101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2635

 

Introduced , by Rep. Allen Skillicorn

 

SYNOPSIS AS INTRODUCED:
 
820 ILCS 305/8  from Ch. 48, par. 138.8
820 ILCS 305/8.3

    Amends the Workers' Compensation Act. Changes the compensation rates for certain accidental injuries to the levels that existed before Public Act 94-277 took effect. Removes language requiring employers to make payments on annual adjustments to the compensation rate in awards for permanent total disability for every accident occurring on or after July 20, 2005 but before November 11, 2005 (the date Public Act 94-695 took effect). Directs the Workers' Compensation Medical Fee Advisory Board to develop a fee payment schedule for procedures, treatments, and services covered under the Act based upon fees for such procedures, treatments, and services authorized under Medicare. Makes other changes.


LRB101 06273 TAE 51299 b

 

 

A BILL FOR

 

HB2635LRB101 06273 TAE 51299 b

1    AN ACT concerning employment.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Workers' Compensation Act is amended by
5changing Sections 8 and 8.3 as follows:
 
6    (820 ILCS 305/8)  (from Ch. 48, par. 138.8)
7    Sec. 8. The amount of compensation which shall be paid to
8the employee for an accidental injury not resulting in death
9is:
10    (a) The employer shall provide and pay the negotiated rate,
11if applicable, or the lesser of the health care provider's
12actual charges or according to a fee schedule, subject to
13Section 8.2, in effect at the time the service was rendered for
14all the necessary first aid, medical and surgical services, and
15all necessary medical, surgical and hospital services
16thereafter incurred, limited, however, to that which is
17reasonably required to cure or relieve from the effects of the
18accidental injury, even if a health care provider sells,
19transfers, or otherwise assigns an account receivable for
20procedures, treatments, or services covered under this Act. If
21the employer does not dispute payment of first aid, medical,
22surgical, and hospital services, the employer shall make such
23payment to the provider on behalf of the employee. The employer

 

 

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1shall also pay for treatment, instruction and training
2necessary for the physical, mental and vocational
3rehabilitation of the employee, including all maintenance
4costs and expenses incidental thereto. If as a result of the
5injury the employee is unable to be self-sufficient the
6employer shall further pay for such maintenance or
7institutional care as shall be required.
8    The employee may at any time elect to secure his own
9physician, surgeon and hospital services at the employer's
10expense, or,
11    Upon agreement between the employer and the employees, or
12the employees' exclusive representative, and subject to the
13approval of the Illinois Workers' Compensation Commission, the
14employer shall maintain a list of physicians, to be known as a
15Panel of Physicians, who are accessible to the employees. The
16employer shall post this list in a place or places easily
17accessible to his employees. The employee shall have the right
18to make an alternative choice of physician from such Panel if
19he is not satisfied with the physician first selected. If, due
20to the nature of the injury or its occurrence away from the
21employer's place of business, the employee is unable to make a
22selection from the Panel, the selection process from the Panel
23shall not apply. The physician selected from the Panel may
24arrange for any consultation, referral or other specialized
25medical services outside the Panel at the employer's expense.
26Provided that, in the event the Commission shall find that a

 

 

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1doctor selected by the employee is rendering improper or
2inadequate care, the Commission may order the employee to
3select another doctor certified or qualified in the medical
4field for which treatment is required. If the employee refuses
5to make such change the Commission may relieve the employer of
6his obligation to pay the doctor's charges from the date of
7refusal to the date of compliance.
8    Any vocational rehabilitation counselors who provide
9service under this Act shall have appropriate certifications
10which designate the counselor as qualified to render opinions
11relating to vocational rehabilitation. Vocational
12rehabilitation may include, but is not limited to, counseling
13for job searches, supervising a job search program, and
14vocational retraining including education at an accredited
15learning institution. The employee or employer may petition to
16the Commission to decide disputes relating to vocational
17rehabilitation and the Commission shall resolve any such
18dispute, including payment of the vocational rehabilitation
19program by the employer.
20    The maintenance benefit shall not be less than the
21temporary total disability rate determined for the employee. In
22addition, maintenance shall include costs and expenses
23incidental to the vocational rehabilitation program.
24    When the employee is working light duty on a part-time
25basis or full-time basis and earns less than he or she would be
26earning if employed in the full capacity of the job or jobs,

 

 

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1then the employee shall be entitled to temporary partial
2disability benefits. Temporary partial disability benefits
3shall be equal to two-thirds of the difference between the
4average amount that the employee would be able to earn in the
5full performance of his or her duties in the occupation in
6which he or she was engaged at the time of accident and the
7gross amount which he or she is earning in the modified job
8provided to the employee by the employer or in any other job
9that the employee is working.
10    Every hospital, physician, surgeon or other person
11rendering treatment or services in accordance with the
12provisions of this Section shall upon written request furnish
13full and complete reports thereof to, and permit their records
14to be copied by, the employer, the employee or his dependents,
15as the case may be, or any other party to any proceeding for
16compensation before the Commission, or their attorneys.
17    Notwithstanding the foregoing, the employer's liability to
18pay for such medical services selected by the employee shall be
19limited to:
20        (1) all first aid and emergency treatment; plus
21        (2) all medical, surgical and hospital services
22    provided by the physician, surgeon or hospital initially
23    chosen by the employee or by any other physician,
24    consultant, expert, institution or other provider of
25    services recommended by said initial service provider or
26    any subsequent provider of medical services in the chain of

 

 

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1    referrals from said initial service provider; plus
2        (3) all medical, surgical and hospital services
3    provided by any second physician, surgeon or hospital
4    subsequently chosen by the employee or by any other
5    physician, consultant, expert, institution or other
6    provider of services recommended by said second service
7    provider or any subsequent provider of medical services in
8    the chain of referrals from said second service provider.
9    Thereafter the employer shall select and pay for all
10    necessary medical, surgical and hospital treatment and the
11    employee may not select a provider of medical services at
12    the employer's expense unless the employer agrees to such
13    selection. At any time the employee may obtain any medical
14    treatment he desires at his own expense. This paragraph
15    shall not affect the duty to pay for rehabilitation
16    referred to above.
17        (4) The following shall apply for injuries occurring on
18    or after June 28, 2011 (the effective date of Public Act
19    97-18) and only when an employer has an approved preferred
20    provider program pursuant to Section 8.1a on the date the
21    employee sustained his or her accidental injuries:
22            (A) The employer shall, in writing, on a form
23        promulgated by the Commission, inform the employee of
24        the preferred provider program;
25            (B) Subsequent to the report of an injury by an
26        employee, the employee may choose in writing at any

