Ridge & Downes - Law Firm

  • PROOF BY ASSERTION: If you repeat a lie often enough, it becomes the truth.

    Governor Rauner is still demanding workers’ compensation “reform” in the ongoing budget standoff.  In pursuit of this goal, the Governor has adopted the political rhetoric in which a proposition is repeatedly restated regardless of its’ truth.  He is trying to brainwash the people of this State into believing that everything that is wrong with Illinois is because of workers’ compensation.  We refuse to allow the Governor’s political rhetoric to go uncontradicted.

    This month, we want to bring you some facts about workers’ compensation in Illinois so when you see issues in the press you can spread the truth to those around you.

    If you follow workers’ compensation debates, you may have heard of the Oregon Study. If you haven’t, each year the State of Oregon publishes a comprehensive study about Workers’ Compensation throughout the USA. So what does this report actually say?  Illinois’ premium index rate has decreased 11.32% from 2004 to 2014. 

    Some more fun facts:

    • Insurers reported a 19% decrease in total benefit payments (loss costs) between 2011 and 2015, largely the result of the 2011 Amendments, which reduced medical fees by 30% and made other changes.  Further savings is anticipated once the full effects of the 2011 Amendments are felt. 
    • The Workers’ Compensation Research Institute reported in October 2015 that medical payments in Illinois feel below neighboring states of Indiana, Wisconsin, and Iowa.  The report says that the 2011changes lowered the amount insurers spent per claim by 20 percent.  This is the largest decrease in the average medical payment per claim among study states.
    • Illinois wages are 6% higher than the U.S. average. (Workers’ Compensation premiums are based, in part, on wages.)
    • Illinois has the most workers’ compensation insurers of any state.  Since 2006, the number of insurance companies writing workers’ compensation policies in Illinois has jumped 13 percent.
    • The National Council on Compensation Insurance recommended a 20% reduction for Illinois workers’ Compensation insurance rates.
    • A report from the Illinois Department of Insurance shows that profits within the Illinois workers’ compensation sector have increased since the 2011 changes.  Insurers are not passing on the profits to employers in the form of premium decreases.

    Instead of passing these savings on to Illinois businesses, insurers are throwing parties complete with Hummer limos, go-go dancers, a live alligator and glowing aliens in spandex.  This is according to the next edition of the ProPublica/NPR investigation into the race to the bottom occurring nationwide.  ProPublica investigated the National Workers’ Compensation and Disability Conference & Expo.  They reported that there are more than 150 such conferences a year, bringing together claims professionals (adjusters) and members of the cost containment cottage industries that serve them: companies that provide networks of doctors and companies that review medical bills, firms that provide expert medical opinions and firms that specialize in complex claims, defense lawyers, data processing firms, rehab facilities, surveillance companies, outside claims shops, occupational medicine clinics, pain management services, translators, schedulers, headhunters, labs that test injured workers’ urine for illegal drugs, labs that test urine to ensure workers are taking the prescribed drugs instead of selling them.  These groups have a lot to celebrate, many of them have seen their stock prices double in the last couple years.  But the growth of these cost containment firms has added another layer of cold bureaucracy and complication to an already complex system that the average worker finds himself lost in.

    Tell Governor Rauner that you know better.  The benefits provided to injured workers is not what needs reform.  Further reforms should focus on insurance industry and self-insureds’ transparency and oversight.  The Legislative Research Unit reports that workers’ compensation costs for State employees fell 8% between 2013 and 2014, however other self-insured employers, such as Caterpillar, have refused to disclose the savings they are experiencing from the 2011 Amendments.  There are two bills pending that would create a task force to study premium rates and self-insurance transparency: House Bill 1287 and Senate Bill 162.

    If you ever have any questions about the hard facts, give us a call at (312) 372-8282.  We are happy to answer any questions you have about personal injury or workers’ compensation.

  • Work Comp costs drop, so why are employers still complaining?

