SPRINGFIELD -- Most of those involved in Illinois workers’ compensation system agree reforms are needed, but there’s no agreement yet on what form those changes should take. 

SPRINGFIELD -- Most of those involved in Illinois workers’ compensation system agree reforms are needed, but there’s no agreement yet on what form those changes should take.


“It’s a very complex issue – we’re moving along, but I wouldn’t say we’ve reached any major agreements,” said Rep. Dan Brady, R-Bloomington, who represents Illinois House Republicans on a bipartisan workers’ comp committee set up by Gov. Pat Quinn.


Proponents of reform say costs are too high for businesses and the system is full of fraud. Opponents say some proposed changes wouldn’t be in the best interest of those the compensation system was designed to help –workers.


“There are a variety of stakeholders – doctors, business, labor, lawyers,” Brady said. “All have differing opinions on how to change the system. We’re trying to bring all sides together.”


Here is how different groups view the controversy.


 


Business


“We think it (workers’ compensation) is stifling job growth,” said Todd Maisch, vice president of government affairs for the Illinois Chamber of Commerce. “The real insidious effect is that businesses are choosing to create jobs elsewhere.”


State Sen. John Millner, R-Carol Stream, said at a recent committee hearing that he was trying to woo a 100-employee firm to his district, but Illinois’ workers’ compensation costs are an impediment, he said.


“In Pennsylvania, it will cost this company $50,265,” Millner said. “In Illinois – $230,040.”


Mark Denzler, vice president of the Illinois Manufacturers Association, said employers want an effective workers’ comp system.


“They want employees to get better and get back to work,” he said.


However, business owners are wary of fraud. One reform they would like to see is a requirement that the workplace be the primary place of injury.


“You can hurt your knee playing Sunday softball, go into work on Monday, twist it again and claim workers’ compensation,” Denzler said.


Business interests would also want a cap on how long workers can receive benefits based on their pay before and after their injuries, called the wage differential. There’s no limit now, but Denzler said his organization wants those benefits to cease at age 67 or five years after the injury, whichever comes later.


Business interests also want changes in how physicians are selected in workers’ comp cases. Denzler said some workers shop around for doctors who will give diagnoses the patients want to hear. One option would be to have a worker see a company doctor, as well as one other physician of his or her choice for a second opinion, if desired.


Not all of these reforms may be feasible, Denzler said.


“Workers’ compensation is very lucrative for doctors and trial lawyers,” he said. “They say it (their opposition) is not about the money. But it’s about the money.”


 


Doctors


Doctors like the system the way it is, at least as far as their involvement is concerned.


“One of the biggest things they (proponents of reform) are looking at is taking away patient choice,” said Dr. Steven Malkin, president of the Illinois State Medical Society. “It’s the basic tenet of practicing medicine – the physician-patient relationship.”


Company doctors don’t always have workers’ best interest in mind, Malkin said.


Payments to doctors in Illinois are the second-highest in the nation, according to the Department of Insurance and business groups.


However, Malkin said, treating patients in the workers’ compensation system is inherently more expensive. A workers’ comp case means more paperwork and more involvement with lawyers and human resources departments.


“It’s a much more expensive process – there’s no inflated costs there,” Malkin said. “A lot of doctors don’t want to participate because it’s a pain in the neck.”


 


Lawyers


The Illinois Trial Lawyers Association also balks at the accusation that attorneys oppose reform because of the money.


“Do lawyers make money for representing people? Yeah, we do – I guess the business and insurance industry prefer people go unrepresented,” said ITLA president Todd Smith. “It’s always easy to shoot the messenger.


“I prefer to argue these things on the merits of the issue, like doctor choice and rising premiums.”


Workers’ comp claims have fallen by nearly 30,000 in the last decade, Smith said.


The real problem is the climb in premiums charged by insurance companies, Smith said.


“The focus tends to be on workers, in terms of reducing injured workers’ rights, instead of finding out why it is premiums continue to rise in the face of declining claims,” he said.


Lawmakers should implement safety programs and put teeth in anti-fraud legislation, Smith said.


Fraud is a very real problem, said Michael McRaith, director of the Illinois Department of Insurance said.


“We can’t be sure about the prevalence of workers’ compensation fraud with empirical data,” McRaith said. “There are studies that estimate, but unfortunately the data are misleading. Fraud can be perpetrated by employers, by employees, by doctors, by members of the legal community.”


The department’s fraud investigation unit has six investigators, he said.


 


Labor


The most important component in any reform is to preserve workers’ rights, said Illinois AFL-CIO president Michael Carrigan.


