99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4223

 

Introduced , by Rep. Jim Durkin

 

SYNOPSIS AS INTRODUCED:
 
820 ILCS 305/1  from Ch. 48, par. 138.1
820 ILCS 305/4  from Ch. 48, par. 138.4
820 ILCS 305/8  from Ch. 48, par. 138.8
820 ILCS 305/8.1b
820 ILCS 305/8.2
820 ILCS 305/8.2a
820 ILCS 305/14  from Ch. 48, par. 138.14
820 ILCS 305/19  from Ch. 48, par. 138.19

    Amends the Workers' Compensation Act. Provides that to obtain compensation, an employee has the burden of showing by a preponderance of the evidence that the accidental injury arising out of the course of employment is the major contributing cause of the medical condition or injury for which compensation is sought. Excludes from "arising out of the course of employment" injuries resulting from a hazard or risk to which the general public is also exposed or a medical condition or disability resulting from a personal or neutral risk. Provides that "major contributing cause" of a medical condition or injury is the cause that is greater than 50% of all combined causes of the medical condition or injury. Applies that standard to repetitive injuries. Reduces employer liability for injuries incurred while traveling. Provides for a reduction in an award by amounts an injured worker has previously received for prior injuries that resulted in permanency awards. Reduces certain payments under fee schedules to 49% of the scheduled amount after January 1, 2016. Provides that the Illinois Workers' Compensation Commission, rather than the Director of Insurance, shall adopt rules regarding electronic claims. Makes other changes.


LRB099 12524 JLS 35982 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4223LRB099 12524 JLS 35982 b

1    AN ACT concerning employment.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Workers' Compensation Act is amended by
5changing Sections 1, 4, 8, 8.1b, 8.2, 8.2a, 14, and 19 as
6follows:
 
7    (820 ILCS 305/1)  (from Ch. 48, par. 138.1)
8    Sec. 1. This Act may be cited as the Workers' Compensation
9Act.
10    (a) The term "employer" as used in this Act means:
11    1. The State and each county, city, town, township,
12incorporated village, school district, body politic, or
13municipal corporation therein.
14    2. Every person, firm, public or private corporation,
15including hospitals, public service, eleemosynary, religious
16or charitable corporations or associations who has any person
17in service or under any contract for hire, express or implied,
18oral or written, and who is engaged in any of the enterprises
19or businesses enumerated in Section 3 of this Act, or who at or
20prior to the time of the accident to the employee for which
21compensation under this Act may be claimed, has in the manner
22provided in this Act elected to become subject to the
23provisions of this Act, and who has not, prior to such

 

 

HB4223- 2 -LRB099 12524 JLS 35982 b

1accident, effected a withdrawal of such election in the manner
2provided in this Act.
3    3. Any one engaging in any business or enterprise referred
4to in subsections 1 and 2 of Section 3 of this Act who
5undertakes to do any work enumerated therein, is liable to pay
6compensation to his own immediate employees in accordance with
7the provisions of this Act, and in addition thereto if he
8directly or indirectly engages any contractor whether
9principal or sub-contractor to do any such work, he is liable
10to pay compensation to the employees of any such contractor or
11sub-contractor unless such contractor or sub-contractor has
12insured, in any company or association authorized under the
13laws of this State to insure the liability to pay compensation
14under this Act, or guaranteed his liability to pay such
15compensation. With respect to any time limitation on the filing
16of claims provided by this Act, the timely filing of a claim
17against a contractor or subcontractor, as the case may be,
18shall be deemed to be a timely filing with respect to all
19persons upon whom liability is imposed by this paragraph.
20    In the event any such person pays compensation under this
21subsection he may recover the amount thereof from the
22contractor or sub-contractor, if any, and in the event the
23contractor pays compensation under this subsection he may
24recover the amount thereof from the sub-contractor, if any.
25    This subsection does not apply in any case where the
26accident occurs elsewhere than on, in or about the immediate

 

 

HB4223- 3 -LRB099 12524 JLS 35982 b

1premises on which the principal has contracted that the work be
2done.
3    4. Where an employer operating under and subject to the
4provisions of this Act loans an employee to another such
5employer and such loaned employee sustains a compensable
6accidental injury in the employment of such borrowing employer
7and where such borrowing employer does not provide or pay the
8benefits or payments due such injured employee, such loaning
9employer is liable to provide or pay all benefits or payments
10due such employee under this Act and as to such employee the
11liability of such loaning and borrowing employers is joint and
12several, provided that such loaning employer is in the absence
13of agreement to the contrary entitled to receive from such
14borrowing employer full reimbursement for all sums paid or
15incurred pursuant to this paragraph together with reasonable
16attorneys' fees and expenses in any hearings before the
17Illinois Workers' Compensation Commission or in any action to
18secure such reimbursement. Where any benefit is provided or
19paid by such loaning employer the employee has the duty of
20rendering reasonable cooperation in any hearings, trials or
21proceedings in the case, including such proceedings for
22reimbursement.
23    Where an employee files an Application for Adjustment of
24Claim with the Illinois Workers' Compensation Commission
25alleging that his claim is covered by the provisions of the
26preceding paragraph, and joining both the alleged loaning and

 

 

HB4223- 4 -LRB099 12524 JLS 35982 b

1borrowing employers, they and each of them, upon written demand
2by the employee and within 7 days after receipt of such demand,
3shall have the duty of filing with the Illinois Workers'
4Compensation Commission a written admission or denial of the
5allegation that the claim is covered by the provisions of the
6preceding paragraph and in default of such filing or if any
7such denial be ultimately determined not to have been bona fide
8then the provisions of Paragraph K of Section 19 of this Act
9shall apply.
10    An employer whose business or enterprise or a substantial
11part thereof consists of hiring, procuring or furnishing
12employees to or for other employers operating under and subject
13to the provisions of this Act for the performance of the work
14of such other employers and who pays such employees their
15salary or wages notwithstanding that they are doing the work of
16such other employers shall be deemed a loaning employer within
17the meaning and provisions of this Section.
18    (b) The term "employee" as used in this Act means:
19    1. Every person in the service of the State, including
20members of the General Assembly, members of the Commerce
21Commission, members of the Illinois Workers' Compensation
22Commission, and all persons in the service of the University of
23Illinois, county, including deputy sheriffs and assistant
24state's attorneys, city, town, township, incorporated village
25or school district, body politic, or municipal corporation
26therein, whether by election, under appointment or contract of

 

 

HB4223- 5 -LRB099 12524 JLS 35982 b

1hire, express or implied, oral or written, including all
2members of the Illinois National Guard while on active duty in
3the service of the State, and all probation personnel of the
4Juvenile Court appointed pursuant to Article VI of the Juvenile
5Court Act of 1987, and including any official of the State, any
6county, city, town, township, incorporated village, school
7district, body politic or municipal corporation therein except
8any duly appointed member of a police department in any city
9whose population exceeds 500,000 according to the last Federal
10or State census, and except any member of a fire insurance
11patrol maintained by a board of underwriters in this State. A
12duly appointed member of a fire department in any city, the
13population of which exceeds 500,000 according to the last
14federal or State census, is an employee under this Act only
15with respect to claims brought under paragraph (c) of Section
168.
17    One employed by a contractor who has contracted with the
18State, or a county, city, town, township, incorporated village,
19school district, body politic or municipal corporation
20therein, through its representatives, is not considered as an
21employee of the State, county, city, town, township,
22incorporated village, school district, body politic or
23municipal corporation which made the contract.
24    2. Every person in the service of another under any
25contract of hire, express or implied, oral or written,
26including persons whose employment is outside of the State of

 

 

HB4223- 6 -LRB099 12524 JLS 35982 b

1Illinois where the contract of hire is made within the State of
2Illinois, persons whose employment results in fatal or
3non-fatal injuries within the State of Illinois where the
4contract of hire is made outside of the State of Illinois, and
5persons whose employment is principally localized within the
6State of Illinois, regardless of the place of the accident or
7the place where the contract of hire was made, and including
8aliens, and minors who, for the purpose of this Act are
9considered the same and have the same power to contract,
10receive payments and give quittances therefor, as adult
11employees.
12    3. Every sole proprietor and every partner of a business
13may elect to be covered by this Act.
14    An employee or his dependents under this Act who shall have
15a cause of action by reason of any injury, disablement or death
16arising out of and in the course of his employment may elect to
17pursue his remedy in the State where injured or disabled, or in
18the State where the contract of hire is made, or in the State
19where the employment is principally localized.
20    However, any employer may elect to provide and pay
21compensation to any employee other than those engaged in the
22usual course of the trade, business, profession or occupation
23of the employer by complying with Sections 2 and 4 of this Act.
24Employees are not included within the provisions of this Act
25when excluded by the laws of the United States relating to
26liability of employers to their employees for personal injuries

 

 

HB4223- 7 -LRB099 12524 JLS 35982 b

1where such laws are held to be exclusive.
2    The term "employee" does not include persons performing
3services as real estate broker, broker-salesman, or salesman
4when such persons are paid by commission only.
5    (c) "Commission" means the Industrial Commission created
6by Section 5 of "The Civil Administrative Code of Illinois",
7approved March 7, 1917, as amended, or the Illinois Workers'
8Compensation Commission created by Section 13 of this Act.
9    (d) (1) To obtain compensation under this Act, an employee
10bears the burden of showing, by a preponderance of the credible
11evidence, that (i) he or she has sustained accidental injuries
12arising out of and in the course of the employment and (ii) the
13accidental injuries arising out of and in the course of the
14employment are the major contributing cause of the medical
15condition or injury for which compensation is being sought.
16    The "major contributing cause" of a medical condition or
17injury is the cause that is greater than 50% of all combined
18causes of the medical condition or injury.
19    Accidental injuries shall not be considered to be "arising
20out of and in the course of employment" if, without limitation:
21(A) the accident resulted from a hazard or risk that was not
22incidental to the employment or the accident resulted from a
23hazard or risk to which the general public is also exposed, (B)
24the accident did not occur at a time and place and under
25circumstances reasonably required by the employment, or (C) the
26medical condition or injury for which compensation is being

 

 

HB4223- 8 -LRB099 12524 JLS 35982 b

1sought resulted from a personal or neutral risk.
2    (2) For the purposes of clause (ii) of paragraph (1) only,
3if an employee has suffered cumulative or repetitive accidental
4injuries while employed in the same occupation or industry by
5multiple employers over time, the accidental injuries arising
6out of and in the course of the employment shall be considered
7to be the major contributing cause of the medical condition or
8injury for which compensation is being sought if those
9cumulative or repetitive accidental injuries suffered during
10employment in that occupation or industry are greater than 50%
11of all combined causes of the medical condition or injury. In
12that circumstance, the employer liable for compensation under
13this Act shall be the most recent current or former employer
14who has employed the employee for at least 3 months.
15    (3) An injury, its occupational cause, and any resulting
16manifestations or disability must be established to a
17reasonable degree of medical certainty, based on objective
18relevant medical findings.
19    (e) An employee who is required to travel in connection
20with his or her employment and who suffers an injury while in
21travel status shall be eligible for benefits only if the injury
22arises out of and in the course of employment and the travel is
23necessary for the performance of job duties. Travel is
24necessary for the performance of job duties if (i) the employer
25furnishes the transportation or the employee receives
26reimbursement from the employer for costs of travel, gas, or

 

 

HB4223- 9 -LRB099 12524 JLS 35982 b

1lodging as part of the employee's benefits or employment
2agreement and (ii) travel is required by the employer as part
3of the employee's job duties.
4    An injury suffered by a traveling employee is deemed to
5arise out of his or her employment if caused by a risk
6incidental to or connected with the employment. Risk is not to
7be determined by a reasonable and foreseeable standard.
8    Arising in and out of the course of employment does not
9include travel to and from work or when an employee is on a
10paid or unpaid break and is not performing any specific tasks
11for the employer during the break. Common risks associated with
12travel even where the traveling employee is exposed to a
13greater degree than the general public do not arise out of the
14employment.
15(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,
16eff. 7-13-12.)
 
17    (820 ILCS 305/4)  (from Ch. 48, par. 138.4)
18    Sec. 4. (a) Any employer, including but not limited to
19general contractors and their subcontractors, who shall come
20within the provisions of Section 3 of this Act, and any other
21employer who shall elect to provide and pay the compensation
22provided for in this Act shall:
23        (1) File with the Commission annually an application
24    for approval as a self-insurer which shall include a
25    current financial statement, and annually, thereafter, an

 

 

HB4223- 10 -LRB099 12524 JLS 35982 b

1    application for renewal of self-insurance, which shall
2    include a current financial statement. Said application
3    and financial statement shall be signed and sworn to by the
4    president or vice president and secretary or assistant
5    secretary of the employer if it be a corporation, or by all
6    of the partners, if it be a copartnership, or by the owner
7    if it be neither a copartnership nor a corporation. All
8    initial applications and all applications for renewal of
9    self-insurance must be submitted at least 60 days prior to
10    the requested effective date of self-insurance. An
11    employer may elect to provide and pay compensation as
12    provided for in this Act as a member of a group workers'
13    compensation pool under Article V 3/4 of the Illinois
14    Insurance Code. If an employer becomes a member of a group
15    workers' compensation pool, the employer shall not be
16    relieved of any obligations imposed by this Act.
17        If the sworn application and financial statement of any
18    such employer does not satisfy the Commission of the
19    financial ability of the employer who has filed it, the
20    Commission shall require such employer to,
21        (2) Furnish security, indemnity or a bond guaranteeing
22    the payment by the employer of the compensation provided
23    for in this Act, provided that any such employer whose
24    application and financial statement shall not have
25    satisfied the commission of his or her financial ability
26    and who shall have secured his liability in part by excess

 

 

HB4223- 11 -LRB099 12524 JLS 35982 b

1    workers' compensation liability insurance shall be
2    required to furnish to the Commission security, indemnity
3    or bond guaranteeing his or her payment up to the effective
4    limits of the excess coverage, or
5        (3) Insure his entire liability to pay such
6    compensation in some workers' compensation insurance
7    carrier authorized, licensed, or permitted to do such
8    insurance business in this State. Every policy of a
9    workers' compensation an insurance carrier, insuring the
10    payment of compensation under this Act shall cover all the
11    employees and the entire compensation liability of the
12    insured: Provided, however, that any employer may insure
13    his or her compensation liability with 2 or more workers'
14    compensation insurance carriers or may insure a part and
15    qualify under subsection 1, 2, or 4 for the remainder of
16    his or her liability to pay such compensation, subject to
17    the following two provisions:
18            Firstly, the entire compensation liability of the
19        employer to employees working at or from one location
20        shall be insured in one such workers' compensation
21        insurance carrier or shall be self-insured, and
22            Secondly, the employer shall submit evidence
23        satisfactorily to the Commission that his or her entire
24        liability for the compensation provided for in this Act
25        will be secured. Any provisions in any policy, or in
26        any endorsement attached thereto, attempting to limit

 

 

HB4223- 12 -LRB099 12524 JLS 35982 b

1        or modify in any way, the liability of the workers'
2        compensation insurance carriers issuing the same
3        except as otherwise provided herein shall be wholly
4        void.
5        Nothing herein contained shall apply to policies of
6    excess liability carriage secured by employers who have
7    been approved by the Commission as self-insurers, or
8        (4) Make some other provision, satisfactory to the
9    Commission, for the securing of the payment of compensation
10    provided for in this Act, and
11        (5) Upon becoming subject to this Act and thereafter as
12    often as the Commission may in writing demand, file with
13    the Commission in form prescribed by it evidence of his or
14    her compliance with the provision of this Section.
15    (a-1) Regardless of its state of domicile or its principal
16place of business, an employer shall make payments to its
17workers' compensation insurance carrier or group
18self-insurance fund, where applicable, based upon the premium
19rates of the situs where the work or project is located in
20Illinois if:
21        (A) the employer is engaged primarily in the building
22    and construction industry; and
23        (B) subdivision (a)(3) of this Section applies to the
24    employer or the employer is a member of a group
25    self-insurance plan as defined in subsection (1) of Section
26    4a.

 

 

HB4223- 13 -LRB099 12524 JLS 35982 b

1    The Illinois Workers' Compensation Commission shall impose
2a penalty upon an employer for violation of this subsection
3(a-1) if:
4        (i) the employer is given an opportunity at a hearing
5    to present evidence of its compliance with this subsection
6    (a-1); and
7        (ii) after the hearing, the Commission finds that the
8    employer failed to make payments upon the premium rates of
9    the situs where the work or project is located in Illinois.
10    The penalty shall not exceed $1,000 for each day of work
11for which the employer failed to make payments upon the premium
12rates of the situs where the work or project is located in
13Illinois, but the total penalty shall not exceed $50,000 for
14each project or each contract under which the work was
15performed.
16    Any penalty under this subsection (a-1) must be imposed not
17later than one year after the expiration of the applicable
18limitation period specified in subsection (d) of Section 6 of
19this Act. Penalties imposed under this subsection (a-1) shall
20be deposited into the Illinois Workers' Compensation
21Commission Operations Fund, a special fund that is created in
22the State treasury. Subject to appropriation, moneys in the
23Fund shall be used solely for the operations of the Illinois
24Workers' Compensation Commission and by the Department of
25Insurance for the purposes authorized in subsection (c) of
26Section 25.5 of this Act.

