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1 | | AN ACT concerning employment. |
2 | | Be it enacted by the People of the State of Illinois, |
3 | | represented in the General Assembly: |
4 | | Section 5. The Illinois Insurance Code is amended by |
5 | | changing Section 416 as follows: |
6 | | (215 ILCS 5/416) |
7 | | Sec. 416. Illinois Workers' Compensation Commission |
8 | | Operations Fund Surcharge. |
9 | | (a) As of July 30, 2004 (the effective date of Public Act |
10 | | 93-840), every company licensed or authorized by the Illinois |
11 | | Department of Insurance and insuring employers' liabilities |
12 | | arising under the Workers' Compensation Act or the Workers' |
13 | | Occupational Diseases Act shall remit to the Director a |
14 | | surcharge based upon the annual direct written premium, as |
15 | | reported under Section 136 of this Act, of the company in the |
16 | | manner provided in this Section. Such proceeds shall be |
17 | | deposited into the Illinois Workers' Compensation Commission |
18 | | Operations Fund as established in the Workers' Compensation |
19 | | Act. If a company survives or was formed by a merger, |
20 | | consolidation, reorganization, or reincorporation, the direct |
21 | | written premiums of all companies party to the merger, |
22 | | consolidation, reorganization, or reincorporation shall, for |
23 | | purposes of determining the amount of the fee imposed by this |
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1 | | Section, be regarded as those of the surviving or new company. |
2 | | (b) Beginning (1) Except as provided in subsection (b)(2) |
3 | | of this Section, beginning on July 30, 2004 (the effective |
4 | | date of Public Act 93-840) and on July 1 of each year |
5 | | thereafter through 2023 , the Director shall charge an annual |
6 | | Illinois Workers' Compensation Commission Operations Fund |
7 | | Surcharge from every company subject to subsection (a) of this |
8 | | Section equal to 1.01% of its direct written premium for |
9 | | insuring employers' liabilities arising under the Workers' |
10 | | Compensation Act or Workers' Occupational Diseases Act as |
11 | | reported in each company's annual statement filed for the |
12 | | previous year as required by Section 136. Within 15 days after |
13 | | the effective date of this amendatory Act of the 103rd General |
14 | | Assembly and on July 1 of each year thereafter, the Director |
15 | | shall charge an annual Illinois Workers' Compensation |
16 | | Commission Operations Fund Surcharge from every company |
17 | | subject to subsection (a) of this Section equal to 1.092% of |
18 | | its direct written premium for insuring employers' liabilities |
19 | | arising under the Workers' Compensation Act or Workers' |
20 | | Occupational Diseases Act as reported in each company's annual |
21 | | statement filed for the previous year as required by Section |
22 | | 136. The Illinois Workers' Compensation Commission Operations |
23 | | Fund Surcharge shall be collected by companies subject to |
24 | | subsection (a) of this Section as a separately stated |
25 | | surcharge on insured employers at the rate of 1.092% 1.01% of |
26 | | direct written premium for the surcharge due in 2024 and each |
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1 | | year thereafter . The Illinois Workers' Compensation Commission |
2 | | Operations Fund Surcharge shall not be collected by companies |
3 | | subject to subsection (a) of this Section from any employer |
4 | | that self-insures its liabilities arising under the Workers' |
5 | | Compensation Act or Workers' Occupational Diseases Act, |
6 | | provided that the employer has paid the Illinois Workers' |
7 | | Compensation Commission Operations Fund Fee pursuant to |
8 | | Section 4d of the Workers' Compensation Act. All sums |
9 | | collected by the Department of Insurance under the provisions |
10 | | of this Section shall be paid promptly after the receipt of the |
11 | | same, accompanied by a detailed statement thereof, into the |
12 | | Illinois Workers' Compensation Commission Operations Fund in |
13 | | the State treasury. |
14 | | (b)(2) (Blank). The surcharge due pursuant to Public Act |
15 | | 93-840 shall be collected instead of the surcharge due on July |
16 | | 1, 2004 under Public Act 93-32. Payment of the surcharge due |
17 | | under Public Act 93-840 shall discharge the employer's |
18 | | obligations due on July 1, 2004. |
19 | | (c) In addition to the authority specifically granted |
20 | | under Article XXV of this Code, the Director shall have such |
21 | | authority to adopt rules or establish forms as may be |
22 | | reasonably necessary for purposes of enforcing this Section. |
23 | | The Director shall also have authority to defer, waive, or |
24 | | abate the surcharge or any penalties imposed by this Section |
25 | | if in the Director's opinion the company's solvency and |
26 | | ability to meet its insured obligations would be immediately |
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1 | | threatened by payment of the surcharge due. |
2 | | (d) When a company fails to pay the full amount of any |
3 | | annual Illinois Workers' Compensation Commission Operations |
4 | | Fund Surcharge of $100 or more due under this Section, there |
5 | | shall be added to the amount due as a penalty an amount equal |
6 | | to 10% of the deficiency for each month or part of a month that |
7 | | the deficiency remains unpaid. |
8 | | (e) The Department of Insurance may enforce the collection |
9 | | of any delinquent payment, penalty, or portion thereof by |
10 | | legal action or in any other manner by which the collection of |
11 | | debts due the State of Illinois may be enforced under the laws |
12 | | of this State. |
13 | | (f) Whenever it appears to the satisfaction of the |
14 | | Director that a company has paid pursuant to this Act an |
15 | | Illinois Workers' Compensation Commission Operations Fund |
16 | | Surcharge in an amount in excess of the amount legally |
17 | | collectable from the company, the Director shall issue a |
18 | | credit memorandum for an amount equal to the amount of such |
19 | | overpayment. A credit memorandum may be applied for the 2-year |
20 | | period from the date of issuance, against the payment of any |
21 | | amount due during that period under the surcharge imposed by |
22 | | this Section or, subject to reasonable rule of the Department |
23 | | of Insurance including requirement of notification, may be |
24 | | assigned to any other company subject to regulation under this |
25 | | Act. Any application of credit memoranda after the period |
26 | | provided for in this Section is void. |
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1 | | (g) Annually, the Governor may direct a transfer of up to |
2 | | 2% of all moneys collected under this Section to the Insurance |
3 | | Financial Regulation Fund. |
4 | | (Source: P.A. 102-775, eff. 5-13-22.) |
5 | | Section 10. The Workers' Compensation Act is amended by |
6 | | changing Sections 4, 4a-5, 4d, 7, 19, and 25.5 as follows: |
7 | | (820 ILCS 305/4) (from Ch. 48, par. 138.4) |
8 | | (Text of Section from P.A. 101-40 and 102-37) |
9 | | Sec. 4. (a) Any employer, including but not limited to |
10 | | general contractors and their subcontractors, who shall come |
11 | | within the provisions of Section 3 of this Act, and any other |
12 | | employer who shall elect to provide and pay the compensation |
13 | | provided for in this Act shall: |
14 | | (1) File with the Commission annually an application |
15 | | for approval as a self-insurer which shall include a |
16 | | current financial statement, and annually, thereafter, an |
17 | | application for renewal of self-insurance, which shall |
18 | | include a current financial statement. Said application |
19 | | and financial statement shall be signed and sworn to by |
20 | | the president or vice president and secretary or assistant |
21 | | secretary of the employer if it be a corporation, or by all |
22 | | of the partners, if it be a copartnership, or by the owner |
23 | | if it be neither a copartnership nor a corporation. All |
24 | | initial applications and all applications for renewal of |
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1 | | self-insurance must be submitted at least 60 days prior to |
2 | | the requested effective date of self-insurance. An |
3 | | employer may elect to provide and pay compensation as |
4 | | provided for in this Act as a member of a group workers' |
5 | | compensation pool under Article V 3/4 of the Illinois |
6 | | Insurance Code. If an employer becomes a member of a group |
7 | | workers' compensation pool, the employer shall not be |
8 | | relieved of any obligations imposed by this Act. |
9 | | If the sworn application and financial statement of |
10 | | any such employer does not satisfy the Commission of the |
11 | | financial ability of the employer who has filed it, the |
12 | | Commission shall require such employer to, |
13 | | (2) Furnish security, indemnity or a bond guaranteeing |
14 | | the payment by the employer of the compensation provided |
15 | | for in this Act, provided that any such employer whose |
16 | | application and financial statement shall not have |
17 | | satisfied the commission of his or her financial ability |
18 | | and who shall have secured his liability in part by excess |
19 | | liability insurance shall be required to furnish to the |
20 | | Commission security, indemnity or bond guaranteeing his or |
21 | | her payment up to the effective limits of the excess |
22 | | coverage, or |
23 | | (3) Insure his entire liability to pay such |
24 | | compensation in some insurance carrier authorized, |
25 | | licensed, or permitted to do such insurance business in |
26 | | this State. Every policy of an insurance carrier, insuring |
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1 | | the payment of compensation under this Act shall cover all |
2 | | the employees and the entire compensation liability of the |
3 | | insured: Provided, however, that any employer may insure |
4 | | his or her compensation liability with 2 or more insurance |
5 | | carriers or may insure a part and qualify under subsection |
6 | | 1, 2, or 4 for the remainder of his or her liability to pay |
7 | | such compensation, subject to the following two |
8 | | provisions: |
9 | | Firstly, the entire compensation liability of the |
10 | | employer to employees working at or from one location |
11 | | shall be insured in one such insurance carrier or |
12 | | shall be self-insured, and |
13 | | Secondly, the employer shall submit evidence |
14 | | satisfactorily to the Commission that his or her |
15 | | entire liability for the compensation provided for in |
16 | | this Act will be secured. Any provisions in any |
17 | | policy, or in any endorsement attached thereto, |
18 | | attempting to limit or modify in any way, the |
19 | | liability of the insurance carriers issuing the same |
20 | | except as otherwise provided herein shall be wholly |
21 | | void. |
22 | | Nothing herein contained shall apply to policies of |
23 | | excess liability carriage secured by employers who have |
24 | | been approved by the Commission as self-insurers, or |
25 | | (4) Make some other provision, satisfactory to the |
26 | | Commission, for the securing of the payment of |
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1 | | compensation provided for in this Act, and |
2 | | (5) Upon becoming subject to this Act and thereafter |
3 | | as often as the Commission may in writing demand, file |
4 | | with the Commission in form prescribed by it evidence of |
5 | | his or her compliance with the provision of this Section. |
6 | | (a-1) Regardless of its state of domicile or its principal |
7 | | place of business, an employer shall make payments to its |
8 | | insurance carrier or group self-insurance fund, where |
9 | | applicable, based upon the premium rates of the situs where |
10 | | the work or project is located in Illinois if: |
11 | | (A) the employer is engaged primarily in the building |
12 | | and construction industry; and |
13 | | (B) subdivision (a)(3) of this Section applies to the |
14 | | employer or the employer is a member of a group |
15 | | self-insurance plan as defined in subsection (1) of |
16 | | Section 4a. |
17 | | The Illinois Workers' Compensation Commission shall impose |
18 | | a penalty upon an employer for violation of this subsection |
19 | | (a-1) if: |
20 | | (i) the employer is given an opportunity at a hearing |
21 | | to present evidence of its compliance with this subsection |
22 | | (a-1); and |
23 | | (ii) after the hearing, the Commission finds that the |
24 | | employer failed to make payments upon the premium rates of |
25 | | the situs where the work or project is located in |
26 | | Illinois. |
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1 | | The penalty shall not exceed $1,000 for each day of work |
2 | | for which the employer failed to make payments upon the |
3 | | premium rates of the situs where the work or project is located |
4 | | in Illinois, but the total penalty shall not exceed $50,000 |
5 | | for each project or each contract under which the work was |
6 | | performed. |
7 | | Any penalty under this subsection (a-1) must be imposed |
8 | | not later than one year after the expiration of the applicable |
9 | | limitation period specified in subsection (d) of Section 6 of |
10 | | this Act. Penalties imposed under this subsection (a-1) shall |
11 | | be deposited into the Illinois Workers' Compensation |
12 | | Commission Operations Fund, a special fund that is created in |
13 | | the State treasury. Subject to appropriation, moneys in the |
14 | | Fund shall be used solely for the operations of the Illinois |
15 | | Workers' Compensation Commission, the salaries and benefits of |
16 | | the Self-Insurers Advisory Board employees, the operating |
17 | | costs of the Self-Insurers Advisory Board, and by the |
18 | | Department of Insurance for the purposes authorized in |
19 | | subsection (c) of Section 25.5 of this Act. |
20 | | (a-2) Every Employee Leasing Company (ELC), as defined in |
21 | | Section 15 of the Employee Leasing Company Act, shall at a |
22 | | minimum provide the following information to the Commission or |
23 | | any entity designated by the Commission regarding each |
24 | | workers' compensation insurance policy issued to the ELC: |
25 | | (1) Any client company of the ELC listed as an |
26 | | additional named insured. |
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1 | | (2) Any informational schedule attached to the master |
2 | | policy that identifies any individual client company's |
3 | | name, FEIN, and job location. |
4 | | (3) Any certificate of insurance coverage document |
5 | | issued to a client company specifying its rights and |
6 | | obligations under the master policy that establishes both |
7 | | the identity and status of the client, as well as the dates |
8 | | of inception and termination of coverage, if applicable. |
9 | | (b) The sworn application and financial statement, or |
10 | | security, indemnity or bond, or amount of insurance, or other |
11 | | provisions, filed, furnished, carried, or made by the |
12 | | employer, as the case may be, shall be subject to the approval |
13 | | of the Commission. |
14 | | Deposits under escrow agreements shall be cash, negotiable |
15 | | United States government bonds or negotiable general |
16 | | obligation bonds of the State of Illinois. Such cash or bonds |
17 | | shall be deposited in escrow with any State or National Bank or |
18 | | Trust Company having trust authority in the State of Illinois. |
19 | | Upon the approval of the sworn application and financial |
20 | | statement, security, indemnity or bond or amount of insurance, |
21 | | filed, furnished or carried, as the case may be, the |
22 | | Commission shall send to the employer written notice of its |
23 | | approval thereof. The certificate of compliance by the |
24 | | employer with the provisions of subparagraphs (2) and (3) of |
25 | | paragraph (a) of this Section shall be delivered by the |
26 | | insurance carrier to the Illinois Workers' Compensation |
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1 | | Commission within five days after the effective date of the |
2 | | policy so certified. The insurance so certified shall cover |
3 | | all compensation liability occurring during the time that the |
4 | | insurance is in effect and no further certificate need be |
5 | | filed in case such insurance is renewed, extended or otherwise |
6 | | continued by such carrier. The insurance so certified shall |
7 | | not be cancelled or in the event that such insurance is not |
8 | | renewed, extended or otherwise continued, such insurance shall |
9 | | not be terminated until at least 10 days after receipt by the |
10 | | Illinois Workers' Compensation Commission of notice of the |
11 | | cancellation or termination of said insurance; provided, |
12 | | however, that if the employer has secured insurance from |
13 | | another insurance carrier, or has otherwise secured the |
14 | | payment of compensation in accordance with this Section, and |
15 | | such insurance or other security becomes effective prior to |
16 | | the expiration of the 10 days, cancellation or termination |
17 | | may, at the option of the insurance carrier indicated in such |
18 | | notice, be effective as of the effective date of such other |
19 | | insurance or security. |
20 | | (c) Whenever the Commission shall find that any |
21 | | corporation, company, association, aggregation of individuals, |
22 | | reciprocal or interinsurers exchange, or other insurer |
23 | | effecting workers' compensation insurance in this State shall |
24 | | be insolvent, financially unsound, or unable to fully meet all |
25 | | payments and liabilities assumed or to be assumed for |
26 | | compensation insurance in this State, or shall practice a |
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1 | | policy of delay or unfairness toward employees in the |
2 | | adjustment, settlement, or payment of benefits due such |
3 | | employees, the Commission may after reasonable notice and |
4 | | hearing order and direct that such corporation, company, |
5 | | association, aggregation of individuals, reciprocal or |
6 | | interinsurers exchange, or insurer, shall from and after a |
7 | | date fixed in such order discontinue the writing of any such |
8 | | workers' compensation insurance in this State. Subject to such |
9 | | modification of the order as the Commission may later make on |
10 | | review of the order, as herein provided, it shall thereupon be |
11 | | unlawful for any such corporation, company, association, |
12 | | aggregation of individuals, reciprocal or interinsurers |
13 | | exchange, or insurer to effect any workers' compensation |
14 | | insurance in this State. A copy of the order shall be served |
15 | | upon the Director of Insurance by registered mail. Whenever |
16 | | the Commission finds that any service or adjustment company |
17 | | used or employed by a self-insured employer or by an insurance |
18 | | carrier to process, adjust, investigate, compromise or |
19 | | otherwise handle claims under this Act, has practiced or is |
20 | | practicing a policy of delay or unfairness toward employees in |
21 | | the adjustment, settlement or payment of benefits due such |
22 | | employees, the Commission may after reasonable notice and |
23 | | hearing order and direct that such service or adjustment |
24 | | company shall from and after a date fixed in such order be |
25 | | prohibited from processing, adjusting, investigating, |
26 | | compromising or otherwise handling claims under this Act. |
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1 | | Whenever the Commission finds that any self-insured |
2 | | employer has practiced or is practicing delay or unfairness |
3 | | toward employees in the adjustment, settlement or payment of |
4 | | benefits due such employees, the Commission may, after |
5 | | reasonable notice and hearing, order and direct that after a |
6 | | date fixed in the order such self-insured employer shall be |
7 | | disqualified to operate as a self-insurer and shall be |
8 | | required to insure his entire liability to pay compensation in |
9 | | some insurance carrier authorized, licensed and permitted to |
10 | | do such insurance business in this State, as provided in |
11 | | subparagraph 3 of paragraph (a) of this Section. |
12 | | All orders made by the Commission under this Section shall |
13 | | be subject to review by the courts, said review to be taken in |
14 | | the same manner and within the same time as provided by Section |
15 | | 19 of this Act for review of awards and decisions of the |
16 | | Commission, upon the party seeking the review filing with the |
17 | | clerk of the court to which said review is taken a bond in an |
18 | | amount to be fixed and approved by the court to which the |
19 | | review is taken, conditioned upon the payment of all |
20 | | compensation awarded against the person taking said review |
21 | | pending a decision thereof and further conditioned upon such |
22 | | other obligations as the court may impose. Upon the review the |
23 | | Circuit Court shall have power to review all questions of fact |
24 | | as well as of law. The penalty hereinafter provided for in this |
25 | | paragraph shall not attach and shall not begin to run until the |
26 | | final determination of the order of the Commission. |
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1 | | (d) Whenever a Commissioner, with due process and after a |
2 | | hearing, determines an employer has knowingly failed to |
3 | | provide coverage as required by paragraph (a) of this Section, |
4 | | the failure shall be deemed an immediate serious danger to |
5 | | public health, safety, and welfare sufficient to justify |
6 | | service by the Commission of a work-stop order on such |
7 | | employer, requiring the cessation of all business operations |
8 | | of such employer at the place of employment or job site. If a |
9 | | business is declared to be extra hazardous, as defined in |
10 | | Section 3, a Commissioner may issue an emergency work-stop |
11 | | order on such an employer ex parte, prior to holding a hearing, |
12 | | requiring the cessation of all business operations of such |
13 | | employer at the place of employment or job site while awaiting |
14 | | the ruling of the Commission. Whenever a Commissioner issues |
15 | | an emergency work-stop order, the Commission shall issue a |
16 | | notice of emergency work-stop hearing to be posted at the |
17 | | employer's places of employment and job sites. Any law |
18 | | enforcement agency in the State shall, at the request of the |
