Illinois scandal updated–with report from ’08–as legislature resolves reform bill

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‘Human nature’ to gamble?

An opinion piece at a Pennsylvania news site brings up an unusual topic: injured workers who gamble away workers’ comp benefits.

Human nature cannot be repealed. So it’s hardly surprising that some unemployed people gamble away their workers’ compensation at casinos. Gamblers, after all, often try to cover big losses with bigger bets, despite the proven long odds. Why wouldn’t some people who have lost their jobs try to cover those losses at a slot machine or black jack table?

Neither the state Department of Labor and Industry nor the state Gaming Control Board has hard data on how many unemployed Pennsylvanians have gambled their workers’ compensation benefits because there is no way to track it. But the issue arose at a recent state Senate hearing on extending benefits for about 45,000 of the more than 450,000 Pennsylvanians receiving workers’ compensation.

Unemployed versus injured

I don’t quite get the qualified distinction of “some unemployed people” and “workers’ compensation.” Why would an injured employee be unemployed? I can understand an injured worker having to miss work while recuperating, but if employees are dismissed because they filed for workers’ comp benefits, that cause for litigation and further redress.

One idea: block workers’ comp debit cards

That point aside, the opinion goes on to note that a state senator says that “jobless patrons spend millions of dollars in workers compensation benefits at casinos,” and that she has proposed legislation that would require casinos to “block workers’ comp debit cards from their automated teller machines. By regulation, casino ATMs must reject debit cards issued by the state Department of Public Welfare.”

The whole thing sounds odd, to me. Why are injured workers receiving money in the first place, regardless of whether by direct deposit or transfer to a card? Seems to me the injured worker would receive treatment from the medical provider, who then would bill the workers’ comp insurance carrier for payment. Sounds like another state in need of workers’ comp reform, as we have been covering in preceding posts.

Extra effort results in bill’s passage–finally

Speaking of which, Illinois has finally passed a measure that will be sent to the governor soon, following an epic battle that we most recently discussed here. As reported June 5, in a long, thorough behind-the-scenes piece, “Ultimately, the overhaul was approved 62-43. Gov. Pat Quinn has said he plans to sign it, potentially saving Illinois businesses more than $500 million, largely by cutting fees to doctors for treating work-related injuries.

“The story behind the resurrection of the workers’ comp overhaul is a classic Springfield tale of power and persuasion. It demonstrates the hard-bargaining agenda legislative leaders set during the spring session, with the state facing serious questions about its business climate.”

It’s an able bit of reporting and a dandy read, not only for those in Illinois who are following along blow-by-blow but also for residents of other states who recognize the need for upgrading workers’ comp systems.

However, scandal news continues to emerge

In related news, the Belleville News-Democrat–which has broken several significant pieces concerning the Illinois workers’ comp scandals, cites a 2008 study in its story headlined “Study: Guards’ duties did not cause injuries; but CMS OK’d millions in workers’ comp claims“:

Three years ago, officials at a state agency became suspicious when dozens of guards from the Menard Correctional Center filed workers’ compensation claims for debilitating injuries from turning keys and manually operating cell locking devices.

Central Management Services, the agency that processes workers’ comp claims, brought in an expert to do on-site evaluations of whether those duties could cause repetitive trauma injuries, including the most common — carpal tunnel syndrome.

A 17-page report by Midwest Rehabilitation Inc. of Springfield, received Sept. 30, 2008, stated that the duties of guards at the Chester prison did not approach even minimal levels on its Stress Index.

The index is a method of measuring the potential for repetitive trauma. A score below 3 is considered safe. None of the Menard guards’ duties tested, including operating a crank that opens 24 cells at one time, scored higher than 1.5, according to the report.

But instead of challenging the taxpayer-paid settlements — which ranged from $20,000 to $100,000 — CMS continued to approve payments to guards for repetitive trauma. They turned over copies of the 2008 report to the Illinois Department of Corrections and attorney general’s office, then filed it with no investigation.

