Keefe, Campbell & Associates, LLC

Editor’s comment: This is actually the extended answer to our KC&A Trivia Corner question last week. We got so many quizzical inquiries; we wanted to make sure all of you were on board with this mildly unusual and hopefully rare work injury claim.

Illinois claimants are entitled to a bunch of things when they suffer a compensable amputation at work. Amputation to a finger or toe occurs when the affected digit(s) suffer any bone loss. It is possible to cut off the tip of one’s finger and not suffer a compensable amputation—the lost tissue cannot contain any bone. In the vast majority of situations, tissue without bone loss grows back and may result in typical compensation for either specific loss or disfigurement at normal PPD rates. When you ask a veteran defense lawyer about whether it is an amputation, they will first ask about bone loss—check x-rays or other medical tests for accuracy on the issue.

If the employee suffers an amputation of even a miniscule portion of bone at the tip of the finger or toe, three issues arise for the claims handler to consider.

• The low-wage employee becomes entitled to the very high minimum PPD rate for amputation loss—it is currently set at $456.28. Therefore, if you have a worker making $95 per week who suffers the loss of some bone in the tip of his middle finger, he is entitled to 50% of the middle finger or 19 weeks times $456.28.
• The high-wage employee becomes entitled to the very high maximum PPD rate for amputation loss—it is currently set at $1,216.75. The maximum PPD rate is set by taking 60% of the average weekly wage to the maximum for amputation loss. To reach the maximum PPD rate for amputation loss, an employee would have to make $2,027.92 per week or just over $100K per year. You may note the full undiscounted value of 100% loss of use of the thumb in this state for a maximum amputation rate claimant is 76 weeks times $1,216.75 or $92,473.00!
• Claimant attorneys in Illinois who handle undisputed amputations claims typically receive legal fees of $100. There is one major exception to this limitation—as a claims handler with an amputation loss; you have to start paying weekly PPD benefits at the correct rate as soon as the employee reaches MMI. If you don’t, whether you knew the rules or not, a claimant attorney can seek to receive both a 50% penalty for claimant and a 20% attorney fee on accrued PPD due until the weekly amounts due are paid up to date. Please note you may still continue to negotiate with claimant to close the balance of PPD due and any future medical rights but you have to continue paying weekly PPD while you are doing so.

We want all of our readers to know the last trivia question is a teaser—we inquired as to whether a surgically reattached member can still qualify for amputation handling. Having again recently researched the issue, we are confident the IWCC has not yet decided such a case. We don’t feel one should be able to receive the additional and generous benefits for amputation if the member is reattached and works normally. But we aren’t in a position to make that final decision so we will continue to wait and watch until our Commissioners tackle the problem and then report their wisdom on what may be a tough ruling.

Please also note many claims handlers are confused by the provision of the Act that allows the loss of two or more digits to be treated as the loss of use of the hand. Our vote is don’t be confused. If you do the math, the sum of the Illinois weekly PPD values for the thumb and other fingers actually exceeds the loss of use of the hand. If you compensate for 100% loss of use of the first and second fingers, it is the equivalent of 39.5% loss of use of the hand. If the Arbitrator writes the award on the fingers or the hand, it typically won’t make a great deal of difference.

Our strong vote on amputation claims is TLC—apply tender loving care to someone who is suffers one of the cruelest losses a human can suffer. Go the extra mile to insure the employee is taken care of and advised they will get the best possible medical care and benefits during their recovery. Consider referrals to hand specialists like Drs. Jay Pomerance, Michael I. Vender, Evan Crandall or Peter Hoepfner. When the worker reaches MMI, let them know you are taking further care of them by both accommodating any restrictions and also paying them what they are due under our Act. Many of our clients have obtained best possible outcomes with this approach. If you have further questions, thoughts or comments about handling amputation losses in Illinois, please send a reply.