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	<title>Keefe, Campbell &#38; Associates, LLC &#187; Permanency</title>
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	<description>KCA&#039;s Workers Compensation &#38; Employment Law Blog</description>
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		<title>Illinois Supreme Court shocker—in the middle of this recession, you now have to send the underwriters back to review and probably raise reserves on your biggest Illinois claims. Please don’t shoot the messengers.</title>
		<link>http://keefe-law.com/blog/2009/06/01/illinois-supreme-court-shocker%e2%80%94in-the-middle-of-this-recession-you-now-have-to-send-the-underwriters-back-to-review-and-probably-raise-reserves-on-your-biggest-illinois-claims-please-don/</link>
		<comments>http://keefe-law.com/blog/2009/06/01/illinois-supreme-court-shocker%e2%80%94in-the-middle-of-this-recession-you-now-have-to-send-the-underwriters-back-to-review-and-probably-raise-reserves-on-your-biggest-illinois-claims-please-don/#comments</comments>
		<pubDate>Mon, 01 Jun 2009 14:26:16 +0000</pubDate>
		<dc:creator>Eugene Keefe</dc:creator>
				<category><![CDATA[Illinois]]></category>
		<category><![CDATA[Workers Compensation]]></category>
		<category><![CDATA[Permanency]]></category>
		<category><![CDATA[Total & Permanent]]></category>
		<category><![CDATA[Windfall]]></category>

		<guid isPermaLink="false">http://keefe-law.com/blog/?p=119</guid>
		<description><![CDATA[Editor’s  comment: We wonder if our  highest Court has noticed all the empty homes that no one is buying and all the  cars that are sitting rusting on dealer lots that are closing and all the jobs  that may be leaving our state. Outside the halls of the Illinois Supreme Court, [...]]]></description>
			<content:encoded><![CDATA[<p><strong>Editor’s  comment:</strong> We wonder if our  highest Court has noticed all the empty homes that no one is buying and all the  cars that are sitting rusting on dealer lots that are closing and all the jobs  that may be leaving our state. Outside the halls of the Illinois Supreme Court,  we see labor’s political forces amassed to include the Illinois Trial Lawyers  Ass’n and union representatives apparently devoted to making Illinois a graveyard for U.S.  business. Their bent seems to be a goal to make our workers’ compensation  benefits as painful and as expensive as possible. We assure all of you this  ruling will add a significant level of confusion and uncertainty to the  supposedly structured workers’ compensation benefit process. When all is said  and done, the ruling may also affect only about one-two hundred Illinois citizens  annually—with the awful anti-business message it sends, why did they  bother?</p>
<p>The  Illinois Workers’ Compensation Act was initially passed by the Illinois legislature one hundred years ago in 1909  following a disaster at the Cherry Mine in central Illinois. We assert  Illinois now  has the highest total and permanent disability maximum and minimum rates in the  world. Right now, an injured Illinois worker making $50 a week who is  adjudicated T&amp;P gets $461.78 per week or $24,012.56 per year! The maximum is  a hefty $1,231.41 or $64,033.32 per year. An Illinois worker doesn’t hit the max until they make  $96,049.98 unless Illinois’ wacky method of calculating the  average weekly wage under <strong><em>Sylvester</em></strong><strong><em> </em></strong>is used. For a  30-year-old worker who has a  45-year life expectancy,  the full undiscounted value of a total and permanent disability is  $2,881,499.40. While we don’t want anyone to suffer a catastrophic injury, if it  happens, we consider that amount more than satisfactory when one understands the  worker also gets get unlimited on-demand medical attention, home and auto  improvements to adjust to their disability and favorable public parking  places.</p>
<p>Until last  week, the highest benefit payable under our Workers’ Compensation Act for a  single injury was the lifetime weekly benefits outlined above for a total and  permanent disability. Three years ago, our friends in Illinois labor demanded and got funding from Illinois business for  COLA increases guaranteed to keep such benefits consistent over the entire life  of an injured claimant. Again, while some states do and some states don’t, it is  hard to fight over COLA benefits for statutory T&amp;P  claimants.</p>
<p>So what  happened last week? Well, the Supreme Court may have arguably doubled this  already gigantic benefit. If they didn’t double it, they increased it greatly.  In <strong><em>Beelman  Trucking v. Workers’ Compensation Commission</em></strong>, claimant suffered a  very serious injury involving paralysis to both legs and one arm along with  amputation of the other arm at the elbow. We join with the employer in extending  our concerns for this severely injured worker. There is no question he is  entitled to lifetime statutory total and permanent disability benefits at the  appropriate rate—he had already received $274,000 from his employer at the time  of the hearing. We don’t understand why such a claim needed to be litigated in  any way. An attorney taking such a claim gets a statutory $100 fee pursuant to  Illinois law.  It would appear obvious he found a zealot to represent him who then took the  matter through five different levels of litigation over 15 years, probably  costing the employer tens of thousands of dollars fighting over this  mess.</p>