 

 

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1        time to decline the preferred provider program, in
2        which case that would constitute one of the two choices
3        of medical providers to which the employee is entitled
4        under subsection (a)(2) or (a)(3); and
5            (C) Prior to the report of an injury by an
6        employee, when an employee chooses non-emergency
7        treatment from a provider not within the preferred
8        provider program, that would constitute the employee's
9        one choice of medical providers to which the employee
10        is entitled under subsection (a)(2) or (a)(3).
11    When an employer and employee so agree in writing, nothing
12in this Act prevents an employee whose injury or disability has
13been established under this Act, from relying in good faith, on
14treatment by prayer or spiritual means alone, in accordance
15with the tenets and practice of a recognized church or
16religious denomination, by a duly accredited practitioner
17thereof, and having nursing services appropriate therewith,
18without suffering loss or diminution of the compensation
19benefits under this Act. However, the employee shall submit to
20all physical examinations required by this Act. The cost of
21such treatment and nursing care shall be paid by the employee
22unless the employer agrees to make such payment.
23    Where the accidental injury results in the amputation of an
24arm, hand, leg or foot, or the enucleation of an eye, or the
25loss of any of the natural teeth, the employer shall furnish an
26artificial of any such members lost or damaged in accidental

 

 

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1injury arising out of and in the course of employment, and
2shall also furnish the necessary braces in all proper and
3necessary cases. In cases of the loss of a member or members by
4amputation, the employer shall, whenever necessary, maintain
5in good repair, refit or replace the artificial limbs during
6the lifetime of the employee. Where the accidental injury
7accompanied by physical injury results in damage to a denture,
8eye glasses or contact eye lenses, or where the accidental
9injury results in damage to an artificial member, the employer
10shall replace or repair such denture, glasses, lenses, or
11artificial member.
12    The furnishing by the employer of any such services or
13appliances is not an admission of liability on the part of the
14employer to pay compensation.
15    The furnishing of any such services or appliances or the
16servicing thereof by the employer is not the payment of
17compensation.
18    (b) If the period of temporary total incapacity for work
19lasts more than 3 working days, weekly compensation as
20hereinafter provided shall be paid beginning on the 4th day of
21such temporary total incapacity and continuing as long as the
22total temporary incapacity lasts. In cases where the temporary
23total incapacity for work continues for a period of 14 days or
24more from the day of the accident compensation shall commence
25on the day after the accident.
26        1. The compensation rate for temporary total

 

 

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1    incapacity under this paragraph (b) of this Section shall
2    be equal to 66 2/3% of the employee's average weekly wage
3    computed in accordance with Section 10, provided that it
4    shall be not less than the following amounts in the
5    following cases:
6            $100.90 in case of a single person;
7            $105.50 in case of a married person with no
8        children;
9            $108.30 in case of one child;
10            $113.40 in case of 2 children;
11            $117.40 in case of 3 children;
12            $124.30 in case of 4 or more children;
13    66 2/3% of the sum of the Federal minimum wage under the
14    Fair Labor Standards Act, or the Illinois minimum wage
15    under the Minimum Wage Law, whichever is more, multiplied
16    by 40 hours. This percentage rate shall be increased by 10%
17    for each spouse and child, not to exceed 100% of the total
18    minimum wage calculation,
19     nor exceed the employee's average weekly wage computed in
20    accordance with the provisions of Section 10, whichever is
21    less.
22        2. The compensation rate in all cases other than for
23    temporary total disability under this paragraph (b), and
24    other than for serious and permanent disfigurement under
25    paragraph (c) and other than for permanent partial
26    disability under subparagraph (2) of paragraph (d) or under

 

 

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1    paragraph (e), of this Section shall be equal to 66 2/3% of
2    the employee's average weekly wage computed in accordance
3    with the provisions of Section 10, provided that it shall
4    be not less than the following amounts in the following
5    cases:
6            $80.90 in case of a single person;
7            $83.20 in case of a married person with no
8        children;
9            $86.10 in case of one child;
10            $88.90 in case of 2 children;
11            $91.80 in case of 3 children;
12            $96.90 in case of 4 or more children;
13    66 2/3% of the sum of the Federal minimum wage under the
14    Fair Labor Standards Act, or the Illinois minimum wage
15    under the Minimum Wage Law, whichever is more, multiplied
16    by 40 hours. This percentage rate shall be increased by 10%
17    for each spouse and child, not to exceed 100% of the total
18    minimum wage calculation,
19     nor exceed the employee's average weekly wage computed in
20    accordance with the provisions of Section 10, whichever is
21    less.
22        2.1. The compensation rate in all cases of serious and
23    permanent disfigurement under paragraph (c) and of
24    permanent partial disability under subparagraph (2) of
25    paragraph (d) or under paragraph (e) of this Section shall
26    be equal to 60% of the employee's average weekly wage

 

 

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1    computed in accordance with the provisions of Section 10,
2    provided that it shall be not less than the following
3    amounts in the following cases:
4            $80.90 in case of a single person;
5            $83.20 in case of a married person with no
6        children;
7            $86.10 in case of one child;
8            $88.90 in case of 2 children;
9            $91.80 in case of 3 children;
10            $96.90 in case of 4 or more children;
11    66 2/3% of the sum of the Federal minimum wage under the
12    Fair Labor Standards Act, or the Illinois minimum wage
13    under the Minimum Wage Law, whichever is more, multiplied
14    by 40 hours. This percentage rate shall be increased by 10%
15    for each spouse and child, not to exceed 100% of the total
16    minimum wage calculation, nor exceed the employee's
17    average weekly wage computed in accordance with the
18    provisions of Section 10, whichever is less.
19        3. As used in this Section the term "child" means a
20    child of the employee including any child legally adopted
21    before the accident or whom at the time of the accident the
22    employee was under legal obligation to support or to whom
23    the employee stood in loco parentis, and who at the time of
24    the accident was under 18 years of age and not emancipated.
25    The term "children" means the plural of "child".
26        4. All weekly compensation rates provided under

