100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB5470

 

Introduced , by Rep. Jerry Lee Long

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Creates the Collective Bargaining Freedom and Consistent Wage Act. Provides that the authority to enact any ordinance, rule, or regulation, or in any way prohibit, restrict, or regulate the use of union security agreements between an employer and labor organization authorized under federal law vests exclusively with the General Assembly. Limits home rule powers. Amends the Freedom of Information Act. Exempts from public inspection certain information collected by the Illinois Workers' Compensation Commission and the Department of Insurance. Amends the Criminal Code of 2012 regarding workers' compensation fraud penalties. Amends the Workers' Compensation Act. Makes changes concerning: when an accidental injury shall not be considered to be "arising out of and in the course of employment" if the accidental injury or medical condition occurred while the claimant was traveling away from the employer's premises; the maximum compensation rate for a period of temporary total incapacity; compensation awards for injuries to the shoulder and hip; annual reports on the state of self-insurance for workers' compensation in Illinois; and other matters. Amends the Franchise Disclosure Act of 1987. Repeals the substantive provisions of the Act except for provisions concerning findings and purposes, provisions imposing fees, and saving provisions. Effective immediately.


LRB100 18092 JLS 33285 b

CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY
HOME RULE NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB5470LRB100 18092 JLS 33285 b

1    AN ACT concerning business.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Collective Bargaining Freedom and Consistent Wage Act.
 
6    Section 5. Purpose. It is the policy of the State of
7Illinois that:
8        (1) employers, employees, and labor organizations are
9    free to negotiate collectively;
10        (2) employers, employees, and labor organizations may
11    freely negotiate union security agreements, including, but
12    not limited to, those requiring membership in a labor
13    organization as permitted under 29 U.S.C. 158(a)(3); and
14        (3) local governmental units may not create or enforce
15    any ordinance, regulation, rule, or in any way prohibits,
16    restricts, or regulates the use of union security
17    agreements between a labor organization and an employer as
18    permitted under 29 U.S.C. 158(a)(3).
 
19    Section 10. Definitions. In this Act:
20    "Employer" includes any person acting as an agent of an
21employer, directly or indirectly. "Employer" does not include
22the United States, a wholly-owned government corporation, a

 

 

HB5470- 2 -LRB100 18092 JLS 33285 b

1Federal Reserve Bank, a state or political subdivision of a
2state, a person subject to the Railway Labor Act (45 U.S.C. 151
3et seq.), a labor organization (other than when acting as an
4employer), or anyone acting in the capacity of officer or agent
5of such labor organization.
6    "Labor organization" means an organization of any kind or
7an agency or employee representation committee or plan in which
8employees participate and which exists for the purpose, in
9whole or in part, of dealing with employers concerning
10grievances, labor disputes, wages, rates of pay, hours of
11employment, or conditions of work.
12    "Local governmental unit" includes, but is not limited to,
13a unit of local government, State college or university,
14community college, school district, and any other district,
15agency, or political subdivision authorized to legislate or
16enact laws affecting its respective jurisdiction,
17notwithstanding the local governmental unit's authority to
18exercise any power and perform any function pertaining to its
19government and affairs granted to it by the Illinois
20Constitution, a law, or otherwise.
 
21    Section 15. Authority to enact legislation affecting union
22security agreements.
23    (a) The authority to enact any ordinance, rule, or
24regulation, or in any way prohibit, restrict, or regulate the
25use of union security agreements between an employer and labor

 

 

HB5470- 3 -LRB100 18092 JLS 33285 b

1organization as authorized under 29 U.S.C. 158(a)(3) vests
2exclusively with the General Assembly.
3    (b) A local governmental unit is not permitted to enact or
4enforce any ordinance, rule, or regulation, or in any way
5prohibit, restrict, or regulate the use of union security
6agreements between an employer and labor organization as
7authorized under 29 U.S.C. 158(a)(3).
8    (c) Nothing in this Act shall be construed as prohibiting
9the General Assembly from enacting legislation barring the
10execution or application of union security agreements as
11authorized under 29 U.S.C. 164(b).
12    (d) Enacting and enforcing any law, rule, or regulation,
13and the prohibition, restriction, and regulation of the use of
14union security agreements between an employer and labor
15organization as authorized under 29 U.S.C. 158(a)(3) are
16exclusive powers and functions of the State. A home rule unit
17is not permitted to enact or enforce any ordinance, rule, or
18regulation, or in any way prohibit, restrict, or regulate the
19use of union security agreements between an employer and labor
20organization as authorized under 29 U.S.C. 158(a)(3). This
21Section is a denial and limitation of home rule powers and
22functions under subsection (h) of Section 6 of Article VII of
23the Illinois Constitution.
 