<p>What the  Arbitrator and Commission did, for the first and only time in Illinois history is not  only allow him to prove-up his right to statutory total and permanent weekly  benefits for a single injury, they awarded additional or double weekly benefits  on top of lifetime benefits!! As our system provides for weekly benefits only,  one has to wonder when the benefits following lifetime benefits might be due. Do  they have bank accounts that take weekly deposits in  heaven?</p>
<p>What  the Arbitrator and  Commission panel did instead was to “deform” the weekly benefit system in an  unprecedented fashion—they doubled the weekly benefit, requiring the employer to  now pay “permanency” twice. The method used was to look at the statute that  provides weekly lifetime total and permanent benefits to anyone losing the use  of two limbs and confirm that is one benefit under the Act. They then ruled, if  someone loses more than two limbs they get additional weekly benefits for the  other lost limbs without any “credit” for the T&amp;P weekly benefit already  clearly due.</p>
<p>In this  case, they provided a lifetime weekly total and permanent benefit for the  undisputed loss of the legs along with another 100% loss of use of each arm or  253 weeks of additional benefits consistent with amputation losses for each lost  limb. The additional amount awarded could be as high as $1,231.41 per week times  506 weeks or <strong>$623,093.46</strong>. The additional amount  can be no less than the minimum amputation value of <strong>$233,660.68</strong>.  Ouch.</p>
<p>As you may  be able to tell from the tenor of this article, we consider that outcome  preposterous under the law as it has evolved. As workers’ compensation law  professors, such a ruling is a paradigm shift away from the clear language,  intent and scope of the legislation that has been in place for 100 years. We  also point out the clear alarm for all Illinois employers that chaos appears to be  afoot—we have no idea where these folks are going to drive such a concept and  what new claims may ensue. We pray calmer heads will prevail and our hearing  officers, judges and justices return to a more traditional reading and  interpretation of the “plain language” of the Act.</p>
<p>Although  the Arbitrator and Commission ruling was rubber-stamped by the Circuit Court,  the Appellate Court, Workers’ Compensation Commission Division should be  applauded for reversing it with a very solid ruling confirming how obtuse the  legal theory was. Although we do not always agree with their rulings, these  justices continue to be a gateway for common sense and tradition in their  management of our workers’ compensation legal system. We like to characterize  them as liberal yet careful jurists. Again, one would have thought this case  would have ended with this Appellate Court reversal. However, the Supreme Court  agreed to take the case for reasons known only to the members of that court.</p>
<p>In  <strong><em>Beelman  Trucking</em></strong>, the Supreme Court  came up with a theory to allow double weekly benefits for a single accident for  the first time in Illinois history. It is worth noting the  Illinois Trial Lawyers Association’s amicus brief was mentioned in this ruling.  At no point do they mention the fact all permanency benefits arising from a  single accident for the last hundred years have been paid weekly and now will  have to be double-paid. And try to imagine how  happy Sam Beelman, the president of Beelman Trucking had to be to learn the  Illinois Trial Lawyers Ass’n had lined up to file a brief and thereby advocate  against his company. We don’t feel any single business entity has any chance  against ITLA’s political clout and campaign largesse; certainly not a  modest-sized southern Illinois trucking concern. If ITLA writes a  brief to the Court, you can bet the Court will listen more than carefully—at  this level of the judicial spectrum, whatever ITLA wants, ITLA gets. Again, as  the future legal fees on such claims should be capped at $100, why did ITLA  care?</p>
<p>The Court  reaches the conclusion that loss of use of two limbs does entitle a worker to  lifetime weekly total and permanent disability benefits—this aspect of the award  was proper and undisputed. However, the Court then finds the right to permanency  doesn’t end there and any other injuries suffered in the same event now entitle  the injured worker to double their weekly recovery. So, we ask all of our  readers the obvious question, why isn’t this claim a “double” total and  permanent disability? If the answer is that wouldn’t make sense, we don’t think  any of this makes any sense. The Court interprets statutory total and permanent  disability to arise from a loss of use of two members. This guy sadly lost 100  per cent of all four members—why doesn’t he get lifetime benefits twice? The  statute doesn’t provide “credit” for the first T&amp;P award, does  it?</p>