    Every two years the State of Oregon Department of Consumer and Business Services conducts a study on workers’ compensation insurance premiums.  In October 2014, they found that Illinois experienced the steepest reductions in workers’ compensation insurance premiums in the country in the last two years.  The study estimates that Illinois rates dropped 24 percentage points from 2012 to 2014, whereas the national median was a reduction of only 2 percent. 

    In September, 2014, the National Council on Compensation Insurance reported a 19.3% drop in loss costs since 2011.  This is a savings of more than $450 million since the amendments to the Workers’ Compensation Act were passed in 2011.  For 2015, the Department of Insurance recommended a 5.5% cut in rates.  This is the third straight year a rate reduction has been recommended.  If insurance companies had followed the NCCI’s recommended rate reductions, employers could have released an additional $1 billion in premium decreases.  However, insurance companies are not required to make the recommended reductions in premiums.

    If Illinois has experienced nearly a 20% reduction in loss costs, why are business associations calling for more “reform”?  This would only take away more rights from injured workers and increase the insurance industry’s profits.  Real reform should promote transparency in the insurance industry to determine why the reduction in loss costs is not being translated into even further rate reductions for employers.  Given the lack of premium oversight, workers’ compensation insurance remains the second most profitable line of insurance after auto insurance.  Before the legislature contemplates taking away the rights of injured workers, they should mandate the insurance industry pass the cost savings along to employers by way of further premium reductions.

    So what is the answer: Insurance Reform! Injured workers and medical professionals have accepted steep decreases in benefits and reimbursement in order to lower costs for business. The next step to insure rate reductions keep pace with lowered costs is regulation of the insurance industry to assure that they pass along cost savings to consumers.

  • Decreases in Settlement Values

    The more time that passes since the Workers’ Compensation reforms of 2011, the more the effects of those reforms become apparent. One category of workers’ compensation benefits that have seen a substantial decrease are permanent partial disability (PPD) benefits. As you may know, you generally are entitled to receive three different categories of benefits when you sustain a work-related injury: 1) medical benefits, 2) off work benefits (TTD), and 3) permanent disability benefits.

    “Permanency” is a term used in workers’ compensation to represent the monetary compensation an injured worker is entitled to based on the permanent injury that he/she suffered. The “permanency” portion of a workers’ compensation claim is generally the lump-sum settlement or award an injured worker receives at the end of the case. The 2011 reforms changed the method by which a workers’ compensation Arbitrator must decide how to calculate and determine the permanency (or value) of a workers’ compensation claim.

    We have generally seen a substantial decrease in permanency awards as a result of the changes included in the 2011 reforms. It is now more important than ever to take action to protect yourself and to ensure you receive the compensation you are entitled to should your case proceed to hearing. The best way to improve the chances of a fair permanency award starts as soon as you sustain a work-related injury. When seeking medical treatment, it is vital to be very clear and detailed to your doctors when explaining both how the accident occurred, and what you are feeling. As you progress through your medical treatment, it is always important to tell your doctors exactly what you are feeling, and what limitations you are experiencing. Never assume that your doctor knows what you are feeling, or that he or she will document all of your complaints.

    Providing this information to your doctor is important because one of the factors an Arbitrator will consider is evidence of your disability, your testimony, corroborated by the treating medical records. This means that the symptoms and complaints you provide to the Arbitrator will be given weight only if they also are contained in your medical records.

    The details you provide to your doctor should not be limited to the pain or stiffness or other physical complaints you have. You should also make an effort to tell the doctor how these physical complaints are affecting your everyday life including the effects on your ability to perform job activities and activities of daily living. For example, if your wrist hurts, do not simply tell the doctor that your wrist hurts. Instead, try to be as detailed as possible as to how the pain affects your daily life. Does it hurt when you brush your teeth? Does it hurt when you drive? Can you button a shirt by yourself? What things could you do without issue before that now give you difficulty? You should always be honest with yourself and your doctor, but never assume that your doctor knows how your injury is affecting you. If you are detailed, informative and honest, you will greatly increase your chances of receiving fair compensation for a work-related injury.

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