 

 

HB4223- 14 -LRB099 12524 JLS 35982 b

1    (a-2) Every Employee Leasing Company (ELC), as defined in
2Section 15 of the Employee Leasing Company Act, shall at a
3minimum provide the following information to the Commission or
4any entity designated by the Commission regarding each workers'
5compensation insurance policy issued to the ELC:
6        (1) Any client company of the ELC listed as an
7    additional named insured.
8        (2) Any informational schedule attached to the master
9    policy that identifies any individual client company's
10    name, FEIN, and job location.
11        (3) Any certificate of workers' compensation insurance
12    coverage document issued to a client company specifying its
13    rights and obligations under the master policy that
14    establishes both the identity and status of the client, as
15    well as the dates of inception and termination of coverage,
16    if applicable.
17    (b) The sworn application and financial statement, or
18security, indemnity or bond, or amount of insurance, or other
19provisions, filed, furnished, carried, or made by the employer,
20as the case may be, shall be subject to the approval of the
21Commission.
22    Deposits under escrow agreements shall be cash, negotiable
23United States government bonds or negotiable general
24obligation bonds of the State of Illinois. Such cash or bonds
25shall be deposited in escrow with any State or National Bank or
26Trust Company having trust authority in the State of Illinois.

 

 

HB4223- 15 -LRB099 12524 JLS 35982 b

1    Upon the approval of the sworn application and financial
2statement, security, indemnity or bond or amount of insurance,
3filed, furnished or carried, as the case may be, the Commission
4shall send to the employer written notice of its approval
5thereof. The certificate of compliance by the employer with the
6provisions of subparagraphs (2) and (3) of paragraph (a) of
7this Section shall be delivered by the workers' compensation
8insurance carrier to the Illinois Workers' Compensation
9Commission within five days after the effective date of the
10policy so certified. The workers' compensation insurance so
11certified shall cover all compensation liability occurring
12during the time that the insurance is in effect and no further
13certificate need be filed in case such insurance is renewed,
14extended or otherwise continued by such carrier. The insurance
15so certified shall not be cancelled or in the event that such
16insurance is not renewed, extended or otherwise continued, such
17insurance shall not be terminated until at least 10 days after
18receipt by the Illinois Workers' Compensation Commission of
19notice of the cancellation or termination of said insurance;
20provided, however, that if the employer has secured insurance
21from another workers' compensation insurance carrier, or has
22otherwise secured the payment of compensation in accordance
23with this Section, and such insurance or other security becomes
24effective prior to the expiration of the 10 days, cancellation
25or termination may, at the option of the insurance carrier
26indicated in such notice, be effective as of the effective date

 

 

HB4223- 16 -LRB099 12524 JLS 35982 b

1of such other insurance or security.
2    (c) Whenever the Commission shall find that any
3corporation, company, association, aggregation of individuals,
4reciprocal or interinsurers exchange, or other insurer
5effecting workers' compensation insurance in this State shall
6be insolvent, financially unsound, or unable to fully meet all
7payments and liabilities assumed or to be assumed for workers'
8compensation insurance in this State, or shall practice a
9policy of delay or unfairness toward employees in the
10adjustment, settlement, or payment of benefits due such
11employees, the Commission may after reasonable notice and
12hearing order and direct that such corporation, company,
13association, aggregation of individuals, reciprocal or
14interinsurers exchange, or insurer, shall from and after a date
15fixed in such order discontinue the writing of any such
16workers' compensation insurance in this State. Subject to such
17modification of the order as the Commission may later make on
18review of the order, as herein provided, it shall thereupon be
19unlawful for any such corporation, company, association,
20aggregation of individuals, reciprocal or interinsurers
21exchange, or insurer to effect any workers' compensation
22insurance in this State. A copy of the order shall be served
23upon the Director of Insurance by registered mail. Whenever the
24Commission finds that any service or adjustment company used or
25employed by a self-insured employer or by an insurance carrier
26to process, adjust, investigate, compromise or otherwise

 

 

HB4223- 17 -LRB099 12524 JLS 35982 b

1handle claims under this Act, has practiced or is practicing a
2policy of delay or unfairness toward employees in the
3adjustment, settlement or payment of benefits due such
4employees, the Commission may after reasonable notice and
5hearing order and direct that such service or adjustment
6company shall from and after a date fixed in such order be
7prohibited from processing, adjusting, investigating,
8compromising or otherwise handling claims under this Act.
9    Whenever the Commission finds that any self-insured
10employer has practiced or is practicing delay or unfairness
11toward employees in the adjustment, settlement or payment of
12benefits due such employees, the Commission may, after
13reasonable notice and hearing, order and direct that after a
14date fixed in the order such self-insured employer shall be
15disqualified to operate as a self-insurer and shall be required
16to insure his entire liability to pay compensation in some
17workers' compensation insurance carrier authorized, licensed
18and permitted to do such insurance business in this State, as
19provided in subparagraph 3 of paragraph (a) of this Section.
20    All orders made by the Commission under this Section shall
21be subject to review by the courts, said review to be taken in
22the same manner and within the same time as provided by Section
2319 of this Act for review of awards and decisions of the
24Commission, upon the party seeking the review filing with the
25clerk of the court to which said review is taken a bond in an
26amount to be fixed and approved by the court to which the

 

 

HB4223- 18 -LRB099 12524 JLS 35982 b

1review is taken, conditioned upon the payment of all
2compensation awarded against the person taking said review
3pending a decision thereof and further conditioned upon such
4other obligations as the court may impose. Upon the review the
5Circuit Court shall have power to review all questions of fact
6as well as of law. The penalty hereinafter provided for in this
7paragraph shall not attach and shall not begin to run until the
8final determination of the order of the Commission.
9    (d) Whenever a panel of 3 Commissioners comprised of one
10member of the employing class, one member of the employee
11class, and one member not identified with either the employing
12or employee class, with due process and after a hearing,
13determines an employer has knowingly failed to provide coverage
14as required by paragraph (a) of this Section, the failure shall
15be deemed an immediate serious danger to public health, safety,
16and welfare sufficient to justify service by the Commission of
17a work-stop order on such employer, requiring the cessation of
18all business operations of such employer at the place of
19employment or job site. Any law enforcement agency in the State
20shall, at the request of the Commission, render any assistance
21necessary to carry out the provisions of this Section,
22including, but not limited to, preventing any employee of such
23employer from remaining at a place of employment or job site
24after a work-stop order has taken effect. Any work-stop order
25shall be lifted upon proof of workers' compensation insurance
26as required by this Act. Any orders under this Section are

 

 

HB4223- 19 -LRB099 12524 JLS 35982 b

1appealable under Section 19(f) to the Circuit Court.
2    Any individual employer, corporate officer or director of a
3corporate employer, partner of an employer partnership, or
4member of an employer limited liability company who knowingly
5fails to provide coverage as required by paragraph (a) of this
6Section is guilty of a Class 4 felony. This provision shall not
7apply to any corporate officer or director of any
8publicly-owned corporation. Each day's violation constitutes a
9separate offense. The State's Attorney of the county in which
10the violation occurred, or the Attorney General, shall bring
11such actions in the name of the People of the State of
12Illinois, or may, in addition to other remedies provided in
13this Section, bring an action for an injunction to restrain the
14violation or to enjoin the operation of any such employer.
15    Any individual employer, corporate officer or director of a
16corporate employer, partner of an employer partnership, or
17member of an employer limited liability company who negligently
18fails to provide coverage as required by paragraph (a) of this
19Section is guilty of a Class A misdemeanor. This provision
20shall not apply to any corporate officer or director of any
21publicly-owned corporation. Each day's violation constitutes a
22separate offense. The State's Attorney of the county in which
23the violation occurred, or the Attorney General, shall bring
24such actions in the name of the People of the State of
25Illinois.
26    The criminal penalties in this subsection (d) shall not

 

 

HB4223- 20 -LRB099 12524 JLS 35982 b

1apply where there exists a good faith dispute as to the
2existence of an employment relationship. Evidence of good faith
3shall include, but not be limited to, compliance with the
4definition of employee as used by the Internal Revenue Service.
5    Employers who are subject to and who knowingly fail to
6comply with this Section shall not be entitled to the benefits
7of this Act during the period of noncompliance, but shall be
8liable in an action under any other applicable law of this
9State. In the action, such employer shall not avail himself or
10herself of the defenses of assumption of risk or negligence or
11that the injury was due to a co-employee. In the action, proof
12of the injury shall constitute prima facie evidence of
13negligence on the part of such employer and the burden shall be
14on such employer to show freedom of negligence resulting in the
15injury. The employer shall not join any other defendant in any
16such civil action. Nothing in this amendatory Act of the 94th
17General Assembly shall affect the employee's rights under
18subdivision (a)3 of Section 1 of this Act. Any employer or
19carrier who makes payments under subdivision (a)3 of Section 1
20of this Act shall have a right of reimbursement from the
21proceeds of any recovery under this Section.
22    An employee of an uninsured employer, or the employee's
23dependents in case death ensued, may, instead of proceeding
24against the employer in a civil action in court, file an
25application for adjustment of claim with the Commission in
26accordance with the provisions of this Act and the Commission

 

 

HB4223- 21 -LRB099 12524 JLS 35982 b

1shall hear and determine the application for adjustment of
2claim in the manner in which other claims are heard and
3determined before the Commission.
4    All proceedings under this subsection (d) shall be reported
5on an annual basis to the Workers' Compensation Advisory Board.
6    An investigator with the Illinois Workers' Compensation
7Commission Insurance Compliance Division may issue a citation
8to any employer that is not in compliance with its obligation
9to have workers' compensation insurance under this Act. The
10amount of the fine shall be based on the period of time the
11employer was in non-compliance, but shall be no less than $500,
12and shall not exceed $2,500. An employer that has been issued a
13citation shall pay the fine to the Commission and provide to
14the Commission proof that it obtained the required workers'
15compensation insurance within 10 days after the citation was
16issued. This Section does not affect any other obligations this
17Act imposes on employers.
18    Upon a finding by the Commission, after reasonable notice
19and hearing, of the knowing and wilful failure or refusal of an
20employer to comply with any of the provisions of paragraph (a)
21of this Section, the failure or refusal of an employer, service
22or adjustment company, or an insurance carrier to comply with
23any order of the Illinois Workers' Compensation Commission
24pursuant to paragraph (c) of this Section disqualifying him or
25her to operate as a self insurer and requiring him or her to
26insure his or her liability, or the knowing and willful failure

 

 

HB4223- 22 -LRB099 12524 JLS 35982 b

1of an employer to comply with a citation issued by an
2investigator with the Illinois Workers' Compensation
3Commission Insurance Compliance Division, the Commission may
4assess a civil penalty of up to $500 per day for each day of
5such failure or refusal after the effective date of this
6amendatory Act of 1989. The minimum penalty under this Section
7shall be the sum of $10,000. Each day of such failure or
8refusal shall constitute a separate offense. The Commission may
9assess the civil penalty personally and individually against
10the corporate officers and directors of a corporate employer,
11the partners of an employer partnership, and the members of an
12employer limited liability company, after a finding of a
13knowing and willful refusal or failure of each such named
14corporate officer, director, partner, or member to comply with
15this Section. The liability for the assessed penalty shall be
16against the named employer first, and if the named employer
17fails or refuses to pay the penalty to the Commission within 30
18days after the final order of the Commission, then the named
19corporate officers, directors, partners, or members who have
20been found to have knowingly and willfully refused or failed to
21comply with this Section shall be liable for the unpaid penalty
22or any unpaid portion of the penalty. Upon investigation by the
23insurance non-compliance unit of the Commission, the Attorney
24General shall have the authority to prosecute all proceedings
25to enforce the civil and administrative provisions of this
26Section before the Commission. The Commission shall promulgate

 

 

HB4223- 23 -LRB099 12524 JLS 35982 b

1procedural rules for enforcing this Section.
2    Upon the failure or refusal of any employer, service or
3adjustment company or insurance carrier to comply with the
4provisions of this Section and with the orders of the
5Commission under this Section, or the order of the court on
6review after final adjudication, the Commission may bring a
7civil action to recover the amount of the penalty in Cook
8County or in Sangamon County in which litigation the Commission
9shall be represented by the Attorney General. The Commission
10shall send notice of its finding of non-compliance and
11assessment of the civil penalty to the Attorney General. It
12shall be the duty of the Attorney General within 30 days after
13receipt of the notice, to institute prosecutions and promptly
14prosecute all reported violations of this Section.
15    Any individual employer, corporate officer or director of a
16corporate employer, partner of an employer partnership, or
17member of an employer limited liability company who, with the
18intent to avoid payment of compensation under this Act to an
19injured employee or the employee's dependents, knowingly
20transfers, sells, encumbers, assigns, or in any manner disposes
21of, conceals, secretes, or destroys any property belonging to
22the employer, officer, director, partner, or member is guilty
23of a Class 4 felony.
24    Penalties and fines collected pursuant to this paragraph
25(d) shall be deposited upon receipt into a special fund which
26shall be designated the Injured Workers' Benefit Fund, of which

 

 

HB4223- 24 -LRB099 12524 JLS 35982 b

1the State Treasurer is ex-officio custodian, such special fund
2to be held and disbursed in accordance with this paragraph (d)
3for the purposes hereinafter stated in this paragraph (d), upon
4the final order of the Commission. The Injured Workers' Benefit
5Fund shall be deposited the same as are State funds and any
6interest accruing thereon shall be added thereto every 6
7months. The Injured Workers' Benefit Fund is subject to audit
8the same as State funds and accounts and is protected by the
9general bond given by the State Treasurer. The Injured Workers'
10Benefit Fund is considered always appropriated for the purposes
11of disbursements as provided in this paragraph, and shall be
12paid out and disbursed as herein provided and shall not at any
13time be appropriated or diverted to any other use or purpose.
14Moneys in the Injured Workers' Benefit Fund shall be used only
15for payment of workers' compensation benefits for injured
16employees when the employer has failed to provide coverage as
17determined under this paragraph (d) and has failed to pay the
18benefits due to the injured employee. The Commission shall have
19the right to obtain reimbursement from the employer for
20compensation obligations paid by the Injured Workers' Benefit
21Fund. Any such amounts obtained shall be deposited by the
22Commission into the Injured Workers' Benefit Fund. If an
23injured employee or his or her personal representative receives
24payment from the Injured Workers' Benefit Fund, the State of
25Illinois has the same rights under paragraph (b) of Section 5
26that the employer who failed to pay the benefits due to the

 

 

HB4223- 25 -LRB099 12524 JLS 35982 b

1injured employee would have had if the employer had paid those
2benefits, and any moneys recovered by the State as a result of
3the State's exercise of its rights under paragraph (b) of
4Section 5 shall be deposited into the Injured Workers' Benefit
5Fund. The custodian of the Injured Workers' Benefit Fund shall
6be joined with the employer as a party respondent in the
7application for adjustment of claim. After July 1, 2006, the
8Commission shall make disbursements from the Fund once each
9year to each eligible claimant. An eligible claimant is an
10injured worker who has within the previous fiscal year obtained
11a final award for benefits from the Commission against the
12employer and the Injured Workers' Benefit Fund and has notified
13the Commission within 90 days of receipt of such award. Within
14a reasonable time after the end of each fiscal year, the
15Commission shall make a disbursement to each eligible claimant.
16At the time of disbursement, if there are insufficient moneys
17in the Fund to pay all claims, each eligible claimant shall
18receive a pro-rata share, as determined by the Commission, of
19the available moneys in the Fund for that year. Payment from
20the Injured Workers' Benefit Fund to an eligible claimant
21pursuant to this provision shall discharge the obligations of
22the Injured Workers' Benefit Fund regarding the award entered
23by the Commission.
24    (e) This Act shall not affect or disturb the continuance of
25any existing workers' compensation insurance, mutual aid,
26benefit, or relief association or department, whether

 

 