 

 

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1    subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
2    Section shall be subject to the following limitations:
3        The maximum weekly compensation rate from July 1, 1975,
4    except as hereinafter provided, shall be 100% of the
5    State's average weekly wage in covered industries under the
6    Unemployment Insurance Act, that being the wage that most
7    closely approximates the State's average weekly wage.
8        The maximum weekly compensation rate, for the period
9    July 1, 1984, through June 30, 1987, except as hereinafter
10    provided, shall be $293.61. Effective July 1, 1987 and on
11    July 1 of each year thereafter the maximum weekly
12    compensation rate, except as hereinafter provided, shall
13    be determined as follows: if during the preceding 12 month
14    period there shall have been an increase in the State's
15    average weekly wage in covered industries under the
16    Unemployment Insurance Act, the weekly compensation rate
17    shall be proportionately increased by the same percentage
18    as the percentage of increase in the State's average weekly
19    wage in covered industries under the Unemployment
20    Insurance Act during such period.
21        The maximum weekly compensation rate, for the period
22    January 1, 1981 through December 31, 1983, except as
23    hereinafter provided, shall be 100% of the State's average
24    weekly wage in covered industries under the Unemployment
25    Insurance Act in effect on January 1, 1981. Effective
26    January 1, 1984 and on January 1, of each year thereafter

 

 

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1    the maximum weekly compensation rate, except as
2    hereinafter provided, shall be determined as follows: if
3    during the preceding 12 month period there shall have been
4    an increase in the State's average weekly wage in covered
5    industries under the Unemployment Insurance Act, the
6    weekly compensation rate shall be proportionately
7    increased by the same percentage as the percentage of
8    increase in the State's average weekly wage in covered
9    industries under the Unemployment Insurance Act during
10    such period.
11        From July 1, 1977 and thereafter such maximum weekly
12    compensation rate in death cases under Section 7, and
13    permanent total disability cases under paragraph (f) or
14    subparagraph 18 of paragraph (3) of this Section and for
15    temporary total disability under paragraph (b) of this
16    Section and for amputation of a member or enucleation of an
17    eye under paragraph (e) of this Section shall be increased
18    to 133-1/3% of the State's average weekly wage in covered
19    industries under the Unemployment Insurance Act.
20        For injuries occurring on or after February 1, 2006,
21    the maximum weekly benefit under paragraph (d)1 of this
22    Section shall be 100% of the State's average weekly wage in
23    covered industries under the Unemployment Insurance Act.
24        4.1. Any provision herein to the contrary
25    notwithstanding, the weekly compensation rate for
26    compensation payments under subparagraph 18 of paragraph

 

 

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1    (e) of this Section and under paragraph (f) of this Section
2    and under paragraph (a) of Section 7 and for amputation of
3    a member or enucleation of an eye under paragraph (e) of
4    this Section, shall in no event be less than 50% of the
5    State's average weekly wage in covered industries under the
6    Unemployment Insurance Act.
7        4.2. Any provision to the contrary notwithstanding,
8    the total compensation payable under Section 7 shall not
9    exceed the greater of $250,000 $500,000 or 20 25 years.
10        5. For the purpose of this Section this State's average
11    weekly wage in covered industries under the Unemployment
12    Insurance Act on July 1, 1975 is hereby fixed at $228.16
13    per week and the computation of compensation rates shall be
14    based on the aforesaid average weekly wage until modified
15    as hereinafter provided.
16        6. The Department of Employment Security of the State
17    shall on or before the first day of December, 1977, and on
18    or before the first day of June, 1978, and on the first day
19    of each December and June of each year thereafter, publish
20    the State's average weekly wage in covered industries under
21    the Unemployment Insurance Act and the Illinois Workers'
22    Compensation Commission shall on the 15th day of January,
23    1978 and on the 15th day of July, 1978 and on the 15th day
24    of each January and July of each year thereafter, post and
25    publish the State's average weekly wage in covered
26    industries under the Unemployment Insurance Act as last

 

 

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1    determined and published by the Department of Employment
2    Security. The amount when so posted and published shall be
3    conclusive and shall be applicable as the basis of
4    computation of compensation rates until the next posting
5    and publication as aforesaid.
6        7. The payment of compensation by an employer or his
7    insurance carrier to an injured employee shall not
8    constitute an admission of the employer's liability to pay
9    compensation.
10    (c) For any serious and permanent disfigurement to the
11hand, head, face, neck, arm, leg below the knee or the chest
12above the axillary line, the employee is entitled to
13compensation for such disfigurement, the amount determined by
14agreement at any time or by arbitration under this Act, at a
15hearing not less than 6 months after the date of the accidental
16injury, which amount shall not exceed 150 weeks (if the
17accidental injury occurs on or after the effective date of this
18amendatory Act of the 94th General Assembly but before February
191, 2006) or 162 weeks (if the accidental injury occurs on or
20after February 1, 2006) at the applicable rate provided in
21subparagraph 2.1 of paragraph (b) of this Section.
22    No compensation is payable under this paragraph where
23compensation is payable under paragraphs (d), (e) or (f) of
24this Section.
25    A duly appointed member of a fire department in a city, the
26population of which exceeds 500,000 according to the last

 

 