19 | | Commission, render any assistance necessary to carry out the |
20 | | provisions of this Section, including, but not limited to, |
21 | | preventing any employee of such employer from remaining at a |
22 | | place of employment or job site after a work-stop order has |
23 | | taken effect. Any work-stop order shall be lifted upon proof |
24 | | of insurance as required by this Act. Any orders under this |
25 | | Section are appealable under Section 19(f) to the Circuit |
26 | | Court. |
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1 | | Any individual employer, corporate officer or director of |
2 | | a corporate employer, partner of an employer partnership, or |
3 | | member of an employer limited liability company who knowingly |
4 | | fails to provide coverage as required by paragraph (a) of this |
5 | | Section is guilty of a Class 4 felony. This provision shall not |
6 | | apply to any corporate officer or director of any |
7 | | publicly-owned corporation. Each day's violation constitutes a |
8 | | separate offense. The State's Attorney of the county in which |
9 | | the violation occurred, or the Attorney General, shall bring |
10 | | such actions in the name of the People of the State of |
11 | | Illinois, or may, in addition to other remedies provided in |
12 | | this Section, bring an action for an injunction to restrain |
13 | | the violation or to enjoin the operation of any such employer. |
14 | | Any individual employer, corporate officer or director of |
15 | | a corporate employer, partner of an employer partnership, or |
16 | | member of an employer limited liability company who |
17 | | negligently fails to provide coverage as required by paragraph |
18 | | (a) of this Section is guilty of a Class A misdemeanor. This |
19 | | provision shall not apply to any corporate officer or director |
20 | | of any publicly-owned corporation. Each day's violation |
21 | | constitutes a separate offense. The State's Attorney of the |
22 | | county in which the violation occurred, or the Attorney |
23 | | General, shall bring such actions in the name of the People of |
24 | | the State of Illinois. |
25 | | The criminal penalties in this subsection (d) shall not |
26 | | apply where there exists a good faith dispute as to the |
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1 | | existence of an employment relationship. Evidence of good |
2 | | faith shall include, but not be limited to, compliance with |
3 | | the definition of employee as used by the Internal Revenue |
4 | | Service. |
5 | | All investigative actions must be acted upon within 90 |
6 | | days of the issuance of the complaint. Employers who are |
7 | | subject to and who knowingly fail to comply with this Section |
8 | | shall not be entitled to the benefits of this Act during the |
9 | | period of noncompliance, but shall be liable in an action |
10 | | under any other applicable law of this State. In the action, |
11 | | such employer shall not avail himself or herself of the |
12 | | defenses of assumption of risk or negligence or that the |
13 | | injury was due to a co-employee. In the action, proof of the |
14 | | injury shall constitute prima facie evidence of negligence on |
15 | | the part of such employer and the burden shall be on such |
16 | | employer to show freedom of negligence resulting in the |
17 | | injury. The employer shall not join any other defendant in any |
18 | | such civil action. Nothing in this amendatory Act of the 94th |
19 | | General Assembly shall affect the employee's rights under |
20 | | subdivision (a)3 of Section 1 of this Act. Any employer or |
21 | | carrier who makes payments under subdivision (a)3 of Section 1 |
22 | | of this Act shall have a right of reimbursement from the |
23 | | proceeds of any recovery under this Section. |
24 | | An employee of an uninsured employer, or the employee's |
25 | | dependents in case death ensued, may, instead of proceeding |
26 | | against the employer in a civil action in court, file an |
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1 | | application for adjustment of claim with the Commission in |
2 | | accordance with the provisions of this Act and the Commission |
3 | | shall hear and determine the application for adjustment of |
4 | | claim in the manner in which other claims are heard and |
5 | | determined before the Commission. |
6 | | All proceedings under this subsection (d) shall be |
7 | | reported on an annual basis to the Workers' Compensation |
8 | | Advisory Board. |
9 | | An investigator with the Department of Insurance may issue |
10 | | a citation to any employer that is not in compliance with its |
11 | | obligation to have workers' compensation insurance under this |
12 | | Act. The amount of the fine shall be based on the period of |
13 | | time the employer was in non-compliance, but shall be no less |
14 | | than $500, and shall not exceed $10,000. An employer that has |
15 | | been issued a citation shall pay the fine to the Department of |
16 | | Insurance and provide to the Department of Insurance proof |
17 | | that it obtained the required workers' compensation insurance |
18 | | within 10 days after the citation was issued. This Section |
19 | | does not affect any other obligations this Act imposes on |
20 | | employers. |
21 | | Upon a finding by the Commission, after reasonable notice |
22 | | and hearing, of the knowing and willful failure or refusal of |
23 | | an employer to comply with any of the provisions of paragraph |
24 | | (a) of this Section, the failure or refusal of an employer, |
25 | | service or adjustment company, or an insurance carrier to |
26 | | comply with any order of the Illinois Workers' Compensation |
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1 | | Commission pursuant to paragraph (c) of this Section |
2 | | disqualifying him or her to operate as a self insurer and |
3 | | requiring him or her to insure his or her liability, or the |
4 | | knowing and willful failure of an employer to comply with a |
5 | | citation issued by an investigator with the Department of |
6 | | Insurance, the Commission may assess a civil penalty of up to |
7 | | $500 per day for each day of such failure or refusal after the |
8 | | effective date of this amendatory Act of 1989. The minimum |
9 | | penalty under this Section shall be the sum of $10,000. Each |
10 | | day of such failure or refusal shall constitute a separate |
11 | | offense. The Commission may assess the civil penalty |
12 | | personally and individually against the corporate officers and |
13 | | directors of a corporate employer, the partners of an employer |
14 | | partnership, and the members of an employer limited liability |
15 | | company, after a finding of a knowing and willful refusal or |
16 | | failure of each such named corporate officer, director, |
17 | | partner, or member to comply with this Section. The liability |
18 | | for the assessed penalty shall be against the named employer |
19 | | first, and if the named employer fails or refuses to pay the |
20 | | penalty to the Commission within 30 days after the final order |
21 | | of the Commission, then the named corporate officers, |
22 | | directors, partners, or members who have been found to have |
23 | | knowingly and willfully refused or failed to comply with this |
24 | | Section shall be liable for the unpaid penalty or any unpaid |
25 | | portion of the penalty. Upon investigation by the Department |
26 | | of Insurance, the Attorney General shall have the authority to |
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| | SB1996 Enrolled | - 19 - | LRB103 28652 SPS 55033 b |
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1 | | prosecute all proceedings to enforce the civil and |
2 | | administrative provisions of this Section before the |
3 | | Commission. The Commission and the Department of Insurance |
4 | | shall promulgate procedural rules for enforcing this Section |
5 | | relating to their respective duties prescribed herein. |
6 | | If an employer is found to be in non-compliance with any |
7 | | provisions of paragraph (a) of this Section more than once, |
8 | | all minimum penalties will double. Therefore, upon the failure |
9 | | or refusal of an employer, service or adjustment company, or |
10 | | insurance carrier to comply with any order of the Commission |
11 | | pursuant to paragraph (c) of this Section disqualifying him or |
12 | | her to operate as a self-insurer and requiring him or her to |
13 | | insure his or her liability, or the knowing and willful |
14 | | failure of an employer to comply with a citation issued by an |
15 | | investigator with the Department of Insurance, the Commission |
16 | | may assess a civil penalty of up to $1,000 per day for each day |
17 | | of such failure or refusal after the effective date of this |
18 | | amendatory Act of the 101st General Assembly. The minimum |
19 | | penalty under this Section shall be the sum of $20,000. In |
20 | | addition, employers with 2 or more violations of any |
21 | | provisions of paragraph (a) of this Section may not |
22 | | self-insure for one year or until all penalties are paid. |
23 | | A Commission decision imposing penalties under this |
24 | | Section may be judicially reviewed only as described in |
25 | | Section 19(f). After expiration of the period for seeking |
26 | | judicial review, the Commission's final decision imposing |
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| | SB1996 Enrolled | - 20 - | LRB103 28652 SPS 55033 b |
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1 | | penalties may be enforced in the same manner as a judgment |
2 | | entered by a court of competent jurisdiction. The Commission's |
3 | | final decision imposing penalties is a debt due and owing to |
4 | | the State and can be enforced to the same extent as a judgment |
5 | | entered by a circuit court. The Attorney General shall |
6 | | represent the Commission and the Department of Insurance in |
7 | | any action challenging the final decision in circuit court. If |
8 | | the court affirms the Commission's decision, the court shall |
9 | | enter judgment against the employer in the amount of the fines |
10 | | assessed by the Commission. The Attorney General shall make |
11 | | reasonable efforts to collect the amounts due under the |
12 | | Commission's decision. |
13 | | Upon the failure or refusal of any employer, service or |
14 | | adjustment company or insurance carrier to comply with the |
15 | | provisions of this Section and with the orders of the |
16 | | Commission under this Section, or the order of the court on |
17 | | review after final adjudication, the Commission may bring a |
18 | | civil action to recover the amount of the penalty in Cook |
19 | | County or in Sangamon County in which litigation the |
20 | | Commission shall be represented by the Attorney General. The |
21 | | Commission shall send notice of its finding of non-compliance |
22 | | and assessment of the civil penalty to the Attorney General. |
23 | | It shall be the duty of the Attorney General within 30 days |
24 | | after receipt of the notice, to institute prosecutions and |
25 | | promptly prosecute all reported violations of this Section. |
26 | | Any individual employer, corporate officer or director of |
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| | SB1996 Enrolled | - 21 - | LRB103 28652 SPS 55033 b |
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1 | | a corporate employer, partner of an employer partnership, or |
2 | | member of an employer limited liability company who, with the |
3 | | intent to avoid payment of compensation under this Act to an |
4 | | injured employee or the employee's dependents, knowingly |
5 | | transfers, sells, encumbers, assigns, or in any manner |
6 | | disposes of, conceals, secretes, or destroys any property |
7 | | belonging to the employer, officer, director, partner, or |
8 | | member is guilty of a Class 4 felony. |
9 | | Penalties and fines collected pursuant to this paragraph |
10 | | (d) shall be deposited upon receipt into a special fund which |
11 | | shall be designated the Injured Workers' Benefit Fund, of |
12 | | which the State Treasurer is ex-officio custodian, such |
13 | | special fund to be held and disbursed in accordance with this |
14 | | paragraph (d) for the purposes hereinafter stated in this |
15 | | paragraph (d), upon the final order of the Commission. The |
16 | | Injured Workers' Benefit Fund shall be deposited the same as |
17 | | are State funds and any interest accruing thereon shall be |
18 | | added thereto every 6 months. The Injured Workers' Benefit |
19 | | Fund is subject to audit the same as State funds and accounts |
20 | | and is protected by the general bond given by the State |
21 | | Treasurer. The Injured Workers' Benefit Fund is considered |
22 | | always appropriated for the purposes of disbursements as |
23 | | provided in this paragraph, and shall be paid out and |
24 | | disbursed as herein provided and shall not at any time be |
25 | | appropriated or diverted to any other use or purpose. Moneys |
26 | | in the Injured Workers' Benefit Fund shall be used only for |
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| | SB1996 Enrolled | - 22 - | LRB103 28652 SPS 55033 b |
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1 | | payment of workers' compensation benefits for injured |
2 | | employees when the employer has failed to provide coverage as |
3 | | determined under this paragraph (d) and has failed to pay the |
4 | | benefits due to the injured employee. The employer shall |
5 | | reimburse the Injured Workers' Benefit Fund for any amounts |
6 | | paid to an employee on account of the compensation awarded by |
7 | | the Commission. The Attorney General shall make reasonable |
8 | | efforts to obtain reimbursement for the Injured Workers' |
9 | | Benefit Fund. |
10 | | The Commission shall have the right to obtain |
11 | | reimbursement from the employer for compensation obligations |
12 | | paid by the Injured Workers' Benefit Fund. Any such amounts |
13 | | obtained shall be deposited by the Commission into the Injured |
14 | | Workers' Benefit Fund. If an injured employee or his or her |
15 | | personal representative receives payment from the Injured |
16 | | Workers' Benefit Fund, the State of Illinois has the same |
17 | | rights under paragraph (b) of Section 5 that the employer who |
18 | | failed to pay the benefits due to the injured employee would |
19 | | have had if the employer had paid those benefits, and any |
20 | | moneys recovered by the State as a result of the State's |
21 | | exercise of its rights under paragraph (b) of Section 5 shall |
22 | | be deposited into the Injured Workers' Benefit Fund. The |
23 | | custodian of the Injured Workers' Benefit Fund shall be joined |
24 | | with the employer as a party respondent in the application for |
25 | | adjustment of claim. After July 1, 2006, the Commission shall |
26 | | make disbursements from the Fund once each year to each |
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| | SB1996 Enrolled | - 23 - | LRB103 28652 SPS 55033 b |
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1 | | eligible claimant. An eligible claimant is an injured worker |
2 | | who has within the previous fiscal year obtained a final award |
3 | | for benefits from the Commission against the employer and the |
4 | | Injured Workers' Benefit Fund and has notified the Commission |
5 | | within 90 days of receipt of such award. Within a reasonable |
6 | | time after the end of each fiscal year, the Commission shall |
7 | | make a disbursement to each eligible claimant. At the time of |
8 | | disbursement, if there are insufficient moneys in the Fund to |
9 | | pay all claims, each eligible claimant shall receive a |
10 | | pro-rata share, as determined by the Commission, of the |
11 | | available moneys in the Fund for that year. Payment from the |
12 | | Injured Workers' Benefit Fund to an eligible claimant pursuant |
13 | | to this provision shall discharge the obligations of the |
14 | | Injured Workers' Benefit Fund regarding the award entered by |
15 | | the Commission. |
16 | | (e) This Act shall not affect or disturb the continuance |
17 | | of any existing insurance, mutual aid, benefit, or relief |
18 | | association or department, whether maintained in whole or in |
19 | | part by the employer or whether maintained by the employees, |
20 | | the payment of benefits of such association or department |
21 | | being guaranteed by the employer or by some person, firm or |
22 | | corporation for him or her: Provided, the employer contributes |
23 | | to such association or department an amount not less than the |
24 | | full compensation herein provided, exclusive of the cost of |
25 | | the maintenance of such association or department and without |
26 | | any expense to the employee. This Act shall not prevent the |
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| | SB1996 Enrolled | - 24 - | LRB103 28652 SPS 55033 b |
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1 | | organization and maintaining under the insurance laws of this |
2 | | State of any benefit or insurance company for the purpose of |
3 | | insuring against the compensation provided for in this Act, |
4 | | the expense of which is maintained by the employer. This Act |
5 | | shall not prevent the organization or maintaining under the |
6 | | insurance laws of this State of any voluntary mutual aid, |
7 | | benefit or relief association among employees for the payment |
8 | | of additional accident or sick benefits. |
9 | | (f) No existing insurance, mutual aid, benefit or relief |
10 | | association or department shall, by reason of anything herein |
11 | | contained, be authorized to discontinue its operation without |
12 | | first discharging its obligations to any and all persons |
13 | | carrying insurance in the same or entitled to relief or |
14 | | benefits therein. |
15 | | (g) Any contract, oral, written or implied, of employment |
16 | | providing for relief benefit, or insurance or any other device |
17 | | whereby the employee is required to pay any premium or |
18 | | premiums for insurance against the compensation provided for |
19 | | in this Act shall be null and void. Any employer withholding |
20 | | from the wages of any employee any amount for the purpose of |
21 | | paying any such premium shall be guilty of a Class B |
22 | | misdemeanor. |
23 | | In the event the employer does not pay the compensation |
24 | | for which he or she is liable, then an insurance company, |
25 | | association or insurer which may have insured such employer |
26 | | against such liability shall become primarily liable to pay to |
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| | SB1996 Enrolled | - 25 - | LRB103 28652 SPS 55033 b |
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1 | | the employee, his or her personal representative or |
2 | | beneficiary the compensation required by the provisions of |
3 | | this Act to be paid by such employer. The insurance carrier may |
4 | | be made a party to the proceedings in which the employer is a |
5 | | party and an award may be entered jointly against the employer |
6 | | and the insurance carrier. |
7 | | (h) It shall be unlawful for any employer, insurance |
8 | | company or service or adjustment company to interfere with, |
9 | | restrain or coerce an employee in any manner whatsoever in the |
10 | | exercise of the rights or remedies granted to him or her by |
11 | | this Act or to discriminate, attempt to discriminate, or |
12 | | threaten to discriminate against an employee in any way |
13 | | because of his or her exercise of the rights or remedies |
14 | | granted to him or her by this Act. |
15 | | It shall be unlawful for any employer, individually or |
16 | | through any insurance company or service or adjustment |
17 | | company, to discharge or to threaten to discharge, or to |
18 | | refuse to rehire or recall to active service in a suitable |
19 | | capacity an employee because of the exercise of his or her |
20 | | rights or remedies granted to him or her by this Act. |
21 | | (i) If an employer elects to obtain a life insurance |
22 | | policy on his employees, he may also elect to apply such |
23 | | benefits in satisfaction of all or a portion of the death |
24 | | benefits payable under this Act, in which case, the employer's |
25 | | compensation premium shall be reduced accordingly. |
26 | | (j) Within 45 days of receipt of an initial application or |
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| | SB1996 Enrolled | - 26 - | LRB103 28652 SPS 55033 b |
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1 | | application to renew self-insurance privileges the |
2 | | Self-Insurers Advisory Board shall review and submit for |
3 | | approval by the Chairman of the Commission recommendations of |
4 | | disposition of all initial applications to self-insure and all |
5 | | applications to renew self-insurance privileges filed by |
6 | | private self-insurers pursuant to the provisions of this |
7 | | Section and Section 4a-9 of this Act. Each private |
8 | | self-insurer shall submit with its initial and renewal |
9 | | applications the application fee required by Section 4a-4 of |
10 | | this Act. |
11 | | The Chairman of the Commission shall promptly act upon all |
12 | | initial applications and applications for renewal in full |
13 | | accordance with the recommendations of the Board or, should |
14 | | the Chairman disagree with any recommendation of disposition |
15 | | of the Self-Insurer's Advisory Board, he shall within 30 days |
16 | | of receipt of such recommendation provide to the Board in |
17 | | writing the reasons supporting his decision. The Chairman |
18 | | shall also promptly notify the employer of his decision within |
19 | | 15 days of receipt of the recommendation of the Board. |
20 | | If an employer is denied a renewal of self-insurance |
21 | | privileges pursuant to application it shall retain said |
22 | | privilege for 120 days after receipt of a notice of |
23 | | cancellation of the privilege from the Chairman of the |
24 | | Commission. |
25 | | All orders made by the Chairman under this Section shall |
26 | | be subject to review by the courts, such review to be taken in |
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| | SB1996 Enrolled | - 27 - | LRB103 28652 SPS 55033 b |
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1 | | the same manner and within the same time as provided by |
2 | | subsection (f) of Section 19 of this Act for review of awards |
3 | | and decisions of the Commission, upon the party seeking the |
4 | | review filing with the clerk of the court to which such review |