HB4223- 26 -LRB099 12524 JLS 35982 b

1maintained in whole or in part by the employer or whether
2maintained by the employees, the payment of benefits of such
3association or department being guaranteed by the employer or
4by some person, firm or corporation for him or her: Provided,
5the employer contributes to such association or department an
6amount not less than the full compensation herein provided,
7exclusive of the cost of the maintenance of such association or
8department and without any expense to the employee. This Act
9shall not prevent the organization and maintaining under the
10insurance laws of this State of any benefit or insurance
11company for the purpose of insuring against the compensation
12provided for in this Act, the expense of which is maintained by
13the employer. This Act shall not prevent the organization or
14maintaining under the insurance laws of this State of any
15voluntary mutual aid, benefit or relief association among
16employees for the payment of additional accident or sick
17benefits.
18    (f) No existing workers' compensation insurance, mutual
19aid, benefit or relief association or department shall, by
20reason of anything herein contained, be authorized to
21discontinue its operation without first discharging its
22obligations to any and all persons carrying insurance in the
23same or entitled to relief or benefits therein.
24    (g) Any contract, oral, written or implied, of employment
25providing for relief benefit, or workers' compensation
26insurance or any other device whereby the employee is required

 

 

HB4223- 27 -LRB099 12524 JLS 35982 b

1to pay any premium or premiums for insurance against the
2compensation provided for in this Act shall be null and void.
3Any employer withholding from the wages of any employee any
4amount for the purpose of paying any such premium shall be
5guilty of a Class B misdemeanor.
6    In the event the employer does not pay the compensation for
7which he or she is liable, then a workers' compensation an
8insurance company, association or insurer which may have
9insured such employer against such liability shall become
10primarily liable to pay to the employee, his or her personal
11representative or beneficiary the compensation required by the
12provisions of this Act to be paid by such employer. The
13insurance carrier may be made a party to the proceedings in
14which the employer is a party and an award may be entered
15jointly against the employer and the insurance carrier.
16    (h) It shall be unlawful for any employer, insurance
17company or service or adjustment company to interfere with,
18restrain or coerce an employee in any manner whatsoever in the
19exercise of the rights or remedies granted to him or her by
20this Act or to discriminate, attempt to discriminate, or
21threaten to discriminate against an employee in any way because
22of his or her exercise of the rights or remedies granted to him
23or her by this Act.
24    It shall be unlawful for any employer, individually or
25through any insurance company or service or adjustment company,
26to discharge or to threaten to discharge, or to refuse to

 

 

HB4223- 28 -LRB099 12524 JLS 35982 b

1rehire or recall to active service in a suitable capacity an
2employee because of the exercise of his or her rights or
3remedies granted to him or her by this Act.
4    (i) If an employer elects to obtain a life insurance policy
5on his employees, he may also elect to apply such benefits in
6satisfaction of all or a portion of the death benefits payable
7under this Act, in which case, the employer's compensation
8premium shall be reduced accordingly.
9    (j) Within 45 days of receipt of an initial application or
10application to renew self-insurance privileges the
11Self-Insurers Advisory Board shall review and submit for
12approval by the Chairman of the Commission recommendations of
13disposition of all initial applications to self-insure and all
14applications to renew self-insurance privileges filed by
15private self-insurers pursuant to the provisions of this
16Section and Section 4a-9 of this Act. Each private self-insurer
17shall submit with its initial and renewal applications the
18application fee required by Section 4a-4 of this Act.
19    The Chairman of the Commission shall promptly act upon all
20initial applications and applications for renewal in full
21accordance with the recommendations of the Board or, should the
22Chairman disagree with any recommendation of disposition of the
23Self-Insurer's Advisory Board, he shall within 30 days of
24receipt of such recommendation provide to the Board in writing
25the reasons supporting his decision. The Chairman shall also
26promptly notify the employer of his decision within 15 days of

 

 

HB4223- 29 -LRB099 12524 JLS 35982 b

1receipt of the recommendation of the Board.
2    If an employer is denied a renewal of self-insurance
3privileges pursuant to application it shall retain said
4privilege for 120 days after receipt of a notice of
5cancellation of the privilege from the Chairman of the
6Commission.
7    All orders made by the Chairman under this Section shall be
8subject to review by the courts, such review to be taken in the
9same manner and within the same time as provided by subsection
10(f) of Section 19 of this Act for review of awards and
11decisions of the Commission, upon the party seeking the review
12filing with the clerk of the court to which such review is
13taken a bond in an amount to be fixed and approved by the court
14to which the review is taken, conditioned upon the payment of
15all compensation awarded against the person taking such review
16pending a decision thereof and further conditioned upon such
17other obligations as the court may impose. Upon the review the
18Circuit Court shall have power to review all questions of fact
19as well as of law.
20(Source: P.A. 97-18, eff. 6-28-11.)
 
21    (820 ILCS 305/8)  (from Ch. 48, par. 138.8)
22    Sec. 8. The amount of compensation which shall be paid to
23the employee for an accidental injury not resulting in death
24is:
25    (a) The employer shall provide and pay the negotiated rate,

 

 

HB4223- 30 -LRB099 12524 JLS 35982 b

1if applicable, or the lesser of the health care provider's
2actual charges or according to a fee schedule, subject to
3Section 8.2, in effect at the time the service was rendered for
4all the necessary first aid, medical and surgical services, and
5all necessary medical, surgical and hospital services
6thereafter incurred, limited, however, to that which is
7reasonably required to cure or relieve from the effects of the
8accidental injury, even if a health care provider sells,
9transfers, or otherwise assigns an account receivable for
10procedures, treatments, or services covered under this Act. If
11the employer does not dispute payment of first aid, medical,
12surgical, and hospital services, the employer shall make such
13payment to the provider on behalf of the employee. The employer
14shall also pay for treatment, instruction and training
15necessary for the physical, mental and vocational
16rehabilitation of the employee, including all maintenance
17costs and expenses incidental thereto. If as a result of the
18injury the employee is unable to be self-sufficient the
19employer shall further pay for such maintenance or
20institutional care as shall be required.
21    The employee may at any time elect to secure his own
22physician, surgeon and hospital services at the employer's
23expense, or,
24    Upon agreement between the employer and the employees, or
25the employees' exclusive representative, and subject to the
26approval of the Illinois Workers' Compensation Commission, the

 

 

HB4223- 31 -LRB099 12524 JLS 35982 b

1employer shall maintain a list of physicians, to be known as a
2Panel of Physicians, who are accessible to the employees. The
3employer shall post this list in a place or places easily
4accessible to his employees. The employee shall have the right
5to make an alternative choice of physician from such Panel if
6he is not satisfied with the physician first selected. If, due
7to the nature of the injury or its occurrence away from the
8employer's place of business, the employee is unable to make a
9selection from the Panel, the selection process from the Panel
10shall not apply. The physician selected from the Panel may
11arrange for any consultation, referral or other specialized
12medical services outside the Panel at the employer's expense.
13Provided that, in the event the Commission shall find that a
14doctor selected by the employee is rendering improper or
15inadequate care, the Commission may order the employee to
16select another doctor certified or qualified in the medical
17field for which treatment is required. If the employee refuses
18to make such change the Commission may relieve the employer of
19his obligation to pay the doctor's charges from the date of
20refusal to the date of compliance.
21    Any vocational rehabilitation counselors who provide
22service under this Act shall have appropriate certifications
23which designate the counselor as qualified to render opinions
24relating to vocational rehabilitation. Vocational
25rehabilitation may include, but is not limited to, counseling
26for job searches, supervising a job search program, and

 

 

HB4223- 32 -LRB099 12524 JLS 35982 b

1vocational retraining including education at an accredited
2learning institution. The employee or employer may petition to
3the Commission to decide disputes relating to vocational
4rehabilitation and the Commission shall resolve any such
5dispute, including payment of the vocational rehabilitation
6program by the employer.
7    The maintenance benefit shall not be less than the
8temporary total disability rate determined for the employee. In
9addition, maintenance shall include costs and expenses
10incidental to the vocational rehabilitation program.
11    When the employee is working light duty on a part-time
12basis or full-time basis and earns less than he or she would be
13earning if employed in the full capacity of the job or jobs,
14then the employee shall be entitled to temporary partial
15disability benefits. Temporary partial disability benefits
16shall be equal to two-thirds of the difference between the
17average amount that the employee would be able to earn in the
18full performance of his or her duties in the occupation in
19which he or she was engaged at the time of accident and the
20gross amount which he or she is earning in the modified job
21provided to the employee by the employer or in any other job
22that the employee is working.
23    Every hospital, physician, surgeon or other person
24rendering treatment or services in accordance with the
25provisions of this Section shall upon written request furnish
26full and complete reports thereof to, and permit their records

 

 

HB4223- 33 -LRB099 12524 JLS 35982 b

1to be copied by, the employer, the employee or his dependents,
2as the case may be, or any other party to any proceeding for
3compensation before the Commission, or their attorneys.
4    Notwithstanding the foregoing, the employer's liability to
5pay for such medical services selected by the employee shall be
6limited to:
7        (1) all first aid and emergency treatment; plus
8        (2) all medical, surgical and hospital services
9    provided by the physician, surgeon or hospital initially
10    chosen by the employee or by any other physician,
11    consultant, expert, institution or other provider of
12    services recommended by said initial service provider or
13    any subsequent provider of medical services in the chain of
14    referrals from said initial service provider; plus
15         (3) all medical, surgical and hospital services
16    provided by any second physician, surgeon or hospital
17    subsequently chosen by the employee or by any other
18    physician, consultant, expert, institution or other
19    provider of services recommended by said second service
20    provider or any subsequent provider of medical services in
21    the chain of referrals from said second service provider.
22    Thereafter the employer shall select and pay for all
23    necessary medical, surgical and hospital treatment and the
24    employee may not select a provider of medical services at
25    the employer's expense unless the employer agrees to such
26    selection. At any time the employee may obtain any medical

 

 

HB4223- 34 -LRB099 12524 JLS 35982 b

1    treatment he desires at his own expense. This paragraph
2    shall not affect the duty to pay for rehabilitation
3    referred to above.
4        (4) The following shall apply for injuries occurring on
5    or after June 28, 2011 (the effective date of Public Act
6    97-18) and only when an employer has an approved preferred
7    provider program pursuant to Section 8.1a on the date the
8    employee sustained his or her accidental injuries:
9            (A) The employer shall, in writing, on a form
10        promulgated by the Commission, inform the employee of
11        the preferred provider program;
12            (B) Subsequent to the report of an injury by an
13        employee, the employee may choose in writing at any
14        time to decline the preferred provider program, in
15        which case that would constitute one of the two choices
16        of medical providers to which the employee is entitled
17        under subsection (a)(2) or (a)(3); and
18            (C) Prior to the report of an injury by an
19        employee, when an employee chooses non-emergency
20        treatment from a provider not within the preferred
21        provider program, that would constitute the employee's
22        one choice of medical providers to which the employee
23        is entitled under subsection (a)(2) or (a)(3).
24    When an employer and employee so agree in writing, nothing
25in this Act prevents an employee whose injury or disability has
26been established under this Act, from relying in good faith, on

 

 

HB4223- 35 -LRB099 12524 JLS 35982 b

1treatment by prayer or spiritual means alone, in accordance
2with the tenets and practice of a recognized church or
3religious denomination, by a duly accredited practitioner
4thereof, and having nursing services appropriate therewith,
5without suffering loss or diminution of the compensation
6benefits under this Act. However, the employee shall submit to
7all physical examinations required by this Act. The cost of
8such treatment and nursing care shall be paid by the employee
9unless the employer agrees to make such payment.
10    Where the accidental injury results in the amputation of an
11arm, hand, leg or foot, or the enucleation of an eye, or the
12loss of any of the natural teeth, the employer shall furnish an
13artificial of any such members lost or damaged in accidental
14injury arising out of and in the course of employment, and
15shall also furnish the necessary braces in all proper and
16necessary cases. In cases of the loss of a member or members by
17amputation, the employer shall, whenever necessary, maintain
18in good repair, refit or replace the artificial limbs during
19the lifetime of the employee. Where the accidental injury
20accompanied by physical injury results in damage to a denture,
21eye glasses or contact eye lenses, or where the accidental
22injury results in damage to an artificial member, the employer
23shall replace or repair such denture, glasses, lenses, or
24artificial member.
25    The furnishing by the employer of any such services or
26appliances is not an admission of liability on the part of the

 

 

HB4223- 36 -LRB099 12524 JLS 35982 b

1employer to pay compensation.
2    The furnishing of any such services or appliances or the
3servicing thereof by the employer is not the payment of
4compensation.
5    (b) If the period of temporary total incapacity for work
6lasts more than 3 working days, weekly compensation as
7hereinafter provided shall be paid beginning on the 4th day of
8such temporary total incapacity and continuing as long as the
9total temporary incapacity lasts. In cases where the temporary
10total incapacity for work continues for a period of 14 days or
11more from the day of the accident compensation shall commence
12on the day after the accident.
13        1. The compensation rate for temporary total
14    incapacity under this paragraph (b) of this Section shall
15    be equal to 66 2/3% of the employee's average weekly wage
16    computed in accordance with Section 10, provided that it
17    shall be not less than 66 2/3% of the sum of the Federal
18    minimum wage under the Fair Labor Standards Act, or the
19    Illinois minimum wage under the Minimum Wage Law, whichever
20    is more, multiplied by 40 hours. This percentage rate shall
21    be increased by 10% for each spouse and child, not to
22    exceed 100% of the total minimum wage calculation,
23    nor exceed the employee's average weekly wage computed in
24    accordance with the provisions of Section 10, whichever is
25    less.
26        2. The compensation rate in all cases other than for

 

 

HB4223- 37 -LRB099 12524 JLS 35982 b

1    temporary total disability under this paragraph (b), and
2    other than for serious and permanent disfigurement under
3    paragraph (c) and other than for permanent partial
4    disability under subparagraph (2) of paragraph (d) or under
5    paragraph (e), of this Section shall be equal to 66 2/3% of
6    the employee's average weekly wage computed in accordance
7    with the provisions of Section 10, provided that it shall
8    be not less than 66 2/3% of the sum of the Federal minimum
9    wage under the Fair Labor Standards Act, or the Illinois
10    minimum wage under the Minimum Wage Law, whichever is more,
11    multiplied by 40 hours. This percentage rate shall be
12    increased by 10% for each spouse and child, not to exceed
13    100% of the total minimum wage calculation,
14    nor exceed the employee's average weekly wage computed in
15    accordance with the provisions of Section 10, whichever is
16    less.
17        2.1. The compensation rate in all cases of serious and
18    permanent disfigurement under paragraph (c) and of
19    permanent partial disability under subparagraph (2) of
20    paragraph (d) or under paragraph (e) of this Section shall
21    be equal to 60% of the employee's average weekly wage
22    computed in accordance with the provisions of Section 10,
23    provided that it shall be not less than 66 2/3% of the sum
24    of the Federal minimum wage under the Fair Labor Standards
25    Act, or the Illinois minimum wage under the Minimum Wage
26    Law, whichever is more, multiplied by 40 hours. This

 

 

HB4223- 38 -LRB099 12524 JLS 35982 b

1    percentage rate shall be increased by 10% for each spouse
2    and child, not to exceed 100% of the total minimum wage
3    calculation,
4    nor exceed the employee's average weekly wage computed in
5    accordance with the provisions of Section 10, whichever is
6    less.
7        3. As used in this Section the term "child" means a
8    child of the employee including any child legally adopted
9    before the accident or whom at the time of the accident the
10    employee was under legal obligation to support or to whom
11    the employee stood in loco parentis, and who at the time of
12    the accident was under 18 years of age and not emancipated.
13    The term "children" means the plural of "child".
14        4. All weekly compensation rates provided under
15    subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
16    Section shall be subject to the following limitations:
17        The maximum weekly compensation rate from July 1, 1975,
18    except as hereinafter provided, shall be 100% of the
19    State's average weekly wage in covered industries under the
20    Unemployment Insurance Act, that being the wage that most
21    closely approximates the State's average weekly wage.
22        The maximum weekly compensation rate, for the period
23    July 1, 1984, through June 30, 1987, except as hereinafter
24    provided, shall be $293.61. Effective July 1, 1987 and on
25    July 1 of each year thereafter the maximum weekly
26    compensation rate, except as hereinafter provided, shall

 

 

HB4223- 39 -LRB099 12524 JLS 35982 b

1    be determined as follows: if during the preceding 12 month
2    period there shall have been an increase in the State's
3    average weekly wage in covered industries under the
4    Unemployment Insurance Act, the weekly compensation rate
5    shall be proportionately increased by the same percentage
6    as the percentage of increase in the State's average weekly
7    wage in covered industries under the Unemployment
8    Insurance Act during such period.
9        The maximum weekly compensation rate, for the period
10    January 1, 1981 through December 31, 1983, except as
11    hereinafter provided, shall be 100% of the State's average
12    weekly wage in covered industries under the Unemployment
13    Insurance Act in effect on January 1, 1981. Effective
14    January 1, 1984 and on January 1, of each year thereafter
15    the maximum weekly compensation rate, except as
16    hereinafter provided, shall be determined as follows: if
17    during the preceding 12 month period there shall have been
18    an increase in the State's average weekly wage in covered
19    industries under the Unemployment Insurance Act, the
20    weekly compensation rate shall be proportionately
21    increased by the same percentage as the percentage of
22    increase in the State's average weekly wage in covered
23    industries under the Unemployment Insurance Act during
24    such period.
25        From July 1, 1977 and thereafter such maximum weekly
26    compensation rate in death cases under Section 7, and