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1federal or State census, is eligible for compensation under
2this paragraph only where such serious and permanent
3disfigurement results from burns.
4    (d) 1. If, after the accidental injury has been sustained,
5the employee as a result thereof becomes partially
6incapacitated from pursuing his usual and customary line of
7employment, he shall, except in cases compensated under the
8specific schedule set forth in paragraph (e) of this Section,
9receive compensation for the duration of his disability,
10subject to the limitations as to maximum amounts fixed in
11paragraph (b) of this Section, equal to 66-2/3% of the
12difference between the average amount which he would be able to
13earn in the full performance of his duties in the occupation in
14which he was engaged at the time of the accident and the
15average amount which he is earning or is able to earn in some
16suitable employment or business after the accident. For
17accidental injuries that occur on or after September 1, 2011,
18an award for wage differential under this subsection shall be
19effective only until the employee reaches the age of 67 or 5
20years from the date the award becomes final, whichever is
21later.
22    2. If, as a result of the accident, the employee sustains
23serious and permanent injuries not covered by paragraphs (c)
24and (e) of this Section or having sustained injuries covered by
25the aforesaid paragraphs (c) and (e), he shall have sustained
26in addition thereto other injuries which injuries do not

 

 

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1incapacitate him from pursuing the duties of his employment but
2which would disable him from pursuing other suitable
3occupations, or which have otherwise resulted in physical
4impairment; or if such injuries partially incapacitate him from
5pursuing the duties of his usual and customary line of
6employment but do not result in an impairment of earning
7capacity, or having resulted in an impairment of earning
8capacity, the employee elects to waive his right to recover
9under the foregoing subparagraph 1 of paragraph (d) of this
10Section then in any of the foregoing events, he shall receive
11in addition to compensation for temporary total disability
12under paragraph (b) of this Section, compensation at the rate
13provided in subparagraph 2.1 of paragraph (b) of this Section
14for that percentage of 500 weeks that the partial disability
15resulting from the injuries covered by this paragraph bears to
16total disability. If the employee shall have sustained a
17fracture of one or more vertebra or fracture of the skull, the
18amount of compensation allowed under this Section shall be not
19less than 6 weeks for a fractured skull and 6 weeks for each
20fractured vertebra, and in the event the employee shall have
21sustained a fracture of any of the following facial bones:
22nasal, lachrymal, vomer, zygoma, maxilla, palatine or
23mandible, the amount of compensation allowed under this Section
24shall be not less than 2 weeks for each such fractured bone,
25and for a fracture of each transverse process not less than 3
26weeks. In the event such injuries shall result in the loss of a

 

 

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1kidney, spleen or lung, the amount of compensation allowed
2under this Section shall be not less than 10 weeks for each
3such organ. Compensation awarded under this subparagraph 2
4shall not take into consideration injuries covered under
5paragraphs (c) and (e) of this Section and the compensation
6provided in this paragraph shall not affect the employee's
7right to compensation payable under paragraphs (b), (c) and (e)
8of this Section for the disabilities therein covered.
9    (e) For accidental injuries in the following schedule, the
10employee shall receive compensation for the period of temporary
11total incapacity for work resulting from such accidental
12injury, under subparagraph 1 of paragraph (b) of this Section,
13and shall receive in addition thereto compensation for a
14further period for the specific loss herein mentioned, but
15shall not receive any compensation under any other provisions
16of this Act. The following listed amounts apply to either the
17loss of or the permanent and complete loss of use of the member
18specified, such compensation for the length of time as follows:
19        1. Thumb-70 weeks.
20            70 weeks if the accidental injury occurs on or
21        after the effective date of this amendatory Act of the
22        94th General Assembly but before February 1, 2006.
23            76 weeks if the accidental injury occurs on or
24        after February 1, 2006.
25        2. First, or index finger-40 weeks.
26            40 weeks if the accidental injury occurs on or

 

 

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1        after the effective date of this amendatory Act of the
2        94th General Assembly but before February 1, 2006.
3            43 weeks if the accidental injury occurs on or
4        after February 1, 2006.
5        3. Second, or middle finger-35 weeks.
6            35 weeks if the accidental injury occurs on or
7        after the effective date of this amendatory Act of the
8        94th General Assembly but before February 1, 2006.
9            38 weeks if the accidental injury occurs on or
10        after February 1, 2006.
11        4. Third, or ring finger-25 weeks.
12            25 weeks if the accidental injury occurs on or
13        after the effective date of this amendatory Act of the
14        94th General Assembly but before February 1, 2006.
15            27 weeks if the accidental injury occurs on or
16        after February 1, 2006.
17        5. Fourth, or little finger-20 weeks.
18            20 weeks if the accidental injury occurs on or
19        after the effective date of this amendatory Act of the
20        94th General Assembly but before February 1, 2006.
21            22 weeks if the accidental injury occurs on or
22        after February 1, 2006.
23        6. Great toe-35 weeks.
24            35 weeks if the accidental injury occurs on or
25        after the effective date of this amendatory Act of the
26        94th General Assembly but before February 1, 2006.

 

 

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1            38 weeks if the accidental injury occurs on or
2        after February 1, 2006.
3        7. Each toe other than great toe-12 weeks.
4            12 weeks if the accidental injury occurs on or
5        after the effective date of this amendatory Act of the
6        94th General Assembly but before February 1, 2006.
7            13 weeks if the accidental injury occurs on or
8        after February 1, 2006.
9        8. The loss of the first or distal phalanx of the thumb
10    or of any finger or toe shall be considered to be equal to
11    the loss of one-half of such thumb, finger or toe and the
12    compensation payable shall be one-half of the amount above
13    specified. The loss of more than one phalanx shall be
14    considered as the loss of the entire thumb, finger or toe.
15    In no case shall the amount received for more than one
16    finger exceed the amount provided in this schedule for the
17    loss of a hand.
18        9. Hand-
19            190 weeks if the accidental injury occurs on or
20        after the effective date of this amendatory Act of the
21        94th General Assembly but before February 1, 2006.
22            205 weeks if the accidental injury occurs on or
23        after February 1, 2006.
24        9. Hand-190 weeks if the accidental injury occurs on or
25    after June 28, 2011 (the effective date of Public Act
26    97-18) and if the accidental injury involves carpal tunnel

 

 