5 | | is taken a bond in an amount to be fixed and approved by the |
6 | | court to which the review is taken, conditioned upon the |
7 | | payment of all compensation awarded against the person taking |
8 | | such review pending a decision thereof and further conditioned |
9 | | upon such other obligations as the court may impose. Upon the |
10 | | review the Circuit Court shall have power to review all |
11 | | questions of fact as well as of law. |
12 | | (Source: P.A. 101-40, eff. 1-1-20; 102-37, eff. 7-1-21.) |
13 | | (Text of Section from P.A. 101-384 and 102-37) |
14 | | Sec. 4. (a) Any employer, including but not limited to |
15 | | general contractors and their subcontractors, who shall come |
16 | | within the provisions of Section 3 of this Act, and any other |
17 | | employer who shall elect to provide and pay the compensation |
18 | | provided for in this Act shall: |
19 | | (1) File with the Commission annually an application |
20 | | for approval as a self-insurer which shall include a |
21 | | current financial statement, and annually, thereafter, an |
22 | | application for renewal of self-insurance, which shall |
23 | | include a current financial statement. Said application |
24 | | and financial statement shall be signed and sworn to by |
25 | | the president or vice president and secretary or assistant |
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| | SB1996 Enrolled | - 28 - | LRB103 28652 SPS 55033 b |
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1 | | secretary of the employer if it be a corporation, or by all |
2 | | of the partners, if it be a copartnership, or by the owner |
3 | | if it be neither a copartnership nor a corporation. All |
4 | | initial applications and all applications for renewal of |
5 | | self-insurance must be submitted at least 60 days prior to |
6 | | the requested effective date of self-insurance. An |
7 | | employer may elect to provide and pay compensation as |
8 | | provided for in this Act as a member of a group workers' |
9 | | compensation pool under Article V 3/4 of the Illinois |
10 | | Insurance Code. If an employer becomes a member of a group |
11 | | workers' compensation pool, the employer shall not be |
12 | | relieved of any obligations imposed by this Act. |
13 | | If the sworn application and financial statement of |
14 | | any such employer does not satisfy the Commission of the |
15 | | financial ability of the employer who has filed it, the |
16 | | Commission shall require such employer to, |
17 | | (2) Furnish security, indemnity or a bond guaranteeing |
18 | | the payment by the employer of the compensation provided |
19 | | for in this Act, provided that any such employer whose |
20 | | application and financial statement shall not have |
21 | | satisfied the commission of his or her financial ability |
22 | | and who shall have secured his liability in part by excess |
23 | | liability insurance shall be required to furnish to the |
24 | | Commission security, indemnity or bond guaranteeing his or |
25 | | her payment up to the effective limits of the excess |
26 | | coverage, or |
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| | SB1996 Enrolled | - 29 - | LRB103 28652 SPS 55033 b |
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1 | | (3) Insure his entire liability to pay such |
2 | | compensation in some insurance carrier authorized, |
3 | | licensed, or permitted to do such insurance business in |
4 | | this State. Every policy of an insurance carrier, insuring |
5 | | the payment of compensation under this Act shall cover all |
6 | | the employees and the entire compensation liability of the |
7 | | insured: Provided, however, that any employer may insure |
8 | | his or her compensation liability with 2 or more insurance |
9 | | carriers or may insure a part and qualify under subsection |
10 | | 1, 2, or 4 for the remainder of his or her liability to pay |
11 | | such compensation, subject to the following two |
12 | | provisions: |
13 | | Firstly, the entire compensation liability of the |
14 | | employer to employees working at or from one location |
15 | | shall be insured in one such insurance carrier or |
16 | | shall be self-insured, and |
17 | | Secondly, the employer shall submit evidence |
18 | | satisfactorily to the Commission that his or her |
19 | | entire liability for the compensation provided for in |
20 | | this Act will be secured. Any provisions in any |
21 | | policy, or in any endorsement attached thereto, |
22 | | attempting to limit or modify in any way, the |
23 | | liability of the insurance carriers issuing the same |
24 | | except as otherwise provided herein shall be wholly |
25 | | void. |
26 | | Nothing herein contained shall apply to policies of |
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| | SB1996 Enrolled | - 30 - | LRB103 28652 SPS 55033 b |
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1 | | excess liability carriage secured by employers who have |
2 | | been approved by the Commission as self-insurers, or |
3 | | (4) Make some other provision, satisfactory to the |
4 | | Commission, for the securing of the payment of |
5 | | compensation provided for in this Act, and |
6 | | (5) Upon becoming subject to this Act and thereafter |
7 | | as often as the Commission may in writing demand, file |
8 | | with the Commission in form prescribed by it evidence of |
9 | | his or her compliance with the provision of this Section. |
10 | | (a-1) Regardless of its state of domicile or its principal |
11 | | place of business, an employer shall make payments to its |
12 | | insurance carrier or group self-insurance fund, where |
13 | | applicable, based upon the premium rates of the situs where |
14 | | the work or project is located in Illinois if: |
15 | | (A) the employer is engaged primarily in the building |
16 | | and construction industry; and |
17 | | (B) subdivision (a)(3) of this Section applies to the |
18 | | employer or the employer is a member of a group |
19 | | self-insurance plan as defined in subsection (1) of |
20 | | Section 4a. |
21 | | The Illinois Workers' Compensation Commission shall impose |
22 | | a penalty upon an employer for violation of this subsection |
23 | | (a-1) if: |
24 | | (i) the employer is given an opportunity at a hearing |
25 | | to present evidence of its compliance with this subsection |
26 | | (a-1); and |
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| | SB1996 Enrolled | - 31 - | LRB103 28652 SPS 55033 b |
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1 | | (ii) after the hearing, the Commission finds that the |
2 | | employer failed to make payments upon the premium rates of |
3 | | the situs where the work or project is located in |
4 | | Illinois. |
5 | | The penalty shall not exceed $1,000 for each day of work |
6 | | for which the employer failed to make payments upon the |
7 | | premium rates of the situs where the work or project is located |
8 | | in Illinois, but the total penalty shall not exceed $50,000 |
9 | | for each project or each contract under which the work was |
10 | | performed. |
11 | | Any penalty under this subsection (a-1) must be imposed |
12 | | not later than one year after the expiration of the applicable |
13 | | limitation period specified in subsection (d) of Section 6 of |
14 | | this Act. Penalties imposed under this subsection (a-1) shall |
15 | | be deposited into the Illinois Workers' Compensation |
16 | | Commission Operations Fund, a special fund that is created in |
17 | | the State treasury. Subject to appropriation, moneys in the |
18 | | Fund shall be used solely for the operations of the Illinois |
19 | | Workers' Compensation Commission and by the Department of |
20 | | Insurance for the purposes authorized in subsection (c) of |
21 | | Section 25.5 of this Act. |
22 | | (a-2) Every Employee Leasing Company (ELC), as defined in |
23 | | Section 15 of the Employee Leasing Company Act, shall at a |
24 | | minimum provide the following information to the Commission or |
25 | | any entity designated by the Commission regarding each |
26 | | workers' compensation insurance policy issued to the ELC: |
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| | SB1996 Enrolled | - 32 - | LRB103 28652 SPS 55033 b |
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1 | | (1) Any client company of the ELC listed as an |
2 | | additional named insured. |
3 | | (2) Any informational schedule attached to the master |
4 | | policy that identifies any individual client company's |
5 | | name, FEIN, and job location. |
6 | | (3) Any certificate of insurance coverage document |
7 | | issued to a client company specifying its rights and |
8 | | obligations under the master policy that establishes both |
9 | | the identity and status of the client, as well as the dates |
10 | | of inception and termination of coverage, if applicable. |
11 | | (b) The sworn application and financial statement, or |
12 | | security, indemnity or bond, or amount of insurance, or other |
13 | | provisions, filed, furnished, carried, or made by the |
14 | | employer, as the case may be, shall be subject to the approval |
15 | | of the Commission. |
16 | | Deposits under escrow agreements shall be cash, negotiable |
17 | | United States government bonds or negotiable general |
18 | | obligation bonds of the State of Illinois. Such cash or bonds |
19 | | shall be deposited in escrow with any State or National Bank or |
20 | | Trust Company having trust authority in the State of Illinois. |
21 | | Upon the approval of the sworn application and financial |
22 | | statement, security, indemnity or bond or amount of insurance, |
23 | | filed, furnished or carried, as the case may be, the |
24 | | Commission shall send to the employer written notice of its |
25 | | approval thereof. The certificate of compliance by the |
26 | | employer with the provisions of subparagraphs (2) and (3) of |
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| | SB1996 Enrolled | - 33 - | LRB103 28652 SPS 55033 b |
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1 | | paragraph (a) of this Section shall be delivered by the |
2 | | insurance carrier to the Illinois Workers' Compensation |
3 | | Commission within five days after the effective date of the |
4 | | policy so certified. The insurance so certified shall cover |
5 | | all compensation liability occurring during the time that the |
6 | | insurance is in effect and no further certificate need be |
7 | | filed in case such insurance is renewed, extended or otherwise |
8 | | continued by such carrier. The insurance so certified shall |
9 | | not be cancelled or in the event that such insurance is not |
10 | | renewed, extended or otherwise continued, such insurance shall |
11 | | not be terminated until at least 10 days after receipt by the |
12 | | Illinois Workers' Compensation Commission of notice of the |
13 | | cancellation or termination of said insurance; provided, |
14 | | however, that if the employer has secured insurance from |
15 | | another insurance carrier, or has otherwise secured the |
16 | | payment of compensation in accordance with this Section, and |
17 | | such insurance or other security becomes effective prior to |
18 | | the expiration of the 10 days, cancellation or termination |
19 | | may, at the option of the insurance carrier indicated in such |
20 | | notice, be effective as of the effective date of such other |
21 | | insurance or security. |
22 | | (c) Whenever the Commission shall find that any |
23 | | corporation, company, association, aggregation of individuals, |
24 | | reciprocal or interinsurers exchange, or other insurer |
25 | | effecting workers' compensation insurance in this State shall |
26 | | be insolvent, financially unsound, or unable to fully meet all |
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| | SB1996 Enrolled | - 34 - | LRB103 28652 SPS 55033 b |
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1 | | payments and liabilities assumed or to be assumed for |
2 | | compensation insurance in this State, or shall practice a |
3 | | policy of delay or unfairness toward employees in the |
4 | | adjustment, settlement, or payment of benefits due such |
5 | | employees, the Commission may after reasonable notice and |
6 | | hearing order and direct that such corporation, company, |
7 | | association, aggregation of individuals, reciprocal or |
8 | | interinsurers exchange, or insurer, shall from and after a |
9 | | date fixed in such order discontinue the writing of any such |
10 | | workers' compensation insurance in this State. Subject to such |
11 | | modification of the order as the Commission may later make on |
12 | | review of the order, as herein provided, it shall thereupon be |
13 | | unlawful for any such corporation, company, association, |
14 | | aggregation of individuals, reciprocal or interinsurers |
15 | | exchange, or insurer to effect any workers' compensation |
16 | | insurance in this State. A copy of the order shall be served |
17 | | upon the Director of Insurance by registered mail. Whenever |
18 | | the Commission finds that any service or adjustment company |
19 | | used or employed by a self-insured employer or by an insurance |
20 | | carrier to process, adjust, investigate, compromise or |
21 | | otherwise handle claims under this Act, has practiced or is |
22 | | practicing a policy of delay or unfairness toward employees in |
23 | | the adjustment, settlement or payment of benefits due such |
24 | | employees, the Commission may after reasonable notice and |
25 | | hearing order and direct that such service or adjustment |
26 | | company shall from and after a date fixed in such order be |
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| | SB1996 Enrolled | - 35 - | LRB103 28652 SPS 55033 b |
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1 | | prohibited from processing, adjusting, investigating, |
2 | | compromising or otherwise handling claims under this Act. |
3 | | Whenever the Commission finds that any self-insured |
4 | | employer has practiced or is practicing delay or unfairness |
5 | | toward employees in the adjustment, settlement or payment of |
6 | | benefits due such employees, the Commission may, after |
7 | | reasonable notice and hearing, order and direct that after a |
8 | | date fixed in the order such self-insured employer shall be |
9 | | disqualified to operate as a self-insurer and shall be |
10 | | required to insure his entire liability to pay compensation in |
11 | | some insurance carrier authorized, licensed and permitted to |
12 | | do such insurance business in this State, as provided in |
13 | | subparagraph 3 of paragraph (a) of this Section. |
14 | | All orders made by the Commission under this Section shall |
15 | | be subject to review by the courts, said review to be taken in |
16 | | the same manner and within the same time as provided by Section |
17 | | 19 of this Act for review of awards and decisions of the |
18 | | Commission, upon the party seeking the review filing with the |
19 | | clerk of the court to which said review is taken a bond in an |
20 | | amount to be fixed and approved by the court to which the |
21 | | review is taken, conditioned upon the payment of all |
22 | | compensation awarded against the person taking said review |
23 | | pending a decision thereof and further conditioned upon such |
24 | | other obligations as the court may impose. Upon the review the |
25 | | Circuit Court shall have power to review all questions of fact |
26 | | as well as of law. The penalty hereinafter provided for in this |
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| | SB1996 Enrolled | - 36 - | LRB103 28652 SPS 55033 b |
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1 | | paragraph shall not attach and shall not begin to run until the |
2 | | final determination of the order of the Commission. |
3 | | (d) Whenever a panel of 3 Commissioners comprised of one |
4 | | member of the employing class, one representative of a labor |
5 | | organization recognized under the National Labor Relations Act |
6 | | or an attorney who has represented labor organizations or has |
7 | | represented employees in workers' compensation cases, and one |
8 | | member not identified with either the employing class or a |
9 | | labor organization, with due process and after a hearing, |
10 | | determines an employer has knowingly failed to provide |
11 | | coverage as required by paragraph (a) of this Section, the |
12 | | failure shall be deemed an immediate serious danger to public |
13 | | health, safety, and welfare sufficient to justify service by |
14 | | the Commission of a work-stop order on such employer, |
15 | | requiring the cessation of all business operations of such |
16 | | employer at the place of employment or job site. Any law |
17 | | enforcement agency in the State shall, at the request of the |
18 | | Commission, render any assistance necessary to carry out the |
19 | | provisions of this Section, including, but not limited to, |
20 | | preventing any employee of such employer from remaining at a |
21 | | place of employment or job site after a work-stop order has |
22 | | taken effect. Any work-stop order shall be lifted upon proof |
23 | | of insurance as required by this Act. Any orders under this |
24 | | Section are appealable under Section 19(f) to the Circuit |
25 | | Court. |
26 | | Any individual employer, corporate officer or director of |
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1 | | a corporate employer, partner of an employer partnership, or |
2 | | member of an employer limited liability company who knowingly |
3 | | fails to provide coverage as required by paragraph (a) of this |
4 | | Section is guilty of a Class 4 felony. This provision shall not |
5 | | apply to any corporate officer or director of any |
6 | | publicly-owned corporation. Each day's violation constitutes a |
7 | | separate offense. The State's Attorney of the county in which |
8 | | the violation occurred, or the Attorney General, shall bring |
9 | | such actions in the name of the People of the State of |
10 | | Illinois, or may, in addition to other remedies provided in |
11 | | this Section, bring an action for an injunction to restrain |
12 | | the violation or to enjoin the operation of any such employer. |
13 | | Any individual employer, corporate officer or director of |
14 | | a corporate employer, partner of an employer partnership, or |
15 | | member of an employer limited liability company who |
16 | | negligently fails to provide coverage as required by paragraph |
17 | | (a) of this Section is guilty of a Class A misdemeanor. This |
18 | | provision shall not apply to any corporate officer or director |
19 | | of any publicly-owned corporation. Each day's violation |
20 | | constitutes a separate offense. The State's Attorney of the |
21 | | county in which the violation occurred, or the Attorney |
22 | | General, shall bring such actions in the name of the People of |
23 | | the State of Illinois. |
24 | | The criminal penalties in this subsection (d) shall not |
25 | | apply where there exists a good faith dispute as to the |
26 | | existence of an employment relationship. Evidence of good |
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| | SB1996 Enrolled | - 38 - | LRB103 28652 SPS 55033 b |
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1 | | faith shall include, but not be limited to, compliance with |
2 | | the definition of employee as used by the Internal Revenue |
3 | | Service. |
4 | | Employers who are subject to and who knowingly fail to |
5 | | comply with this Section shall not be entitled to the benefits |
6 | | of this Act during the period of noncompliance, but shall be |
7 | | liable in an action under any other applicable law of this |
8 | | State. In the action, such employer shall not avail himself or |
9 | | herself of the defenses of assumption of risk or negligence or |
10 | | that the injury was due to a co-employee. In the action, proof |
11 | | of the injury shall constitute prima facie evidence of |
12 | | negligence on the part of such employer and the burden shall be |
13 | | on such employer to show freedom of negligence resulting in |
14 | | the injury. The employer shall not join any other defendant in |
15 | | any such civil action. Nothing in this amendatory Act of the |
16 | | 94th General Assembly shall affect the employee's rights under |
17 | | subdivision (a)3 of Section 1 of this Act. Any employer or |
18 | | carrier who makes payments under subdivision (a)3 of Section 1 |
19 | | of this Act shall have a right of reimbursement from the |
20 | | proceeds of any recovery under this Section. |
21 | | An employee of an uninsured employer, or the employee's |
22 | | dependents in case death ensued, may, instead of proceeding |
23 | | against the employer in a civil action in court, file an |
24 | | application for adjustment of claim with the Commission in |
25 | | accordance with the provisions of this Act and the Commission |
26 | | shall hear and determine the application for adjustment of |
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| | SB1996 Enrolled | - 39 - | LRB103 28652 SPS 55033 b |
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1 | | claim in the manner in which other claims are heard and |
2 | | determined before the Commission. |
3 | | All proceedings under this subsection (d) shall be |
4 | | reported on an annual basis to the Workers' Compensation |
5 | | Advisory Board. |
6 | | An investigator with the Department of Insurance may issue |
7 | | a citation to any employer that is not in compliance with its |
8 | | obligation to have workers' compensation insurance under this |
9 | | Act. The amount of the fine shall be based on the period of |
10 | | time the employer was in non-compliance, but shall be no less |
11 | | than $500, and shall not exceed $2,500. An employer that has |
12 | | been issued a citation shall pay the fine to the Department of |
13 | | Insurance and provide to the Department of Insurance proof |
14 | | that it obtained the required workers' compensation insurance |
15 | | within 10 days after the citation was issued. This Section |
16 | | does not affect any other obligations this Act imposes on |
17 | | employers. |
18 | | Upon a finding by the Commission, after reasonable notice |
19 | | and hearing, of the knowing and wilful failure or refusal of an |
20 | | employer to comply with any of the provisions of paragraph (a) |
21 | | of this Section, the failure or refusal of an employer, |
22 | | service or adjustment company, or an insurance carrier to |
23 | | comply with any order of the Illinois Workers' Compensation |
24 | | Commission pursuant to paragraph (c) of this Section |
25 | | disqualifying him or her to operate as a self insurer and |
