Interview with Howard Ankin – Ankin Law Office
MOSS: Good afternoon and welcome to Spencer Connect on Blog Talk[ph] Radio.My name is Spencer Moss. With me today, I’m very honored to have Howard Ankin,who is owner and partner of Ankin Law Office in Chicago. Mr. Ankin has extensiveexperience in practicing personal injury, workers’ comp, wrongful death, Social Security disability, and criminal and civil litigation. We’re talking today about the new workers’compensation laws and the impact on workers in Illinois. Mr. Ankin, good afternoon.
ANKIN: Good afternoon. Glad to be hear.
MOSS: Thank you. Why don’t you go into a little bit of background on what the new laws are and specifically how they will impact Illinois workers?
ANKIN: The new laws are designed to be a combination of things that are good for injured workers, things that are good for business, and things that are good for the medical or doctors. It’s a compromise amongst those three various parties to try to get something that will work for everybody. The various things that law changes are based on how, when someone gets injured at work, they’re able to be compensated, but at the same time, cost structure for business and doctor reimbursement is fairly taken into consideration.
There’s a host of changes just from minute things like the standard of conduct for the various commissioners or arbitrators to some micromanage type things in the law that would be good for only people that deal with the law on a day to day basis, like special legislation like employee leasing companies have some specialized things. But overall,the crux of the new law focuses on how much the doctors will be reimbursed for injured workers, how they’re able to see or treat with a doctor of their choice, and also how an injured worker will obtain a permanency or monetary recovery at the close of the claim. So, there’s certain things in the new legislation that are major items, and then in this grand, sweeping law change that we haven’t really seen in this state in decades, there’salso some minor things that make up the law change.
MOSS: So, I’m an injured worker. What are my rights to see a doctor of my choice,how is the doctor compensated for treating me, what will this do to my out-of-pocketexpenses?
ANKIN: When you’re injured at work, there’s the Illinois Workers’ Compensation Act which basically, the legislature, they went down to Springfield and they voted and they said this is what you get. Historically within the state, you always get three basic things,which is also for the other 49 states, these are the three basic things that everybody gets:one is the right to get medical care; two is the right to get money or salary while you’reoff work if you’re injured on the job; and three, a permanency award or money provided to you for sustaining the injury at work.
The new law, as far as how does an employee get to see a doctor when he’s injured at which was called a two-doctor rule in the law. Basically, you could go see Doctor A and anybody within the referral chain of that doctor, that was your first choice of doctor, andan injured worker always had the right to go see a second choice of doctor at any time.What they’ve done now is there is no two-doctor rule anymore. What they’ve done now is they’ve created an employer panel of doctors. Basically, if an employer wants to avail themselves of the law, what they’re gonna have to do is they’re gonna have to apply to acommission on the workers’ compensation to say these are a panel of doctors which wewould like to have for all of our injured workers, that would cover a broad cross sectionof all different types of fields of medicine and different localities throughout the state, ordifferent localities that make up the workforce. Basically, an employee could then treatwith a doctor that they would choose off that panel, or if they would choose not to treat off that panel, then they could reject, in writing, the fact that they would use an employer panel doctor, and then they could pick have one choice of doctor on their own instead of what we would normally, historically have as two.
I think then you, as the second part of your question, you asked how is the doctor paid.With that, there is a utilization review or basically there’s a chart that says this is what adoctor can charge for giving certain types of care and treatment. And then as long as thetreatment is necessary and reasonable to alleviate the problems that the injured worker was having, they would submit for payment under the guidelines that are promulgated for the payment of the injured worker. I guess a side note on that is they basically created four GO areas throughout the state which makes up what doctors in those regions wouldcustomarily charge for services, and then they decided that if you fall into whatever oneof those four categories, the doctor can charge within that category to get reimbursement.
MOSS: Do you view this law change as positive more for the workers or for the employers?
ANKIN: This was definitely an employer-pushed change. This is something that is not going to be good for injured workers. Only time will tell how bad this is going to be for injured workers. The reason for that being is that most injured workers are not gonna be familiar with how they are supposed to care and treat for an injury, whether to go to a panel doctor or whether to go to a choice of their own. And if an injured worker is not knowledgeable or made knowledgeable by his union or friend or calls to ask advice, he can find himself having a lot of difficulty in not being able to get the type of care and treatment they need in order to get rehabilitated.
The other thing about why this is bad for injured workers is there is going to be a concept of utilization review, which basically means that they are going to have an independent doctor that can review the care and treatment that the injured worker is getting, and if that independent doctor, when they review the treatment, writes a report that says that thetreatment is not necessarily unreasonable, the preponderance of the evidence under law is going to be that that treatment was not necessary or reasonable treatment. So, it’s going tobe very hard to get reimbursement for medical care and treatment for an injured worker.
guidelines or American Medical Association guidelines as a factor in determining permanency awards at the close of the case. What that means is that if the arbitrators or the commission or adjusters who are adjusting the permanency work for injured workersstart using the AMA guideline itself as the permanency award, it’s going to highly devalue monetary recoveries to injured workers.
MOSS: So, I was injured three years ago. Is the treatment and the payments to me, are those grandfathered under the old law? Or do I have to adjust to the new law?
ANKIN: First, [INAUDIBLE] that you’re injured three years ago, there is customarilya three-year statute of limitations from the date of accident. If your claim is not filed in that time, then it’s time barred, or two years from the date in which you last received temporary benefits. But let’s say you have a three-year-old case that is still within the statute that can be filed, or you filed to [INAUDIBLE] the statute of limitations, basically your question is then is current cases affected by the new law.
The general answer to that is no, the cases that come under the 2005 law change remain the same. There are a couple of changes a couple of minor things that could potentially be in the new act that could affect the old cases, but nothing to speak of.
The problem or an unintended consequence that we may have, however, is that for disputed cases under the old claims, the arbitrators knowing what the new law is and the harsh effects of the new law, it may make it that the tie the unintended consequencemay be for the old cases is it may be harder to win those with the arbitrators now ruling on things under the new law.
MOSS: Why don’t we wrap this up, and if you could kind of summarize the impact of thenew law on workers, we’ve got roughly 90 seconds.
ANKIN: The new impact is that an injured worker is going to have to make sure he understands his choice of going to doctors. The new law is going to affect how an injured worker’s gonna get a permanency award. To have AMA guidelines would be one of the factors of those new laws, and also utilization review and how that’s gonna impact on an injured worker getting reimbursed for his medical care and treatment is also gonna be ahuge factor in the upcoming law, and how cases are ruled upon.
MOSS: Mr. Ankin, thank you very much for joining me today on Spencer Connect. This has been Spencer Moss on Spencer Connect on Blog Talk Radio.