<p>We read  our highest court’s ruling as somewhat blurring—they break down the word “case”  and note Respondent’s brief outlined “case” meant “proceeding” and the court’s  majority felt “case” means “incident” or “example.” It is unclear why the court  went to such great lengths to analyze these terms since it is something only a  lawyer could struggle to make sense of. From the perspective of John Q. Public,  the bigger and more important point is for the last 100 years, Illinois employers have  been taking full care of any injured worker to pay unlimited on-demand medical  for life along with a very generous tax-free weekly T&amp;P benefit with  cost-of-living increases. However one dices and slices the word “case,” do we  really have to throw literally hundreds of thousands of dollars on top of that?  Can and should Illinois business have to afford  it?</p>
<p>So what do  we have to do now? Well, we figure there are three things. One, you have to  understand there is blood in the water and sharks swimming all around looking  for fresh meat. Where is the next launching place for ITLA to sink its teeth  into? These folks have to be emboldened by this victory and looking for new prey  to shoot, field-dress and bring back to their membership. We assure you they are  going to be advertising for this new business as rapidly as possible. We are  also sure that finding new paths to stack benefits will be the next trend at the  IWCC&#8211;if an Illinois worker is injured and gets a “lazy lot” total and permanent  award, can they now go back to the Commission and ask for specific loss for body  parts that were injured but did not cause the restrictions that led to total and  permanent disability? Is this a new method to stack double weekly benefits? If  you can think of any other way benefits could be stacked in this fashion, please  send it along and we will share with our readers.</p>
<p>Second,  please note this ruling affects all pending claims that have not been settled or  tried. One arbitrator who knew of this ruling already advised he had a total and  permanent award where he is going to have to add permanent loss for a shoulder  surgery on top of the T&amp;P award. We therefore feel all underwriters have to  take a fresh look at their biggest claims and reset reserves consistent with  this ruling. Reserves on any pending quadriplegic claim just went up around a  minimum of $230K and possibly as high as $623K. Triple amputees or paralysis  victims will also see concomitant boosts. If you have questions or comments on  reserving major cases following this precedent, send the  inquiry.</p>
<p>Finally,  we have to get to our legislators and try to teach them how bad things are  getting in this state. We also ask you to consider joining the Illinois State  Chamber and its Employers Council. They remain out on the point for Illinois business in the  fight to try to bring workers’ compensation benefits back to some semblance of  reasonableness. While this ruling doesn’t affect thousands of claims, it still  sends a brutal message to Illinois business and prospective employers.  We assure all of our readers most companies with Illinois operations are holding onto cash in  their major claims; it is painful to have to tell them to boost reserves and tie  up even more cash and credit while they are fighting for their  survival.</p>
<p>The ruling  is on the web at: <strong><a title="http://www.state.il.us/court/Opinions/SupremeCourt/2009/May/106680.pdf" href="http://www.state.il.us/court/Opinions/SupremeCourt/2009/May/106680.pdf">http://www.state.il.us/court/Opinions/SupremeCourt/2009/May/106680.pdf</a>.</strong> Please don’t hesitate  to send your thoughts and comments.</p>
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		<title>We have to admit to our readers, we aren’t completely sure about this ruling but are certain you all should and must be aware of it. The Appellate Court of Illinois, Workers’ Compensation Division, appears to rule when someone suffers an injury or exposure and later dies of related causes, double recovery for widow(er)s may now be the law in Illinois by finding the injured workers’ claim for injury while living does not switch to death benefits when the injured worker passed from the same cause.</title>
		<link>http://keefe-law.com/blog/2009/01/26/we-have-to-admit-to-our-readers-we-aren%e2%80%99t-completely-sure-about-this-ruling-but-are-certain-you-all-should-and-must-be-aware-of-it-the-appellate-court-of-illinois-workers%e2%80%99-compensat/</link>