26 | | requiring him or her to insure his or her liability, or the |
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| | SB1996 Enrolled | - 40 - | LRB103 28652 SPS 55033 b |
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1 | | knowing and willful failure of an employer to comply with a |
2 | | citation issued by an investigator with the Department of |
3 | | Insurance, the Commission may assess a civil penalty of up to |
4 | | $500 per day for each day of such failure or refusal after the |
5 | | effective date of this amendatory Act of 1989. The minimum |
6 | | penalty under this Section shall be the sum of $10,000. Each |
7 | | day of such failure or refusal shall constitute a separate |
8 | | offense. The Commission may assess the civil penalty |
9 | | personally and individually against the corporate officers and |
10 | | directors of a corporate employer, the partners of an employer |
11 | | partnership, and the members of an employer limited liability |
12 | | company, after a finding of a knowing and willful refusal or |
13 | | failure of each such named corporate officer, director, |
14 | | partner, or member to comply with this Section. The liability |
15 | | for the assessed penalty shall be against the named employer |
16 | | first, and if the named employer fails or refuses to pay the |
17 | | penalty to the Commission within 30 days after the final order |
18 | | of the Commission, then the named corporate officers, |
19 | | directors, partners, or members who have been found to have |
20 | | knowingly and willfully refused or failed to comply with this |
21 | | Section shall be liable for the unpaid penalty or any unpaid |
22 | | portion of the penalty. Upon investigation by the Department |
23 | | of Insurance, the Attorney General shall have the authority to |
24 | | prosecute all proceedings to enforce the civil and |
25 | | administrative provisions of this Section before the |
26 | | Commission. The Commission and the Department of Insurance |
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| | SB1996 Enrolled | - 41 - | LRB103 28652 SPS 55033 b |
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1 | | shall promulgate procedural rules for enforcing this Section |
2 | | relating to their respective duties prescribed herein. |
3 | | A Commission decision imposing penalties under this |
4 | | Section may be judicially reviewed only as described in |
5 | | Section 19(f). After expiration of the period for seeking |
6 | | judicial review, the Commission's final decision imposing |
7 | | penalties may be enforced in the same manner as a judgment |
8 | | entered by a court of competent jurisdiction. The Commission's |
9 | | final decision imposing penalties is a debt due and owing to |
10 | | the State and can be enforced to the same extent as a judgment |
11 | | entered by a circuit court. The Attorney General shall |
12 | | represent the Commission and the Department of Insurance in |
13 | | any action challenging the final decision in circuit court. If |
14 | | the court affirms the Commission's decision, the court shall |
15 | | enter judgment against the employer in the amount of the fines |
16 | | assessed by the Commission. The Attorney General shall make |
17 | | reasonable efforts to collect the amounts due under the |
18 | | Commission's decision. |
19 | | Upon the failure or refusal of any employer, service or |
20 | | adjustment company or insurance carrier to comply with the |
21 | | provisions of this Section and with the orders of the |
22 | | Commission under this Section, or the order of the court on |
23 | | review after final adjudication, the Commission may bring a |
24 | | civil action to recover the amount of the penalty in Cook |
25 | | County or in Sangamon County in which litigation the |
26 | | Commission shall be represented by the Attorney General. The |
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| | SB1996 Enrolled | - 42 - | LRB103 28652 SPS 55033 b |
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1 | | Commission shall send notice of its finding of non-compliance |
2 | | and assessment of the civil penalty to the Attorney General. |
3 | | It shall be the duty of the Attorney General within 30 days |
4 | | after receipt of the notice, to institute prosecutions and |
5 | | promptly prosecute all reported violations of this Section. |
6 | | Any individual employer, corporate officer or director of |
7 | | a corporate employer, partner of an employer partnership, or |
8 | | member of an employer limited liability company who, with the |
9 | | intent to avoid payment of compensation under this Act to an |
10 | | injured employee or the employee's dependents, knowingly |
11 | | transfers, sells, encumbers, assigns, or in any manner |
12 | | disposes of, conceals, secretes, or destroys any property |
13 | | belonging to the employer, officer, director, partner, or |
14 | | member is guilty of a Class 4 felony. |
15 | | Penalties and fines collected pursuant to this paragraph |
16 | | (d) shall be deposited upon receipt into a special fund which |
17 | | shall be designated the Injured Workers' Benefit Fund, of |
18 | | which the State Treasurer is ex-officio custodian, such |
19 | | special fund to be held and disbursed in accordance with this |
20 | | paragraph (d) for the purposes hereinafter stated in this |
21 | | paragraph (d), upon the final order of the Commission. The |
22 | | Injured Workers' Benefit Fund shall be deposited the same as |
23 | | are State funds and any interest accruing thereon shall be |
24 | | added thereto every 6 months. The Injured Workers' Benefit |
25 | | Fund is subject to audit the same as State funds and accounts |
26 | | and is protected by the general bond given by the State |
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| | SB1996 Enrolled | - 43 - | LRB103 28652 SPS 55033 b |
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1 | | Treasurer. The Injured Workers' Benefit Fund is considered |
2 | | always appropriated for the purposes of disbursements as |
3 | | provided in this paragraph, and shall be paid out and |
4 | | disbursed as herein provided and shall not at any time be |
5 | | appropriated or diverted to any other use or purpose. Moneys |
6 | | in the Injured Workers' Benefit Fund shall be used only for |
7 | | payment of workers' compensation benefits for injured |
8 | | employees when the employer has failed to provide coverage as |
9 | | determined under this paragraph (d) and has failed to pay the |
10 | | benefits due to the injured employee. The employer shall |
11 | | reimburse the Injured Workers' Benefit Fund for any amounts |
12 | | paid to an employee on account of the compensation awarded by |
13 | | the Commission. The Attorney General shall make reasonable |
14 | | efforts to obtain reimbursement for the Injured Workers' |
15 | | Benefit Fund. |
16 | | The Commission shall have the right to obtain |
17 | | reimbursement from the employer for compensation obligations |
18 | | paid by the Injured Workers' Benefit Fund. Any such amounts |
19 | | obtained shall be deposited by the Commission into the Injured |
20 | | Workers' Benefit Fund. If an injured employee or his or her |
21 | | personal representative receives payment from the Injured |
22 | | Workers' Benefit Fund, the State of Illinois has the same |
23 | | rights under paragraph (b) of Section 5 that the employer who |
24 | | failed to pay the benefits due to the injured employee would |
25 | | have had if the employer had paid those benefits, and any |
26 | | moneys recovered by the State as a result of the State's |
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| | SB1996 Enrolled | - 44 - | LRB103 28652 SPS 55033 b |
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1 | | exercise of its rights under paragraph (b) of Section 5 shall |
2 | | be deposited into the Injured Workers' Benefit Fund. The |
3 | | custodian of the Injured Workers' Benefit Fund shall be joined |
4 | | with the employer as a party respondent in the application for |
5 | | adjustment of claim. After July 1, 2006, the Commission shall |
6 | | make disbursements from the Fund once each year to each |
7 | | eligible claimant. An eligible claimant is an injured worker |
8 | | who has within the previous fiscal year obtained a final award |
9 | | for benefits from the Commission against the employer and the |
10 | | Injured Workers' Benefit Fund and has notified the Commission |
11 | | within 90 days of receipt of such award. Within a reasonable |
12 | | time after the end of each fiscal year, the Commission shall |
13 | | make a disbursement to each eligible claimant. At the time of |
14 | | disbursement, if there are insufficient moneys in the Fund to |
15 | | pay all claims, each eligible claimant shall receive a |
16 | | pro-rata share, as determined by the Commission, of the |
17 | | available moneys in the Fund for that year. Payment from the |
18 | | Injured Workers' Benefit Fund to an eligible claimant pursuant |
19 | | to this provision shall discharge the obligations of the |
20 | | Injured Workers' Benefit Fund regarding the award entered by |
21 | | the Commission. |
22 | | (e) This Act shall not affect or disturb the continuance |
23 | | of any existing insurance, mutual aid, benefit, or relief |
24 | | association or department, whether maintained in whole or in |
25 | | part by the employer or whether maintained by the employees, |
26 | | the payment of benefits of such association or department |
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| | SB1996 Enrolled | - 45 - | LRB103 28652 SPS 55033 b |
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1 | | being guaranteed by the employer or by some person, firm or |
2 | | corporation for him or her: Provided, the employer contributes |
3 | | to such association or department an amount not less than the |
4 | | full compensation herein provided, exclusive of the cost of |
5 | | the maintenance of such association or department and without |
6 | | any expense to the employee. This Act shall not prevent the |
7 | | organization and maintaining under the insurance laws of this |
8 | | State of any benefit or insurance company for the purpose of |
9 | | insuring against the compensation provided for in this Act, |
10 | | the expense of which is maintained by the employer. This Act |
11 | | shall not prevent the organization or maintaining under the |
12 | | insurance laws of this State of any voluntary mutual aid, |
13 | | benefit or relief association among employees for the payment |
14 | | of additional accident or sick benefits. |
15 | | (f) No existing insurance, mutual aid, benefit or relief |
16 | | association or department shall, by reason of anything herein |
17 | | contained, be authorized to discontinue its operation without |
18 | | first discharging its obligations to any and all persons |
19 | | carrying insurance in the same or entitled to relief or |
20 | | benefits therein. |
21 | | (g) Any contract, oral, written or implied, of employment |
22 | | providing for relief benefit, or insurance or any other device |
23 | | whereby the employee is required to pay any premium or |
24 | | premiums for insurance against the compensation provided for |
25 | | in this Act shall be null and void. Any employer withholding |
26 | | from the wages of any employee any amount for the purpose of |
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| | SB1996 Enrolled | - 46 - | LRB103 28652 SPS 55033 b |
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1 | | paying any such premium shall be guilty of a Class B |
2 | | misdemeanor. |
3 | | In the event the employer does not pay the compensation |
4 | | for which he or she is liable, then an insurance company, |
5 | | association or insurer which may have insured such employer |
6 | | against such liability shall become primarily liable to pay to |
7 | | the employee, his or her personal representative or |
8 | | beneficiary the compensation required by the provisions of |
9 | | this Act to be paid by such employer. The insurance carrier may |
10 | | be made a party to the proceedings in which the employer is a |
11 | | party and an award may be entered jointly against the employer |
12 | | and the insurance carrier. |
13 | | (h) It shall be unlawful for any employer, insurance |
14 | | company or service or adjustment company to interfere with, |
15 | | restrain or coerce an employee in any manner whatsoever in the |
16 | | exercise of the rights or remedies granted to him or her by |
17 | | this Act or to discriminate, attempt to discriminate, or |
18 | | threaten to discriminate against an employee in any way |
19 | | because of his or her exercise of the rights or remedies |
20 | | granted to him or her by this Act. |
21 | | It shall be unlawful for any employer, individually or |
22 | | through any insurance company or service or adjustment |
23 | | company, to discharge or to threaten to discharge, or to |
24 | | refuse to rehire or recall to active service in a suitable |
25 | | capacity an employee because of the exercise of his or her |
26 | | rights or remedies granted to him or her by this Act. |
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| | SB1996 Enrolled | - 47 - | LRB103 28652 SPS 55033 b |
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1 | | (i) If an employer elects to obtain a life insurance |
2 | | policy on his employees, he may also elect to apply such |
3 | | benefits in satisfaction of all or a portion of the death |
4 | | benefits payable under this Act, in which case, the employer's |
5 | | compensation premium shall be reduced accordingly. |
6 | | (j) Within 45 days of receipt of an initial application or |
7 | | application to renew self-insurance privileges the |
8 | | Self-Insurers Advisory Board shall review and submit for |
9 | | approval by the Chairman of the Commission recommendations of |
10 | | disposition of all initial applications to self-insure and all |
11 | | applications to renew self-insurance privileges filed by |
12 | | private self-insurers pursuant to the provisions of this |
13 | | Section and Section 4a-9 of this Act. Each private |
14 | | self-insurer shall submit with its initial and renewal |
15 | | applications the application fee required by Section 4a-4 of |
16 | | this Act. |
17 | | The Chairman of the Commission shall promptly act upon all |
18 | | initial applications and applications for renewal in full |
19 | | accordance with the recommendations of the Board or, should |
20 | | the Chairman disagree with any recommendation of disposition |
21 | | of the Self-Insurer's Advisory Board, he shall within 30 days |
22 | | of receipt of such recommendation provide to the Board in |
23 | | writing the reasons supporting his decision. The Chairman |
24 | | shall also promptly notify the employer of his decision within |
25 | | 15 days of receipt of the recommendation of the Board. |
26 | | If an employer is denied a renewal of self-insurance |
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| | SB1996 Enrolled | - 48 - | LRB103 28652 SPS 55033 b |
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1 | | privileges pursuant to application it shall retain said |
2 | | privilege for 120 days after receipt of a notice of |
3 | | cancellation of the privilege from the Chairman of the |
4 | | Commission. |
5 | | All orders made by the Chairman under this Section shall |
6 | | be subject to review by the courts, such review to be taken in |
7 | | the same manner and within the same time as provided by |
8 | | subsection (f) of Section 19 of this Act for review of awards |
9 | | and decisions of the Commission, upon the party seeking the |
10 | | review filing with the clerk of the court to which such review |
11 | | is taken a bond in an amount to be fixed and approved by the |
12 | | court to which the review is taken, conditioned upon the |
13 | | payment of all compensation awarded against the person taking |
14 | | such review pending a decision thereof and further conditioned |
15 | | upon such other obligations as the court may impose. Upon the |
16 | | review the Circuit Court shall have power to review all |
17 | | questions of fact as well as of law. |
18 | | (Source: P.A. 101-384, eff. 1-1-20 ; 102-37, eff. 7-1-21.) |
19 | | (820 ILCS 305/4a-5) (from Ch. 48, par. 138.4a-5) |
20 | | Sec. 4a-5. There is hereby created a Self-Insurers |
21 | | Security Fund. The State Treasurer shall be the ex officio |
22 | | custodian of the Self-Insurers Security Fund. Moneys in the |
23 | | Fund shall be deposited in a separate account in the same |
24 | | manner as are State Funds and any interest accruing thereon |
25 | | shall be added thereto every 6 months. It shall be subject to |
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| | SB1996 Enrolled | - 49 - | LRB103 28652 SPS 55033 b |
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1 | | audit the same as State funds and accounts and shall be |
2 | | protected by the general bond given by the State Treasurer. |
3 | | The funds in the Self-Insurers Security Fund shall not be |
4 | | subject to appropriation and shall be made available for the |
5 | | purposes of compensating employees who are eligible to receive |
6 | | benefits from their employers pursuant to the provisions of |
7 | | the Workers' Compensation Act or Workers' Occupational |
8 | | Diseases Act, when, pursuant to this Section, the Board has |
9 | | determined that a private self-insurer has become an insolvent |
10 | | self-insurer and is unable to pay compensation benefits due to |
11 | | financial insolvency. Moneys in the Fund may be used to |
12 | | compensate any type of injury or occupational disease which is |
13 | | compensable under either Act , and for all claims for related |
14 | | administrative fees, operating costs of the Board, attorney's |
15 | | fees, and other costs reasonably incurred by the Board. Moneys |
16 | | in the Self-Insurers Security Fund may also be used for paying |
17 | | the salaries and benefits of the Self-Insurers Advisory Board |
18 | | employees and the operating costs of the Board. The Chairman, |
19 | | with the advice of the Board, may direct the State Comptroller |
20 | | and the State Treasurer to transfer up to $2,000,000 in any |
21 | | fiscal year from the Self-Insurers Security Fund to the |
22 | | Illinois Workers' Compensation Commission Operations Fund, to |
23 | | the extent that there are insufficient funds in the Illinois |
24 | | Workers' Compensation Commission Operations Fund to pay the |
25 | | operating costs of the Illinois Workers' Compensation |
26 | | Commission or the salaries and benefits of employees of the |
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| | SB1996 Enrolled | - 50 - | LRB103 28652 SPS 55033 b |
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1 | | Illinois Workers' Compensation Commission. No later than |
2 | | October 31 of the fiscal year following any transfer from the |
3 | | Self-Insurers Security Fund to the Illinois Workers' |
4 | | Compensation Commission Operations Fund, the Chairman, with |
5 | | the advice of the Board, shall direct the State Comptroller |
6 | | and the State Treasurer to transfer from the Illinois Workers' |
7 | | Compensation Commission Operations Fund to the Self-Insurers |
8 | | Security Fund an amount equivalent to the sum of all amounts |
9 | | transferred from the Self-Insurers Security Fund to the |
10 | | Illinois Workers' Compensation Commission Operations Fund in |
11 | | the prior fiscal year with interest at the rate earned by |
12 | | moneys on deposit in the Self-Insurers Security Fund. Upon |
13 | | receipt of funds from any transfer between the Self-Insurers |
14 | | Security Fund and the Illinois Workers' Compensation |
15 | | Commission Operations Fund, the Chairman shall submit notice, |
16 | | including the date and amount of the transfer, to the Governor |
17 | | and the General Assembly. Payment from the Self-Insurers |
18 | | Security Fund shall be made by the Comptroller only upon the |
19 | | authorization of the Chairman as evidenced by properly |
20 | | certified vouchers of the Commission, upon the direction of |
21 | | the Board. |
22 | | (Source: P.A. 101-40, eff. 1-1-20; 102-558, eff. 8-20-21; |
23 | | 102-910, eff. 5-27-22.) |
24 | | (820 ILCS 305/4d) |
25 | | Sec. 4d. Illinois Workers' Compensation Commission |
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| | SB1996 Enrolled | - 51 - | LRB103 28652 SPS 55033 b |
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1 | | Operations Fund Fee. |
2 | | (a) As of the effective date of this amendatory Act of the |
3 | | 93rd General Assembly, each employer that self-insures its |
4 | | liabilities arising under this Act or Workers' Occupational |
5 | | Diseases Act shall pay a fee measured by the annual actual |
6 | | wages paid in this State of such an employer in the manner |
7 | | provided in this Section. Such proceeds shall be deposited in |
8 | | the Illinois Workers' Compensation Commission Operations Fund. |
9 | | If an employer survives or was formed by a merger, |
10 | | consolidation, reorganization, or reincorporation, the actual |
11 | | wages paid in this State of all employers party to the merger, |
12 | | consolidation, reorganization, or reincorporation shall, for |
13 | | purposes of determining the amount of the fee imposed by this |
14 | | Section, be regarded as those of the surviving or new |
15 | | employer. |
16 | | (b) Beginning on July 30, 2004 (the effective date of |
17 | | Public Act 93-840) and on July 1 of each year thereafter |
18 | | through 2023 , the Chairman shall charge and collect an annual |
19 | | Illinois Workers' Compensation Commission Operations Fund Fee |
20 | | from every employer subject to subsection (a) of this Section |
21 | | equal to 0.0075% of its annual actual wages paid in this State |
22 | | as reported in each employer's annual self-insurance renewal |
23 | | filed for the previous year as required by Section 4 of this |
24 | | Act and Section 4 of the Workers' Occupational Diseases Act. |
25 | | Beginning on July 1, 2024 and on July 1 of each year |
26 | | thereafter, the Chairman shall charge and collect an annual |
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| | SB1996 Enrolled | - 52 - | LRB103 28652 SPS 55033 b |
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1 | | Illinois Workers' Compensation Commission Operations Fund Fee |
2 | | from every employer subject to subsection (a) of this Section |
3 | | equal to 0.0081% of its annual actual wages paid in this State |
4 | | as reported in each employer's annual self-insurance renewal |
5 | | filed for the previous year as required by Section 4 of this |
6 | | Act and Section 4 of the Workers' Occupational Diseases Act. |
7 | | All sums collected by the Commission under the provisions of |