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1    syndrome due to repetitive or cumulative trauma, in which
2    case the permanent partial disability shall not exceed 15%
3    loss of use of the hand, except for cause shown by clear
4    and convincing evidence and in which case the award shall
5    not exceed 30% loss of use of the hand.
6        The loss of 2 or more digits, or one or more phalanges
7    of 2 or more digits, of a hand may be compensated on the
8    basis of partial loss of use of a hand, provided, further,
9    that the loss of 4 digits, or the loss of use of 4 digits,
10    in the same hand shall constitute the complete loss of a
11    hand.
12        10. Arm-
13            235 weeks if the accidental injury occurs on or
14        after the effective date of this amendatory Act of the
15        94th General Assembly but before February 1, 2006.
16            253 weeks if the accidental injury occurs on or
17        after February 1, 2006.
18        10. Arm-235 weeks. Where an accidental injury results
19    in the amputation of an arm below the elbow, such injury
20    shall be compensated as a loss of an arm. Where an
21    accidental injury results in the amputation of an arm above
22    the elbow, compensation for an additional 15 weeks (if the
23    accidental injury occurs on or after the effective date of
24    this amendatory Act of the 94th General Assembly but before
25    February 1, 2006) or an additional 17 weeks (if the
26    accidental injury occurs on or after February 1, 2006)

 

 

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1    shall be paid, except where the accidental injury results
2    in the amputation of an arm at the shoulder joint, or so
3    close to shoulder joint that an artificial arm cannot be
4    used, or results in the disarticulation of an arm at the
5    shoulder joint, in which case compensation for an
6    additional 65 weeks (if the accidental injury occurs on or
7    after the effective date of this amendatory Act of the 94th
8    General Assembly but before February 1, 2006) or an
9    additional 70 weeks (if the accidental injury occurs on or
10    after February 1, 2006) shall be paid.
11        11. Foot-155 weeks.
12            155 weeks if the accidental injury occurs on or
13        after the effective date of this amendatory Act of the
14        94th General Assembly but before February 1, 2006.
15            167 weeks if the accidental injury occurs on or
16        after February 1, 2006.
17        12. Leg-
18            200 weeks if the accidental injury occurs on or
19        after the effective date of this amendatory Act of the
20        94th General Assembly but before February 1, 2006.
21            215 weeks if the accidental injury occurs on or
22        after February 1, 2006.
23        12. Leg-200 weeks. Where an accidental injury results
24    in the amputation of a leg below the knee, such injury
25    shall be compensated as loss of a leg. Where an accidental
26    injury results in the amputation of a leg above the knee,

 

 

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1    compensation for an additional 25 weeks (if the accidental
2    injury occurs on or after the effective date of this
3    amendatory Act of the 94th General Assembly but before
4    February 1, 2006) or an additional 27 weeks (if the
5    accidental injury occurs on or after February 1, 2006)
6    shall be paid, except where the accidental injury results
7    in the amputation of a leg at the hip joint, or so close to
8    the hip joint that an artificial leg cannot be used, or
9    results in the disarticulation of a leg at the hip joint,
10    in which case compensation for an additional 75 weeks (if
11    the accidental injury occurs on or after the effective date
12    of this amendatory Act of the 94th General Assembly but
13    before February 1, 2006) or an additional 81 weeks (if the
14    accidental injury occurs on or after February 1, 2006)
15    shall be paid.
16        13. Eye-
17            150 weeks if the accidental injury occurs on or
18        after the effective date of this amendatory Act of the
19        94th General Assembly but before February 1, 2006.
20            162 weeks if the accidental injury occurs on or
21        after February 1, 2006.
22        13. Eye-150 weeks. Where an accidental injury results
23    in the enucleation of an eye, compensation for an
24    additional 10 weeks (if the accidental injury occurs on or
25    after the effective date of this amendatory Act of the 94th
26    General Assembly but before February 1, 2006) or an

 

 

HB2635- 23 -LRB101 06273 TAE 51299 b

1    additional 11 weeks (if the accidental injury occurs on or
2    after February 1, 2006) shall be paid.
3        14. Loss of hearing of one ear-50 weeks.
4            50 weeks if the accidental injury occurs on or
5        after the effective date of this amendatory Act of the
6        94th General Assembly but before February 1, 2006.
7            54 weeks if the accidental injury occurs on or
8        after February 1, 2006.
9        Total and permanent loss of hearing of both ears-200
10    weeks.
11            200 weeks if the accidental injury occurs on or
12        after the effective date of this amendatory Act of the
13        94th General Assembly but before February 1, 2006.
14            215 weeks if the accidental injury occurs on or
15        after February 1, 2006.
16        15. Testicle-50 weeks.
17            50 weeks if the accidental injury occurs on or
18        after the effective date of this amendatory Act of the
19        94th General Assembly but before February 1, 2006.
20            54 weeks if the accidental injury occurs on or
21        after February 1, 2006.
22        Both testicles-150 weeks.
23            150 weeks if the accidental injury occurs on or
24        after the effective date of this amendatory Act of the
25        94th General Assembly but before February 1, 2006.
26            162 weeks if the accidental injury occurs on or

 

 

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1        after February 1, 2006.
2        16. For the permanent partial loss of use of a member
3    or sight of an eye, or hearing of an ear, compensation
4    during that proportion of the number of weeks in the
5    foregoing schedule provided for the loss of such member or
6    sight of an eye, or hearing of an ear, which the partial
7    loss of use thereof bears to the total loss of use of such
8    member, or sight of eye, or hearing of an ear.
9            (a) Loss of hearing for compensation purposes
10        shall be confined to the frequencies of 1,000, 2,000
11        and 3,000 cycles per second. Loss of hearing ability
12        for frequency tones above 3,000 cycles per second are
13        not to be considered as constituting disability for
14        hearing.
15            (b) The percent of hearing loss, for purposes of
16        the determination of compensation claims for
17        occupational deafness, shall be calculated as the
18        average in decibels for the thresholds of hearing for
19        the frequencies of 1,000, 2,000 and 3,000 cycles per
20        second. Pure tone air conduction audiometric
21        instruments, approved by nationally recognized
22        authorities in this field, shall be used for measuring
23        hearing loss. If the losses of hearing average 30
24        decibels or less in the 3 frequencies, such losses of
25        hearing shall not then constitute any compensable
26        hearing disability. If the losses of hearing average 85

