NASI Publishes Interesting Read on Illinois WC Statistics

Friday, October 22, 2010 | 0

By Eugene Keefe
Keefe, Campbell & Associates

One of our readers sent the recent report  of the National Association of Social Insurance or NASI. This report provides some of the matrices on interstate and federal workers compensation comparisons.

You may note Illinois, in 2008, the last year in which numbers were available was the third-highest in total payout behind California and New York. We point out the payout is just under $3 billion and only includes dollars flowing through our Illinois Workers' Compensation Commission.

Temporary total disability is typically the second highest workers compensation benefit, after medical payments. Cash benefits differ according to the duration and severity of the worker’s disability. Temporary total disability benefits are paid when the worker is temporarily precluded from performing the pre-injury job or another job for the employer that the worker could have performed prior to the injury. Most states pay weekly benefits for temporary total disability that replace two-thirds of the worker’s pre-injury wage (tax free), subject to a dollar maximum that varies from state to state.

The maximum weekly benefit for temporary total disability (TTD) ranged from $1,366 in Iowa to 398.93 in Mississippi. In comparison to the high of $1,366, you may note Illinois’ maximum TTD benefit rate is about $1,243. Nine states had a maximum of $1,000 or more: Connecticut, District of Columbia, Illinois, Iowa, Massachusetts, New Hampshire, Oregon, Vermont and Washington. The eleven states with a maximum of weekly TTD of less than $600 include Arizona, Arkansas, Georgia, Idaho, Kansas, Louisiana, Maine, Mississippi, New York, Oklahoma and South Dakota.

NASI statistics indicate roughly 70% of all workers compensation claims are for medical payments only, i.e., there is no compensable claim for lost time from work. Please note such claims do not flow through some state agencies.

For most lost time injuries, workers fully recover, return to work, and benefits end. In some cases, they return to work before they reach maximum medical improvement, usually with restricted duties and lower pay. In those cases, they receive temporary partial disability benefits in most states. Temporary disability benefits are the most common type of cash benefits. They account for 63% of cases involving cash benefits and 16% of total benefits incurred.

If a worker has very significant impairments that are judged to be permanent after he or she reaches maximum medical improvement, permanent total disability benefits might be paid. These cases are relatively rare. Permanent total disabilities, together with fatalities, account for one percent of all cases that involve cash benefits, and seventeen per cent of total cash benefit payments. As we indicate above, it is a statistical anomaly for the State of Illinois to have 450 total and permanent claims pending.

Permanent partial disability benefits are paid when the worker has physical impairments that, although permanent, do not completely limit the worker’s ability to work. States differ in their methods for determining whether a worker is entitled to permanent partial benefits, the degree of partial disability and the amount of benefits to be paid. In some states, the permanent partial disability benefit begins after maximum medical improvement has been achieved. In some cases permanent disability benefits can simply be the extension of temporary disability benefits until the disabled worker returns to employment.

We caution our reader to remember Illinois doesn’t follow American Medical Association impairment ratings but uses a system similar to stare decisis—we award what other arbitrators and commissioners have awarded in past similar claims.

Eugene Keefe is founding partner for Keefe, Campbell & Associates, a Chicago workers' compensation defense firm.