saw a Dr. Louis who is on the web as a “pain management specialist” with complaints of ongoing low back and right shoulder pain since the incident with the box of meat. Dr. Louis diagnosed her with a lumbar strain and right shoulder pain. He also excused her from work.

Claimant filed a workers’ compensation claim on Oct. 23, 2012, and notice was provided to McDonald's the next day.

On Nov. 8, 2012, Claimant saw a different doctor, again complaining of lower back and right shoulder pain. This physician suggested Claimant undergo an MRI, which she did. On Nov. 26, 2012, Claimant saw Dr. Jain, who examined her and reviewed the results of the MRI exams. Dr. Jain recommended epidural injections and a referral for an orthopedic evaluation. He opined her shoulder and back symptoms were "directly related to the injury," and the treatment provided to date was reasonable and "of necessary frequency and duration."

Claimant returned to work, with restrictions in December 2012.

In January 2013, she saw Dr. Gregory Markarian, an orthopedic surgeon. Dr. Markarian recommended continuing physical therapy and discontinuing work.

In April 2013, Dr. Jain administered injections to Claimant’s back. She reported an improvement in her pain afterward. On June 20, 2013, Dr. Markarian administered an injection to Claimant’s shoulder. She reported relief.

Nine months after onset, on June 28, 2013, another doctor got involved—a Dr. Vargas recommended Claimant undergo “facet joint injections” that I personally consider hogwash. This new doctor also recommended an FCE—I don’t consider FCE’s to be scientific or “medical treatment.” I want to confirm for all defense readers there is no value in paying for an FCE in an Illinois WC claim.

Claimant was finally discharged from physical therapy in August 2013 (UR should have blocked all that expensive PT), and she underwent an FCE in September. The FCE evaluator summarily and eternally placed Claimant’s capabilities at a sedentary to light level.

In November 2013, thirteen months after onset, Dr. Vargas administered more “facet joint injections” to Claimant’s back. Again, I feel UR should have been used for approval or non-certification.

On Nov. 27, 2013, again thirteen months after onset and without much recorded care in the interim, Dr. Markarian recommended shoulder surgery.

About six months later, In March-April 2014, Dr. Vargas administered even more nerve-block injections to Claimant’s back. He also recommended radiofrequency ablation that I feel has literally no value of any kind.

Claimant did not have the shoulder surgery or ablation. She continued working for McDonald's in a light-duty capacity cleaning tables.

Dr. Mather conducted a review of Claimant’s medical records. He concluded she suffered a lumbar strain from the initial injury. Dr. Mather opined injections were not necessary and the FCE was valid. He further opined that Claimant needed no treatment beyond two weeks after her injury and she should have no work restrictions.

Dr. Craig Phillips also examined Claimant and concluded her shoulder and arm issues were caused by the work accident. He also thought she should be restricted to lifting no more than 10 pounds and refrain from any overhead activities.

In January 2019, the IL WC Arbitrator found Claimant suffered a work-related accident, that she gave timely and appropriate notice to McDonald's and that her current condition was causally related to the accident. The arbitrator found Claimant was entitled to her past medical expenses and that the nature and extent of her injuries amounted to 17.5% loss of her person as a whole.

The arbitrator also awarded Claimant attorney fees and penalties, finding McDonald’s had acted vexatiously in disputing the issue of notice and the occurrence of an accident.

The Illinois Workers' Compensation Commission panel affirmed the decision after correcting the arbitrator's average weekly wage calculation and deducting travel expenses from some physical therapy services.

A Circuit Court judge affirmed the Commission’s decision. McDonald’s appealed their ruling to the IL Appellate Court, WC Division.

The Illinois Appellate Court ruled the Commission’s finding Claimant suffered an accident at work is not against the manifest weight of the evidence. The court noted she testified how the accident occurred in some detail and McDonald's offered no material evidence to rebut her testimony or counter her claim. The owner of the McDonald's franchise acknowledged Claimant suffered an accident at work. The court found there was timely and proper notice of the accident was given on the day of its occurrence, as McDonald’s conceded on appeal.

The court also said the expert hired by McDonald’s opined that Claimant’s shoulder and arm injuries were caused by her work accident and that her description of the mechanism of injury certainly could result in injury to the back and shoulder.

The IL Appellate Court, WC Division ruled an IL employer must have a reasonable basis to take a position. A position is not legitimate or reasonable simply because the Workers’ Compensation Act permits it.

If you are handling an IL WC claim and facing petition for penalties/fees and want a second opinion from a veteran defense attorney on your overall chances, send a reply.

To read the court’s decision, click here.

Synopsis: IRS Raises Standard Mileage Rate for Final 6 Months of 2022.

Editor’s comment: For reasons I respectfully disagree with, IL WC claims pay mileage for travel to and from Independent Medical Exams under Section 12 based upon standard IRS mileage rates.

The IRS announced a rare midyear increase in the standard mileage rate for the final six months of 2022, to 62.5 cents per mile, due to soaring gas prices.

Please use this new rate if you are setting an IME in an IL WC claim—please also note it is not worth the time or money to fight over this amount.