 

 

HB4223- 40 -LRB099 12524 JLS 35982 b

1    permanent total disability cases under paragraph (f) or
2    subparagraph 18 of paragraph (3) of this Section and for
3    temporary total disability under paragraph (b) of this
4    Section and for amputation of a member or enucleation of an
5    eye under paragraph (e) of this Section shall be increased
6    to 133-1/3% of the State's average weekly wage in covered
7    industries under the Unemployment Insurance Act.
8        For injuries occurring on or after February 1, 2006,
9    the maximum weekly benefit under paragraph (d)1 of this
10    Section shall be 100% of the State's average weekly wage in
11    covered industries under the Unemployment Insurance Act.
12        4.1. Any provision herein to the contrary
13    notwithstanding, the weekly compensation rate for
14    compensation payments under subparagraph 18 of paragraph
15    (e) of this Section and under paragraph (f) of this Section
16    and under paragraph (a) of Section 7 and for amputation of
17    a member or enucleation of an eye under paragraph (e) of
18    this Section, shall in no event be less than 50% of the
19    State's average weekly wage in covered industries under the
20    Unemployment Insurance Act.
21        4.2. Any provision to the contrary notwithstanding,
22    the total compensation payable under Section 7 shall not
23    exceed the greater of $500,000 or 25 years.
24        5. For the purpose of this Section this State's average
25    weekly wage in covered industries under the Unemployment
26    Insurance Act on July 1, 1975 is hereby fixed at $228.16

 

 

HB4223- 41 -LRB099 12524 JLS 35982 b

1    per week and the computation of compensation rates shall be
2    based on the aforesaid average weekly wage until modified
3    as hereinafter provided.
4        6. The Department of Employment Security of the State
5    shall on or before the first day of December, 1977, and on
6    or before the first day of June, 1978, and on the first day
7    of each December and June of each year thereafter, publish
8    the State's average weekly wage in covered industries under
9    the Unemployment Insurance Act and the Illinois Workers'
10    Compensation Commission shall on the 15th day of January,
11    1978 and on the 15th day of July, 1978 and on the 15th day
12    of each January and July of each year thereafter, post and
13    publish the State's average weekly wage in covered
14    industries under the Unemployment Insurance Act as last
15    determined and published by the Department of Employment
16    Security. The amount when so posted and published shall be
17    conclusive and shall be applicable as the basis of
18    computation of compensation rates until the next posting
19    and publication as aforesaid.
20        7. The payment of compensation by an employer or his
21    insurance carrier to an injured employee shall not
22    constitute an admission of the employer's liability to pay
23    compensation.
24    (c) For any serious and permanent disfigurement to the
25hand, head, face, neck, arm, leg below the knee or the chest
26above the axillary line, the employee is entitled to

 

 

HB4223- 42 -LRB099 12524 JLS 35982 b

1compensation for such disfigurement, the amount determined by
2agreement at any time or by arbitration under this Act, at a
3hearing not less than 6 months after the date of the accidental
4injury, which amount shall not exceed 150 weeks (if the
5accidental injury occurs on or after the effective date of this
6amendatory Act of the 94th General Assembly but before February
71, 2006) or 162 weeks (if the accidental injury occurs on or
8after February 1, 2006) at the applicable rate provided in
9subparagraph 2.1 of paragraph (b) of this Section.
10    No compensation is payable under this paragraph where
11compensation is payable under paragraphs (d), (e) or (f) of
12this Section.
13    A duly appointed member of a fire department in a city, the
14population of which exceeds 500,000 according to the last
15federal or State census, is eligible for compensation under
16this paragraph only where such serious and permanent
17disfigurement results from burns.
18    (d) 1. If, after the accidental injury has been sustained,
19the employee as a result thereof becomes partially
20incapacitated from pursuing his usual and customary line of
21employment, he shall, except in cases compensated under the
22specific schedule set forth in paragraph (e) of this Section,
23receive compensation for the duration of his disability,
24subject to the limitations as to maximum amounts fixed in
25paragraph (b) of this Section, equal to 66-2/3% of the
26difference between the average amount which he would be able to

 

 

HB4223- 43 -LRB099 12524 JLS 35982 b

1earn in the full performance of his duties in the occupation in
2which he was engaged at the time of the accident and the
3average amount which he is earning or is able to earn in some
4suitable employment or business after the accident. For
5accidental injuries that occur on or after September 1, 2011,
6an award for wage differential under this subsection shall be
7effective only until the employee reaches the age of 67 or 5
8years from the date the award becomes final, whichever is
9later.
10    2. If, as a result of the accident, the employee sustains
11serious and permanent injuries not covered by paragraphs (c)
12and (e) of this Section or having sustained injuries covered by
13the aforesaid paragraphs (c) and (e), he shall have sustained
14in addition thereto other injuries which injuries do not
15incapacitate him from pursuing the duties of his employment but
16which would disable him from pursuing other suitable
17occupations, or which have otherwise resulted in physical
18impairment; or if such injuries partially incapacitate him from
19pursuing the duties of his usual and customary line of
20employment but do not result in an impairment of earning
21capacity, or having resulted in an impairment of earning
22capacity, the employee elects to waive his right to recover
23under the foregoing subparagraph 1 of paragraph (d) of this
24Section then in any of the foregoing events, he shall receive
25in addition to compensation for temporary total disability
26under paragraph (b) of this Section, compensation at the rate

 

 

HB4223- 44 -LRB099 12524 JLS 35982 b

1provided in subparagraph 2.1 of paragraph (b) of this Section
2for that percentage of 500 weeks that the partial disability
3resulting from the injuries covered by this paragraph bears to
4total disability. If the employee shall have sustained a
5fracture of one or more vertebra or fracture of the skull, the
6amount of compensation allowed under this Section shall be not
7less than 6 weeks for a fractured skull and 6 weeks for each
8fractured vertebra, and in the event the employee shall have
9sustained a fracture of any of the following facial bones:
10nasal, lachrymal, vomer, zygoma, maxilla, palatine or
11mandible, the amount of compensation allowed under this Section
12shall be not less than 2 weeks for each such fractured bone,
13and for a fracture of each transverse process not less than 3
14weeks. In the event such injuries shall result in the loss of a
15kidney, spleen or lung, the amount of compensation allowed
16under this Section shall be not less than 10 weeks for each
17such organ. Compensation awarded under this subparagraph 2
18shall not take into consideration injuries covered under
19paragraphs (c) and (e) of this Section and the compensation
20provided in this paragraph shall not affect the employee's
21right to compensation payable under paragraphs (b), (c) and (e)
22of this Section for the disabilities therein covered.
23    In computing the compensation to be paid to any employee
24who, before the accident for which he or she claims
25compensation, had previously sustained an injury resulting in
26an award or settlement for permanency given under this

 

 

HB4223- 45 -LRB099 12524 JLS 35982 b

1subparagraph 2, such percentage of partial disability shall be
2deducted from any award made for the subsequent injury
3resulting in an award or settlement for permanency given under
4this subparagraph 2.
5    (e) For accidental injuries in the following schedule, the
6employee shall receive compensation for the period of temporary
7total incapacity for work resulting from such accidental
8injury, under subparagraph 1 of paragraph (b) of this Section,
9and shall receive in addition thereto compensation for a
10further period for the specific loss herein mentioned, but
11shall not receive any compensation under any other provisions
12of this Act. The following listed amounts apply to either the
13loss of or the permanent and complete loss of use of the member
14specified, such compensation for the length of time as follows:
15        1. Thumb-
16            70 weeks if the accidental injury occurs on or
17        after the effective date of this amendatory Act of the
18        94th General Assembly but before February 1, 2006.
19            76 weeks if the accidental injury occurs on or
20        after February 1, 2006.
21        2. First, or index finger-
22            40 weeks if the accidental injury occurs on or
23        after the effective date of this amendatory Act of the
24        94th General Assembly but before February 1, 2006.
25            43 weeks if the accidental injury occurs on or
26        after February 1, 2006.

 

 

HB4223- 46 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 47 -LRB099 12524 JLS 35982 b

1        after the effective date of this amendatory Act of the
2        94th General Assembly but before February 1, 2006.
3            13 weeks if the accidental injury occurs on or
4        after February 1, 2006.
5        8. The loss of the first or distal phalanx of the thumb
6    or of any finger or toe shall be considered to be equal to
7    the loss of one-half of such thumb, finger or toe and the
8    compensation payable shall be one-half of the amount above
9    specified. The loss of more than one phalanx shall be
10    considered as the loss of the entire thumb, finger or toe.
11    In no case shall the amount received for more than one
12    finger exceed the amount provided in this schedule for the
13    loss of a hand.
14        9. Hand-
15            190 weeks if the accidental injury occurs on or
16        after the effective date of this amendatory Act of the
17        94th General Assembly but before February 1, 2006.
18            205 weeks if the accidental injury occurs on or
19        after February 1, 2006.
20            190 weeks if the accidental injury occurs on or
21        after June 28, 2011 (the effective date of Public Act
22        97-18) and if the accidental injury involves carpal
23        tunnel syndrome due to repetitive or cumulative
24        trauma, in which case the permanent partial disability
25        shall not exceed 15% loss of use of the hand, except
26        for cause shown by clear and convincing evidence and in

 

 

HB4223- 48 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 49 -LRB099 12524 JLS 35982 b

1    disarticulation of an arm at the shoulder joint, in which
2    case compensation for an additional 65 weeks (if the
3    accidental injury occurs on or after the effective date of
4    this amendatory Act of the 94th General Assembly but before
5    February 1, 2006) or an additional 70 weeks (if the
6    accidental injury occurs on or after February 1, 2006)
7    shall be paid.
8        11. Foot-
9            155 weeks if the accidental injury occurs on or
10        after the effective date of this amendatory Act of the
11        94th General Assembly but before February 1, 2006.
12            167 weeks if the accidental injury occurs on or
13        after February 1, 2006.
14        12. Leg-
15            200 weeks if the accidental injury occurs on or
16        after the effective date of this amendatory Act of the
17        94th General Assembly but before February 1, 2006.
18            215 weeks if the accidental injury occurs on or
19        after February 1, 2006.
20        Where an accidental injury results in the amputation of
21    a leg below the knee, such injury shall be compensated as
22    loss of a leg. Where an accidental injury results in the
23    amputation of a leg above the knee, compensation for an
24    additional 25 weeks (if the accidental injury occurs on or
25    after the effective date of this amendatory Act of the 94th
26    General Assembly but before February 1, 2006) or an

 

 

HB4223- 50 -LRB099 12524 JLS 35982 b

1    additional 27 weeks (if the accidental injury occurs on or
2    after February 1, 2006) shall be paid, except where the
3    accidental injury results in the amputation of a leg at the
4    hip joint, or so close to the hip joint that an artificial
5    leg cannot be used, or results in the disarticulation of a
6    leg at the hip joint, in which case compensation for an
7    additional 75 weeks (if the accidental injury occurs on or
8    after the effective date of this amendatory Act of the 94th
9    General Assembly but before February 1, 2006) or an
10    additional 81 weeks (if the accidental injury occurs on or
11    after February 1, 2006) shall be paid.
12        13. Eye-
13            150 weeks if the accidental injury occurs on or
14        after the effective date of this amendatory Act of the
15        94th General Assembly but before February 1, 2006.
16            162 weeks if the accidental injury occurs on or
17        after February 1, 2006.
18        Where an accidental injury results in the enucleation
19    of an eye, compensation for an additional 10 weeks (if the
20    accidental injury occurs on or after the effective date of
21    this amendatory Act of the 94th General Assembly but before
22    February 1, 2006) or an additional 11 weeks (if the
23    accidental injury occurs on or after February 1, 2006)
24    shall be paid.
25        14. Loss of hearing of one ear-
26            50 weeks if the accidental injury occurs on or

 

 

HB4223- 51 -LRB099 12524 JLS 35982 b

1        after the effective date of this amendatory Act of the
2        94th General Assembly but before February 1, 2006.
3            54 weeks if the accidental injury occurs on or
4        after February 1, 2006.
5        Total and permanent loss of hearing of both ears-
6            200 weeks if the accidental injury occurs on or
7        after the effective date of this amendatory Act of the
8        94th General Assembly but before February 1, 2006.
9            215 weeks if the accidental injury occurs on or
10        after February 1, 2006.
11        15. Testicle-
12            50 weeks if the accidental injury occurs on or
13        after the effective date of this amendatory Act of the
14        94th General Assembly but before February 1, 2006.
15            54 weeks if the accidental injury occurs on or
16        after February 1, 2006.
17        Both testicles-
18            150 weeks if the accidental injury occurs on or
19        after the effective date of this amendatory Act of the
20        94th General Assembly but before February 1, 2006.
21            162 weeks if the accidental injury occurs on or
22        after February 1, 2006.
23        16. For the permanent partial loss of use of a member
24    or sight of an eye, or hearing of an ear, compensation
25    during that proportion of the number of weeks in the
26    foregoing schedule provided for the loss of such member or

 

 

HB4223- 52 -LRB099 12524 JLS 35982 b

1    sight of an eye, or hearing of an ear, which the partial
2    loss of use thereof bears to the total loss of use of such
3    member, or sight of eye, or hearing of an ear.
4            (a) Loss of hearing for compensation purposes
5        shall be confined to the frequencies of 1,000, 2,000
6        and 3,000 cycles per second. Loss of hearing ability
7        for frequency tones above 3,000 cycles per second are
8        not to be considered as constituting disability for
9        hearing.
10            (b) The percent of hearing loss, for purposes of
11        the determination of compensation claims for
12        occupational deafness, shall be calculated as the
13        average in decibels for the thresholds of hearing for
14        the frequencies of 1,000, 2,000 and 3,000 cycles per
15        second. Pure tone air conduction audiometric
16        instruments, approved by nationally recognized
17        authorities in this field, shall be used for measuring
18        hearing loss. If the losses of hearing average 30
19        decibels or less in the 3 frequencies, such losses of
20        hearing shall not then constitute any compensable
21        hearing disability. If the losses of hearing average 85
22        decibels or more in the 3 frequencies, then the same
23        shall constitute and be total or 100% compensable
24        hearing loss.
25            (c) In measuring hearing impairment, the lowest
26        measured losses in each of the 3 frequencies shall be

 

 

HB4223- 53 -LRB099 12524 JLS 35982 b

1        added together and divided by 3 to determine the
2        average decibel loss. For every decibel of loss
3        exceeding 30 decibels an allowance of 1.82% shall be
4        made up to the maximum of 100% which is reached at 85
5        decibels.
6            (d) If a hearing loss is established to have
7        existed on July 1, 1975 by audiometric testing the
8        employer shall not be liable for the previous loss so
9        established nor shall he be liable for any loss for
10        which compensation has been paid or awarded.
11            (e) No consideration shall be given to the question
12        of whether or not the ability of an employee to
13        understand speech is improved by the use of a hearing
14        aid.
15            (f) No claim for loss of hearing due to industrial
16        noise shall be brought against an employer or allowed
17        unless the employee has been exposed for a period of
18        time sufficient to cause permanent impairment to noise
19        levels in excess of the following:
20Sound Level DBA
21Slow ResponseHours Per Day
22908
23926
24954
25973
261002

 

 

HB4223- 54 -LRB099 12524 JLS 35982 b

11021-1/2
21051
31101/2
41151/4
5        This subparagraph (f) shall not be applied in cases of
6    hearing loss resulting from trauma or explosion.
7        17. In computing the compensation to be paid to any
8    employee who, before the accident for which he claims
9    compensation, had before that time sustained an injury
10    resulting in any award or settlement for permanency
11    including, without limitation, the loss by amputation or
12    partial loss by amputation of any member, including hand,
13    arm, thumb or fingers, leg, foot or any toes, the partial
14    loss of sight of an eye, or an award given under paragraph
15    2 of paragraph (d) of Section 8 such award loss or partial
16    loss of any such member shall be deducted from any award or
17    settlement for permanency made for the subsequent injury.
18    For the permanent loss of use or the permanent partial loss
19    of use of any such member or the partial loss of sight of
20    an eye, for which compensation has been paid, then such
21    loss shall be taken into consideration and deducted from
22    any award for the subsequent injury.
23        18. The specific case of loss of both hands, both arms,
24    or both feet, or both legs, or both eyes, or of any two
25    thereof, or the permanent and complete loss of the use
26    thereof, constitutes total and permanent disability, to be