		<comments>http://keefe-law.com/blog/2009/01/26/we-have-to-admit-to-our-readers-we-aren%e2%80%99t-completely-sure-about-this-ruling-but-are-certain-you-all-should-and-must-be-aware-of-it-the-appellate-court-of-illinois-workers%e2%80%99-compensat/#comments</comments>
		<pubDate>Mon, 26 Jan 2009 16:39:09 +0000</pubDate>
		<dc:creator>Matthew Wrigley</dc:creator>
				<category><![CDATA[Workers Compensation]]></category>
		<category><![CDATA[Permanency]]></category>

		<guid isPermaLink="false">http://keefe-law.com/blog/?p=243</guid>
		<description><![CDATA[Editor’s  comment: With respect to the  members of the Court, if our suspicions are correct, we feel this award is  preliminarily confusing and potentially strains credulity. We do not feel the  legislature intended this result and we feel there is nothing clearly outlined  in the legislation upon which the Court [...]]]></description>
			<content:encoded><![CDATA[<p><strong>Editor’s  comment</strong>: With respect to the  members of the Court, if our suspicions are correct, we feel this award is  preliminarily confusing and potentially strains credulity. We do not feel the  legislature intended this result and we feel there is nothing clearly outlined  in the legislation upon which the Court relies to reach this outcome. It is also  may be a matter of unnecessarily generous largesse for every widow or widower in  this state for anyone related to someone injured severely while living who later  passes from related conditions. We also feel it may be a business-destroying,  premiums-about-to-skyrocket decision that will again push jobs away from our  state. Underwriters for Illinois claims  beware!</p>
<p>In light  of this ruling, we are petrified of what to expect in the  <strong><em>Beelman  Trucking</em></strong> ruling currently being  considered by the Illinois Supreme Court. In <strong><em>Beelman  Trucking</em></strong>, claimant suffered  severe injuries and lost both arms. The Arbitrator accurately ruled he was a  statutory total and permanent disability and such benefits are unquestionably  due for life. On top of that, she also ordered 100% loss of use of the limbs so  as to require PPD to be paid weekly at the same time the total and permanent  benefits were being paid—the outcome requires a number of years of “double PPD.”  We are unaware of any legislative scheme in all of the U.S.  workers’ compensation systems that foster such outcomes. Now, Illinois may not have one  but two different scenarios where double-payment is perceived by our Courts to  be the law. Defense observers note there was no compelling reason for the  Supreme Court to consider the <strong><em>Beelman  Trucking</em></strong> decision that  overruled the double-payment scenarios. The ruling in this case we analyze today  now leads us to feel the pro-plaintiff jurists on the reviewing courts may want  double-payment of benefits to become the law in as many settings as  possible.</p>
<p>In  <strong><em>Freeman  United Coal Mining Company v. Van Houten,</em></strong> (No. 4-07-0905WC &amp;  4-07-0907WC September 29, 2008), an Application for exposure to coal dust was  filed by a living coal miner named Kenneth Van Houten on March 10, 2000 for a  February 2, 1998 exposure. He died on May 19, 2000 of what were later determined  to be work-related causes. After his passing, on August 2, 2000, the widow filed  a separate Application for death benefits. We consider the second Application  the confuser and consider it wholly unnecessary—he died of the same cause;  exposure to coal dust.</p>
<p>There is  no dispute Decedent worked as a coal miner for 38 years and was exposed to coal  dust. He developed chronic lung disease in the form of hypoxemia, chronic  obstructive pulmonary disease, long-standing heart disease  and chronic bronchitis. The Arbitrator found Decedent’s exposure to coal and  rock dust a causative factor in the development of his maladies and eventual  death. He awarded the widow benefits under Section 7 of the Act and ordered the  employer to pay for decedent’s funeral expenses.</p>
<p>The  confusion begins when the Arbitrator did not award benefits in the decedent’s  claim that he filed while living, ruling the claims abated on his passing. We  cannot tell if the parties sought TTD from February 2, 1998 until his passing on  May 19, 2000. From our review of the ruling, the condition was work-related and  claimant was disabled from February 2, 1998 until his passing, if Petitioner  asked for it, we assert the Arbitrator could have awarded TTD from the date of  his disablement on February 2, 1998 until death occurred in May 2000. The  Commission effectively affirmed and found the condition abated at death and the  widow was entitled to death benefits only.</p>