In most workers’ comp cases, a state arbitrator gives final approval to claims after a treating physician provides an opinion that the injury exists.

Hundreds of claims, millions of dollars

According to BND, the claims from Menard workers–mostly guards–eventually exceeded 230, with about half having been settled for nearly $7 million.  In total, counting all prison staff and a variety of complaints, claims of nearly 400 have resulted in payouts of nearly $10 million, “including a carpal tunnel settlement of $75,678 for the warden. Millions more in medical fees were billed to the public.”

We can help you find an attorney

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

An ongoing issue in the NFL concerns injured players who file for workers’ comp benefits in states where they played games rather than in the state where the team is based. We first covered the issue last year here and here, describing what was originally known as “the Bengals’ situation,” which expanded to the point that hundreds of retired, injured players were filing in California because of its unique circumstance.

The California system vs. newer contracts

We quoted from an April piece from The New York Times: “California provides the only workers’ compensation system that allows retired pro athletes to file claims for long-term injuries sustained on playing fields years or even decades before. Quietly, hundreds of football players have received awards or settlements worth at least $100,000 and 700 more players are pursuing claims, many of them by satisfying California’s unique requirement that they played at least one game within state borders.”

By last spring, teams that were watching or fighting similar actions included at least the Bengals, Dolphins, Saints, Titans and Rams. The Titans and Bengals had already begun inserting specific language into player contracts restricting workers’ comp actions to their home states.

The battle expands

Now, the Miami Dolphins are fighting on another front. According to a Feb. 14 article in the Pittsburgh Post-Gazette the workers’ comp issue has become part of “the war” between owners and players:

Kendall M. Newson caught just two passes in his National Football League career, but now the former Miami Dolphin is the star of a legal battle, fought Downtown last week, in the war between the teams and players.

Lawyers for the Dolphins asked U.S. Magistrate Judge Lisa Pupo Lenihan to put the kibosh on Mr. Newson’s workers’ compensation case related to a 2005 knee injury, sustained in a preseason game at Heinz Field, that ended his career. They said the claim should be decided by an arbitrator, not by Workers’ Compensation Judge Pamela L. Briston.

Lawyers for Mr. Newson and the NFL Players Association countered that there was no legal precedent for a federal judge stopping a state workers’ compensation case and added that such a measure would be especially damaging due to the current contract dispute between the league and players.

In other words, the scenario is escalating. For Newson, prevailing under Pennsylvania law would mean the difference of nearly $4,000 a year plus medical benefits that his attorneys say are better than those available in Florida. Dolphins’ management wants the case to be settled via arbitration in Florida: one player’s benefits may not seem like much, but increased benefits for hundreds of players, over time, add up significantly.

Florida’s new workers’ comp bill

An unrelated issue in Florida is a new bill that is designed to:

• modernize and set standards for certain underwriting ratings
• create a new position within the Office of Insurance Regulation, called the Worker’s Compensation Administrator, which would
• reduce overlap among current responsibilities spread over several offices.

According to a Feb. 10 piece at InsuranceJournal.com, “In 2003, lawmakers created a new subplan D that was designed to provide coverage to small employees with 15 or fewer employees and non-profit organizations. Primarily, the subplan was provided as a safety net for small contractors after lawmakers ended workers’ compensation exemptions in the construction industry. Unlike the other three subplans that had actuarially sound rates, subplan D rates were capped at a small percentage above rates charged in the voluntary market and were assessable policies. The subplan quickly ran up a deficit and in 2004 lawmakers appropriated money from the state’s Workers’ Compensation Administrative Trust Fund to retire the shortage. They also eliminated the subplans in favor of a three tier rating plan.”

In other words, the former “fix” for small contractors didn’t work out. Reportedly, this bill is on a fast-track to becoming new legislation. We’ll keep tracking it and report as developments are known.

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Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

One thing about workers comp cases–the issues can be so broad that you never know what oddity may pop up.