 

 

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1        decibels or more in the 3 frequencies, then the same
2        shall constitute and be total or 100% compensable
3        hearing loss.
4            (c) In measuring hearing impairment, the lowest
5        measured losses in each of the 3 frequencies shall be
6        added together and divided by 3 to determine the
7        average decibel loss. For every decibel of loss
8        exceeding 30 decibels an allowance of 1.82% shall be
9        made up to the maximum of 100% which is reached at 85
10        decibels.
11            (d) If a hearing loss is established to have
12        existed on July 1, 1975 by audiometric testing the
13        employer shall not be liable for the previous loss so
14        established nor shall he be liable for any loss for
15        which compensation has been paid or awarded.
16            (e) No consideration shall be given to the question
17        of whether or not the ability of an employee to
18        understand speech is improved by the use of a hearing
19        aid.
20            (f) No claim for loss of hearing due to industrial
21        noise shall be brought against an employer or allowed
22        unless the employee has been exposed for a period of
23        time sufficient to cause permanent impairment to noise
24        levels in excess of the following:
25Sound Level DBA
26Slow ResponseHours Per Day

 

 

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1908
2926
3954
4973
51002
61021-1/2
71051
81101/2
91151/4
10        This subparagraph (f) shall not be applied in cases of
11    hearing loss resulting from trauma or explosion.
12        17. In computing the compensation to be paid to any
13    employee who, before the accident for which he claims
14    compensation, had before that time sustained an injury
15    resulting in the loss by amputation or partial loss by
16    amputation of any member, including hand, arm, thumb or
17    fingers, leg, foot or any toes, such loss or partial loss
18    of any such member shall be deducted from any award made
19    for the subsequent injury. For the permanent loss of use or
20    the permanent partial loss of use of any such member or the
21    partial loss of sight of an eye, for which compensation has
22    been paid, then such loss shall be taken into consideration
23    and deducted from any award for the subsequent injury.
24        18. The specific case of loss of both hands, both arms,
25    or both feet, or both legs, or both eyes, or of any two
26    thereof, or the permanent and complete loss of the use

 

 

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1    thereof, constitutes total and permanent disability, to be
2    compensated according to the compensation fixed by
3    paragraph (f) of this Section. These specific cases of
4    total and permanent disability do not exclude other cases.
5        Any employee who has previously suffered the loss or
6    permanent and complete loss of the use of any of such
7    members, and in a subsequent independent accident loses
8    another or suffers the permanent and complete loss of the
9    use of any one of such members the employer for whom the
10    injured employee is working at the time of the last
11    independent accident is liable to pay compensation only for
12    the loss or permanent and complete loss of the use of the
13    member occasioned by the last independent accident.
14        19. In a case of specific loss and the subsequent death
15    of such injured employee from other causes than such injury
16    leaving a widow, widower, or dependents surviving before
17    payment or payment in full for such injury, then the amount
18    due for such injury is payable to the widow or widower and,
19    if there be no widow or widower, then to such dependents,
20    in the proportion which such dependency bears to total
21    dependency.
22    Beginning July 1, 1980, and every 6 months thereafter, the
23Commission shall examine the Second Injury Fund and when, after
24deducting all advances or loans made to such Fund, the amount
25therein is $500,000 then the amount required to be paid by
26employers pursuant to paragraph (f) of Section 7 shall be

 

 

HB2635- 28 -LRB101 06273 TAE 51299 b

1reduced by one-half. When the Second Injury Fund reaches the
2sum of $600,000 then the payments shall cease entirely.
3However, when the Second Injury Fund has been reduced to
4$400,000, payment of one-half of the amounts required by
5paragraph (f) of Section 7 shall be resumed, in the manner
6herein provided, and when the Second Injury Fund has been
7reduced to $300,000, payment of the full amounts required by
8paragraph (f) of Section 7 shall be resumed, in the manner
9herein provided. The Commission shall make the changes in
10payment effective by general order, and the changes in payment
11become immediately effective for all cases coming before the
12Commission thereafter either by settlement agreement or final
13order, irrespective of the date of the accidental injury.
14    On August 1, 1996 and on February 1 and August 1 of each
15subsequent year, the Commission shall examine the special fund
16designated as the "Rate Adjustment Fund" and when, after
17deducting all advances or loans made to said fund, the amount
18therein is $4,000,000, the amount required to be paid by
19employers pursuant to paragraph (f) of Section 7 shall be
20reduced by one-half. When the Rate Adjustment Fund reaches the
21sum of $5,000,000 the payment therein shall cease entirely.
22However, when said Rate Adjustment Fund has been reduced to
23$3,000,000 the amounts required by paragraph (f) of Section 7
24shall be resumed in the manner herein provided.
25    (f) In case of complete disability, which renders the
26employee wholly and permanently incapable of work, or in the

 

 

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1specific case of total and permanent disability as provided in
2subparagraph 18 of paragraph (e) of this Section, compensation
3shall be payable at the rate provided in subparagraph 2 of
4paragraph (b) of this Section for life.
5    An employee entitled to benefits under paragraph (f) of
6this Section shall also be entitled to receive from the Rate
7Adjustment Fund provided in paragraph (f) of Section 7 of the
8supplementary benefits provided in paragraph (g) of this
9Section 8.
10    If any employee who receives an award under this paragraph
11afterwards returns to work or is able to do so, and earns or is
12able to earn as much as before the accident, payments under
13such award shall cease. If such employee returns to work, or is
14able to do so, and earns or is able to earn part but not as much
15as before the accident, such award shall be modified so as to
16conform to an award under paragraph (d) of this Section. If
17such award is terminated or reduced under the provisions of
18this paragraph, such employees have the right at any time
19within 30 months after the date of such termination or
20reduction to file petition with the Commission for the purpose
21of determining whether any disability exists as a result of the
22original accidental injury and the extent thereof.
23    Disability as enumerated in subdivision 18, paragraph (e)
24of this Section is considered complete disability.
25    If an employee who had previously incurred loss or the
26permanent and complete loss of use of one member, through the