8 | | this Section shall be paid promptly after the receipt of the |
9 | | same, accompanied by a detailed statement thereof, into the |
10 | | Illinois Workers' Compensation Commission Operations Fund. The |
11 | | fee due pursuant to Public Act 93-840 shall be collected |
12 | | instead of the fee due on July 1, 2004 under Public Act 93-32. |
13 | | Payment of the fee due under Public Act 93-840 shall discharge |
14 | | the employer's obligations due on July 1, 2004. |
15 | | (c) In addition to the authority specifically granted |
16 | | under Section 16, the Chairman shall have such authority to |
17 | | adopt rules or establish forms as may be reasonably necessary |
18 | | for purposes of enforcing this Section. The Commission shall |
19 | | have authority to defer, waive, or abate the fee or any |
20 | | penalties imposed by this Section if in the Commission's |
21 | | opinion the employer's solvency and ability to meet its |
22 | | obligations to pay workers' compensation benefits would be |
23 | | immediately threatened by payment of the fee due. |
24 | | (d) When an employer fails to pay the full amount of any |
25 | | annual Illinois Workers' Compensation Commission Operations |
26 | | Fund Fee of $100 or more due under this Section, there shall be |
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| | SB1996 Enrolled | - 53 - | LRB103 28652 SPS 55033 b |
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1 | | added to the amount due as a penalty the greater of $1,000 or |
2 | | an amount equal to 5% of the deficiency for each month or part |
3 | | of a month that the deficiency remains unpaid. |
4 | | (e) The Commission may enforce the collection of any |
5 | | delinquent payment, penalty or portion thereof by legal action |
6 | | or in any other manner by which the collection of debts due the |
7 | | State of Illinois may be enforced under the laws of this State. |
8 | | (f) Whenever it appears to the satisfaction of the |
9 | | Chairman that an employer has paid pursuant to this Act an |
10 | | Illinois Workers' Compensation Commission Operations Fund Fee |
11 | | in an amount in excess of the amount legally collectable from |
12 | | the employer, the Chairman shall issue a credit memorandum for |
13 | | an amount equal to the amount of such overpayment. A credit |
14 | | memorandum may be applied for the 2-year period from the date |
15 | | of issuance against the payment of any amount due during that |
16 | | period under the fee imposed by this Section or, subject to |
17 | | reasonable rule of the Commission including requirement of |
18 | | notification, may be assigned to any other employer subject to |
19 | | regulation under this Act. Any application of credit memoranda |
20 | | after the period provided for in this Section is void. |
21 | | (Source: P.A. 95-331, eff. 8-21-07.) |
22 | | (820 ILCS 305/7) (from Ch. 48, par. 138.7) |
23 | | Sec. 7. The amount of compensation which shall be paid for |
24 | | an accidental injury to the employee resulting in death is: |
25 | | (a) If the employee leaves surviving a widow, widower, |
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1 | | child or children, the applicable weekly compensation rate |
2 | | computed in accordance with subparagraph 2 of paragraph (b) of |
3 | | Section 8, shall be payable during the life of the widow or |
4 | | widower and if any surviving child or children shall not be |
5 | | physically or mentally incapacitated then until the death of |
6 | | the widow or widower or until the youngest child shall reach |
7 | | the age of 18, whichever shall come later; provided that if |
8 | | such child or children shall be enrolled as a full time student |
9 | | in any accredited educational institution, the payments shall |
10 | | continue until such child has attained the age of 25. In the |
11 | | event any surviving child or children shall be physically or |
12 | | mentally incapacitated, the payments shall continue for the |
13 | | duration of such incapacity. |
14 | | The term "child" means a child whom the deceased employee |
15 | | left surviving, including a posthumous child, a child legally |
16 | | adopted, a child whom the deceased employee was legally |
17 | | obligated to support or a child to whom the deceased employee |
18 | | stood in loco parentis. The term "children" means the plural |
19 | | of "child". |
20 | | The term "physically or mentally incapacitated child or |
21 | | children" means a child or children incapable of engaging in |
22 | | regular and substantial gainful employment. |
23 | | In the event of the remarriage of a widow or widower, where |
24 | | the decedent did not leave surviving any child or children |
25 | | who, at the time of such remarriage, are entitled to |
26 | | compensation benefits under this Act, the surviving spouse |
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1 | | shall be paid a lump sum equal to 2 years compensation benefits |
2 | | and all further rights of such widow or widower shall be |
3 | | extinguished. |
4 | | If the employee leaves surviving any child or children |
5 | | under 18 years of age who at the time of death shall be |
6 | | entitled to compensation under this paragraph (a) of this |
7 | | Section, the weekly compensation payments herein provided for |
8 | | such child or children shall in any event continue for a period |
9 | | of not less than 6 years. |
10 | | Any beneficiary entitled to compensation under this |
11 | | paragraph (a) of this Section shall receive from the special |
12 | | fund provided in paragraph (f) of this Section, in addition to |
13 | | the compensation herein provided, supplemental benefits in |
14 | | accordance with paragraph (g) of Section 8. |
15 | | (b) If no compensation is payable under paragraph (a) of |
16 | | this Section and the employee leaves surviving a parent or |
17 | | parents who at the time of the accident were totally dependent |
18 | | upon the earnings of the employee then weekly payments equal |
19 | | to the compensation rate payable in the case where the |
20 | | employee leaves surviving a widow or widower, shall be paid to |
21 | | such parent or parents for the duration of their lives, and in |
22 | | the event of the death of either, for the life of the survivor. |
23 | | (c) If no compensation is payable under paragraphs (a) or |
24 | | (b) of this Section and the employee leaves surviving any |
25 | | child or children who are not entitled to compensation under |
26 | | the foregoing paragraph (a) but who at the time of the accident |
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1 | | were nevertheless in any manner dependent upon the earnings of |
2 | | the employee, or leaves surviving a parent or parents who at |
3 | | the time of the accident were partially dependent upon the |
4 | | earnings of the employee, then there shall be paid to such |
5 | | dependent or dependents for a period of 8 years weekly |
6 | | compensation payments at such proportion of the applicable |
7 | | rate if the employee had left surviving a widow or widower as |
8 | | such dependency bears to total dependency. In the event of the |
9 | | death of any such beneficiary the share of such beneficiary |
10 | | shall be divided equally among the surviving beneficiaries and |
11 | | in the event of the death of the last such beneficiary all the |
12 | | rights under this paragraph shall be extinguished. |
13 | | (d) If no compensation is payable under paragraphs (a), |
14 | | (b) or (c) of this Section and the employee leaves surviving |
15 | | any grandparent, grandparents, grandchild or grandchildren or |
16 | | collateral heirs dependent upon the employee's earnings to the |
17 | | extent of 50% or more of total dependency, then there shall be |
18 | | paid to such dependent or dependents for a period of 5 years |
19 | | weekly compensation payments at such proportion of the |
20 | | applicable rate if the employee had left surviving a widow or |
21 | | widower as such dependency bears to total dependency. In the |
22 | | event of the death of any such beneficiary the share of such |
23 | | beneficiary shall be divided equally among the surviving |
24 | | beneficiaries and in the event of the death of the last such |
25 | | beneficiary all rights hereunder shall be extinguished. |
26 | | (e) The compensation to be paid for accidental injury |
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1 | | which results in death, as provided in this Section, shall be |
2 | | paid to the persons who form the basis for determining the |
3 | | amount of compensation to be paid by the employer, the |
4 | | respective shares to be in the proportion of their respective |
5 | | dependency at the time of the accident on the earnings of the |
6 | | deceased. The Commission or an Arbitrator thereof may, in its |
7 | | or his discretion, order or award the payment to the parent or |
8 | | grandparent of a child for the latter's support the amount of |
9 | | compensation which but for such order or award would have been |
10 | | paid to such child as its share of the compensation payable, |
11 | | which order or award may be modified from time to time by the |
12 | | Commission in its discretion with respect to the person to |
13 | | whom shall be paid the amount of the order or award remaining |
14 | | unpaid at the time of the modification. |
15 | | The payments of compensation by the employer in accordance |
16 | | with the order or award of the Commission discharges such |
17 | | employer from all further obligation as to such compensation. |
18 | | (f) The sum of $8,000 for burial expenses shall be paid by |
19 | | the employer to the widow or widower, other dependent, next of |
20 | | kin or to the person or persons incurring the expense of |
21 | | burial. |
22 | | In the event the employer failed to provide necessary |
23 | | first aid, medical, surgical or hospital service, he shall pay |
24 | | the cost thereof to the person or persons entitled to |
25 | | compensation under paragraphs (a), (b), (c) or (d) of this |
26 | | Section, or to the person or persons incurring the obligation |
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1 | | therefore, or providing the same. |
2 | | On January 15 and July 15, 1981, and on January 15 and July |
3 | | 15 of each year thereafter the employer shall within 60 days |
4 | | pay a sum equal to 1/8 of 1% of all compensation payments made |
5 | | by him after July 1, 1980, either under this Act or the |
6 | | Workers' Occupational Diseases Act, whether by lump sum |
7 | | settlement or weekly compensation payments, but not including |
8 | | hospital, surgical or rehabilitation payments, made during the |
9 | | first 6 months and during the second 6 months respectively of |
10 | | the fiscal year next preceding the date of the payments, into a |
11 | | special fund which shall be designated the "Second Injury |
12 | | Fund", of which the State Treasurer is ex-officio custodian, |
13 | | such special fund to be held and disbursed for the purposes |
14 | | hereinafter stated in paragraphs (f) and (g) of Section 8, |
15 | | either upon the order of the Commission or of a competent |
16 | | court. Said special fund shall be deposited the same as are |
17 | | State funds and any interest accruing thereon shall be added |
18 | | thereto every 6 months. It is subject to audit the same as |
19 | | State funds and accounts and is protected by the General bond |
20 | | given by the State Treasurer. It is considered always |
21 | | appropriated for the purposes of disbursements as provided in |
22 | | Section 8, paragraph (f), of this Act, and shall be paid out |
23 | | and disbursed as therein provided and shall not at any time be |
24 | | appropriated or diverted to any other use or purpose. |
25 | | On January 15, 1991, the employer shall further pay a sum |
26 | | equal to one half of 1% of all compensation payments made by |
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1 | | him from January 1, 1990 through June 30, 1990 either under |
2 | | this Act or under the Workers' Occupational Diseases Act, |
3 | | whether by lump sum settlement or weekly compensation |
4 | | payments, but not including hospital, surgical or |
5 | | rehabilitation payments, into an additional Special Fund which |
6 | | shall be designated as the "Rate Adjustment Fund". On March |
7 | | 15, 1991, the employer shall pay into the Rate Adjustment Fund |
8 | | a sum equal to one half of 1% of all such compensation payments |
9 | | made from July 1, 1990 through December 31, 1990. Within 60 |
10 | | days after July 15, 1991, the employer shall pay into the Rate |
11 | | Adjustment Fund a sum equal to one half of 1% of all such |
12 | | compensation payments made from January 1, 1991 through June |
13 | | 30, 1991. Within 60 days after January 15 of 1992 and each |
14 | | subsequent year through 1996, the employer shall pay into the |
15 | | Rate Adjustment Fund a sum equal to one half of 1% of all such |
16 | | compensation payments made in the last 6 months of the |
17 | | preceding calendar year. Within 60 days after July 15 of 1992 |
18 | | and each subsequent year through 1995, the employer shall pay |
19 | | into the Rate Adjustment Fund a sum equal to one half of 1% of |
20 | | all such compensation payments made in the first 6 months of |
21 | | the same calendar year. Within 60 days after January 15 of 1997 |
22 | | and each subsequent year through 2005, the employer shall pay |
23 | | into the Rate Adjustment Fund a sum equal to three-fourths of |
24 | | 1% of all such compensation payments made in the last 6 months |
25 | | of the preceding calendar year. Within 60 days after July 15 of |
26 | | 1996 and each subsequent year through 2004, the employer shall |
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1 | | pay into the Rate Adjustment Fund a sum equal to three-fourths |
2 | | of 1% of all such compensation payments made in the first 6 |
3 | | months of the same calendar year. Within 60 days after July 15 |
4 | | of 2005, the employer shall pay into the Rate Adjustment Fund a |
5 | | sum equal to 1% of such compensation payments made in the first |
6 | | 6 months of the same calendar year. Within 60 days after |
7 | | January 15 of 2006 and each subsequent year through 2024 , the |
8 | | employer shall pay into the Rate Adjustment Fund a sum equal to |
9 | | 1.25% of such compensation payments made in the last 6 months |
10 | | of the preceding calendar year. Within 60 days after July 15 of |
11 | | 2006 and each subsequent year through 2023 , the employer shall |
12 | | pay into the Rate Adjustment Fund a sum equal to 1.25% of such |
13 | | compensation payments made in the first 6 months of the same |
14 | | calendar year. Within 60 days after July 15 of 2024 and each |
15 | | subsequent year thereafter, the employer shall pay into the |
16 | | Rate Adjustment Fund a sum equal to 1.375% of such |
17 | | compensation payments made in the first 6 months of the same |
18 | | calendar year. Within 60 days after January 15 of 2025 and each |
19 | | subsequent year thereafter, the employer shall pay into the |
20 | | Rate Adjustment Fund a sum equal to 1.375% of such |
21 | | compensation payments made in the last 6 months of the |
22 | | preceding calendar year. The administrative costs of |
23 | | collecting assessments from employers for the Rate Adjustment |
24 | | Fund shall be paid from the Rate Adjustment Fund. The cost of |
25 | | an actuarial audit of the Fund shall be paid from the Rate |
26 | | Adjustment Fund. The State Treasurer is ex officio custodian |
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1 | | of such Special Fund and the same shall be held and disbursed |
2 | | for the purposes hereinafter stated in paragraphs (f) and (g) |
3 | | of Section 8 upon the order of the Commission or of a competent |
4 | | court. The Rate Adjustment Fund shall be deposited the same as |
5 | | are State funds and any interest accruing thereon shall be |
6 | | added thereto every 6 months. It shall be subject to audit the |
7 | | same as State funds and accounts and shall be protected by the |
8 | | general bond given by the State Treasurer. It is considered |
9 | | always appropriated for the purposes of disbursements as |
10 | | provided in paragraphs (f) and (g) of Section 8 of this Act and |
11 | | shall be paid out and disbursed as therein provided and shall |
12 | | not at any time be appropriated or diverted to any other use or |
13 | | purpose. Within 5 days after the effective date of this |
14 | | amendatory Act of 1990, the Comptroller and the State |
15 | | Treasurer shall transfer $1,000,000 from the General Revenue |
16 | | Fund to the Rate Adjustment Fund. By February 15, 1991, the |
17 | | Comptroller and the State Treasurer shall transfer $1,000,000 |
18 | | from the Rate Adjustment Fund to the General Revenue Fund. The |
19 | | Comptroller and Treasurer are authorized to make transfers at |
20 | | the request of the Chairman up to a total of $19,000,000 from |
21 | | the Second Injury Fund, the General Revenue Fund, and the |
22 | | Workers' Compensation Benefit Trust Fund to the Rate |
23 | | Adjustment Fund to the extent that there is insufficient money |
24 | | in the Rate Adjustment Fund to pay claims and obligations. |
25 | | Amounts may be transferred from the General Revenue Fund only |
26 | | if the funds in the Second Injury Fund or the Workers' |
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1 | | Compensation Benefit Trust Fund are insufficient to pay claims |
2 | | and obligations of the Rate Adjustment Fund. All amounts |
3 | | transferred from the Second Injury Fund, the General Revenue |
4 | | Fund, and the Workers' Compensation Benefit Trust Fund shall |
5 | | be repaid from the Rate Adjustment Fund within 270 days of a |
6 | | transfer, together with interest at the rate earned by moneys |
7 | | on deposit in the Fund or Funds from which the moneys were |
8 | | transferred. |
9 | | Upon a finding by the Commission, after reasonable notice |
10 | | and hearing, that any employer has willfully and knowingly |
11 | | failed to pay the proper amounts into the Second Injury Fund or |
12 | | the Rate Adjustment Fund required by this Section or if such |
13 | | payments are not made within the time periods prescribed by |
14 | | this Section, the employer shall, in addition to such |
15 | | payments, pay a penalty of 20% of the amount required to be |
16 | | paid or $2,500, whichever is greater, for each year or part |
17 | | thereof of such failure to pay. This penalty shall only apply |
18 | | to obligations of an employer to the Second Injury Fund or the |
19 | | Rate Adjustment Fund accruing after the effective date of this |
20 | | amendatory Act of 1989. All or part of such a penalty may be |
21 | | waived by the Commission for good cause shown. |
22 | | Any obligations of an employer to the Second Injury Fund |
23 | | and Rate Adjustment Fund accruing prior to the effective date |
24 | | of this amendatory Act of 1989 shall be paid in full by such |
25 | | employer within 5 years of the effective date of this |
26 | | amendatory Act of 1989, with at least one-fifth of such |
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1 | | obligation to be paid during each year following the effective |
2 | | date of this amendatory Act of 1989. If the Commission finds, |
3 | | following reasonable notice and hearing, that an employer has |
4 | | failed to make timely payment of any obligation accruing under |
5 | | the preceding sentence, the employer shall, in addition to all |
6 | | other payments required by this Section, be liable for a |
7 | | penalty equal to 20% of the overdue obligation or $2,500, |
8 | | whichever is greater, for each year or part thereof that |
9 | | obligation is overdue. All or part of such a penalty may be |
10 | | waived by the Commission for good cause shown. |
11 | | The Chairman of the Illinois Workers' Compensation |
12 | | Commission shall, annually, furnish to the Director of the |
13 | | Department of Insurance a list of the amounts paid into the |
14 | | Second Injury Fund and the Rate Adjustment Fund by each |
15 | | insurance company on behalf of their insured employers. The |
16 | | Director shall verify to the Chairman that the amounts paid by |
17 | | each insurance company are accurate as best as the Director |
18 | | can determine from the records available to the Director. The |
19 | | Chairman shall verify that the amounts paid by each |
20 | | self-insurer are accurate as best as the Chairman can |
21 | | determine from records available to the Chairman. The Chairman |
22 | | may require each self-insurer to provide information |
23 | | concerning the total compensation payments made upon which |
24 | | contributions to the Second Injury Fund and the Rate |
25 | | Adjustment Fund are predicated and any additional information |
26 | | establishing that such payments have been made into these |
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1 | | funds. Any deficiencies in payments noted by the Director or |
2 | | Chairman shall be subject to the penalty provisions of this |
3 | | Act. |
4 | | The State Treasurer, or his duly authorized |
5 | | representative, shall be named as a party to all proceedings |
6 | | in all cases involving claim for the loss of, or the permanent |
7 | | and complete loss of the use of one eye, one foot, one leg, one |
8 | | arm or one hand. |
9 | | The State Treasurer or his duly authorized agent shall |
10 | | have the same rights as any other party to the proceeding, |
11 | | including the right to petition for review of any award. The |
12 | | reasonable expenses of litigation, such as medical |
13 | | examinations, testimony, and transcript of evidence, incurred |
14 | | by the State Treasurer or his duly authorized representative, |
15 | | shall be borne by the Second Injury Fund. |
16 | | If the award is not paid within 30 days after the date the |
17 | | award has become final, the Commission shall proceed to take |
18 | | judgment thereon in its own name as is provided for other |
19 | | awards by paragraph (g) of Section 19 of this Act and take the |
20 | | necessary steps to collect the award. |
21 | | Any person, corporation or organization who has paid or |
22 | | become liable for the payment of burial expenses of the |
23 | | deceased employee may in his or its own name institute |
24 | | proceedings before the Commission for the collection thereof. |
25 | | For the purpose of administration, receipts and |
26 | | disbursements, the Special Fund provided for in paragraph (f) |
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1 | | of this Section shall be administered jointly with the Special |
2 | | Fund provided for in Section 7, paragraph (f) of the Workers' |
