'We need a system that works': Quinn wants workers' comp reform plan to catch abuse

News-DemocratApril 2, 2011 

Proponents of Gov. Pat Quinn's workers' compensation reform package say it would annually cut $500 million in medical fees for private and state employers, add more stringent requirements for arbitrators and set up a system to catch pockets of abuse.

Quinn, a Democrat, is attempting to push his reforms through the legislature before the mid-April legislative break, said three representatives for the governor and Michael McRaith, director of the Department of Insurance, during a conference telephone call Friday with Belleville News-Democrat reporters and editorial staff.

The proposals follow months of reporting by the BND that included articles in December that stated 389 employees of the Menard Correctional Center received injury settlements totaling nearly $10 million in three years. These claims include more than 230 for repetitive trauma filed mostly by guards who stated that operating heavy cell door locking mechanisms gave them disabling carpal tunnel syndrome of the wrist and similar injuries to the elbow.

The BND's reporting has prompted state probes and an ongoing grand jury investigation brought by U.S. attorneys in southern and central Illinois.

"We need a system that works for everyone. The continued protection of our workers is essential to any reform," Quinn stated in a written release.

Adam Braun, of the governor's office, said Illinois' current workers' compensation medical fee schedule, or the amounts paid for various surgical and medical procedures, is nearly the highest in the country.

"It is second only to Alaska," Braun said. The proposal would reduce medical fees by 30 percent, although they would remain much higher than payments allowed under the federal Medicaid and Medicare programs.

But the plan does not include a key element of workers' compensation reform backed by some Republicans in the legislature. This would be changing Illinois law to require that before an award or settlement can be made, a worker must show that an accident or condition resulting from employment was a "significant" or "primary" factor that caused disability. Under current law, all that it must be shown is that a workplace accident or condition was a "possible" factor.

"The issue is not causation, the issue is fairness," McRaith said, adding that older workers often are more affected by on the job injuries than younger workers and that adopting the "significant cause" clause would be unfair to them.

But Sen. Kyle McCarter, R-Lebanon, said the workers' compensation law needs to change so the workplace accident must be the primary cause of the injury.

Competing states such as Missouri and Indiana have changed their laws and brought their workers' comp insurance rates down, McCarter said.

"I wouldn't vote for it," McCarter said. "What would be the point?"

Rep Dwight Kay, R-Glen Carbon, agreed.

"The first paragraph of any reform story related to workers' compensation is primary cause," Kay said.

Kay said Quinn's failure to take on the primary cause issue doesn't address the real concerns of businesses, such as Caterpillar, which are considering leaving the state in search of more hospitable environments.

Quinn also proposed:

* Personal claims made by arbitrators and commission employees will be heard by the Illinois Court of Claims, instead of other Illinois Workers' Compensation Commission arbitrators.

* Arbitrators must, by statute, be licensed attorneys, act in an unbiased, impartial manner and adhere to the Code of Judicial Conduct.

* When the six-year terms end for current arbitrators, they must be lawyers and receive a suitable evaluation in a process to be established under the control of workers' compensation commissioners before they can be reappointed. New terms will be three years.

Under this requirement, arbitrator John Dibble of Freeburg, who is on paid leave, would not be reappointed because he is not an attorney. Dibble received a $48,790 settlement for repetitive trauma in October after he claimed he fell on stairs in 2009 at a workers' compensation hearing site in Herrin.

* Carpal tunnel total disability payments, or weekly tax-free paychecks equal to two-thirds of salary, be capped at 20 weeks.

* Claims by intoxicated workers injured by their inebriation be denied.

* A special assistant attorney general will be assigned to investigate fraud and assist the Department of Insurance, which will be given more authority to investigate and prosecute workers' comp fraud.

* Insurers must accept cheaper electronic billing from medical providers.

* Attorneys who appear before the commission must adhere to the same rules as they do when they appear before a court.

* The state can consider the use of outside companies to operate all or part of the state's self-insurance workers' compensation program.

Contact reporter George Pawlaczyk at gpawlaczyk@bnd.com or 239-2625. Contact reporter Beth Hundsdorfer at bhundsdorfer@bnd.com or 239-2570.

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