On May 5, 2015, the Illinois House of Representatives convened a hearing that went for some eight hours. Much of the eight hours included testimony and questions of injured workers who had been affected by this Compensation Act, some from the state of Indiana. Except for the testimony of the injured workers, much of what was said by the legislators regarding the pros and cons of different aspects of the Illinois Workers’ Compensation Act was almost unintelligible to the average person.

There was heart-wrenching testimony from a nurse who was injured in the state of Indiana. She portrayed her struggle to repair herself in the face of controls that Indiana had in place at the time of her injuries. Most notably, the fact that she could not choose her own doctor, and therefore suffered many months before she was able to finally pay out of her pocket to have the injury repaired. The result of the delay would not allow her to go back on the nursing floor, and she now works as a home healthcare nurse because of the limited use of her upper extremity. Some have referred to the state of Indiana as the “Bangladesh” of state workers’ compensation systems.

Of particular note was the statement of John F. Burton, Junior Professor Emeritus, Rutgers University and Cornell University, which was presented to the committee of the whole before the Illinois House of Representatives. In addition to describing how each state had a workers’ compensation program that provided cash benefits and medical care rehabilitation benefits to workers disabled by work-related injuries and diseases, he also described the survivors’ benefits to families of workers who lose their lives in connection with a job injury or accident. The first state workers’ compensation programs were enacted in 1911. They were then referred to as workmans’ compensation, the oldest social insurance program in the United States. Mr. Burton chronicled what has occurred over the last 100 years, with the system having experienced periods from reform to regression.

Regarding workers’ compensation in Illinois, changes were enacted in 2011, adding several requirements, specifically placing the burden of proof to be shown by a preponderance of the evidence, that the worker sustained the injury in an accident arising out of and in the course of the employment. This, in effect, was the law in Illinois at the time the bill was passed in 2011. More significantly, there was a limitation placed on the choice of treating physician and revisions in the medical fee schedule, which was reduced a whopping 30% from where it had been the previous year. It diminished awards for carpal tunnel syndrome for no apparent reason, and required the use of the American Medical Association Guides to the Evaluation of Permanent Impairment to determine impairment ratings for permanent partial disability benefits.

This is an excerpt from the testimony of Mr. David Menchetti, regarding the application and use of the Sixth Edition of the AMA Guides to the Evaluation of Permanent Impairment, and how this document was drafted. Essentially, he stated that the document was consensus-based, meaning that the authors’ consensus on what an impairment rating should be was only their opinion. The guides are not an evidence-based document, and bear very little resemblance to actual disability suffered by an injured worker, thus demonstrating the negative impact these guides would have, even though the guides are only one of five criteria for evaluation of permanent impairment.

Illinois Governor Bruce Rauner, elected in 2015, of course has his own agenda about further reducing benefits of injured workers, and making it more difficult for an injured worker to qualify for workers’ compensation benefits at all. Professor Burton concluded adoption of Governor Rauner’s proposals would, “…unquestionably reduce costs of workers’ compensation benefits for employers, but poses a significant threat to the increased costs for employers. Injured workers excluded from the system through the proposals would allow them to file a civil lawsuit and seek civil damages, which have no cap.” The Illinois House of Representatives plans to call these matters to a vote as early as May 17, 2015. What will happen with this situation—and how much it could impact the injured workers of Illinois—remains to be seen.

AMA Guides, Bruce Rauner, Illinois Workers’ Compensation Act