Workers’ compensation costs would be lower if employers stopped fighting legitimate claims, he said.


“Nobody wins when lawyers spend their time fighting,” Carrigan said.


“I have personally seen people injured on the job, and there’s no question they were injured on the job,” he said. “They (employers) try to mount a defense that it was a preexisting condition or didn’t happen at the workplace. Then the injured worker feels like David versus Goliath.”


Carrington declined to comment on reform possibilities he favors because negotiations are still under way.


 


Legislators


Businesses pay $3 billion annually in workers’ compensation premiums, insurance director McRaith said, and most legislators agree that some kind of cost-cutting reform is necessary.


“We're all for workers' comp reforms,” Senate President John Cullerton, D-Chicago, told The State Journal-Register editorial board late last month. “It’s not a Democrat-versus-Republican issue. It's an intramural issue within both parties.”


The General Assembly passed a set of reforms in 2005, but they failed to hold down costs, said Patty Schuh, spokeswoman for Senate Minority Leader Christine Radogno, R-Lemont, who represents the Senate Republicans on the Committee.


“Fixing the jobs climate is one of the pieces necessary to fix Illinois’ budget,” Schuh said. “We don’t want to open Pandora’s Box and nibble around the edges.”


Andy Brownfield can be reached at (217) 782-3095.


 


What is workers’ compensation?


Workers' compensation is designed to compensate employees who are injured on the job (or their survivors, if a worker suffers a fatal accident) for their lost wages and medical expenses. In return, employers generally give up the right to sue their employers as the result of an injury.


Workers’ compensation committee members


Senate Minority Leader Christine Radogno, R-Lemont (630) 243-0800


Sen. Kwame Raoul, D-Chicago (773) 363-1996


Rep. Dan Brady, R-Bloomington (309) 662-1100


Rep. John Bradley, D-Marion (618) 997-9697


A number of members of Gov. Pat Quinn’s administration also sit in on committee meetings, according to a spokeswoman for Quinn. 


Pain, frustration lie behind workers' comp cases


Mike Nixon, 48, of Decatur was climbing a ladder when he felt his knee pop.


Nixon, a college-educated heating, ventilation and air-conditioning technician, had made similar climbs, carrying in excess of 75 pounds of instruments and tools, hundreds of times before.


“I really liked working for these people, and I hadn’t been working for them that long,” Nixon said of his previous employer, who he declined to name. “You know how a guy feels – he wants to do the best he can, and he doesn’t want to rock the boat.”


So Nixon didn’t file a workers’ compensation claim immediately after his injury. Over the next weekend, however, he visited a doctor and found that his knee had been torn so badly that bone was rubbing bone. He ultimately needed a knee replacement.


It took five years of challenges and hearings before the state’s Workers’ Compensation Commission before his workers’ comp claim was finally settled.


“It cost me my marriage,” Nixon said. “I lost my wife. She was scared that our life was going to go completely downhill, and at that time it was dim.”


Nixon said stress caused him to go blind for six months. Only with the help of a doctor did he finally to regain sight in one eye.


“Nobody’s going to hire you in my trade with a knee that can’t climb and then you can’t see either,” he said.


Nixon now works 40 hours a month – all his disability will allow – as an instructor in a sheet metal worker apprenticeship program. He also has a part-time job helping ex-convicts reenter the workforce. He used to earn $50,000 a year, but in 2010, Nixon made $19,800.


In 2010, 55,497 claims were filed with the Illinois Workers’ Compensation Commission, according to its annual report (1,436 of those came from Springfield).


On the other side of each of those claims is an employer – and they are frustrated with the system as well.


Bill Hahn owns three businesses and employs nearly 250 workers.


At one point, he said, he hired a housekeeper for Northfield Suites & Conference Center, which he owns.


“She worked 21 days for us and claimed double carpal tunnel (affecting both hands),” Hahn said. “We ended up paying $44,000” in workers’ compensation.


Carpal tunnel syndrome can lead to numbness, weakness and muscle damage.


Hahn said he finds it hard to believe the woman developed the condition in 21 days of vacuuming, making beds and cleaning bathrooms, but because the injury was discovered while she was in his employ, he was responsible for the costs.


“As claims go up, rates go up, and the cost of doing business goes up,” Hahn said. “If we need to raise room rates to cover workers’ compensation rates, we lose that business.”


Hahn said he typically deals with five to 10 claims in an average year. He can’t remember the last year where there were none.


“That’s not to say that all workers’ compensation claims are bad,” Hahn said. “It makes it pretty tough as an employer, though.”


 


-- Andy Brownfield