 

 

HB4223- 55 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 56 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 57 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 58 -LRB099 12524 JLS 35982 b

1one arm, one foot, one leg, or one eye, incurs permanent and
2complete disability through the loss or the permanent and
3complete loss of the use of another member, he shall receive,
4in addition to the compensation payable by the employer and
5after such payments have ceased, an amount from the Second
6Injury Fund provided for in paragraph (f) of Section 7, which,
7together with the compensation payable from the employer in
8whose employ he was when the last accidental injury was
9incurred, will equal the amount payable for permanent and
10complete disability as provided in this paragraph of this
11Section.
12    The custodian of the Second Injury Fund provided for in
13paragraph (f) of Section 7 shall be joined with the employer as
14a party respondent in the application for adjustment of claim.
15The application for adjustment of claim shall state briefly and
16in general terms the approximate time and place and manner of
17the loss of the first member.
18    In its award the Commission or the Arbitrator shall
19specifically find the amount the injured employee shall be
20weekly paid, the number of weeks compensation which shall be
21paid by the employer, the date upon which payments begin out of
22the Second Injury Fund provided for in paragraph (f) of Section
237 of this Act, the length of time the weekly payments continue,
24the date upon which the pension payments commence and the
25monthly amount of the payments. The Commission shall 30 days
26after the date upon which payments out of the Second Injury

 

 

HB4223- 59 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 60 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 61 -LRB099 12524 JLS 35982 b

1existing compensation rate. The within paragraph shall not
2apply to cases where there is disputed liability and in which a
3compromise lump sum settlement between the employer and the
4injured employee, or his dependents, as the case may be, has
5been duly approved by the Illinois Workers' Compensation
6Commission.
7    Provided, that in cases of awards entered by the Commission
8for injuries occurring before July 1, 1975, the increases in
9the compensation rate adjusted under the foregoing provision of
10this paragraph (g) shall be limited to increases in the State's
11average weekly wage in covered industries under the
12Unemployment Insurance Act occurring after July 1, 1975.
13    For every accident occurring on or after July 20, 2005 but
14before the effective date of this amendatory Act of the 94th
15General Assembly (Senate Bill 1283 of the 94th General
16Assembly), the annual adjustments to the compensation rate in
17awards for death benefits or permanent total disability, as
18provided in this Act, shall be paid by the employer. The
19adjustment shall be made by the employer on July 15 of the
20second year next following the date of the entry of the award
21and shall further be made on July 15 annually thereafter. If
22during the intervening period from the date of the entry of the
23award, or the last periodic adjustment, there shall have been
24an increase in the State's average weekly wage in covered
25industries under the Unemployment Insurance Act, the employer
26shall increase the weekly compensation rate proportionately by

 

 

HB4223- 62 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 63 -LRB099 12524 JLS 35982 b

1heir or any collateral heir dependent at the time of the
2accident upon the earnings of the employee to the extent of 50%
3or more of total dependency) such compensation shall be paid to
4the beneficiaries of the deceased employee and distributed as
5provided in paragraph (g) of Section 7.
6    (h-1) In case an injured employee is under legal disability
7at the time when any right or privilege accrues to him or her
8under this Act, a guardian may be appointed pursuant to law,
9and may, on behalf of such person under legal disability, claim
10and exercise any such right or privilege with the same effect
11as if the employee himself or herself had claimed or exercised
12the right or privilege. No limitations of time provided by this
13Act run so long as the employee who is under legal disability
14is without a conservator or guardian.
15    (i) In case the injured employee is under 16 years of age
16at the time of the accident and is illegally employed, the
17amount of compensation payable under paragraphs (b), (c), (d),
18(e) and (f) of this Section is increased 50%.
19    However, where an employer has on file an employment
20certificate issued pursuant to the Child Labor Law or work
21permit issued pursuant to the Federal Fair Labor Standards Act,
22as amended, or a birth certificate properly and duly issued,
23such certificate, permit or birth certificate is conclusive
24evidence as to the age of the injured minor employee for the
25purposes of this Section.
26    Nothing herein contained repeals or amends the provisions

 

 

HB4223- 64 -LRB099 12524 JLS 35982 b

1of the Child Labor Law relating to the employment of minors
2under the age of 16 years.
3    (j) 1. In the event the injured employee receives benefits,
4including medical, surgical or hospital benefits under any
5group plan covering non-occupational disabilities contributed
6to wholly or partially by the employer, which benefits should
7not have been payable if any rights of recovery existed under
8this Act, then such amounts so paid to the employee from any
9such group plan as shall be consistent with, and limited to,
10the provisions of paragraph 2 hereof, shall be credited to or
11against any compensation payment for temporary total
12incapacity for work or any medical, surgical or hospital
13benefits made or to be made under this Act. In such event, the
14period of time for giving notice of accidental injury and
15filing application for adjustment of claim does not commence to
16run until the termination of such payments. This paragraph does
17not apply to payments made under any group plan which would
18have been payable irrespective of an accidental injury under
19this Act. Any employer receiving such credit shall keep such
20employee safe and harmless from any and all claims or
21liabilities that may be made against him by reason of having
22received such payments only to the extent of such credit.
23    Any excess benefits paid to or on behalf of a State
24employee by the State Employees' Retirement System under
25Article 14 of the Illinois Pension Code on a death claim or
26disputed disability claim shall be credited against any

 

 

HB4223- 65 -LRB099 12524 JLS 35982 b

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

 

 

HB4223- 66 -LRB099 12524 JLS 35982 b

1    (820 ILCS 305/8.1b)
2    Sec. 8.1b. Determination of permanent partial disability.
3For accidental injuries that occur on or after September 1,
42011, permanent partial disability shall be established using
5the following criteria:
6    (a) A physician licensed to practice medicine in all of its
7branches preparing a permanent partial disability impairment
8report shall report the level of impairment in writing. The
9report shall include an evaluation of medically defined and
10professionally appropriate measurements of impairment that
11include, but are not limited to: loss of range of motion; loss
12of strength; measured atrophy of tissue mass consistent with
13the injury; and any other measurements that establish the
14nature and extent of the impairment. The most current edition
15of the American Medical Association's "Guides to the Evaluation
16of Permanent Impairment" shall be used by the physician in
17determining the level of impairment.
18    (b) In determining the level of permanent partial
19disability, the Commission shall base its determination on the
20following factors: (i) the reported level of impairment
21pursuant to subsection (a); (ii) the occupation of the injured
22employee; (iii) the age of the employee at the time of the
23injury; (iv) the employee's future earning capacity; and (v)
24evidence of disability corroborated by objective findings in
25the treating medical records and independent medical

 

 

HB4223- 67 -LRB099 12524 JLS 35982 b

1examinations. No single enumerated factor shall be the sole
2determinant of disability. In determining the level of
3disability, the relevance and weight of any factors used in
4addition to the level of impairment as reported by the
5physician must be explained in a written order.
6(Source: P.A. 97-18, eff. 6-28-11.)
 
7    (820 ILCS 305/8.2)
8    Sec. 8.2. Fee schedule.
9    (a) Except as provided for in subsection (c), for
10procedures, treatments, or services covered under this Act and
11rendered or to be rendered on and after February 1, 2006, the
12maximum allowable payment shall be 90% of the 80th percentile
13of charges and fees as determined by the Commission utilizing
14information provided by employers' and insurers' national
15databases, with a minimum of 12,000,000 Illinois line item
16charges and fees comprised of health care provider and hospital
17charges and fees as of August 1, 2004 but not earlier than
18August 1, 2002. These charges and fees are provider billed
19amounts and shall not include discounted charges. The 80th
20percentile is the point on an ordered data set from low to high
21such that 80% of the cases are below or equal to that point and
22at most 20% are above or equal to that point. The Commission
23shall adjust these historical charges and fees as of August 1,
242004 by the Consumer Price Index-U for the period August 1,
252004 through September 30, 2005. The Commission shall establish

 

 

HB4223- 68 -LRB099 12524 JLS 35982 b

1fee schedules for procedures, treatments, or services for
2hospital inpatient, hospital outpatient, emergency room and
3trauma, ambulatory surgical treatment centers, and
4professional services. These charges and fees shall be
5designated by geozip or any smaller geographic unit. The data
6shall in no way identify or tend to identify any patient,
7employer, or health care provider. As used in this Section,
8"geozip" means a three-digit zip code based on data
9similarities, geographical similarities, and frequencies. A
10geozip does not cross state boundaries. As used in this
11Section, "three-digit zip code" means a geographic area in
12which all zip codes have the same first 3 digits. If a geozip
13does not have the necessary number of charges and fees to
14calculate a valid percentile for a specific procedure,
15treatment, or service, the Commission may combine data from the
16geozip with up to 4 other geozips that are demographically and
17economically similar and exhibit similarities in data and
18frequencies until the Commission reaches 9 charges or fees for
19that specific procedure, treatment, or service. In cases where
20the compiled data contains less than 9 charges or fees for a
21procedure, treatment, or service, reimbursement shall occur at
2276% of charges and fees as determined by the Commission in a
23manner consistent with the provisions of this paragraph.
24Providers of out-of-state procedures, treatments, services,
25products, or supplies shall be reimbursed at the lesser of that
26state's fee schedule amount or the fee schedule amount for the

 

 

HB4223- 69 -LRB099 12524 JLS 35982 b

1region in which the employee resides. If no fee schedule exists
2in that state, the provider shall be reimbursed at the lesser
3of the actual charge or the fee schedule amount for the region
4in which the employee resides. Not later than September 30 in
52006 and each year thereafter, the Commission shall
6automatically increase or decrease the maximum allowable
7payment for a procedure, treatment, or service established and
8in effect on January 1 of that year by the percentage change in
9the Consumer Price Index-U for the 12 month period ending
10August 31 of that year. The increase or decrease shall become
11effective on January 1 of the following year. As used in this
12Section, "Consumer Price Index-U" means the index published by
13the Bureau of Labor Statistics of the U.S. Department of Labor,
14that measures the average change in prices of all goods and
15services purchased by all urban consumers, U.S. city average,
16all items, 1982-84=100.
17    (a-1) Notwithstanding the provisions of subsection (a) and
18unless otherwise indicated, the following provisions shall
19apply to the medical fee schedule starting on September 1,
202011:
21        (1) The Commission shall establish and maintain fee
22    schedules for procedures, treatments, products, services,
23    or supplies for hospital inpatient, hospital outpatient,
24    emergency room, ambulatory surgical treatment centers,
25    accredited ambulatory surgical treatment facilities,
26    prescriptions filled and dispensed outside of a licensed

 

 

HB4223- 70 -LRB099 12524 JLS 35982 b

1    pharmacy, dental services, and professional services. This
2    fee schedule shall be based on the fee schedule amounts
3    already established by the Commission pursuant to
4    subsection (a) of this Section. However, starting on
5    January 1, 2012, these fee schedule amounts shall be
6    grouped into geographic regions in the following manner:
7            (A) Four regions for non-hospital fee schedule
8        amounts shall be utilized:
9                (i) Cook County;
10                (ii) DuPage, Kane, Lake, and Will Counties;
11                (iii) Bond, Calhoun, Clinton, Jersey,
12            Macoupin, Madison, Monroe, Montgomery, Randolph,
13            St. Clair, and Washington Counties; and
14                (iv) All other counties of the State.
15            (B) Fourteen regions for hospital fee schedule
16        amounts shall be utilized:
17                (i) Cook, DuPage, Will, Kane, McHenry, DeKalb,
18            Kendall, and Grundy Counties;
19                (ii) Kankakee County;
20                (iii) Madison, St. Clair, Macoupin, Clinton,
21            Monroe, Jersey, Bond, and Calhoun Counties;
22                (iv) Winnebago and Boone Counties;
23                (v) Peoria, Tazewell, Woodford, Marshall, and
24            Stark Counties;
25                (vi) Champaign, Piatt, and Ford Counties;
26                (vii) Rock Island, Henry, and Mercer Counties;

 

 

HB4223- 71 -LRB099 12524 JLS 35982 b

1                (viii) Sangamon and Menard Counties;
2                (ix) McLean County;
3                (x) Lake County;
4                (xi) Macon County;
5                (xii) Vermilion County;
6                (xiii) Alexander County; and
7                (xiv) All other counties of the State.
8        (2) If a geozip, as defined in subsection (a) of this
9    Section, overlaps into one or more of the regions set forth
10    in this Section, then the Commission shall average or
11    repeat the charges and fees in a geozip in order to
12    designate charges and fees for each region.
13        (3) In cases where the compiled data contains less than
14    9 charges or fees for a procedure, treatment, product,
15    supply, or service or where the fee schedule amount cannot
16    be determined by the non-discounted charge data,
17    non-Medicare relative values and conversion factors
18    derived from established fee schedule amounts, coding
19    crosswalks, or other data as determined by the Commission,
20    reimbursement shall occur at 76% of charges and fees until
21    September 1, 2011 and 53.2% of charges and fees thereafter
22    as determined by the Commission in a manner consistent with
23    the provisions of this paragraph.
24        (4) To establish additional fee schedule amounts, the
25    Commission shall utilize provider non-discounted charge
26    data, non-Medicare relative values and conversion factors

 

 

HB4223- 72 -LRB099 12524 JLS 35982 b

1    derived from established fee schedule amounts, and coding
2    crosswalks. The Commission may establish additional fee
3    schedule amounts based on either the charge or cost of the
4    procedure, treatment, product, supply, or service.
5        (5) Implants shall be reimbursed at 25% above the net
6    manufacturer's invoice price less rebates, plus actual
7    reasonable and customary shipping charges whether or not
8    the implant charge is submitted by a provider in
9    conjunction with a bill for all other services associated
10    with the implant, submitted by a provider on a separate
11    claim form, submitted by a distributor, or submitted by the
12    manufacturer of the implant. "Implants" include the
13    following codes or any substantially similar updated code
14    as determined by the Commission: 0274
15    (prosthetics/orthotics); 0275 (pacemaker); 0276 (lens
16    implant); 0278 (implants); 0540 and 0545 (ambulance); 0624
17    (investigational devices); and 0636 (drugs requiring
18    detailed coding). Non-implantable devices or supplies
19    within these codes shall be reimbursed at 65% of actual
20    charge, which is the provider's normal rates under its
21    standard chargemaster. A standard chargemaster is the
22    provider's list of charges for procedures, treatments,
23    products, supplies, or services used to bill payers in a
24    consistent manner.
25        (6) The Commission shall automatically update all
26    codes and associated rules with the version of the codes

 

 

HB4223- 73 -LRB099 12524 JLS 35982 b

1    and rules valid on January 1 of that year.
2    (a-2) For procedures, treatments, services, or supplies
3covered under this Act and rendered or to be rendered on or
4after September 1, 2011, the maximum allowable payment shall be
570% of the fee schedule amounts, which shall be adjusted yearly
6by the Consumer Price Index-U, as described in subsection (a)
7of this Section.
8    (a-2.5) For procedures, treatments, services, or supplies
9rendered under Sections 1, 2, 6, 7, and 8 of the fee schedule
10covered under this Act and rendered or to be rendered on or
11after January 1, 2016, the maximum allowable payment shall be
1249% of the fee schedule amount, which shall be adjusted yearly
13by the Consumer Price Index-U, as described in subsection (a)
14of this Section. This shall not apply to any procedure,
15treatment, or service classified by an evaluation and
16management code or a physical medicine code in Section 8 of the
17fee schedule.
18    (a-3) Prescriptions filled and dispensed outside of a
19licensed pharmacy shall be subject to a fee schedule that shall
20not exceed the Average Wholesale Price (AWP) plus a dispensing
21fee of $4.18. AWP or its equivalent as registered by the
22National Drug Code shall be set forth for that drug on that
23date as published in Medispan.
24    (b) Notwithstanding the provisions of subsection (a), if
25the Commission finds that there is a significant limitation on
26access to quality health care in either a specific field of

 

 

HB4223- 74 -LRB099 12524 JLS 35982 b

1health care services or a specific geographic limitation on
2access to health care, it may change the Consumer Price Index-U
3increase or decrease for that specific field or specific
4geographic limitation on access to health care to address that
5limitation.
6    (c) The Commission shall establish by rule a process to
7review those medical cases or outliers that involve
8extra-ordinary treatment to determine whether to make an
9additional adjustment to the maximum payment within a fee
10schedule for a procedure, treatment, or service.
11    (d) When a patient notifies a provider that the treatment,
12procedure, or service being sought is for a work-related
13illness or injury and furnishes the provider the name and
14address of the responsible employer, the provider shall bill
15the employer directly. The employer shall make payment and
16providers shall submit bills and records in accordance with the
17provisions of this Section.
18        (1) All payments to providers for treatment provided
19    pursuant to this Act shall be made within 30 days of
20    receipt of the bills as long as the claim contains
21    substantially all the required data elements necessary to
22    adjudicate the bills.
23        (2) If the claim does not contain substantially all the
24    required data elements necessary to adjudicate the bill, or
25    the claim is denied for any other reason, in whole or in
26    part, the employer or insurer shall provide written