3 | | Occupational Diseases Act. |
4 | | (g) All compensation, except for burial expenses provided |
5 | | in this Section to be paid in case accident results in death, |
6 | | shall be paid in installments equal to the percentage of the |
7 | | average earnings as provided for in Section 8, paragraph (b) |
8 | | of this Act, at the same intervals at which the wages or |
9 | | earnings of the employees were paid. If this is not feasible, |
10 | | then the installments shall be paid weekly. Such compensation |
11 | | may be paid in a lump sum upon petition as provided in Section |
12 | | 9 of this Act. However, in addition to the benefits provided by |
13 | | Section 9 of this Act where compensation for death is payable |
14 | | to the deceased's widow, widower or to the deceased's widow, |
15 | | widower and one or more children, and where a partial lump sum |
16 | | is applied for by such beneficiary or beneficiaries within 18 |
17 | | months after the deceased's death, the Commission may, in its |
18 | | discretion, grant a partial lump sum of not to exceed 100 weeks |
19 | | of the compensation capitalized at their present value upon |
20 | | the basis of interest calculated at 3% per annum with annual |
21 | | rests, upon a showing that such partial lump sum is for the |
22 | | best interest of such beneficiary or beneficiaries. |
23 | | (h) In case the injured employee is under 16 years of age |
24 | | at the time of the accident and is illegally employed, the |
25 | | amount of compensation payable under paragraphs (a), (b), (c), |
26 | | (d) and (f) of this Section shall be increased 50%. |
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1 | | Nothing herein contained repeals or amends the provisions |
2 | | of the Child Labor Law relating to the employment of minors |
3 | | under the age of 16 years. |
4 | | However, where an employer has on file an employment |
5 | | certificate issued pursuant to the Child Labor Law or work |
6 | | permit issued pursuant to the Federal Fair Labor Standards |
7 | | Act, as amended, or a birth certificate properly and duly |
8 | | issued, such certificate, permit or birth certificate is |
9 | | conclusive evidence as to the age of the injured minor |
10 | | employee for the purposes of this Section only. |
11 | | (i) Whenever the dependents of a deceased employee are |
12 | | noncitizens not residing in the United States, Mexico or |
13 | | Canada, the amount of compensation payable is limited to the |
14 | | beneficiaries described in paragraphs (a), (b) and (c) of this |
15 | | Section and is 50% of the compensation provided in paragraphs |
16 | | (a), (b) and (c) of this Section, except as otherwise provided |
17 | | by treaty. |
18 | | In a case where any of the persons who would be entitled to |
19 | | compensation is living at any place outside of the United |
20 | | States, then payment shall be made to the personal |
21 | | representative of the deceased employee. The distribution by |
22 | | such personal representative to the persons entitled shall be |
23 | | made to such persons and in such manner as the Commission |
24 | | orders. |
25 | | (Source: P.A. 102-1030, eff. 5-27-22.) |
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1 | | (820 ILCS 305/19) (from Ch. 48, par. 138.19) |
2 | | Sec. 19. Any disputed questions of law or fact shall be |
3 | | determined as herein provided. |
4 | | (a) It shall be the duty of the Commission upon |
5 | | notification that the parties have failed to reach an |
6 | | agreement, to designate an Arbitrator. |
7 | | 1. Whenever any claimant misconceives his remedy and |
8 | | files an application for adjustment of claim under this |
9 | | Act and it is subsequently discovered, at any time before |
10 | | final disposition of such cause, that the claim for |
11 | | disability or death which was the basis for such |
12 | | application should properly have been made under the |
13 | | Workers' Occupational Diseases Act, then the provisions of |
14 | | Section 19, paragraph (a-1) of the Workers' Occupational |
15 | | Diseases Act having reference to such application shall |
16 | | apply. |
17 | | 2. Whenever any claimant misconceives his remedy and |
18 | | files an application for adjustment of claim under the |
19 | | Workers' Occupational Diseases Act and it is subsequently |
20 | | discovered, at any time before final disposition of such |
21 | | cause that the claim for injury or death which was the |
22 | | basis for such application should properly have been made |
23 | | under this Act, then the application so filed under the |
24 | | Workers' Occupational Diseases Act may be amended in form, |
25 | | substance or both to assert claim for such disability or |
26 | | death under this Act and it shall be deemed to have been so |
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1 | | filed as amended on the date of the original filing |
2 | | thereof, and such compensation may be awarded as is |
3 | | warranted by the whole evidence pursuant to this Act. When |
4 | | such amendment is submitted, further or additional |
5 | | evidence may be heard by the Arbitrator or Commission when |
6 | | deemed necessary. Nothing in this Section contained shall |
7 | | be construed to be or permit a waiver of any provisions of |
8 | | this Act with reference to notice but notice if given |
9 | | shall be deemed to be a notice under the provisions of this |
10 | | Act if given within the time required herein. |
11 | | (b) The Arbitrator shall make such inquiries and |
12 | | investigations as he or they shall deem necessary and may |
13 | | examine and inspect all books, papers, records, places, or |
14 | | premises relating to the questions in dispute and hear such |
15 | | proper evidence as the parties may submit. |
16 | | The hearings before the Arbitrator shall be held in the |
17 | | vicinity where the injury occurred after 10 days' notice of |
18 | | the time and place of such hearing shall have been given to |
19 | | each of the parties or their attorneys of record. |
20 | | The Arbitrator may find that the disabling condition is |
21 | | temporary and has not yet reached a permanent condition and |
22 | | may order the payment of compensation up to the date of the |
23 | | hearing, which award shall be reviewable and enforceable in |
24 | | the same manner as other awards, and in no instance be a bar to |
25 | | a further hearing and determination of a further amount of |
26 | | temporary total compensation or of compensation for permanent |
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1 | | disability, but shall be conclusive as to all other questions |
2 | | except the nature and extent of said disability. |
3 | | The decision of the Arbitrator shall be filed with the |
4 | | Commission which Commission shall immediately send to each |
5 | | party or his attorney a copy of such decision, together with a |
6 | | notification of the time when it was filed. As of the effective |
7 | | date of this amendatory Act of the 94th General Assembly, all |
8 | | decisions of the Arbitrator shall set forth in writing |
9 | | findings of fact and conclusions of law, separately stated, if |
10 | | requested by either party. Unless a petition for review is |
11 | | filed by either party within 30 days after the receipt by such |
12 | | party of the copy of the decision and notification of time when |
13 | | filed, and unless such party petitioning for a review shall |
14 | | within 35 days after the receipt by him of the copy of the |
15 | | decision, file with the Commission either an agreed statement |
16 | | of the facts appearing upon the hearing before the Arbitrator, |
17 | | or if such party shall so elect a correct transcript of |
18 | | evidence of the proceedings at such hearings, then the |
19 | | decision shall become the decision of the Commission and in |
20 | | the absence of fraud shall be conclusive. The Petition for |
21 | | Review shall contain a statement of the petitioning party's |
22 | | specific exceptions to the decision of the arbitrator. The |
23 | | jurisdiction of the Commission to review the decision of the |
24 | | arbitrator shall not be limited to the exceptions stated in |
25 | | the Petition for Review. The Commission, or any member |
26 | | thereof, may grant further time not exceeding 30 days, in |
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1 | | which to file such agreed statement or transcript of evidence. |
2 | | Such agreed statement of facts or correct transcript of |
3 | | evidence, as the case may be, shall be authenticated by the |
4 | | signatures of the parties or their attorneys, and in the event |
5 | | they do not agree as to the correctness of the transcript of |
6 | | evidence it shall be authenticated by the signature of the |
7 | | Arbitrator designated by the Commission. |
8 | | Whether the employee is working or not, if the employee is |
9 | | not receiving or has not received medical, surgical, or |
10 | | hospital services or other services or compensation as |
11 | | provided in paragraph (a) of Section 8, or compensation as |
12 | | provided in paragraph (b) of Section 8, the employee may at any |
13 | | time petition for an expedited hearing by an Arbitrator on the |
14 | | issue of whether or not he or she is entitled to receive |
15 | | payment of the services or compensation. Provided the employer |
16 | | continues to pay compensation pursuant to paragraph (b) of |
17 | | Section 8, the employer may at any time petition for an |
18 | | expedited hearing on the issue of whether or not the employee |
19 | | is entitled to receive medical, surgical, or hospital services |
20 | | or other services or compensation as provided in paragraph (a) |
21 | | of Section 8, or compensation as provided in paragraph (b) of |
22 | | Section 8. When an employer has petitioned for an expedited |
23 | | hearing, the employer shall continue to pay compensation as |
24 | | provided in paragraph (b) of Section 8 unless the arbitrator |
25 | | renders a decision that the employee is not entitled to the |
26 | | benefits that are the subject of the expedited hearing or |
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1 | | unless the employee's treating physician has released the |
2 | | employee to return to work at his or her regular job with the |
3 | | employer or the employee actually returns to work at any other |
4 | | job. If the arbitrator renders a decision that the employee is |
5 | | not entitled to the benefits that are the subject of the |
6 | | expedited hearing, a petition for review filed by the employee |
7 | | shall receive the same priority as if the employee had filed a |
8 | | petition for an expedited hearing by an Arbitrator. Neither |
9 | | party shall be entitled to an expedited hearing when the |
10 | | employee has returned to work and the sole issue in dispute |
11 | | amounts to less than 12 weeks of unpaid compensation pursuant |
12 | | to paragraph (b) of Section 8. |
13 | | Expedited hearings shall have priority over all other |
14 | | petitions and shall be heard by the Arbitrator and Commission |
15 | | with all convenient speed. Any party requesting an expedited |
16 | | hearing shall give notice of a request for an expedited |
17 | | hearing under this paragraph. A copy of the Application for |
18 | | Adjustment of Claim shall be attached to the notice. The |
19 | | Commission shall adopt rules and procedures under which the |
20 | | final decision of the Commission under this paragraph is filed |
21 | | not later than 180 days from the date that the Petition for |
22 | | Review is filed with the Commission. |
23 | | Where 2 or more insurance carriers, private self-insureds, |
24 | | or a group workers' compensation pool under Article V 3/4 of |
25 | | the Illinois Insurance Code dispute coverage for the same |
26 | | injury, any such insurance carrier, private self-insured, or |
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1 | | group workers' compensation pool may request an expedited |
2 | | hearing pursuant to this paragraph to determine the issue of |
3 | | coverage, provided coverage is the only issue in dispute and |
4 | | all other issues are stipulated and agreed to and further |
5 | | provided that all compensation benefits including medical |
6 | | benefits pursuant to Section 8(a) continue to be paid to or on |
7 | | behalf of petitioner. Any insurance carrier, private |
8 | | self-insured, or group workers' compensation pool that is |
9 | | determined to be liable for coverage for the injury in issue |
10 | | shall reimburse any insurance carrier, private self-insured, |
11 | | or group workers' compensation pool that has paid benefits to |
12 | | or on behalf of petitioner for the injury. |
13 | | (b-1) If the employee is not receiving medical, surgical |
14 | | or hospital services as provided in paragraph (a) of Section 8 |
15 | | or compensation as provided in paragraph (b) of Section 8, the |
16 | | employee, in accordance with Commission Rules, may file a |
17 | | petition for an emergency hearing by an Arbitrator on the |
18 | | issue of whether or not he is entitled to receive payment of |
19 | | such compensation or services as provided therein. Such |
20 | | petition shall have priority over all other petitions and |
21 | | shall be heard by the Arbitrator and Commission with all |
22 | | convenient speed. |
23 | | Such petition shall contain the following information and |
24 | | shall be served on the employer at least 15 days before it is |
25 | | filed: |
26 | | (i) the date and approximate time of accident; |
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1 | | (ii) the approximate location of the accident; |
2 | | (iii) a description of the accident; |
3 | | (iv) the nature of the injury incurred by the |
4 | | employee; |
5 | | (v) the identity of the person, if known, to whom the |
6 | | accident was reported and the date on which it was |
7 | | reported; |
8 | | (vi) the name and title of the person, if known, |
9 | | representing the employer with whom the employee conferred |
10 | | in any effort to obtain compensation pursuant to paragraph |
11 | | (b) of Section 8 of this Act or medical, surgical or |
12 | | hospital services pursuant to paragraph (a) of Section 8 |
13 | | of this Act and the date of such conference; |
14 | | (vii) a statement that the employer has refused to pay |
15 | | compensation pursuant to paragraph (b) of Section 8 of |
16 | | this Act or for medical, surgical or hospital services |
17 | | pursuant to paragraph (a) of Section 8 of this Act; |
18 | | (viii) the name and address, if known, of each witness |
19 | | to the accident and of each other person upon whom the |
20 | | employee will rely to support his allegations; |
21 | | (ix) the dates of treatment related to the accident by |
22 | | medical practitioners, and the names and addresses of such |
23 | | practitioners, including the dates of treatment related to |
24 | | the accident at any hospitals and the names and addresses |
25 | | of such hospitals, and a signed authorization permitting |
26 | | the employer to examine all medical records of all |
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1 | | practitioners and hospitals named pursuant to this |
2 | | paragraph; |
3 | | (x) a copy of a signed report by a medical |
4 | | practitioner, relating to the employee's current inability |
5 | | to return to work because of the injuries incurred as a |
6 | | result of the accident or such other documents or |
7 | | affidavits which show that the employee is entitled to |
8 | | receive compensation pursuant to paragraph (b) of Section |
9 | | 8 of this Act or medical, surgical or hospital services |
10 | | pursuant to paragraph (a) of Section 8 of this Act. Such |
11 | | reports, documents or affidavits shall state, if possible, |
12 | | the history of the accident given by the employee, and |
13 | | describe the injury and medical diagnosis, the medical |
14 | | services for such injury which the employee has received |
15 | | and is receiving, the physical activities which the |
16 | | employee cannot currently perform as a result of any |
17 | | impairment or disability due to such injury, and the |
18 | | prognosis for recovery; |
19 | | (xi) complete copies of any reports, records, |
20 | | documents and affidavits in the possession of the employee |
21 | | on which the employee will rely to support his |
22 | | allegations, provided that the employer shall pay the |
23 | | reasonable cost of reproduction thereof; |
24 | | (xii) a list of any reports, records, documents and |
25 | | affidavits which the employee has demanded by subpoena and |
26 | | on which he intends to rely to support his allegations; |
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1 | | (xiii) a certification signed by the employee or his |
2 | | representative that the employer has received the petition |
3 | | with the required information 15 days before filing. |
4 | | Fifteen days after receipt by the employer of the petition |
5 | | with the required information the employee may file said |
6 | | petition and required information and shall serve notice of |
7 | | the filing upon the employer. The employer may file a motion |
8 | | addressed to the sufficiency of the petition. If an objection |
9 | | has been filed to the sufficiency of the petition, the |
10 | | arbitrator shall rule on the objection within 2 working days. |
11 | | If such an objection is filed, the time for filing the final |
12 | | decision of the Commission as provided in this paragraph shall |
13 | | be tolled until the arbitrator has determined that the |
14 | | petition is sufficient. |
15 | | The employer shall, within 15 days after receipt of the |
16 | | notice that such petition is filed, file with the Commission |
17 | | and serve on the employee or his representative a written |
18 | | response to each claim set forth in the petition, including |
19 | | the legal and factual basis for each disputed allegation and |
20 | | the following information: (i) complete copies of any reports, |
21 | | records, documents and affidavits in the possession of the |
22 | | employer on which the employer intends to rely in support of |
23 | | his response, (ii) a list of any reports, records, documents |
24 | | and affidavits which the employer has demanded by subpoena and |
25 | | on which the employer intends to rely in support of his |
26 | | response, (iii) the name and address of each witness on whom |
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1 | | the employer will rely to support his response, and (iv) the |
2 | | names and addresses of any medical practitioners selected by |
3 | | the employer pursuant to Section 12 of this Act and the time |
4 | | and place of any examination scheduled to be made pursuant to |
5 | | such Section. |
6 | | Any employer who does not timely file and serve a written |
7 | | response without good cause may not introduce any evidence to |
8 | | dispute any claim of the employee but may cross examine the |
9 | | employee or any witness brought by the employee and otherwise |
10 | | be heard. |
11 | | No document or other evidence not previously identified by |
12 | | either party with the petition or written response, or by any |
13 | | other means before the hearing, may be introduced into |
14 | | evidence without good cause. If, at the hearing, material |
15 | | information is discovered which was not previously disclosed, |
16 | | the Arbitrator may extend the time for closing proof on the |
17 | | motion of a party for a reasonable period of time which may be |
18 | | more than 30 days. No evidence may be introduced pursuant to |
19 | | this paragraph as to permanent disability. No award may be |
20 | | entered for permanent disability pursuant to this paragraph. |
21 | | Either party may introduce into evidence the testimony taken |
22 | | by deposition of any medical practitioner. |
23 | | The Commission shall adopt rules, regulations and |
24 | | procedures whereby the final decision of the Commission is |
25 | | filed not later than 90 days from the date the petition for |
26 | | review is filed but in no event later than 180 days from the |
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1 | | date the petition for an emergency hearing is filed with the |
2 | | Illinois Workers' Compensation Commission. |
3 | | All service required pursuant to this paragraph (b-1) must |
4 | | be by personal service or by certified mail and with evidence |
5 | | of receipt. In addition for the purposes of this paragraph, |
6 | | all service on the employer must be at the premises where the |
7 | | accident occurred if the premises are owned or operated by the |
8 | | employer. Otherwise service must be at the employee's |
9 | | principal place of employment by the employer. If service on |
10 | | the employer is not possible at either of the above, then |
11 | | service shall be at the employer's principal place of |
12 | | business. After initial service in each case, service shall be |
13 | | made on the employer's attorney or designated representative. |
14 | | (c)(1) At a reasonable time in advance of and in |
15 | | connection with the hearing under Section 19(e) or 19(h), the |
16 | | Commission may on its own motion order an impartial physical |
17 | | or mental examination of a petitioner whose mental or physical |
18 | | condition is in issue, when in the Commission's discretion it |
19 | | appears that such an examination will materially aid in the |
20 | | just determination of the case. The examination shall be made |
21 | | by a member or members of a panel of physicians chosen for |
22 | | their special qualifications by the Illinois State Medical |
23 | | Society. The Commission shall establish procedures by which a |
24 | | physician shall be selected from such list. |
25 | | (2) Should the Commission at any time during the hearing |
26 | | find that compelling considerations make it advisable to have |
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1 | | an examination and report at that time, the commission may in |
2 | | its discretion so order. |
3 | | (3) A copy of the report of examination shall be given to |
4 | | the Commission and to the attorneys for the parties. |
5 | | (4) Either party or the Commission may call the examining |
6 | | physician or physicians to testify. Any physician so called |
7 | | shall be subject to cross-examination. |
8 | | (5) The examination shall be made, and the physician or |
9 | | physicians, if called, shall testify, without cost to the |
10 | | parties. The Commission shall determine the compensation and |
11 | | the pay of the physician or physicians. The compensation for |
12 | | this service shall not exceed the usual and customary amount |
13 | | for such service. |