 

 

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1loss or the permanent and complete loss of the use of one hand,
2one arm, one foot, one leg, or one eye, incurs permanent and
3complete disability through the loss or the permanent and
4complete loss of the use of another member, he shall receive,
5in addition to the compensation payable by the employer and
6after such payments have ceased, an amount from the Second
7Injury Fund provided for in paragraph (f) of Section 7, which,
8together with the compensation payable from the employer in
9whose employ he was when the last accidental injury was
10incurred, will equal the amount payable for permanent and
11complete disability as provided in this paragraph of this
12Section.
13    The custodian of the Second Injury Fund provided for in
14paragraph (f) of Section 7 shall be joined with the employer as
15a party respondent in the application for adjustment of claim.
16The application for adjustment of claim shall state briefly and
17in general terms the approximate time and place and manner of
18the loss of the first member.
19    In its award the Commission or the Arbitrator shall
20specifically find the amount the injured employee shall be
21weekly paid, the number of weeks compensation which shall be
22paid by the employer, the date upon which payments begin out of
23the Second Injury Fund provided for in paragraph (f) of Section
247 of this Act, the length of time the weekly payments continue,
25the date upon which the pension payments commence and the
26monthly amount of the payments. The Commission shall 30 days

 

 

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1after the date upon which payments out of the Second Injury
2Fund have begun as provided in the award, and every month
3thereafter, prepare and submit to the State Comptroller a
4voucher for payment for all compensation accrued to that date
5at the rate fixed by the Commission. The State Comptroller
6shall draw a warrant to the injured employee along with a
7receipt to be executed by the injured employee and returned to
8the Commission. The endorsed warrant and receipt is a full and
9complete acquittance to the Commission for the payment out of
10the Second Injury Fund. No other appropriation or warrant is
11necessary for payment out of the Second Injury Fund. The Second
12Injury Fund is appropriated for the purpose of making payments
13according to the terms of the awards.
14    As of July 1, 1980 to July 1, 1982, all claims against and
15obligations of the Second Injury Fund shall become claims
16against and obligations of the Rate Adjustment Fund to the
17extent there is insufficient money in the Second Injury Fund to
18pay such claims and obligations. In that case, all references
19to "Second Injury Fund" in this Section shall also include the
20Rate Adjustment Fund.
21    (g) Every award for permanent total disability entered by
22the Commission on and after July 1, 1965 under which
23compensation payments shall become due and payable after the
24effective date of this amendatory Act, and every award for
25death benefits or permanent total disability entered by the
26Commission on and after the effective date of this amendatory

 

 

HB2635- 32 -LRB101 06273 TAE 51299 b

1Act shall be subject to annual adjustments as to the amount of
2the compensation rate therein provided. Such adjustments shall
3first be made on July 15, 1977, and all awards made and entered
4prior to July 1, 1975 and on July 15 of each year thereafter.
5In all other cases such adjustment shall be made on July 15 of
6the second year next following the date of the entry of the
7award and shall further be made on July 15 annually thereafter.
8If during the intervening period from the date of the entry of
9the award, or the last periodic adjustment, there shall have
10been an increase in the State's average weekly wage in covered
11industries under the Unemployment Insurance Act, the weekly
12compensation rate shall be proportionately increased by the
13same percentage as the percentage of increase in the State's
14average weekly wage in covered industries under the
15Unemployment Insurance Act. The increase in the compensation
16rate under this paragraph shall in no event bring the total
17compensation rate to an amount greater than the prevailing
18maximum rate at the time that the annual adjustment is made.
19Such increase shall be paid in the same manner as herein
20provided for payments under the Second Injury Fund to the
21injured employee, or his dependents, as the case may be, out of
22the Rate Adjustment Fund provided in paragraph (f) of Section 7
23of this Act. Payments shall be made at the same intervals as
24provided in the award or, at the option of the Commission, may
25be made in quarterly payment on the 15th day of January, April,
26July and October of each year. In the event of a decrease in

 

 

HB2635- 33 -LRB101 06273 TAE 51299 b

1such average weekly wage there shall be no change in the then
2existing compensation rate. The within paragraph shall not
3apply to cases where there is disputed liability and in which a
4compromise lump sum settlement between the employer and the
5injured employee, or his dependents, as the case may be, has
6been duly approved by the Illinois Workers' Compensation
7Commission.
8    Provided, that in cases of awards entered by the Commission
9for injuries occurring before July 1, 1975, the increases in
10the compensation rate adjusted under the foregoing provision of
11this paragraph (g) shall be limited to increases in the State's
12average weekly wage in covered industries under the
13Unemployment Insurance Act occurring after July 1, 1975.
14    For every accident occurring on or after July 20, 2005 but
15before the effective date of this amendatory Act of the 94th
16General Assembly (Senate Bill 1283 of the 94th General
17Assembly), the annual adjustments to the compensation rate in
18awards for death benefits or permanent total disability, as
19provided in this Act, shall be paid by the employer. The
20adjustment shall be made by the employer on July 15 of the
21second year next following the date of the entry of the award
22and shall further be made on July 15 annually thereafter. If
23during the intervening period from the date of the entry of the
24award, or the last periodic adjustment, there shall have been
25an increase in the State's average weekly wage in covered
26industries under the Unemployment Insurance Act, the employer

 

 

HB2635- 34 -LRB101 06273 TAE 51299 b

1shall increase the weekly compensation rate proportionately by
2the same percentage as the percentage of increase in the
3State's average weekly wage in covered industries under the
4Unemployment Insurance Act. The increase in the compensation
5rate under this paragraph shall in no event bring the total
6compensation rate to an amount greater than the prevailing
7maximum rate at the time that the annual adjustment is made. In
8the event of a decrease in such average weekly wage there shall
9be no change in the then existing compensation rate. Such
10increase shall be paid by the employer in the same manner and
11at the same intervals as the payment of compensation in the
12award. This paragraph shall not apply to cases where there is
13disputed liability and in which a compromise lump sum
14settlement between the employer and the injured employee, or
15his or her dependents, as the case may be, has been duly
16approved by the Illinois Workers' Compensation Commission.
17    The annual adjustments for every award of death benefits or
18permanent total disability involving accidents occurring
19before July 20, 2005 and accidents occurring on or after the
20effective date of this amendatory Act of the 94th General
21Assembly (Senate Bill 1283 of the 94th General Assembly) shall
22continue to be paid from the Rate Adjustment Fund pursuant to
23this paragraph and Section 7(f) of this Act.
24    (h) In case death occurs from any cause before the total
25compensation to which the employee would have been entitled has
26been paid, then in case the employee leaves any widow, widower,

