Illinois Legislators Start 2011 with WC Reform

Happy New Year to all of you!  We hope you enjoyed your holidays, and we welcome all of our readers to 2011, when we continue to follow the progress of WC reform efforts started at the end of 2010.

In a recent meeting of the Illinois Chamber of Commerce Workers’ Compensation Committee, we learned that the House and Senate Special Committees on Workers’ Compensation have continued to work around the holidays, and it is anticipated that there will be draft legislation for review and consideration published for review sometime this week.  Please keep informed through our blog postings, and we will give you updates as they occur!

As it currently stands, through considerable resistance to meaningful reform on the part of labor organizations, the anticipated changes to the Illinois Workers’ Compensation Act will target only five major points as follows:

1.  employer choice of physician for the first physician and perhaps some standards set for allowing employees to then choose a second choice of physician;

2.  utilization review will require use of IL physicians and specialists only, with employers, in exchange, seeking to have a “rebuttable presumption” standard put in place for UR reports in addressing the issue of “reasonableness and necessity” of medical care;

3.  capping wage differential payments at age 67 and perhaps allowing for adjustments for change in economic circumstances;

4.  implementation of a statutory intoxication defense that places the burden on the employee to show his intoxication was not the cause of the accident and that if the intoxication level is over the legal limit (currently 0.08% blood alcohol level), then there is no recovery; and,

5.  a 15% medical fee schedule reduction across the board, a provision proposed by the IWCC Chairman that has created a lot of debate as to the actual savings employers would expect in the long-term.

The IWCC has also requested additional changes including a provision allowing a single Commissioner to be able to issue a work-stop order against an uninsured employer following a hearing before that Commissioner; changes to the Rate Adjustment Fund and how it is administered; inclusion of pharmacy and dental expenses, as well as reimbursement for the cost of implants, in the Fee Schedule (including payment for implants at 25% over provider purchase price); reduction of 29 geozips to four Medicare regions; assignment of special attorney general to prosecute WC fraud; and requirement that all Arbitrators hereafter appointed be attorneys.

It is anticipated that there will be no change to the medical causation standard and no introduction/adoption of AMA or similar guidelines for permanency.

We will continue to monitor the progress of the proposed amendments to the Illinois Workers’ Compensation Act, and if you have any questions or comments, please let us know.  We also suggest that you contact your local state legislators if you are interested in seeing these changes occur.  Best wishes to all of you in this New Year!

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