14 | | (6) The fees and payment thereof of all attorneys and |
15 | | physicians for services authorized by the Commission under |
16 | | this Act shall, upon request of either the employer or the |
17 | | employee or the beneficiary affected, be subject to the review |
18 | | and decision of the Commission. |
19 | | (d) If any employee shall persist in insanitary or |
20 | | injurious practices which tend to either imperil or retard his |
21 | | recovery or shall refuse to submit to such medical, surgical, |
22 | | or hospital treatment as is reasonably essential to promote |
23 | | his recovery, the Commission may, in its discretion, reduce or |
24 | | suspend the compensation of any such injured employee. |
25 | | However, when an employer and employee so agree in writing, |
26 | | the foregoing provision shall not be construed to authorize |
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1 | | the reduction or suspension of compensation of an employee who |
2 | | is relying in good faith, on treatment by prayer or spiritual |
3 | | means alone, in accordance with the tenets and practice of a |
4 | | recognized church or religious denomination, by a duly |
5 | | accredited practitioner thereof. |
6 | | (e) This paragraph shall apply to all hearings before the |
7 | | Commission. Such hearings may be held in its office or |
8 | | elsewhere as the Commission may deem advisable. The taking of |
9 | | testimony on such hearings may be had before any member of the |
10 | | Commission. If a petition for review and agreed statement of |
11 | | facts or transcript of evidence is filed, as provided herein, |
12 | | the Commission shall promptly review the decision of the |
13 | | Arbitrator and all questions of law or fact which appear from |
14 | | the statement of facts or transcript of evidence. |
15 | | In all cases in which the hearing before the arbitrator is |
16 | | held after December 18, 1989, no additional evidence shall be |
17 | | introduced by the parties before the Commission on review of |
18 | | the decision of the Arbitrator. In reviewing decisions of an |
19 | | arbitrator the Commission shall award such temporary |
20 | | compensation, permanent compensation and other payments as are |
21 | | due under this Act. The Commission shall file in its office its |
22 | | decision thereon, and shall immediately send to each party or |
23 | | his attorney a copy of such decision and a notification of the |
24 | | time when it was filed. Decisions shall be filed within 60 days |
25 | | after the Statement of Exceptions and Supporting Brief and |
26 | | Response thereto are required to be filed or oral argument |
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1 | | whichever is later. |
2 | | In the event either party requests oral argument, such |
3 | | argument shall be had before a panel of 3 members of the |
4 | | Commission (or before all available members pursuant to the |
5 | | determination of 7 members of the Commission that such |
6 | | argument be held before all available members of the |
7 | | Commission) pursuant to the rules and regulations of the |
8 | | Commission. A panel of 3 members, which shall be comprised of |
9 | | not more than one representative citizen of the employing |
10 | | class and not more than one representative from a labor |
11 | | organization recognized under the National Labor Relations Act |
12 | | or an attorney who has represented labor organizations or has |
13 | | represented employees in workers' compensation cases, shall |
14 | | hear the argument; provided that if all the issues in dispute |
15 | | are solely the nature and extent of the permanent partial |
16 | | disability, if any, a majority of the panel may deny the |
17 | | request for such argument and such argument shall not be held; |
18 | | and provided further that 7 members of the Commission may |
19 | | determine that the argument be held before all available |
20 | | members of the Commission. A decision of the Commission shall |
21 | | be approved by a majority of Commissioners present at such |
22 | | hearing if any; provided, if no such hearing is held, a |
23 | | decision of the Commission shall be approved by a majority of a |
24 | | panel of 3 members of the Commission as described in this |
25 | | Section. The Commission shall give 10 days' notice to the |
26 | | parties or their attorneys of the time and place of such taking |
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1 | | of testimony and of such argument. |
2 | | In any case the Commission in its decision may find |
3 | | specially upon any question or questions of law or fact which |
4 | | shall be submitted in writing by either party whether ultimate |
5 | | or otherwise; provided that on issues other than nature and |
6 | | extent of the disability, if any, the Commission in its |
7 | | decision shall find specially upon any question or questions |
8 | | of law or fact, whether ultimate or otherwise, which are |
9 | | submitted in writing by either party; provided further that |
10 | | not more than 5 such questions may be submitted by either |
11 | | party. Any party may, within 20 days after receipt of notice of |
12 | | the Commission's decision, or within such further time, not |
13 | | exceeding 30 days, as the Commission may grant, file with the |
14 | | Commission either an agreed statement of the facts appearing |
15 | | upon the hearing, or, if such party shall so elect, a correct |
16 | | transcript of evidence of the additional proceedings presented |
17 | | before the Commission, in which report the party may embody a |
18 | | correct statement of such other proceedings in the case as |
19 | | such party may desire to have reviewed, such statement of |
20 | | facts or transcript of evidence to be authenticated by the |
21 | | signature of the parties or their attorneys, and in the event |
22 | | that they do not agree, then the authentication of such |
23 | | transcript of evidence shall be by the signature of any member |
24 | | of the Commission. |
25 | | If a reporter does not for any reason furnish a transcript |
26 | | of the proceedings before the Arbitrator in any case for use on |
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1 | | a hearing for review before the Commission, within the |
2 | | limitations of time as fixed in this Section, the Commission |
3 | | may, in its discretion, order a trial de novo before the |
4 | | Commission in such case upon application of either party. The |
5 | | applications for adjustment of claim and other documents in |
6 | | the nature of pleadings filed by either party, together with |
7 | | the decisions of the Arbitrator and of the Commission and the |
8 | | statement of facts or transcript of evidence hereinbefore |
9 | | provided for in paragraphs (b) and (c) shall be the record of |
10 | | the proceedings of the Commission, and shall be subject to |
11 | | review as hereinafter provided. |
12 | | At the request of either party or on its own motion, the |
13 | | Commission shall set forth in writing the reasons for the |
14 | | decision, including findings of fact and conclusions of law |
15 | | separately stated. The Commission shall by rule adopt a format |
16 | | for written decisions for the Commission and arbitrators. The |
17 | | written decisions shall be concise and shall succinctly state |
18 | | the facts and reasons for the decision. The Commission may |
19 | | adopt in whole or in part, the decision of the arbitrator as |
20 | | the decision of the Commission. When the Commission does so |
21 | | adopt the decision of the arbitrator, it shall do so by order. |
22 | | Whenever the Commission adopts part of the arbitrator's |
23 | | decision, but not all, it shall include in the order the |
24 | | reasons for not adopting all of the arbitrator's decision. |
25 | | When a majority of a panel, after deliberation, has arrived at |
26 | | its decision, the decision shall be filed as provided in this |
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1 | | Section without unnecessary delay, and without regard to the |
2 | | fact that a member of the panel has expressed an intention to |
3 | | dissent. Any member of the panel may file a dissent. Any |
4 | | dissent shall be filed no later than 10 days after the decision |
5 | | of the majority has been filed. |
6 | | Decisions rendered by the Commission and dissents, if any, |
7 | | shall be published together by the Commission. The conclusions |
8 | | of law set out in such decisions shall be regarded as |
9 | | precedents by arbitrators for the purpose of achieving a more |
10 | | uniform administration of this Act. |
11 | | (f) The decision of the Commission acting within its |
12 | | powers, according to the provisions of paragraph (d) of |
13 | | Section 4 and paragraph (e) of this Section shall, in the |
14 | | absence of fraud, be conclusive unless reviewed as in this |
15 | | paragraph hereinafter provided. However, the Arbitrator or the |
16 | | Commission may on his or its own motion, or on the motion of |
17 | | either party, correct any clerical error or errors in |
18 | | computation within 15 days after the date of receipt of any |
19 | | award by such Arbitrator or any decision on review of the |
20 | | Commission and shall have the power to recall the original |
21 | | award on arbitration or decision on review, and issue in lieu |
22 | | thereof such corrected award or decision. Where such |
23 | | correction is made the time for review herein specified shall |
24 | | begin to run from the date of the receipt of the corrected |
25 | | award or decision. |
26 | | (1) Except in cases of claims against the State of |
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1 | | Illinois other than those claims under Section 18.1, in |
2 | | which case the decision of the Commission shall not be |
3 | | subject to judicial review, the Circuit Court of the |
4 | | county where any of the parties defendant may be found, or |
5 | | if none of the parties defendant can be found in this State |
6 | | then the Circuit Court of the county where the accident |
7 | | occurred, shall by summons to the Commission have power to |
8 | | review all questions of law and fact presented by such |
9 | | record. |
10 | | A proceeding for review shall be commenced within 20 |
11 | | days of the receipt of notice of the decision of the |
12 | | Commission. The summons shall be issued by the clerk of |
13 | | such court upon written request returnable on a designated |
14 | | return day, not less than 10 or more than 60 days from the |
15 | | date of issuance thereof, and the written request shall |
16 | | contain the last known address of other parties in |
17 | | interest and their attorneys of record who are to be |
18 | | served by summons. Service upon any member of the |
19 | | Commission or the Secretary or the Assistant Secretary |
20 | | thereof shall be service upon the Commission, and service |
21 | | upon other parties in interest and their attorneys of |
22 | | record shall be by summons, and such service shall be made |
23 | | upon the Commission and other parties in interest by |
24 | | mailing notices of the commencement of the proceedings and |
25 | | the return day of the summons to the office of the |
26 | | Commission and to the last known place of residence of |
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1 | | other parties in interest or their attorney or attorneys |
2 | | of record. The clerk of the court issuing the summons |
3 | | shall on the day of issue mail notice of the commencement |
4 | | of the proceedings which shall be done by mailing a copy of |
5 | | the summons to the office of the Commission, and a copy of |
6 | | the summons to the other parties in interest or their |
7 | | attorney or attorneys of record and the clerk of the court |
8 | | shall make certificate that he has so sent said notices in |
9 | | pursuance of this Section, which shall be evidence of |
10 | | service on the Commission and other parties in interest. |
11 | | The Commission shall not be required to certify the |
12 | | record of their proceedings to the Circuit Court, unless |
13 | | the party commencing the proceedings for review in the |
14 | | Circuit Court as above provided, shall file with the |
15 | | Commission notice of intent to file for review in Circuit |
16 | | Court. It shall be the duty of the Commission upon such |
17 | | filing of notice of intent to file for review in the |
18 | | Circuit Court to prepare a true and correct copy of such |
19 | | testimony and a true and correct copy of all other matters |
20 | | contained in such record and certified to by the Secretary |
21 | | or Assistant Secretary thereof. The changes made to this |
22 | | subdivision (f)(1) by this amendatory Act of the 98th |
23 | | General Assembly apply to any Commission decision entered |
24 | | after the effective date of this amendatory Act of the |
25 | | 98th General Assembly. |
26 | | No request for a summons may be filed and no summons |
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1 | | shall issue unless the party seeking to review the |
2 | | decision of the Commission shall exhibit to the clerk of |
3 | | the Circuit Court proof of filing with the Commission of |
4 | | the notice of the intent to file for review in the Circuit |
5 | | Court or an affidavit of the attorney setting forth that |
6 | | notice of intent to file for review in the Circuit Court |
7 | | has been given in writing to the Secretary or Assistant |
8 | | Secretary of the Commission. |
9 | | (2) No such summons shall issue unless the one against |
10 | | whom the Commission shall have rendered an award for the |
11 | | payment of money shall upon the filing of his written |
12 | | request for such summons file with the clerk of the court a |
13 | | bond conditioned that if he shall not successfully |
14 | | prosecute the review, he will pay the award and the costs |
15 | | of the proceedings in the courts. The amount of the bond |
16 | | shall be fixed by any member of the Commission and the |
17 | | surety or sureties of the bond shall be approved by the |
18 | | clerk of the court. The acceptance of the bond by the clerk |
19 | | of the court shall constitute evidence of his approval of |
20 | | the bond. |
21 | | The following shall not be required to file a bond to |
22 | | secure the payment of the award and the costs of the |
23 | | proceedings in the court to authorize the court to issue |
24 | | such summons: |
25 | | (1) the State Treasurer, for a fund administered |
26 | | by the State Treasurer ex officio against whom the |
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1 | | Commission shall have rendered an award for the |
2 | | payment of money; and |
3 | | (2) a county, city, town, township, incorporated |
4 | | village, school district, body politic, or municipal |
5 | | corporation against whom the Commission shall have |
6 | | rendered an award for the payment of money. |
7 | | The court may confirm or set aside the decision of the |
8 | | Commission. If the decision is set aside and the facts |
9 | | found in the proceedings before the Commission are |
10 | | sufficient, the court may enter such decision as is |
11 | | justified by law, or may remand the cause to the |
12 | | Commission for further proceedings and may state the |
13 | | questions requiring further hearing, and give such other |
14 | | instructions as may be proper. If the court affirms the |
15 | | Commission's decision imposing fines on the employer under |
16 | | subsection (d) of Section 4, the court shall enter |
17 | | judgment against the employer in the amount of the fines |
18 | | assessed by the Commission. Appeals shall be taken to the |
19 | | Appellate Court in accordance with Supreme Court Rules |
20 | | 22(g) and 303. Appeals shall be taken from the Appellate |
21 | | Court to the Supreme Court in accordance with Supreme |
22 | | Court Rule 315. |
23 | | It shall be the duty of the clerk of any court |
24 | | rendering a decision affecting or affirming an award of |
25 | | the Commission to promptly furnish the Commission with a |
26 | | copy of such decision, without charge. |
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1 | | The decision of a majority of the members of the panel |
2 | | of the Commission, shall be considered the decision of the |
3 | | Commission. |
4 | | (g) Except in the case of a claim against the State of |
5 | | Illinois, either party may present a certified copy of the |
6 | | award of the Arbitrator, or a certified copy of the decision of |
7 | | the Commission when the same has become final, when no |
8 | | proceedings for review are pending, providing for the payment |
9 | | of compensation according to this Act, to the Circuit Court of |
10 | | the county in which such accident occurred or either of the |
11 | | parties are residents, whereupon the court shall enter a |
12 | | judgment in accordance therewith. In a case where the employer |
13 | | refuses to pay compensation according to such final award or |
14 | | such final decision upon which such judgment is entered the |
15 | | court shall in entering judgment thereon, tax as costs against |
16 | | him the reasonable costs and attorney fees in the arbitration |
17 | | proceedings and in the court entering the judgment for the |
18 | | person in whose favor the judgment is entered, which judgment |
19 | | and costs taxed as therein provided shall, until and unless |
20 | | set aside, have the same effect as though duly entered in an |
21 | | action duly tried and determined by the court, and shall with |
22 | | like effect, be entered and docketed. The Circuit Court shall |
23 | | have power at any time upon application to make any such |
24 | | judgment conform to any modification required by any |
25 | | subsequent decision of the Supreme Court upon appeal, or as |
26 | | the result of any subsequent proceedings for review, as |
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1 | | provided in this Act. |
2 | | Judgment shall not be entered until 15 days' notice of the |
3 | | time and place of the application for the entry of judgment |
4 | | shall be served upon the employer by filing such notice with |
5 | | the Commission, which Commission shall, in case it has on file |
6 | | the address of the employer or the name and address of its |
7 | | agent upon whom notices may be served, immediately send a copy |
8 | | of the notice to the employer or such designated agent. |
9 | | (h) An agreement or award under this Act providing for |
10 | | compensation in installments, may at any time within 18 months |
11 | | after such agreement or award be reviewed by the Commission at |
12 | | the request of either the employer or the employee, on the |
13 | | ground that the disability of the employee has subsequently |
14 | | recurred, increased, diminished or ended. |
15 | | However, as to accidents occurring subsequent to July 1, |
16 | | 1955, which are covered by any agreement or award under this |
17 | | Act providing for compensation in installments made as a |
18 | | result of such accident, such agreement or award may at any |
19 | | time within 30 months, or 60 months in the case of an award |
20 | | under Section 8(d)1, after such agreement or award be reviewed |
21 | | by the Commission at the request of either the employer or the |
22 | | employee on the ground that the disability of the employee has |
23 | | subsequently recurred, increased, diminished or ended. |
24 | | On such review, compensation payments may be |
25 | | re-established, increased, diminished or ended. The Commission |
26 | | shall give 15 days' notice to the parties of the hearing for |
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1 | | review. Any employee, upon any petition for such review being |
2 | | filed by the employer, shall be entitled to one day's notice |
3 | | for each 100 miles necessary to be traveled by him in attending |
4 | | the hearing of the Commission upon the petition, and 3 days in |
5 | | addition thereto. Such employee shall, at the discretion of |
6 | | the Commission, also be entitled to 5 cents per mile |
7 | | necessarily traveled by him within the State of Illinois in |
8 | | attending such hearing, not to exceed a distance of 300 miles, |
9 | | to be taxed by the Commission as costs and deposited with the |
10 | | petition of the employer. |
11 | | When compensation which is payable in accordance with an |
12 | | award or settlement contract approved by the Commission, is |
13 | | ordered paid in a lump sum by the Commission, no review shall |
14 | | be had as in this paragraph mentioned. |
15 | | (i) Each party, upon taking any proceedings or steps |
16 | | whatsoever before any Arbitrator, Commission or court, shall |
17 | | file with the Commission his address, or the name and address |
18 | | of any agent upon whom all notices to be given to such party |
19 | | shall be served, either personally or by registered mail, |
20 | | addressed to such party or agent at the last address so filed |
21 | | with the Commission. In the event such party has not filed his |
22 | | address, or the name and address of an agent as above provided, |
23 | | service of any notice may be had by filing such notice with the |
24 | | Commission. |
25 | | (j) Whenever in any proceeding testimony has been taken or |
26 | | a final decision has been rendered and after the taking of such |
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1 | | testimony or after such decision has become final, the injured |
2 | | employee dies, then in any subsequent proceedings brought by |
3 | | the personal representative or beneficiaries of the deceased |
4 | | employee, such testimony in the former proceeding may be |
5 | | introduced with the same force and effect as though the |
6 | | witness having so testified were present in person in such |
7 | | subsequent proceedings and such final decision, if any, shall |
8 | | be taken as final adjudication of any of the issues which are |
9 | | the same in both proceedings. |
10 | | (k) In case where there has been any unreasonable or |
11 | | vexatious delay of payment or intentional underpayment of |
12 | | compensation, or proceedings have been instituted or carried |
13 | | on by the one liable to pay the compensation, which do not |
14 | | present a real controversy, but are merely frivolous or for |
15 | | delay, then the Commission may award compensation additional |
16 | | to that otherwise payable under this Act equal to 50% of the |
17 | | amount payable at the time of such award. Failure to pay |
18 | | compensation in accordance with the provisions of Section 8, |
19 | | paragraph (b) of this Act, shall be considered unreasonable |
20 | | delay. |
21 | | When determining whether this subsection (k) shall apply, |