 

 

HB2635- 35 -LRB101 06273 TAE 51299 b

1child, parent (or any grandchild, grandparent or other lineal
2heir or any collateral heir dependent at the time of the
3accident upon the earnings of the employee to the extent of 50%
4or more of total dependency) such compensation shall be paid to
5the beneficiaries of the deceased employee and distributed as
6provided in paragraph (g) of Section 7.
7    (h-1) In case an injured employee is under legal disability
8at the time when any right or privilege accrues to him or her
9under this Act, a guardian may be appointed pursuant to law,
10and may, on behalf of such person under legal disability, claim
11and exercise any such right or privilege with the same effect
12as if the employee himself or herself had claimed or exercised
13the right or privilege. No limitations of time provided by this
14Act run so long as the employee who is under legal disability
15is without a conservator or guardian.
16    (i) In case the injured employee is under 16 years of age
17at the time of the accident and is illegally employed, the
18amount of compensation payable under paragraphs (b), (c), (d),
19(e) and (f) of this Section is increased 50%.
20    However, where an employer has on file an employment
21certificate issued pursuant to the Child Labor Law or work
22permit issued pursuant to the Federal Fair Labor Standards Act,
23as amended, or a birth certificate properly and duly issued,
24such certificate, permit or birth certificate is conclusive
25evidence as to the age of the injured minor employee for the
26purposes of this Section.

 

 

HB2635- 36 -LRB101 06273 TAE 51299 b

1    Nothing herein contained repeals or amends the provisions
2of the Child Labor Law relating to the employment of minors
3under the age of 16 years.
4    (j) 1. In the event the injured employee receives benefits,
5including medical, surgical or hospital benefits under any
6group plan covering non-occupational disabilities contributed
7to wholly or partially by the employer, which benefits should
8not have been payable if any rights of recovery existed under
9this Act, then such amounts so paid to the employee from any
10such group plan as shall be consistent with, and limited to,
11the provisions of paragraph 2 hereof, shall be credited to or
12against any compensation payment for temporary total
13incapacity for work or any medical, surgical or hospital
14benefits made or to be made under this Act. In such event, the
15period of time for giving notice of accidental injury and
16filing application for adjustment of claim does not commence to
17run until the termination of such payments. This paragraph does
18not apply to payments made under any group plan which would
19have been payable irrespective of an accidental injury under
20this Act. Any employer receiving such credit shall keep such
21employee safe and harmless from any and all claims or
22liabilities that may be made against him by reason of having
23received such payments only to the extent of such credit.
24    Any excess benefits paid to or on behalf of a State
25employee by the State Employees' Retirement System under
26Article 14 of the Illinois Pension Code on a death claim or

 

 

HB2635- 37 -LRB101 06273 TAE 51299 b

1disputed disability claim shall be credited against any
2payments made or to be made by the State of Illinois to or on
3behalf of such employee under this Act, except for payments for
4medical expenses which have already been incurred at the time
5of the award. The State of Illinois shall directly reimburse
6the State Employees' Retirement System to the extent of such
7credit.
8    2. Nothing contained in this Act shall be construed to give
9the employer or the insurance carrier the right to credit for
10any benefits or payments received by the employee other than
11compensation payments provided by this Act, and where the
12employee receives payments other than compensation payments,
13whether as full or partial salary, group insurance benefits,
14bonuses, annuities or any other payments, the employer or
15insurance carrier shall receive credit for each such payment
16only to the extent of the compensation that would have been
17payable during the period covered by such payment.
18    3. The extension of time for the filing of an Application
19for Adjustment of Claim as provided in paragraph 1 above shall
20not apply to those cases where the time for such filing had
21expired prior to the date on which payments or benefits
22enumerated herein have been initiated or resumed. Provided
23however that this paragraph 3 shall apply only to cases wherein
24the payments or benefits hereinabove enumerated shall be
25received after July 1, 1969.
26(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,

 

 

HB2635- 38 -LRB101 06273 TAE 51299 b

1eff. 7-13-12.)
 
2    (820 ILCS 305/8.3)
3    Sec. 8.3. Workers' Compensation Medical Fee Advisory
4Board. There is created a Workers' Compensation Medical Fee
5Advisory Board consisting of 9 members appointed by the
6Governor with the advice and consent of the Senate. Three
7members of the Advisory Board shall be representative citizens
8chosen from the employee class, 3 members shall be
9representative citizens chosen from the employing class, and 3
10members shall be representative citizens chosen from the
11medical provider class. Each member shall serve a 4-year term
12and shall continue to serve until a successor is appointed. A
13vacancy on the Advisory Board shall be filled by the Governor
14for the unexpired term.
15    Members of the Advisory Board shall receive no compensation
16for their services but shall be reimbursed for expenses
17incurred in the performance of their duties by the Commission
18from appropriations made to the Commission for that purpose.
19    The Advisory Board shall advise the Commission on
20establishment of fees for medical services and accessibility of
21medical treatment.
22    The Advisory Board shall develop a fee schedule for
23procedures, treatments, and services overed under this Act to
24be implemented by the Commission. The medical fee schedule
25shall provide for payments based upon the fees for such

 

 

HB2635- 39 -LRB101 06273 TAE 51299 b

1procedures, treatments, and services authorized under
2Medicare. The Advisory Board shall complete the fee schedule
3and report its recommendations to the Commission no later than
4December 31, 2020.
5(Source: P.A. 94-277, eff. 7-20-05.)