For example, regular readers are aware that most states include undocumented workers in workers comp protection. We discussed a couple of such cases here, one from Michigan and one from Nebraska.

Undocumented workers protest in Michigan

Now Michigan is back in the news. Posted March 11 at WILX.com, this brief describes a protest at the state Capitol, including “[s]ome [who] were illegal immigrants, rallying for the state to grant them rights to workers’ compensation.”

State Rep. Rashida Tlaib (D-Detroit) has introduced a bill that would grant such coverage and was quoted as saying, “We’re only one of two states in the nation that does not allow workers that are undocumented to compensate when they are injured on the job.”

As might be expected, not all her colleagues agree with the idea, indicating its passage has a snowball’s chance…

Rep. Rick Jones (R-Grand Ledge) said, ““The only thing we should be giving illegal immigrants is a bus ride home.”

Jones, taking a “Michigan-workers-first” stance, brought up bogus Social Security IDs and the expense to companies to pay into the workers comp system.

But Tlaib “and others” countered with a point to ponder: pointing out “that requiring companies to pay workers’ comp might discourage them from hiring illegal immigrants in the first place.”

Ex-Deputy Warden cites nepotism as stressful

Now here’s a doozy, from a March 10 post with a Wilkes-Barre (PA) dateline: everybody knows somebody who’s felt disadvantaged by on-the-job nepotism. But in this case, former Deputy Warden Sam Hyder,  Luzerne County Correctional Facility, says nepotism was a major reason for the workplace problems that should leave him eligible for $800 a week in workers comp benefits.

“Hyder claims he suffers from work-related stress due to pressures brought on by” County Commissioner Chairwoman Maryanne Petrilla’s “hiring requests and threats, the suicide of a co-worker, his attendance at an inmate’s autopsy and the publicity he received for outing a drug-dealing prison guard.”

Petrilla has denied not only pushing Hyder to hire unqualified cronies but also says she did not single out Hyder for political reprisal.

According to the article, “Hyder was on medical leave from Aug. 28, 2009 until he was laid off from his $74,263 job in late January 2010. He testified Feb. 2 about how he ‘blacked out’ one day at work from the stress and suffers from anxiety, panic attacks and nightmares. On Tuesday, the county countered with five defense witnesses.”

At least one other employee, a secretary promoted to assistant business manager, seems to back up Hyder’s version, indicating that a “hiring list of the politically connected trumped applications from other qualified candidates.”

Said Jaqueline Grimes: “Everybody, commissioners, judges, magistrates, police officers, would be saying, ‘Give this person a shot. (Prison management) wanted to know, whose person it was. ‘John Doe is my guy, this one is (former Manager/Chief Clerk) Sam Guesto’s.’”

Fired workers say boss pushed her religion on them

And from Ohio, a March 3 AP account reminds us that freedom of religion just might encompass freedom from religion:

“After a sweeping scandal nearly five years ago that cost the state’s insurance fund for injured workers $300 million because of investments in Beanie Babies, rare coins and other risky assets, Ohio beefed up oversight and created a panel to help lawmakers look out for the health of the fund.

“Now, three years after lawmakers created the Ohio Workers’ Compensation Council to advise them on bills involving workers comp issues, the council finds itself entangled in chaos with a director accused of firing the entire staff amid allegations that she pushed her religion on employees.

“The three fired workers each sent letters to council members Tuesday accusing Director Virginia McInerney of wrongful discharge, religious discrimination and harassment, age discrimination and retaliation.”

Described as an occasional guest on “The 700 Club” who also was active in a large evangelical church,  McInerney was said to have led prayers at work and to have passed out religious CDs and at least one religiously themed book.

The piece quotes a former staff attorney as writing in a letter that “It became increasingly clear that the Director was judging employees not on professional performance but on the quality of their faith, according to her beliefs.”

McInerney denies the allegations and says she can’t comment on an ongoing case, but “that she saw no alternative under the law but to fire them.”