 

 

HB4223- 75 -LRB099 12524 JLS 35982 b

1    notification, explaining the basis for the denial and
2    describing any additional necessary data elements, to the
3    provider within 30 days of receipt of the bill.
4        (3) In the case of nonpayment to a provider within 30
5    days of receipt of the bill which contained substantially
6    all of the required data elements necessary to adjudicate
7    the bill or nonpayment to a provider of a portion of such a
8    bill up to the lesser of the actual charge or the payment
9    level set by the Commission in the fee schedule established
10    in this Section, the bill, or portion of the bill, shall
11    incur interest at a rate of 1% per month payable to the
12    provider. Any required interest payments shall be made
13    within 30 days after payment.
14    (e) Except as provided in subsections (e-5), (e-10), and
15(e-15), a provider shall not hold an employee liable for costs
16related to a non-disputed procedure, treatment, or service
17rendered in connection with a compensable injury. The
18provisions of subsections (e-5), (e-10), (e-15), and (e-20)
19shall not apply if an employee provides information to the
20provider regarding participation in a group health plan. If the
21employee participates in a group health plan, the provider may
22submit a claim for services to the group health plan. If the
23claim for service is covered by the group health plan, the
24employee's responsibility shall be limited to applicable
25deductibles, co-payments, or co-insurance. Except as provided
26under subsections (e-5), (e-10), (e-15), and (e-20), a provider

 

 

HB4223- 76 -LRB099 12524 JLS 35982 b

1shall not bill or otherwise attempt to recover from the
2employee the difference between the provider's charge and the
3amount paid by the employer or the insurer on a compensable
4injury, or for medical services or treatment determined by the
5Commission to be excessive or unnecessary.
6    (e-5) If an employer notifies a provider that the employer
7does not consider the illness or injury to be compensable under
8this Act, the provider may seek payment of the provider's
9actual charges from the employee for any procedure, treatment,
10or service rendered. Once an employee informs the provider that
11there is an application filed with the Commission to resolve a
12dispute over payment of such charges, the provider shall cease
13any and all efforts to collect payment for the services that
14are the subject of the dispute. Any statute of limitations or
15statute of repose applicable to the provider's efforts to
16collect payment from the employee shall be tolled from the date
17that the employee files the application with the Commission
18until the date that the provider is permitted to resume
19collection efforts under the provisions of this Section.
20    (e-10) If an employer notifies a provider that the employer
21will pay only a portion of a bill for any procedure, treatment,
22or service rendered in connection with a compensable illness or
23disease, the provider may seek payment from the employee for
24the remainder of the amount of the bill up to the lesser of the
25actual charge, negotiated rate, if applicable, or the payment
26level set by the Commission in the fee schedule established in

 

 

HB4223- 77 -LRB099 12524 JLS 35982 b

1this Section. Once an employee informs the provider that there
2is an application filed with the Commission to resolve a
3dispute over payment of such charges, the provider shall cease
4any and all efforts to collect payment for the services that
5are the subject of the dispute. Any statute of limitations or
6statute of repose applicable to the provider's efforts to
7collect payment from the employee shall be tolled from the date
8that the employee files the application with the Commission
9until the date that the provider is permitted to resume
10collection efforts under the provisions of this Section.
11    (e-15) When there is a dispute over the compensability of
12or amount of payment for a procedure, treatment, or service,
13and a case is pending or proceeding before an Arbitrator or the
14Commission, the provider may mail the employee reminders that
15the employee will be responsible for payment of any procedure,
16treatment or service rendered by the provider. The reminders
17must state that they are not bills, to the extent practicable
18include itemized information, and state that the employee need
19not pay until such time as the provider is permitted to resume
20collection efforts under this Section. The reminders shall not
21be provided to any credit rating agency. The reminders may
22request that the employee furnish the provider with information
23about the proceeding under this Act, such as the file number,
24names of parties, and status of the case. If an employee fails
25to respond to such request for information or fails to furnish
26the information requested within 90 days of the date of the

 

 

HB4223- 78 -LRB099 12524 JLS 35982 b

1reminder, the provider is entitled to resume any and all
2efforts to collect payment from the employee for the services
3rendered to the employee and the employee shall be responsible
4for payment of any outstanding bills for a procedure,
5treatment, or service rendered by a provider.
6    (e-20) Upon a final award or judgment by an Arbitrator or
7the Commission, or a settlement agreed to by the employer and
8the employee, a provider may resume any and all efforts to
9collect payment from the employee for the services rendered to
10the employee and the employee shall be responsible for payment
11of any outstanding bills for a procedure, treatment, or service
12rendered by a provider as well as the interest awarded under
13subsection (d) of this Section. In the case of a procedure,
14treatment, or service deemed compensable, the provider shall
15not require a payment rate, excluding the interest provisions
16under subsection (d), greater than the lesser of the actual
17charge or the payment level set by the Commission in the fee
18schedule established in this Section. Payment for services
19deemed not covered or not compensable under this Act is the
20responsibility of the employee unless a provider and employee
21have agreed otherwise in writing. Services not covered or not
22compensable under this Act are not subject to the fee schedule
23in this Section.
24    (f) Nothing in this Act shall prohibit an employer or
25insurer from contracting with a health care provider or group
26of health care providers for reimbursement levels for benefits

 

 

HB4223- 79 -LRB099 12524 JLS 35982 b

1under this Act different from those provided in this Section.
2    (g) On or before January 1, 2010 the Commission shall
3provide to the Governor and General Assembly a report regarding
4the implementation of the medical fee schedule and the index
5used for annual adjustment to that schedule as described in
6this Section.
7(Source: P.A. 97-18, eff. 6-28-11.)
 
8    (820 ILCS 305/8.2a)
9    Sec. 8.2a. Electronic claims.
10    (a) The Illinois Workers' Compensation Commission Director
11of Insurance shall adopt rules to do all of the following:
12        (1) Ensure that all health care providers and
13    facilities submit medical bills for payment on
14    standardized forms.
15        (2) Require acceptance by employers and insurers of
16    electronic claims for payment of medical services.
17        (3) Ensure confidentiality of medical information
18    submitted on electronic claims for payment of medical
19    services.
20    (b) To the extent feasible, standards adopted pursuant to
21subdivision (a) shall be consistent with existing standards
22under the federal Health Insurance Portability and
23Accountability Act of 1996 and standards adopted under the
24Illinois Health Information Exchange and Technology Act.
25    (c) The rules requiring employers and insurers to accept

 

 

HB4223- 80 -LRB099 12524 JLS 35982 b

1electronic claims for payment of medical services shall be
2proposed on or before January 1, 2012, and shall require all
3employers and insurers to accept electronic claims for payment
4of medical services on or before June 30, 2012.
5    (d) The Illinois Workers' Compensation Commission Director
6of Insurance shall by rule establish criteria for granting
7exceptions to employers, insurance carriers, and health care
8providers who are unable to submit or accept medical bills
9electronically.
10(Source: P.A. 97-18, eff. 6-28-11.)
 
11    (820 ILCS 305/14)  (from Ch. 48, par. 138.14)
12    Sec. 14. The Commission shall appoint a secretary, an
13assistant secretary, and arbitrators and shall employ such
14assistants and clerical help as may be necessary. Arbitrators
15shall be appointed pursuant to this Section, notwithstanding
16any provision of the Personnel Code.
17    Each arbitrator appointed after June 28, 2011 shall be
18required to demonstrate in writing his or her knowledge of and
19expertise in the law of and judicial processes of the Workers'
20Compensation Act and the Occupational Diseases Act.
21    A formal training program for newly-hired arbitrators
22shall be implemented. The training program shall include the
23following:
24        (a) substantive and procedural aspects of the
25    arbitrator position;

 

 

HB4223- 81 -LRB099 12524 JLS 35982 b

1        (b) current issues in workers' compensation law and
2    practice;
3        (c) medical lectures by specialists in areas such as
4    orthopedics, ophthalmology, psychiatry, rehabilitation
5    counseling;
6        (d) orientation to each operational unit of the
7    Illinois Workers' Compensation Commission;
8        (e) observation of experienced arbitrators conducting
9    hearings of cases, combined with the opportunity to discuss
10    evidence presented and rulings made;
11        (f) the use of hypothetical cases requiring the trainee
12    to issue judgments as a means to evaluating knowledge and
13    writing ability;
14        (g) writing skills;
15        (h) professional and ethical standards pursuant to
16    Section 1.1 of this Act;
17        (i) detection of workers' compensation fraud and
18    reporting obligations of Commission employees and
19    appointees;
20        (j) standards of evidence-based medical treatment and
21    best practices for measuring and improving quality and
22    health care outcomes in the workers' compensation system,
23    including but not limited to the use of the American
24    Medical Association's "Guides to the Evaluation of
25    Permanent Impairment" and the practice of utilization
26    review; and

 

 

HB4223- 82 -LRB099 12524 JLS 35982 b

1        (k) substantive and procedural aspects of coal
2    workers' pneumoconiosis (black lung) cases.
3    A formal and ongoing professional development program
4including, but not limited to, the above-noted areas shall be
5implemented to keep arbitrators informed of recent
6developments and issues and to assist them in maintaining and
7enhancing their professional competence. Each arbitrator shall
8complete 20 hours of training in the above-noted areas during
9every 2 years such arbitrator shall remain in office.
10    Each arbitrator shall devote full time to his or her duties
11and shall serve when assigned as an acting Commissioner when a
12Commissioner is unavailable in accordance with the provisions
13of Section 13 of this Act. Any arbitrator who is an
14attorney-at-law shall not engage in the practice of law, nor
15shall any arbitrator hold any other office or position of
16profit under the United States or this State or any municipal
17corporation or political subdivision of this State.
18Notwithstanding any other provision of this Act to the
19contrary, an arbitrator who serves as an acting Commissioner in
20accordance with the provisions of Section 13 of this Act shall
21continue to serve in the capacity of Commissioner until a
22decision is reached in every case heard by that arbitrator
23while serving as an acting Commissioner.
24    Notwithstanding any other provision of this Section, the
25term of all arbitrators serving on the effective date of this
26amendatory Act of the 97th General Assembly, including any

 

 

HB4223- 83 -LRB099 12524 JLS 35982 b

1arbitrators on administrative leave, shall terminate at the
2close of business on July 1, 2011, but the incumbents shall
3continue to exercise all of their duties until they are
4reappointed or their successors are appointed.
5    On and after the effective date of this amendatory Act of
6the 97th General Assembly, arbitrators shall be appointed to
73-year terms as follows:
8        (1) All appointments shall be made by the Governor with
9    the advice and consent of the Senate.
10        (2) For their initial appointments, 12 arbitrators
11    shall be appointed to terms expiring July 1, 2012; 12
12    arbitrators shall be appointed to terms expiring July 1,
13    2013; and all additional arbitrators shall be appointed to
14    terms expiring July 1, 2014. Thereafter, all arbitrators
15    shall be appointed to 3-year terms.
16    Upon the expiration of a term, the Chairman shall evaluate
17the performance of the arbitrator and may recommend to the
18Governor that he or she be reappointed to a second or
19subsequent term by the Governor with the advice and consent of
20the Senate.
21    Each arbitrator appointed on or after the effective date of
22this amendatory Act of the 97th General Assembly and who has
23not previously served as an arbitrator for the Commission shall
24be required to be authorized to practice law in this State by
25the Supreme Court, and to maintain this authorization
26throughout his or her term of employment.

 

 

HB4223- 84 -LRB099 12524 JLS 35982 b

1    The performance of all arbitrators shall be reviewed by the
2Chairman on an annual basis. The Chairman shall allow input
3from the Commissioners in all such reviews.
4    The Commission shall assign no fewer than 3 arbitrators to
5each hearing site. The Commission shall establish a procedure
6to ensure that the arbitrators assigned to each hearing site
7are assigned cases on a random basis. The Chairman of the
8Illinois Workers' Compensation Commission shall have
9discretion to assign and reassign arbitrators to each hearing
10site as needed. No arbitrator shall hear cases in any county,
11other than Cook County, for more than 2 years in each 3-year
12term.
13    The Secretary and each arbitrator shall receive a per annum
14salary of $4,000 less than the per annum salary of members of
15The Illinois Workers' Compensation Commission as provided in
16Section 13 of this Act, payable in equal monthly installments.
17    The members of the Commission, Arbitrators and other
18employees whose duties require them to travel, shall have
19reimbursed to them their actual traveling expenses and
20disbursements made or incurred by them in the discharge of
21their official duties while away from their place of residence
22in the performance of their duties.
23    The Commission shall provide itself with a seal for the
24authentication of its orders, awards and proceedings upon which
25shall be inscribed the name of the Commission and the words
26"Illinois--Seal".

 

 

HB4223- 85 -LRB099 12524 JLS 35982 b

1    The Secretary or Assistant Secretary, under the direction
2of the Commission, shall have charge and custody of the seal of
3the Commission and also have charge and custody of all records,
4files, orders, proceedings, decisions, awards and other
5documents on file with the Commission. He shall furnish
6certified copies, under the seal of the Commission, of any such
7records, files, orders, proceedings, decisions, awards and
8other documents on file with the Commission as may be required.
9Certified copies so furnished by the Secretary or Assistant
10Secretary shall be received in evidence before the Commission
11or any Arbitrator thereof, and in all courts, provided that the
12original of such certified copy is otherwise competent and
13admissible in evidence. The Secretary or Assistant Secretary
14shall perform such other duties as may be prescribed from time
15to time by the Commission.
16(Source: P.A. 97-18, eff. 6-28-11; 97-719, eff. 6-29-12; 98-40,
17eff. 6-28-13.)
 
18    (820 ILCS 305/19)  (from Ch. 48, par. 138.19)
19    Sec. 19. Any disputed questions of law or fact shall be
20determined as herein provided.
21    (a) It shall be the duty of the Commission upon
22notification that the parties have failed to reach an
23agreement, to designate an Arbitrator.
24        1. Whenever any claimant misconceives his remedy and
25    files an application for adjustment of claim under this Act

 

 

HB4223- 86 -LRB099 12524 JLS 35982 b

1    and it is subsequently discovered, at any time before final
2    disposition of such cause, that the claim for disability or
3    death which was the basis for such application should
4    properly have been made under the Workers' Occupational
5    Diseases Act, then the provisions of Section 19, paragraph
6    (a-1) of the Workers' Occupational Diseases Act having
7    reference to such application shall apply.
8        2. Whenever any claimant misconceives his remedy and
9    files an application for adjustment of claim under the
10    Workers' Occupational Diseases Act and it is subsequently
11    discovered, at any time before final disposition of such
12    cause that the claim for injury or death which was the
13    basis for such application should properly have been made
14    under this Act, then the application so filed under the
15    Workers' Occupational Diseases Act may be amended in form,
16    substance or both to assert claim for such disability or
17    death under this Act and it shall be deemed to have been so
18    filed as amended on the date of the original filing
19    thereof, and such compensation may be awarded as is
20    warranted by the whole evidence pursuant to this Act. When
21    such amendment is submitted, further or additional
22    evidence may be heard by the Arbitrator or Commission when
23    deemed necessary. Nothing in this Section contained shall
24    be construed to be or permit a waiver of any provisions of
25    this Act with reference to notice but notice if given shall
26    be deemed to be a notice under the provisions of this Act

 

 

HB4223- 87 -LRB099 12524 JLS 35982 b

1    if given within the time required herein.
2    (b) The Arbitrator shall make such inquiries and
3investigations as he or they shall deem necessary and may
4examine and inspect all books, papers, records, places, or
5premises relating to the questions in dispute and hear such
6proper evidence as the parties may submit.
7    The hearings before the Arbitrator shall be held in the
8vicinity where the injury occurred after 10 days' notice of the
9time and place of such hearing shall have been given to each of
10the parties or their attorneys of record.
11    The Arbitrator may find that the disabling condition is
12temporary and has not yet reached a permanent condition and may
13order the payment of compensation up to the date of the
14hearing, which award shall be reviewable and enforceable in the
15same manner as other awards, and in no instance be a bar to a
16further hearing and determination of a further amount of
17temporary total compensation or of compensation for permanent
18disability, but shall be conclusive as to all other questions
19except the nature and extent of said disability.
20    The decision of the Arbitrator shall be filed with the
21Commission which Commission shall immediately send to each
22party or his attorney a copy of such decision, together with a
23notification of the time when it was filed. As of the effective
24date of this amendatory Act of the 94th General Assembly, all
25decisions of the Arbitrator shall set forth in writing findings
26of fact and conclusions of law, separately stated, if requested