<p>On appeal,  the widow argued the Commission’s finding which ruled Decedent’s claim brought  while living abated by virtue of Section 8(h) was “legal error.” The Appellate  Court reviewed this issue <strong><em>de  novo</em></strong> as one of statutory  construction. Delivering the opinion of the court, Justice McCullough found  Section 8(h) unambiguously “provides that benefits to which the employee would  have been entitled but for his death are to be paid to the employee’s survivors  upon his death from any cause.” The Court further held if a claimant “dies  during the pendency of the claims process, the claim shall proceed as if the  death had not occurred.” If the claim prevails, “all compensation that would  have been awarded to the claimant shall be paid to the dependents of the  deceased claimant” and “any other claims any dependent might have as a result of  the claimant’s death shall proceed unaffected.”</p>
<p>We point  out the statute doesn’t say what the Court says it does—the words “the claim  shall proceed as if the death had not occurred” aren’t in Illinois law. We also  point out all Illinois workers’ compensation benefits are to  be paid weekly. There is no indication our legislature wanted double weekly  payments to be paid at any time to widows or anyone else. One reading of this  challenging decision may allow for double weekly checks to be awarded—we  consider that to be anomalous and inconsistent with most U.S. workers’  compensation systems and legislative intent.</p>
<p>So our  worry is a hypothetical claimant who smokes a “clove cigarette” at lunch and  then falls from a ladder at work. During emergency care, the physicians amputate  his/her arms and legs. Claimant survived but never recovered consciousness and  he/she dies one week later of the injuries. In such a scenario, it would appear  his/her widow(er) would be entitled to one week of TTD (less the waiting period)  and then the full death benefit. To the contrary, in this unanimous decision,  the Court appears to rule the widow would get the full death benefit that is a  minimum in this state of at least $560K up to about $1.6 million dollars and on  top of that, the widow could also file a second Application for the same  accident/exposure and would also get 100% loss of use of each leg and each arm.  Such a scenario would add at least an additional 936 weeks of benefits or  potentially over $1 million more to the death benefit. If the Commission truly  felt generous, they could dump in another 500 weeks for 100% loss of use of the  “person as a whole” which would give the estate another $325K. In such a  scenario, the award could exceed $3 million! We will leave all of that to your  imaginations because that is where we feel this is coming  from.</p>
<p>We feel the accurate  ruling in this matter is claimant had one case for one exposure on February 2,  1998—the second filing is duplicative and unnecessary; you can’t and shouldn’t  be able to file and maintain two Applications for one exposure on one day. We  assert the second Application should have been dismissed and urge Respondent’s  counsel to move to dismiss it right now to protect the record. We also feel it  may or may not have confused the reviewing court because the plain reading of  their decision is confusing us. We note the Court specifically rules “Any  <strong>other claims</strong> any dependent might  have as a result of the claimant&#8217;s death shall proceed unaffected.” (emphasis  added; we also note the decision is referring to dependents when they appear to  actually refer to the widow who isn’t necessarily a dependent). We have no idea  what, why and how a widow of a deceased injured worker has “any other claim”  arising out of one exposure on one day.</p>
<p>Under the  statutory provision cited by the Court in their decision, we feel the widow(er)  unquestionably takes any workers’ compensation benefits be it medical bills, TTD  or PPD due to claimant while living. Upon passing, the living claim for any  pending benefits would shift/abate/whatever-you-want-to-call-it to allow the  widow(er) to then be entitled to the full weekly death benefit. Please note the  death benefit might be dramatically higher for a lower wage individual than PPD  rates for scheduled injuries. Under our view, using a “plain English language”  reading of the Act, he/she would never be entitled to both weekly PPD for the  claim to be paid after the passing of claimant with weekly death benefits at the  same time.</p>
<p>If the  Court simply intended to allow for an award of TTD from February 2, 1998 until  May 19, 2000 and remanded the matter for that purpose, the decision should say  so. As we read the ruling, it would appear the Court wants double payment of  weekly benefits when they refer to “any other claims” and say “the claim shall  proceed as if the death had not occurred.” We feel this is wholly inconsistent  with the legislation and hope the anomaly is  clarified.</p>
<p>We hope  the legislative gurus at the <strong>Illinois  State Chamber</strong> read this one  carefully and put it on the list of stuff that may need to be reformed. This  article was drafted by <strong>Matthew  A. Wrigley, J.D.</strong> and  <strong>Eugene  F. Keefe, J.D.</strong> We invite your  thoughts and replies.</p>
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