Gov. Bruce Rauner came into Springfield as a veteran and successful business person but a newbie governor. Our newly sworn-in governor had a group of action items he wanted to implement to improve Illinois’ government and overall situation, particularly in the interest of jobs and business.
One headline item in his “Turnaround Agenda” was workers’ compensation reform. At the time of his election, the only national scale of any value was the every-other-year Oregon WC premium rankings that had Illinois as the seventh most expensive state of the U.S. for workers’ comp insurance premiums.
At the time and even now, I don’t feel Gov. Rauner got great political advice on how to cut workers’ comp costs for your bosses and mine. His goal was to enact/bargain/force what he felt were significant legislative reforms his advisers had to feel would cut workers’ comp costs.
As I said then and continue to assure my readers, several of the legislative proposals could have inadvertently expanded coverage of the state Workers' Compensation Act and increase costs! Rauner’s WC legislative reform proposals were met with a lot of “crazy-making” from the other side that proposed creating a tiny mutual insurance company to supposedly demonstrate that all major U.S. workers’ comp insurers were somehow magically manipulating profits in only our state to somehow keep premiums artificially high.
I pointed out the state is comically broke, and to take money from the Illinois Workers' Compensation Commission would cripple that administrative agency. The gurus at the state Chamber of Commerce, and other commentators, repeatedly confirmed that crooked/corrupt/bumbling state government has no idea how to run a successful private competitive company. They forecast financial doom for this silly effort.
That said, we assure you that progress is afoot for the state WC system. As always, I closely watch IWCC decisions and review court rulings. Here are three recent rulings of note to all Illinois claims/risk/government and insurance folks.
The main problem with the claim is that the claimant appears to have “forgotten” to immediately mention or document the claimed knee work injury, first claiming this story about a month after the occurrence.
An arbitrator awarded benefits, but the commission reversed, denying the claim. The local circuit court reinstated the arbitrator’s award, but the unanimous WC division appellate court reversed and closely followed state law to confirm the facts, and found that the IWCC panel is controlling.
This came to light when the City of Mt. Vernon sued the Jefferson County sheriff’s candidate for misrepresenting the knee injury. It confirmed that its claims handler innocently paid, and claimant improperly received, $7,043 in workers' compensation benefits to which he allegedly was not entitled. The city recently filed a lawsuit against him in small claims court to recover the money.
The arbitrator and IWCC ruled that her job didn’t include high-fiving coworkers and that she either voluntarily increased the risk of injury or was engaged in horseplay.
When the claimant landed, he broke his foot. The arbitrator and IWCC panel found the claimant unnecessarily and dramatically increased the risk of injury, and denied benefits. This claim hasn’t gone final, so I am not reporting the names of the parties and have no intention to impact any later appeal, if one might be filed. The point is, we salute the IWCC and arbitrator for their strong views on such challenging claims.
Another point I am making is that the IWCC is doing an amazing job of reining in WC costs. I am sure the numbers are slow to appear but should be significant when the next Oregon survey of U.S. premium costs takes place next fall.
It is my hope that Illinois businesses and local governments benefit from the IWCC’s hard work. And if you support lower workers’ comp costs and want more jobs in this nutty state, align behind Gov. Rauner.
I will continue to watch and report the rulings that I feel support or rebut my thoughts on lower WC costs/premiums.
Eugene Keefe is a founding partner of Keefe, Campbell, Biery and Associates, a Chicago-based workers' compensation defense firm. This column was reprinted with his permission from the firm's client newsletter.
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