 

 

HB4223- 88 -LRB099 12524 JLS 35982 b

1by either party. Unless a petition for review is filed by
2either party within 30 days after the receipt by such party of
3the copy of the decision and notification of time when filed,
4and unless such party petitioning for a review shall within 35
5days after the receipt by him of the copy of the decision, file
6with the Commission either an agreed statement of the facts
7appearing upon the hearing before the Arbitrator, or if such
8party shall so elect a correct transcript of evidence of the
9proceedings at such hearings, then the decision shall become
10the decision of the Commission and in the absence of fraud
11shall be conclusive. The Petition for Review shall contain a
12statement of the petitioning party's specific exceptions to the
13decision of the arbitrator. The jurisdiction of the Commission
14to review the decision of the arbitrator shall not be limited
15to the exceptions stated in the Petition for Review. The
16Commission, or any member thereof, may grant further time not
17exceeding 30 days, in which to file such agreed statement or
18transcript of evidence. Such agreed statement of facts or
19correct transcript of evidence, as the case may be, shall be
20authenticated by the signatures of the parties or their
21attorneys, and in the event they do not agree as to the
22correctness of the transcript of evidence it shall be
23authenticated by the signature of the Arbitrator designated by
24the Commission.
25    Whether the employee is working or not, if the employee is
26not receiving or has not received medical, surgical, or

 

 

HB4223- 89 -LRB099 12524 JLS 35982 b

1hospital services or other services or compensation as provided
2in paragraph (a) of Section 8, or compensation as provided in
3paragraph (b) of Section 8, the employee may at any time
4petition for an expedited hearing by an Arbitrator on the issue
5of whether or not he or she is entitled to receive payment of
6the services or compensation. Provided the employer continues
7to pay compensation pursuant to paragraph (b) of Section 8, the
8employer may at any time petition for an expedited hearing on
9the issue of whether or not the employee is entitled to receive
10medical, surgical, or hospital services or other services or
11compensation as provided in paragraph (a) of Section 8, or
12compensation as provided in paragraph (b) of Section 8. When an
13employer has petitioned for an expedited hearing, the employer
14shall continue to pay compensation as provided in paragraph (b)
15of Section 8 unless the arbitrator renders a decision that the
16employee is not entitled to the benefits that are the subject
17of the expedited hearing or unless the employee's treating
18physician has released the employee to return to work at his or
19her regular job with the employer or the employee actually
20returns to work at any other job. If the arbitrator renders a
21decision that the employee is not entitled to the benefits that
22are the subject of the expedited hearing, a petition for review
23filed by the employee shall receive the same priority as if the
24employee had filed a petition for an expedited hearing by an
25Arbitrator. Neither party shall be entitled to an expedited
26hearing when the employee has returned to work and the sole

 

 

HB4223- 90 -LRB099 12524 JLS 35982 b

1issue in dispute amounts to less than 12 weeks of unpaid
2compensation pursuant to paragraph (b) of Section 8.
3    Expedited hearings shall have priority over all other
4petitions and shall be heard by the Arbitrator and Commission
5with all convenient speed. Any party requesting an expedited
6hearing shall give notice of a request for an expedited hearing
7under this paragraph. A copy of the Application for Adjustment
8of Claim shall be attached to the notice. The Commission shall
9adopt rules and procedures under which the final decision of
10the Commission under this paragraph is filed not later than 180
11days from the date that the Petition for Review is filed with
12the Commission.
13    Where 2 or more insurance carriers, private self-insureds,
14or a group workers' compensation pool under Article V 3/4 of
15the Illinois Insurance Code dispute coverage for the same
16injury, any such insurance carrier, private self-insured, or
17group workers' compensation pool may request an expedited
18hearing pursuant to this paragraph to determine the issue of
19coverage, provided coverage is the only issue in dispute and
20all other issues are stipulated and agreed to and further
21provided that all compensation benefits including medical
22benefits pursuant to Section 8(a) continue to be paid to or on
23behalf of petitioner. Any insurance carrier, private
24self-insured, or group workers' compensation pool that is
25determined to be liable for coverage for the injury in issue
26shall reimburse any insurance carrier, private self-insured,

 

 

HB4223- 91 -LRB099 12524 JLS 35982 b

1or group workers' compensation pool that has paid benefits to
2or on behalf of petitioner for the injury.
3    (b-1) If the employee is not receiving medical, surgical or
4hospital services as provided in paragraph (a) of Section 8 or
5compensation as provided in paragraph (b) of Section 8, the
6employee, in accordance with Commission Rules, may file a
7petition for an emergency hearing by an Arbitrator on the issue
8of whether or not he is entitled to receive payment of such
9compensation or services as provided therein. Such petition
10shall have priority over all other petitions and shall be heard
11by the Arbitrator and Commission with all convenient speed.
12    Such petition shall contain the following information and
13shall be served on the employer at least 15 days before it is
14filed:
15        (i) the date and approximate time of accident;
16        (ii) the approximate location of the accident;
17        (iii) a description of the accident;
18        (iv) the nature of the injury incurred by the employee;
19        (v) the identity of the person, if known, to whom the
20    accident was reported and the date on which it was
21    reported;
22        (vi) the name and title of the person, if known,
23    representing the employer with whom the employee conferred
24    in any effort to obtain compensation pursuant to paragraph
25    (b) of Section 8 of this Act or medical, surgical or
26    hospital services pursuant to paragraph (a) of Section 8 of

 

 

HB4223- 92 -LRB099 12524 JLS 35982 b

1    this Act and the date of such conference;
2        (vii) a statement that the employer has refused to pay
3    compensation pursuant to paragraph (b) of Section 8 of this
4    Act or for medical, surgical or hospital services pursuant
5    to paragraph (a) of Section 8 of this Act;
6        (viii) the name and address, if known, of each witness
7    to the accident and of each other person upon whom the
8    employee will rely to support his allegations;
9        (ix) the dates of treatment related to the accident by
10    medical practitioners, and the names and addresses of such
11    practitioners, including the dates of treatment related to
12    the accident at any hospitals and the names and addresses
13    of such hospitals, and a signed authorization permitting
14    the employer to examine all medical records of all
15    practitioners and hospitals named pursuant to this
16    paragraph;
17        (x) a copy of a signed report by a medical
18    practitioner, relating to the employee's current inability
19    to return to work because of the injuries incurred as a
20    result of the accident or such other documents or
21    affidavits which show that the employee is entitled to
22    receive compensation pursuant to paragraph (b) of Section 8
23    of this Act or medical, surgical or hospital services
24    pursuant to paragraph (a) of Section 8 of this Act. Such
25    reports, documents or affidavits shall state, if possible,
26    the history of the accident given by the employee, and

 

 

HB4223- 93 -LRB099 12524 JLS 35982 b

1    describe the injury and medical diagnosis, the medical
2    services for such injury which the employee has received
3    and is receiving, the physical activities which the
4    employee cannot currently perform as a result of any
5    impairment or disability due to such injury, and the
6    prognosis for recovery;
7        (xi) complete copies of any reports, records,
8    documents and affidavits in the possession of the employee
9    on which the employee will rely to support his allegations,
10    provided that the employer shall pay the reasonable cost of
11    reproduction thereof;
12        (xii) a list of any reports, records, documents and
13    affidavits which the employee has demanded by subpoena and
14    on which he intends to rely to support his allegations;
15        (xiii) a certification signed by the employee or his
16    representative that the employer has received the petition
17    with the required information 15 days before filing.
18    Fifteen days after receipt by the employer of the petition
19with the required information the employee may file said
20petition and required information and shall serve notice of the
21filing upon the employer. The employer may file a motion
22addressed to the sufficiency of the petition. If an objection
23has been filed to the sufficiency of the petition, the
24arbitrator shall rule on the objection within 2 working days.
25If such an objection is filed, the time for filing the final
26decision of the Commission as provided in this paragraph shall

 

 

HB4223- 94 -LRB099 12524 JLS 35982 b

1be tolled until the arbitrator has determined that the petition
2is sufficient.
3    The employer shall, within 15 days after receipt of the
4notice that such petition is filed, file with the Commission
5and serve on the employee or his representative a written
6response to each claim set forth in the petition, including the
7legal and factual basis for each disputed allegation and the
8following information: (i) complete copies of any reports,
9records, documents and affidavits in the possession of the
10employer on which the employer intends to rely in support of
11his response, (ii) a list of any reports, records, documents
12and affidavits which the employer has demanded by subpoena and
13on which the employer intends to rely in support of his
14response, (iii) the name and address of each witness on whom
15the employer will rely to support his response, and (iv) the
16names and addresses of any medical practitioners selected by
17the employer pursuant to Section 12 of this Act and the time
18and place of any examination scheduled to be made pursuant to
19such Section.
20    Any employer who does not timely file and serve a written
21response without good cause may not introduce any evidence to
22dispute any claim of the employee but may cross examine the
23employee or any witness brought by the employee and otherwise
24be heard.
25    No document or other evidence not previously identified by
26either party with the petition or written response, or by any

 

 

HB4223- 95 -LRB099 12524 JLS 35982 b

1other means before the hearing, may be introduced into evidence
2without good cause. If, at the hearing, material information is
3discovered which was not previously disclosed, the Arbitrator
4may extend the time for closing proof on the motion of a party
5for a reasonable period of time which may be more than 30 days.
6No evidence may be introduced pursuant to this paragraph as to
7permanent disability. No award may be entered for permanent
8disability pursuant to this paragraph. Either party may
9introduce into evidence the testimony taken by deposition of
10any medical practitioner.
11    The Commission shall adopt rules, regulations and
12procedures whereby the final decision of the Commission is
13filed not later than 90 days from the date the petition for
14review is filed but in no event later than 180 days from the
15date the petition for an emergency hearing is filed with the
16Illinois Workers' Compensation Commission.
17    All service required pursuant to this paragraph (b-1) must
18be by personal service or by certified mail and with evidence
19of receipt. In addition for the purposes of this paragraph, all
20service on the employer must be at the premises where the
21accident occurred if the premises are owned or operated by the
22employer. Otherwise service must be at the employee's principal
23place of employment by the employer. If service on the employer
24is not possible at either of the above, then service shall be
25at the employer's principal place of business. After initial
26service in each case, service shall be made on the employer's

 

 

HB4223- 96 -LRB099 12524 JLS 35982 b

1attorney or designated representative.
2    (c)(1) At a reasonable time in advance of and in connection
3with the hearing under Section 19(e) or 19(h), the Commission
4may on its own motion order an impartial physical or mental
5examination of a petitioner whose mental or physical condition
6is in issue, when in the Commission's discretion it appears
7that such an examination will materially aid in the just
8determination of the case. The examination shall be made by a
9member or members of a panel of physicians chosen for their
10special qualifications by the Illinois State Medical Society.
11The Commission shall establish procedures by which a physician
12shall be selected from such list.
13    (2) Should the Commission at any time during the hearing
14find that compelling considerations make it advisable to have
15an examination and report at that time, the commission may in
16its discretion so order.
17    (3) A copy of the report of examination shall be given to
18the Commission and to the attorneys for the parties.
19    (4) Either party or the Commission may call the examining
20physician or physicians to testify. Any physician so called
21shall be subject to cross-examination.
22    (5) The examination shall be made, and the physician or
23physicians, if called, shall testify, without cost to the
24parties. The Commission shall determine the compensation and
25the pay of the physician or physicians. The compensation for
26this service shall not exceed the usual and customary amount

 

 

HB4223- 97 -LRB099 12524 JLS 35982 b

1for such service.
2    (6) The fees and payment thereof of all attorneys and
3physicians for services authorized by the Commission under this
4Act shall, upon request of either the employer or the employee
5or the beneficiary affected, be subject to the review and
6decision of the Commission.
7    (d) If any employee shall persist in insanitary or
8injurious practices which tend to either imperil or retard his
9recovery or shall refuse to submit to such medical, surgical,
10or hospital treatment as is reasonably essential to promote his
11recovery, the Commission may, in its discretion, reduce or
12suspend the compensation of any such injured employee. However,
13when an employer and employee so agree in writing, the
14foregoing provision shall not be construed to authorize the
15reduction or suspension of compensation of an employee who is
16relying in good faith, on treatment by prayer or spiritual
17means alone, in accordance with the tenets and practice of a
18recognized church or religious denomination, by a duly
19accredited practitioner thereof.
20    (e) This paragraph shall apply to all hearings before the
21Commission. Such hearings may be held in its office or
22elsewhere as the Commission may deem advisable. The taking of
23testimony on such hearings may be had before any member of the
24Commission. If a petition for review and agreed statement of
25facts or transcript of evidence is filed, as provided herein,
26the Commission shall promptly review the decision of the

 

 

HB4223- 98 -LRB099 12524 JLS 35982 b

1Arbitrator and all questions of law or fact which appear from
2the statement of facts or transcript of evidence.
3    In all cases in which the hearing before the arbitrator is
4held after December 18, 1989, no additional evidence shall be
5introduced by the parties before the Commission on review of
6the decision of the Arbitrator. In reviewing decisions of an
7arbitrator the Commission shall award such temporary
8compensation, permanent compensation and other payments as are
9due under this Act. The Commission shall file in its office its
10decision thereon, and shall immediately send to each party or
11his attorney a copy of such decision and a notification of the
12time when it was filed. Decisions shall be filed within 60 days
13after the Statement of Exceptions and Supporting Brief and
14Response thereto are required to be filed or oral argument
15whichever is later.
16    In the event either party requests oral argument, such
17argument shall be had before a panel of 3 members of the
18Commission (or before all available members pursuant to the
19determination of 7 members of the Commission that such argument
20be held before all available members of the Commission)
21pursuant to the rules and regulations of the Commission. A
22panel of 3 members, which shall be comprised of not more than
23one representative citizen of the employing class and not more
24than one representative citizen of the employee class, shall
25hear the argument; provided that if all the issues in dispute
26are solely the nature and extent of the permanent partial

 

 

HB4223- 99 -LRB099 12524 JLS 35982 b

1disability, if any, a majority of the panel may deny the
2request for such argument and such argument shall not be held;
3and provided further that 7 members of the Commission may
4determine that the argument be held before all available
5members of the Commission. A decision of the Commission shall
6be approved by a majority of Commissioners present at such
7hearing if any; provided, if no such hearing is held, a
8decision of the Commission shall be approved by a majority of a
9panel of 3 members of the Commission as described in this
10Section. The Commission shall give 10 days' notice to the
11parties or their attorneys of the time and place of such taking
12of testimony and of such argument.
13    In any case the Commission in its decision may find
14specially upon any question or questions of law or fact which
15shall be submitted in writing by either party whether ultimate
16or otherwise; provided that on issues other than nature and
17extent of the disability, if any, the Commission in its
18decision shall find specially upon any question or questions of
19law or fact, whether ultimate or otherwise, which are submitted
20in writing by either party; provided further that not more than
215 such questions may be submitted by either party. Any party
22may, within 20 days after receipt of notice of the Commission's
23decision, or within such further time, not exceeding 30 days,
24as the Commission may grant, file with the Commission either an
25agreed statement of the facts appearing upon the hearing, or,
26if such party shall so elect, a correct transcript of evidence

 

 

HB4223- 100 -LRB099 12524 JLS 35982 b

1of the additional proceedings presented before the Commission,
2in which report the party may embody a correct statement of
3such other proceedings in the case as such party may desire to
4have reviewed, such statement of facts or transcript of
5evidence to be authenticated by the signature of the parties or
6their attorneys, and in the event that they do not agree, then
7the authentication of such transcript of evidence shall be by
8the signature of any member of the Commission.
9    If a reporter does not for any reason furnish a transcript
10of the proceedings before the Arbitrator in any case for use on
11a hearing for review before the Commission, within the
12limitations of time as fixed in this Section, the Commission
13may, in its discretion, order a trial de novo before the
14Commission in such case upon application of either party. The
15applications for adjustment of claim and other documents in the
16nature of pleadings filed by either party, together with the
17decisions of the Arbitrator and of the Commission and the
18statement of facts or transcript of evidence hereinbefore
19provided for in paragraphs (b) and (c) shall be the record of
20the proceedings of the Commission, and shall be subject to
21review as hereinafter provided.
22    At the request of either party or on its own motion, the
23Commission shall set forth in writing the reasons for the
24decision, including findings of fact and conclusions of law
25separately stated. The Commission shall by rule adopt a format
26for written decisions for the Commission and arbitrators. The

 

 