22 | | the Commission shall consider whether an Arbitrator has |
23 | | determined that the claim is not compensable or whether the |
24 | | employer has made payments under Section 8(j). |
25 | | (l) If the employee has made written demand for payment of |
26 | | benefits under Section 8(a) or Section 8(b), the employer |
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1 | | shall have 14 days after receipt of the demand to set forth in |
2 | | writing the reason for the delay. In the case of demand for |
3 | | payment of medical benefits under Section 8(a), the time for |
4 | | the employer to respond shall not commence until the |
5 | | expiration of the allotted 30 days specified under Section |
6 | | 8.2(d). In case the employer or his or her insurance carrier |
7 | | shall without good and just cause fail, neglect, refuse, or |
8 | | unreasonably delay the payment of benefits under Section 8(a) |
9 | | or Section 8(b), the Arbitrator or the Commission shall allow |
10 | | to the employee additional compensation in the sum of $30 per |
11 | | day for each day that the benefits under Section 8(a) or |
12 | | Section 8(b) have been so withheld or refused, not to exceed |
13 | | $10,000. A delay in payment of 14 days or more shall create a |
14 | | rebuttable presumption of unreasonable delay. |
15 | | (m) If the commission finds that an accidental injury was |
16 | | directly and proximately caused by the employer's wilful |
17 | | violation of a health and safety standard under the Health and |
18 | | Safety Act or the Occupational Safety and Health Act in force |
19 | | at the time of the accident, the arbitrator or the Commission |
20 | | shall allow to the injured employee or his dependents, as the |
21 | | case may be, additional compensation equal to 25% of the |
22 | | amount which otherwise would be payable under the provisions |
23 | | of this Act exclusive of this paragraph. The additional |
24 | | compensation herein provided shall be allowed by an |
25 | | appropriate increase in the applicable weekly compensation |
26 | | rate. |
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1 | | (n) After June 30, 1984, decisions of the Illinois |
2 | | Workers' Compensation Commission reviewing an award of an |
3 | | arbitrator of the Commission shall draw interest at a rate |
4 | | equal to the yield on indebtedness issued by the United States |
5 | | Government with a 26-week maturity next previously auctioned |
6 | | on the day on which the decision is filed. Said rate of |
7 | | interest shall be set forth in the Arbitrator's Decision. |
8 | | Interest shall be drawn from the date of the arbitrator's |
9 | | award on all accrued compensation due the employee through the |
10 | | day prior to the date of payments. However, when an employee |
11 | | appeals an award of an Arbitrator or the Commission, and the |
12 | | appeal results in no change or a decrease in the award, |
13 | | interest shall not further accrue from the date of such |
14 | | appeal. |
15 | | The employer or his insurance carrier may tender the |
16 | | payments due under the award to stop the further accrual of |
17 | | interest on such award notwithstanding the prosecution by |
18 | | either party of review, certiorari, appeal to the Supreme |
19 | | Court or other steps to reverse, vacate or modify the award. |
20 | | (o) By the 15th day of each month each insurer providing |
21 | | coverage for losses under this Act shall notify each insured |
22 | | employer of any compensable claim incurred during the |
23 | | preceding month and the amounts paid or reserved on the claim |
24 | | including a summary of the claim and a brief statement of the |
25 | | reasons for compensability. A cumulative report of all claims |
26 | | incurred during a calendar year or continued from the previous |
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1 | | year shall be furnished to the insured employer by the insurer |
2 | | within 30 days after the end of that calendar year. |
3 | | The insured employer may challenge, in proceeding before |
4 | | the Commission, payments made by the insurer without |
5 | | arbitration and payments made after a case is determined to be |
6 | | noncompensable. If the Commission finds that the case was not |
7 | | compensable, the insurer shall purge its records as to that |
8 | | employer of any loss or expense associated with the claim, |
9 | | reimburse the employer for attorneys' fees arising from the |
10 | | challenge and for any payment required of the employer to the |
11 | | Rate Adjustment Fund or the Second Injury Fund, and may not |
12 | | reflect the loss or expense for rate making purposes. The |
13 | | employee shall not be required to refund the challenged |
14 | | payment. The decision of the Commission may be reviewed in the |
15 | | same manner as in arbitrated cases. No challenge may be |
16 | | initiated under this paragraph more than 3 years after the |
17 | | payment is made. An employer may waive the right of challenge |
18 | | under this paragraph on a case by case basis. |
19 | | (p) After filing an application for adjustment of claim |
20 | | but prior to the hearing on arbitration the parties may |
21 | | voluntarily agree to submit such application for adjustment of |
22 | | claim for decision by an arbitrator under this subsection (p) |
23 | | where such application for adjustment of claim raises only a |
24 | | dispute over temporary total disability, permanent partial |
25 | | disability or medical expenses. Such agreement shall be in |
26 | | writing in such form as provided by the Commission. |
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1 | | Applications for adjustment of claim submitted for decision by |
2 | | an arbitrator under this subsection (p) shall proceed |
3 | | according to rule as established by the Commission. The |
4 | | Commission shall promulgate rules including, but not limited |
5 | | to, rules to ensure that the parties are adequately informed |
6 | | of their rights under this subsection (p) and of the voluntary |
7 | | nature of proceedings under this subsection (p). The findings |
8 | | of fact made by an arbitrator acting within his or her powers |
9 | | under this subsection (p) in the absence of fraud shall be |
10 | | conclusive. However, the arbitrator may on his own motion, or |
11 | | the motion of either party, correct any clerical errors or |
12 | | errors in computation within 15 days after the date of receipt |
13 | | of such award of the arbitrator and shall have the power to |
14 | | recall the original award on arbitration, and issue in lieu |
15 | | thereof such corrected award. The decision of the arbitrator |
16 | | under this subsection (p) shall be considered the decision of |
17 | | the Commission and proceedings for review of questions of law |
18 | | arising from the decision may be commenced by either party |
19 | | pursuant to subsection (f) of Section 19. The Advisory Board |
20 | | established under Section 13.1 shall compile a list of |
21 | | certified Commission arbitrators, each of whom shall be |
22 | | approved by at least 7 members of the Advisory Board. The |
23 | | chairman shall select 5 persons from such list to serve as |
24 | | arbitrators under this subsection (p). By agreement, the |
25 | | parties shall select one arbitrator from among the 5 persons |
26 | | selected by the chairman except that if the parties do not |
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1 | | agree on an arbitrator from among the 5 persons, the parties |
2 | | may, by agreement, select an arbitrator of the American |
3 | | Arbitration Association, whose fee shall be paid by the State |
4 | | in accordance with rules promulgated by the Commission. |
5 | | Arbitration under this subsection (p) shall be voluntary. |
6 | | (Source: P.A. 101-384, eff. 1-1-20; 102-775, eff. 5-13-22.) |
7 | | (820 ILCS 305/25.5) |
8 | | Sec. 25.5. Unlawful acts; penalties. |
9 | | (a) It is unlawful for any person, company, corporation, |
10 | | insurance carrier, healthcare provider, or other entity to: |
11 | | (1) Intentionally present or cause to be presented any |
12 | | false or fraudulent claim for the payment of any workers' |
13 | | compensation benefit. |
14 | | (2) Intentionally make or cause to be made any false |
15 | | or fraudulent material statement or material |
16 | | representation for the purpose of obtaining or denying any |
17 | | workers' compensation benefit. |
18 | | (3) Intentionally make or cause to be made any false |
19 | | or fraudulent statements with regard to entitlement to |
20 | | workers' compensation benefits with the intent to prevent |
21 | | an injured worker from making a legitimate claim for any |
22 | | workers' compensation benefits. |
23 | | (4) Intentionally prepare or provide an invalid, |
24 | | false, or counterfeit certificate of insurance as proof of |
25 | | workers' compensation insurance. |
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1 | | (5) Intentionally make or cause to be made any false |
2 | | or fraudulent material statement or material |
3 | | representation for the purpose of obtaining workers' |
4 | | compensation insurance at less than the proper amount for |
5 | | that insurance. |
6 | | (6) Intentionally make or cause to be made any false |
7 | | or fraudulent material statement or material |
8 | | representation on an initial or renewal self-insurance |
9 | | application or accompanying financial statement for the |
10 | | purpose of obtaining self-insurance status or reducing the |
11 | | amount of security that may be required to be furnished |
12 | | pursuant to Section 4 of this Act. |
13 | | (7) Intentionally make or cause to be made any false |
14 | | or fraudulent material statement to the Department of |
15 | | Insurance's fraud and insurance non-compliance unit in the |
16 | | course of an investigation of fraud or insurance |
17 | | non-compliance. |
18 | | (8) Intentionally assist, abet, solicit, or conspire |
19 | | with any person, company, or other entity to commit any of |
20 | | the acts in paragraph (1), (2), (3), (4), (5), (6), or (7) |
21 | | of this subsection (a). |
22 | | (8.5) Intentionally assist, abet, solicit, or conspire |
23 | | with any person, company, or other entity to commit any of |
24 | | the acts in paragraph (4) of this subsection (a). |
25 | | (9) Intentionally present a bill or statement for the |
26 | | payment for medical services that were not provided. |
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1 | | For the purposes of paragraphs (2), (3), (5), (6), (7), |
2 | | and (9), the term "statement" includes any writing, notice, |
3 | | proof of injury, bill for services, hospital or doctor records |
4 | | and reports, or X-ray and test results. |
5 | | (b) Sentences for violations of paragraphs (1), (2), (3), |
6 | | (5), (6), (7), (8), and (9) of subsection (a) are as follows: |
7 | | (1) A violation in which the value of the property |
8 | | obtained or attempted to be obtained is $300 or less is a |
9 | | Class A misdemeanor. |
10 | | (2) A violation in which the value of the property |
11 | | obtained or attempted to be obtained is more than $300 but |
12 | | not more than $10,000 is a Class 3 felony. |
13 | | (3) A violation in which the value of the property |
14 | | obtained or attempted to be obtained is more than $10,000 |
15 | | but not more than $100,000 is a Class 2 felony. |
16 | | (4) A violation in which the value of the property |
17 | | obtained or attempted to be obtained is more than $100,000 |
18 | | is a Class 1 felony. |
19 | | (5) A person convicted under this subsection Section |
20 | | shall be ordered to pay monetary restitution to the |
21 | | injured worker, insurance company , or self-insured entity , |
22 | | or any other person for any financial loss sustained as a |
23 | | result of a violation of this Section , including any court |
24 | | costs and attorney fees . An order of restitution also |
25 | | includes expenses incurred and paid by the State of |
26 | | Illinois , or an insurance company , a or self-insured |
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1 | | entity , an injured worker, or any other person in |
2 | | connection with any medical evaluation or treatment |
3 | | services. For the purposes of this subsection, "person" |
4 | | includes any legal entity created under Section 535 of the |
5 | | Illinois Insurance Code. |
6 | | For the purposes of this subsection Section , where the |
7 | | exact value of property obtained or attempted to be obtained |
8 | | is either not alleged or is not specifically set by the terms |
9 | | of a policy of insurance, the value of the property shall be |
10 | | the fair market replacement value of the property claimed to |
11 | | be lost, the reasonable costs of reimbursing a vendor or other |
12 | | claimant for services to be rendered, or both. Notwithstanding |
13 | | the foregoing, an injured worker, an insurance company, |
14 | | self-insured entity, or any other person suffering financial |
15 | | loss sustained as a result of violation of this Section may |
16 | | seek restitution, including court costs and attorney's fees in |
17 | | a civil action in a court of competent jurisdiction. |
18 | | (b-5) Sentences for violations of paragraphs (4) and (8.5) |
19 | | of |
| | subsection (a) are as follows: |
20 | | (1) A violation in which the value of the property |
21 | | obtained or attempted to be obtained is $10,000 or less, |
22 | | is a Class 3 felony and a civil penalty of up to $10,000 |
23 | | per violation, payable to the Injured Workers' Benefit |
24 | | Fund, shall be assessed. |
25 | | (2) A violation in which the value of the property |
26 | | obtained or attempted to be obtained is more than $10,000, |
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1 | | but not more than $100,000, is a Class 2 felony and a civil |
2 | | penalty of up to $10,000 per violation, payable to the |
3 | | Injured Workers' Benefit Fund, shall be assessed. |
4 | | (3) A violation in which the value of the property |
5 | | obtained or attempted to be obtained is more than $100,000 |
6 | | is a Class 1 felony and a civil penalty of up to $10,000 |
7 | | per violation, payable to the Injured Workers' Benefit |
8 | | Fund, shall be assessed. |
9 | | (4) A person convicted under this subsection shall be |
10 | | ordered to pay monetary restitution to the injured worker, |
11 | | insurance company, self-insured entity, or any other |
12 | | person for any financial loss sustained as a result of a |
13 | | violation of this Section. An order of restitution also |
14 | | includes expenses incurred and paid by the State of |
15 | | Illinois, an insurance company, a self-insured entity, an |
16 | | injured person, or any other person in connection with any |
17 | | medical evaluation or treatment services. |
18 | | For the purposes of this subsection, the value of the |
19 | | property obtained or attempted to be obtained shall be the |
20 | | amount of premiums saved by use of the invalid, false, or |
21 | | counterfeit certificate of insurance, the value of any |
22 | | payments under any contract obtained by reliance on the |
23 | | invalid, false, or counterfeit certificate of insurance, or |
24 | | both. Notwithstanding the foregoing, an injured worker, |
25 | | insurance company, self-insured entity, or any other person |
26 | | suffering financial loss sustained as a result of violation of |
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1 | | this subsection may seek restitution, including court costs |
2 | | and attorney's fees in a civil action in a court of competent |
3 | | jurisdiction. |
4 | | (c) The Department of Insurance shall establish a fraud |
5 | | and insurance non-compliance unit responsible for |
6 | | investigating incidences of fraud and insurance non-compliance |
7 | | pursuant to this Section. The size of the staff of the unit |
8 | | shall be subject to appropriation by the General Assembly. It |
9 | | shall be the duty of the fraud and insurance non-compliance |
10 | | unit to determine the identity of insurance carriers, |
11 | | employers, employees, or other persons or entities who have |
12 | | violated the fraud and insurance non-compliance provisions of |
13 | | this Section. The fraud and insurance non-compliance unit |
14 | | shall report violations of the fraud and insurance |
15 | | non-compliance provisions of this Section to the Special |
16 | | Prosecutions Bureau of the Criminal Division of the Office of |
17 | | the Attorney General or to the State's Attorney of the county |
18 | | in which the offense allegedly occurred, either of whom has |
19 | | the authority to prosecute violations under this Section. |
20 | | With respect to the subject of any investigation being |
21 | | conducted, the fraud and insurance non-compliance unit shall |
22 | | have the general power of subpoena of the Department of |
23 | | Insurance, including the authority to issue a subpoena to a |
24 | | medical provider, pursuant to Section 8-802 of the Code of |
25 | | Civil Procedure. |
26 | | (d) Any person may report allegations of insurance |
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1 | | non-compliance and fraud pursuant to this Section to the |
2 | | Department of Insurance's fraud and insurance non-compliance |
3 | | unit whose duty it shall be to investigate the report. The unit |
4 | | shall notify the Commission of reports of insurance |
5 | | non-compliance. Any person reporting an allegation of |
6 | | insurance non-compliance or fraud against either an employee |
7 | | or employer under this Section must identify himself. Except |
8 | | as provided in this subsection and in subsection (e), all |
9 | | reports shall remain confidential except to refer an |
10 | | investigation to the Attorney General or State's Attorney for |
11 | | prosecution or if the fraud and insurance non-compliance |
12 | | unit's investigation reveals that the conduct reported may be |
13 | | in violation of other laws or regulations of the State of |
14 | | Illinois, the unit may report such conduct to the appropriate |
15 | | governmental agency charged with administering such laws and |
16 | | regulations. Any person who intentionally makes a false report |
17 | | under this Section to the fraud and insurance non-compliance |
18 | | unit is guilty of a Class A misdemeanor. |
19 | | (e) In order for the fraud and insurance non-compliance |
20 | | unit to investigate a report of fraud related to an employee's |
21 | | claim, (i) the employee must have filed with the Commission an |
22 | | Application for Adjustment of Claim and the employee must have |
23 | | either received or attempted to receive benefits under this |
24 | | Act that are related to the reported fraud or (ii) the employee |
25 | | must have made a written demand for the payment of benefits |
26 | | that are related to the reported fraud. There shall be no |
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1 | | immunity, under this Act or otherwise, for any person who |
2 | | files a false report or who files a report without good and |
3 | | just cause. Confidentiality of medical information shall be |
4 | | strictly maintained. Investigations that are not referred for |
5 | | prosecution shall be destroyed upon the expiration of the |
6 | | statute of limitations for the acts under investigation and |
7 | | shall not be disclosed except that the person making the |
8 | | report shall be notified that the investigation is being |
9 | | closed. It is unlawful for any employer, insurance carrier, |
10 | | service adjustment company, third party administrator, |
11 | | self-insured, or similar entity to file or threaten to file a |
12 | | report of fraud against an employee because of the exercise by |
13 | | the employee of the rights and remedies granted to the |
14 | | employee by this Act. |
15 | | (e-5) (Blank). |
16 | | (f) Any person convicted of fraud related to workers' |
17 | | compensation pursuant to this Section shall be subject to the |
18 | | penalties prescribed in the Criminal Code of 2012 and shall be |
19 | | ineligible to receive or retain any compensation, disability, |
20 | | or medical benefits as defined in this Act if the |
21 | | compensation, disability, or medical benefits were owed or |
22 | | received as a result of fraud for which the recipient of the |
23 | | compensation, disability, or medical benefit was convicted. |
24 | | This subsection applies to accidental injuries or diseases |
25 | | that occur on or after the effective date of this amendatory |
26 | | Act of the 94th General Assembly. |
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1 | | (g) Civil liability. Any person convicted of fraud who |
2 | | knowingly obtains, attempts to obtain, or causes to be |
3 | | obtained any benefits under this Act by the making of a false |
4 | | claim or who knowingly misrepresents any material fact shall |
5 | | be civilly liable to the payor of benefits or the insurer or |
6 | | the payor's or insurer's subrogee or assignee in an amount |
7 | | equal to 3 times the value of the benefits or insurance |
8 | | coverage wrongfully obtained or twice the value of the |
9 | | benefits or insurance coverage attempted to be obtained, plus |
10 | | reasonable attorney's fees and expenses incurred by the payor |
11 | | or the payor's subrogee or assignee who successfully brings a |
12 | | claim under this subsection. This subsection applies to |
13 | | accidental injuries or diseases that occur on or after the |
14 | | effective date of this amendatory Act of the 94th General |
15 | | Assembly. |
16 | | (h) The fraud and insurance non-compliance unit shall |
17 | | submit a written report on an annual basis to the Chairman of |
18 | | the Commission, the Workers' Compensation Advisory Board, the |
19 | | General Assembly, the Governor, and the Attorney General by |
20 | | January 1 and July 1 of each year. This report shall include, |
21 | | at the minimum, the following information: |
22 | | (1) The number of allegations of insurance |
23 | | non-compliance and fraud reported to the fraud and |
24 | | insurance non-compliance unit. |
25 | | (2) The source of the reported allegations |
26 | | (individual, employer, or other). |
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1 | | (3) The number of allegations investigated by the |
2 | | fraud and insurance non-compliance unit. |
3 | | (4) The number of criminal referrals made in |
4 | | accordance with this Section and the entity to which the |
5 | | referral was made. |
6 | | (5) All proceedings under this Section. |
7 | | (6) Recommendations regarding opportunities for |
8 | | additional fraud detection. |
9 | | (Source: P.A. 102-37, eff. 7-1-21.) |
10 | | Section 99. Effective date. This Act takes effect upon |
11 | | becoming law. |