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Whether you’re an injured employee or an aggrieved employer, if you’re facing legal problems regarding workplace injuries, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Denial of benefits

Choosing an attorney

Three recent news items reflect the breadth and depth of disparity among the states’ regulations concerning workers’ compensation.

The first and third are from California and Florida, the second from Pennsylvania; taken together they reveal a shocking disconnect between treatment of perps and victims.

Roofer injured in 2003

According to a March 1 article in the Orange County (CA) Register, roofing contractor Michael Amzie Hollings “is expected to be sentenced to three years in state prison” after pleading guilty to various charges that boiled down to trying to hide workers, thereby paying nothing to the state’s workmen’s comp fund. No word from the Register on how long the scheme lasted, but it began unraveling in 2003 when a worker “fell from a roof and filed a workers’ compensation claim,” which resulted “in a denial of benefits,” according to prosecutors. The account also makes no mention of whether the injured worker ultimately received benefits–or even treatment.

On the one hand, the plea agreement shows how long such cases can slog through the system; on the other, even though Hollings faced a maximum sentence of 21 years and eight months, the expected three-year sentence should serve as a red flag for those who attempt to run similar schemes–at least, in California.

Agency owner dodges more than 1,000 counts

In another plea agreement reported today at pittsburghlive.com, 80-year-old William R. McCandless has apparently slipped through the system with a pretty sweet deal. Charged (along with his business) of “1,054 counts of failure to insure” from August 2006 through July 2009, McCandless “entered a general plea of no contest to a single count of failure to insure,” which is expected to net him a mere $3,000 fine plus probation.

One presumes the agency’s workers are now covered–and, of course, there’s no mention of anyone falling from a roof–but, still…more than a thousand counts? That must be one happy old guy.

Holdup victim awaiting surgery for more than a year

The next case is flat out tragic and has the father of an injured man taking on reform of Florida’s statutes, which were altered to prevent abuse by scam-running workers.

Posted March 01 at myfoxtampabay.com, this account tells the tale of Sam McGinnis, a drug store clerk gunned down during a holdup that netted $88 in Nov. 2008.

“We’ve all seen video of people caught on tape playing up their injuries and claiming benefits: people walking with a walker, and later walking just fine, or using or a cane where now you see it, now you don’t,” writes investifative reporter Doug Smith.

“But there’s nothing funny or phony about the video of Sam McGinnis, a clerk behind the counter at a drug store in Tampa, Florida on November 29, 2008. A camera inside the store shows a holdup.”

Cursed at by the robber and shot twice–for not moving fast enough–McGinnis still has a slug lodged in his back and remains “in constant pain,” with “[e]ven the simplest tasks . . . a challenge . . . and he says the workers’ compensation system is compounding his agony.”

Apparently, Florida’s worker-abuse reform went too far: Not only have the new regs have resulted in denial of surgery that would help McGinnis but also he’s been prevented from using his own private insurance–because he was hurt on the job.

“McGinnis hasn’t been able to get surgery that his doctors say could ease his pain because so far workers’ compensation won’t approve it. McGinnis says he had very good private insurance, but because he was hurt at work, he can’t use it.”

The article also says “McGinnis will need a lifetime of care.”

McGinnis’ father has begun a campaign to change the regs, creating a dual-track system, with one track for more routine on-the-job injuries and another for “for people who are catastrophically injured. . .” The father (Facebook profile here) has launched a Web site with a brief background and links to a youtube video and an online petition.

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Regardless of whether you’ve been hurt on the job, it’s wise to know the basics of workers compensation in case you, a friend or family member need to file a claim in the future. If you do get hurt, you should be aware of the first things to do or what to tell a co-worker who has been injured.

Sometimes an injured employee takes all the correct steps but still has trouble getting the claim taken care of; in that case here’s some information for problems with denial of benefits. If legal help is needed to help with the case, be sure to speak to a trained, experienced attorney.