HB4223- 101 -LRB099 12524 JLS 35982 b

1written decisions shall be concise and shall succinctly state
2the facts and reasons for the decision. The Commission may
3adopt in whole or in part, the decision of the arbitrator as
4the decision of the Commission. When the Commission does so
5adopt the decision of the arbitrator, it shall do so by order.
6Whenever the Commission adopts part of the arbitrator's
7decision, but not all, it shall include in the order the
8reasons for not adopting all of the arbitrator's decision. When
9a majority of a panel, after deliberation, has arrived at its
10decision, the decision shall be filed as provided in this
11Section without unnecessary delay, and without regard to the
12fact that a member of the panel has expressed an intention to
13dissent. Any member of the panel may file a dissent. Any
14dissent shall be filed no later than 10 days after the decision
15of the majority has been filed.
16    Decisions rendered by the Commission and dissents, if any,
17shall be published together by the Commission. The conclusions
18of law set out in such decisions shall be regarded as
19precedents by arbitrators for the purpose of achieving a more
20uniform administration of this Act.
21    (f) The decision of the Commission acting within its
22powers, according to the provisions of paragraph (e) of this
23Section shall, in the absence of fraud, be conclusive unless
24reviewed as in this paragraph hereinafter provided. However,
25the Arbitrator or the Commission may on his or its own motion,
26or on the motion of either party, correct any clerical error or

 

 

HB4223- 102 -LRB099 12524 JLS 35982 b

1errors in computation within 15 days after the date of receipt
2of any award by such Arbitrator or any decision on review of
3the Commission and shall have the power to recall the original
4award on arbitration or decision on review, and issue in lieu
5thereof such corrected award or decision. Where such correction
6is made the time for review herein specified shall begin to run
7from the date of the receipt of the corrected award or
8decision.
9        (1) Except in cases of claims against the State of
10    Illinois other than those claims under Section 18.1, in
11    which case the decision of the Commission shall not be
12    subject to judicial review, the Circuit Court of the county
13    where any of the parties defendant may be found, or if none
14    of the parties defendant can be found in this State then
15    the Circuit Court of the county where the accident
16    occurred, shall by summons to the Commission have power to
17    review all questions of law and fact presented by such
18    record.
19        A proceeding for review shall be commenced within 20
20    days of the receipt of notice of the decision of the
21    Commission. The summons shall be issued by the clerk of
22    such court upon written request returnable on a designated
23    return day, not less than 10 or more than 60 days from the
24    date of issuance thereof, and the written request shall
25    contain the last known address of other parties in interest
26    and their attorneys of record who are to be served by

 

 

HB4223- 103 -LRB099 12524 JLS 35982 b

1    summons. Service upon any member of the Commission or the
2    Secretary or the Assistant Secretary thereof shall be
3    service upon the Commission, and service upon other parties
4    in interest and their attorneys of record shall be by
5    summons, and such service shall be made upon the Commission
6    and other parties in interest by mailing notices of the
7    commencement of the proceedings and the return day of the
8    summons to the office of the Commission and to the last
9    known place of residence of other parties in interest or
10    their attorney or attorneys of record. The clerk of the
11    court issuing the summons shall on the day of issue mail
12    notice of the commencement of the proceedings which shall
13    be done by mailing a copy of the summons to the office of
14    the Commission, and a copy of the summons to the other
15    parties in interest or their attorney or attorneys of
16    record and the clerk of the court shall make certificate
17    that he has so sent said notices in pursuance of this
18    Section, which shall be evidence of service on the
19    Commission and other parties in interest.
20        The Commission shall not be required to certify the
21    record of their proceedings to the Circuit Court, unless
22    the party commencing the proceedings for review in the
23    Circuit Court as above provided, shall file with the
24    Commission notice of intent to file for review in Circuit
25    Court. It shall be the duty of the Commission upon such
26    filing of notice of intent to file for review in the

 

 

HB4223- 104 -LRB099 12524 JLS 35982 b

1    Circuit Court to prepare a true and correct copy of such
2    testimony and a true and correct copy of all other matters
3    contained in such record and certified to by the Secretary
4    or Assistant Secretary thereof. The changes made to this
5    subdivision (f)(1) by this amendatory Act of the 98th
6    General Assembly apply to any Commission decision entered
7    after the effective date of this amendatory Act of the 98th
8    General Assembly.
9        No request for a summons may be filed and no summons
10    shall issue unless the party seeking to review the decision
11    of the Commission shall exhibit to the clerk of the Circuit
12    Court proof of filing with the Commission of the notice of
13    the intent to file for review in the Circuit Court or an
14    affidavit of the attorney setting forth that notice of
15    intent to file for review in the Circuit Court has been
16    given in writing to the Secretary or Assistant Secretary of
17    the Commission.
18        (2) No such summons shall issue unless the one against
19    whom the Commission shall have rendered an award for the
20    payment of money shall upon the filing of his written
21    request for such summons file with the clerk of the court a
22    bond conditioned that if he shall not successfully
23    prosecute the review, he will pay the award and the costs
24    of the proceedings in the courts. The amount of the bond
25    shall be fixed by any member of the Commission and the
26    surety or sureties of the bond shall be approved by the

 

 

HB4223- 105 -LRB099 12524 JLS 35982 b

1    clerk of the court. The acceptance of the bond by the clerk
2    of the court shall constitute evidence of his approval of
3    the bond.
4        The State of Illinois, including its constitutional
5    officers, boards, commissions, agencies, public
6    institutions of higher learning, and funds administered by
7    the Treasurer ex officio, and every Every county, city,
8    town, township, incorporated village, school district,
9    body politic or municipal corporation against whom the
10    Commission shall have rendered an award for the payment of
11    money shall not be required to file a bond to secure the
12    payment of the award and the costs of the proceedings in
13    the court to authorize the court to issue such summons.
14        The court may confirm or set aside the decision of the
15    Commission. If the decision is set aside and the facts
16    found in the proceedings before the Commission are
17    sufficient, the court may enter such decision as is
18    justified by law, or may remand the cause to the Commission
19    for further proceedings and may state the questions
20    requiring further hearing, and give such other
21    instructions as may be proper. Appeals shall be taken to
22    the Appellate Court in accordance with Supreme Court Rules
23    22(g) and 303. Appeals shall be taken from the Appellate
24    Court to the Supreme Court in accordance with Supreme Court
25    Rule 315.
26        It shall be the duty of the clerk of any court

 

 

HB4223- 106 -LRB099 12524 JLS 35982 b

1    rendering a decision affecting or affirming an award of the
2    Commission to promptly furnish the Commission with a copy
3    of such decision, without charge.
4        The decision of a majority of the members of the panel
5    of the Commission, shall be considered the decision of the
6    Commission.
7    (g) Except in the case of a claim against the State of
8Illinois, either party may present a certified copy of the
9award of the Arbitrator, or a certified copy of the decision of
10the Commission when the same has become final, when no
11proceedings for review are pending, providing for the payment
12of compensation according to this Act, to the Circuit Court of
13the county in which such accident occurred or either of the
14parties are residents, whereupon the court shall enter a
15judgment in accordance therewith. In a case where the employer
16refuses to pay compensation according to such final award or
17such final decision upon which such judgment is entered the
18court shall in entering judgment thereon, tax as costs against
19him the reasonable costs and attorney fees in the arbitration
20proceedings and in the court entering the judgment for the
21person in whose favor the judgment is entered, which judgment
22and costs taxed as therein provided shall, until and unless set
23aside, have the same effect as though duly entered in an action
24duly tried and determined by the court, and shall with like
25effect, be entered and docketed. The Circuit Court shall have
26power at any time upon application to make any such judgment

 

 

HB4223- 107 -LRB099 12524 JLS 35982 b

1conform to any modification required by any subsequent decision
2of the Supreme Court upon appeal, or as the result of any
3subsequent proceedings for review, as provided in this Act.
4    Judgment shall not be entered until 15 days' notice of the
5time and place of the application for the entry of judgment
6shall be served upon the employer by filing such notice with
7the Commission, which Commission shall, in case it has on file
8the address of the employer or the name and address of its
9agent upon whom notices may be served, immediately send a copy
10of the notice to the employer or such designated agent.
11    (h) An agreement or award under this Act providing for
12compensation in installments, may at any time within 18 months
13after such agreement or award be reviewed by the Commission at
14the request of either the employer or the employee, on the
15ground that the disability of the employee has subsequently
16recurred, increased, diminished or ended.
17    However, as to accidents occurring subsequent to July 1,
181955, which are covered by any agreement or award under this
19Act providing for compensation in installments made as a result
20of such accident, such agreement or award may at any time
21within 30 months, or 60 months in the case of an award under
22Section 8(d)1, after such agreement or award be reviewed by the
23Commission at the request of either the employer or the
24employee on the ground that the disability of the employee has
25subsequently recurred, increased, diminished or ended.
26    On such review, compensation payments may be

 

 

HB4223- 108 -LRB099 12524 JLS 35982 b

1re-established, increased, diminished or ended. The Commission
2shall give 15 days' notice to the parties of the hearing for
3review. Any employee, upon any petition for such review being
4filed by the employer, shall be entitled to one day's notice
5for each 100 miles necessary to be traveled by him in attending
6the hearing of the Commission upon the petition, and 3 days in
7addition thereto. Such employee shall, at the discretion of the
8Commission, also be entitled to 5 cents per mile necessarily
9traveled by him within the State of Illinois in attending such
10hearing, not to exceed a distance of 300 miles, to be taxed by
11the Commission as costs and deposited with the petition of the
12employer.
13    When compensation which is payable in accordance with an
14award or settlement contract approved by the Commission, is
15ordered paid in a lump sum by the Commission, no review shall
16be had as in this paragraph mentioned.
17    (i) Each party, upon taking any proceedings or steps
18whatsoever before any Arbitrator, Commission or court, shall
19file with the Commission his address, or the name and address
20of any agent upon whom all notices to be given to such party
21shall be served, either personally or by registered mail,
22addressed to such party or agent at the last address so filed
23with the Commission. In the event such party has not filed his
24address, or the name and address of an agent as above provided,
25service of any notice may be had by filing such notice with the
26Commission.

 

 

HB4223- 109 -LRB099 12524 JLS 35982 b

1    (j) Whenever in any proceeding testimony has been taken or
2a final decision has been rendered and after the taking of such
3testimony or after such decision has become final, the injured
4employee dies, then in any subsequent proceedings brought by
5the personal representative or beneficiaries of the deceased
6employee, such testimony in the former proceeding may be
7introduced with the same force and effect as though the witness
8having so testified were present in person in such subsequent
9proceedings and such final decision, if any, shall be taken as
10final adjudication of any of the issues which are the same in
11both proceedings.
12    (k) In case where there has been any unreasonable or
13vexatious delay of payment or intentional underpayment of
14compensation, or proceedings have been instituted or carried on
15by the one liable to pay the compensation, which do not present
16a real controversy, but are merely frivolous or for delay, then
17the Commission may award compensation additional to that
18otherwise payable under this Act equal to 50% of the amount
19payable at the time of such award. Failure to pay compensation
20in accordance with the provisions of Section 8, paragraph (b)
21of this Act, shall be considered unreasonable delay.
22    When determining whether this subsection (k) shall apply,
23the Commission shall consider whether an Arbitrator has
24determined that the claim is not compensable or whether the
25employer has made payments under Section 8(j).
26    (l) If the employee has made written demand for payment of

 

 

HB4223- 110 -LRB099 12524 JLS 35982 b

1benefits under Section 8(a) or Section 8(b), the employer shall
2have 14 days after receipt of the demand to set forth in
3writing the reason for the delay. In the case of demand for
4payment of medical benefits under Section 8(a), the time for
5the employer to respond shall not commence until the expiration
6of the allotted 30 days specified under Section 8.2(d). In case
7the employer or his or her insurance carrier shall without good
8and just cause fail, neglect, refuse, or unreasonably delay the
9payment of benefits under Section 8(a) or Section 8(b), the
10Arbitrator or the Commission shall allow to the employee
11additional compensation in the sum of $30 per day for each day
12that the benefits under Section 8(a) or Section 8(b) have been
13so withheld or refused, not to exceed $10,000. A delay in
14payment of 14 days or more shall create a rebuttable
15presumption of unreasonable delay.
16    (m) If the commission finds that an accidental injury was
17directly and proximately caused by the employer's wilful
18violation of a health and safety standard under the Health and
19Safety Act or the Occupational Safety and Health Act in force
20at the time of the accident, the arbitrator or the Commission
21shall allow to the injured employee or his dependents, as the
22case may be, additional compensation equal to 25% of the amount
23which otherwise would be payable under the provisions of this
24Act exclusive of this paragraph. The additional compensation
25herein provided shall be allowed by an appropriate increase in
26the applicable weekly compensation rate.

 

 

HB4223- 111 -LRB099 12524 JLS 35982 b

1    (n) After June 30, 1984, decisions of the Illinois Workers'
2Compensation Commission reviewing an award of an arbitrator of
3the Commission shall draw interest at a rate equal to the yield
4on indebtedness issued by the United States Government with a
526-week maturity next previously auctioned on the day on which
6the decision is filed. Said rate of interest shall be set forth
7in the Arbitrator's Decision. Interest shall be drawn from the
8date of the arbitrator's award on all accrued compensation due
9the employee through the day prior to the date of payments.
10However, when an employee appeals an award of an Arbitrator or
11the Commission, and the appeal results in no change or a
12decrease in the award, interest shall not further accrue from
13the date of such appeal.
14    The employer or his insurance carrier may tender the
15payments due under the award to stop the further accrual of
16interest on such award notwithstanding the prosecution by
17either party of review, certiorari, appeal to the Supreme Court
18or other steps to reverse, vacate or modify the award.
19    (o) By the 15th day of each month each insurer providing
20coverage for losses under this Act shall notify each insured
21employer of any compensable claim incurred during the preceding
22month and the amounts paid or reserved on the claim including a
23summary of the claim and a brief statement of the reasons for
24compensability. A cumulative report of all claims incurred
25during a calendar year or continued from the previous year
26shall be furnished to the insured employer by the insurer

 

 

HB4223- 112 -LRB099 12524 JLS 35982 b

1within 30 days after the end of that calendar year.
2    The insured employer may challenge, in proceeding before
3the Commission, payments made by the insurer without
4arbitration and payments made after a case is determined to be
5noncompensable. If the Commission finds that the case was not
6compensable, the insurer shall purge its records as to that
7employer of any loss or expense associated with the claim,
8reimburse the employer for attorneys' fees arising from the
9challenge and for any payment required of the employer to the
10Rate Adjustment Fund or the Second Injury Fund, and may not
11reflect the loss or expense for rate making purposes. The
12employee shall not be required to refund the challenged
13payment. The decision of the Commission may be reviewed in the
14same manner as in arbitrated cases. No challenge may be
15initiated under this paragraph more than 3 years after the
16payment is made. An employer may waive the right of challenge
17under this paragraph on a case by case basis.
18    (p) After filing an application for adjustment of claim but
19prior to the hearing on arbitration the parties may voluntarily
20agree to submit such application for adjustment of claim for
21decision by an arbitrator under this subsection (p) where such
22application for adjustment of claim raises only a dispute over
23temporary total disability, permanent partial disability or
24medical expenses. Such agreement shall be in writing in such
25form as provided by the Commission. Applications for adjustment
26of claim submitted for decision by an arbitrator under this

 

 

HB4223- 113 -LRB099 12524 JLS 35982 b

1subsection (p) shall proceed according to rule as established
2by the Commission. The Commission shall promulgate rules
3including, but not limited to, rules to ensure that the parties
4are adequately informed of their rights under this subsection
5(p) and of the voluntary nature of proceedings under this
6subsection (p). The findings of fact made by an arbitrator
7acting within his or her powers under this subsection (p) in
8the absence of fraud shall be conclusive. However, the
9arbitrator may on his own motion, or the motion of either
10party, correct any clerical errors or errors in computation
11within 15 days after the date of receipt of such award of the
12arbitrator and shall have the power to recall the original
13award on arbitration, and issue in lieu thereof such corrected
14award. The decision of the arbitrator under this subsection (p)
15shall be considered the decision of the Commission and
16proceedings for review of questions of law arising from the
17decision may be commenced by either party pursuant to
18subsection (f) of Section 19. The Advisory Board established
19under Section 13.1 shall compile a list of certified Commission
20arbitrators, each of whom shall be approved by at least 7
21members of the Advisory Board. The chairman shall select 5
22persons from such list to serve as arbitrators under this
23subsection (p). By agreement, the parties shall select one
24arbitrator from among the 5 persons selected by the chairman
25except that if the parties do not agree on an arbitrator from
26among the 5 persons, the parties may, by agreement, select an

 

 

HB4223- 114 -LRB099 12524 JLS 35982 b

1arbitrator of the American Arbitration Association, whose fee
2shall be paid by the State in accordance with rules promulgated
3by the Commission. Arbitration under this subsection (p) shall
4be voluntary.
5(Source: P.A. 97-18, eff. 6-28-11; 98-40, eff. 6-28-13; 98-874,
6eff. 1-1-15.)