24    Section 91. The Freedom of Information Act is amended by
25changing Section 7.5 as follows:
 

 

 

HB5470- 4 -LRB100 18092 JLS 33285 b

1    (5 ILCS 140/7.5)
2    (Text of Section before amendment by P.A. 100-512 and
3100-517)
4    Sec. 7.5. Statutory exemptions. To the extent provided for
5by the statutes referenced below, the following shall be exempt
6from inspection and copying:
7        (a) All information determined to be confidential
8    under Section 4002 of the Technology Advancement and
9    Development Act.
10        (b) Library circulation and order records identifying
11    library users with specific materials under the Library
12    Records Confidentiality Act.
13        (c) Applications, related documents, and medical
14    records received by the Experimental Organ Transplantation
15    Procedures Board and any and all documents or other records
16    prepared by the Experimental Organ Transplantation
17    Procedures Board or its staff relating to applications it
18    has received.
19        (d) Information and records held by the Department of
20    Public Health and its authorized representatives relating
21    to known or suspected cases of sexually transmissible
22    disease or any information the disclosure of which is
23    restricted under the Illinois Sexually Transmissible
24    Disease Control Act.
25        (e) Information the disclosure of which is exempted

 

 

HB5470- 5 -LRB100 18092 JLS 33285 b

1    under Section 30 of the Radon Industry Licensing Act.
2        (f) Firm performance evaluations under Section 55 of
3    the Architectural, Engineering, and Land Surveying
4    Qualifications Based Selection Act.
5        (g) Information the disclosure of which is restricted
6    and exempted under Section 50 of the Illinois Prepaid
7    Tuition Act.
8        (h) Information the disclosure of which is exempted
9    under the State Officials and Employees Ethics Act, and
10    records of any lawfully created State or local inspector
11    general's office that would be exempt if created or
12    obtained by an Executive Inspector General's office under
13    that Act.
14        (i) Information contained in a local emergency energy
15    plan submitted to a municipality in accordance with a local
16    emergency energy plan ordinance that is adopted under
17    Section 11-21.5-5 of the Illinois Municipal Code.
18        (j) Information and data concerning the distribution
19    of surcharge moneys collected and remitted by carriers
20    under the Emergency Telephone System Act.
21        (k) Law enforcement officer identification information
22    or driver identification information compiled by a law
23    enforcement agency or the Department of Transportation
24    under Section 11-212 of the Illinois Vehicle Code.
25        (l) Records and information provided to a residential
26    health care facility resident sexual assault and death

 

 

HB5470- 6 -LRB100 18092 JLS 33285 b

1    review team or the Executive Council under the Abuse
2    Prevention Review Team Act.
3        (m) Information provided to the predatory lending
4    database created pursuant to Article 3 of the Residential
5    Real Property Disclosure Act, except to the extent
6    authorized under that Article.
7        (n) Defense budgets and petitions for certification of
8    compensation and expenses for court appointed trial
9    counsel as provided under Sections 10 and 15 of the Capital
10    Crimes Litigation Act. This subsection (n) shall apply
11    until the conclusion of the trial of the case, even if the
12    prosecution chooses not to pursue the death penalty prior
13    to trial or sentencing.
14        (o) Information that is prohibited from being
15    disclosed under Section 4 of the Illinois Health and
16    Hazardous Substances Registry Act.
17        (p) Security portions of system safety program plans,
18    investigation reports, surveys, schedules, lists, data, or
19    information compiled, collected, or prepared by or for the
20    Regional Transportation Authority under Section 2.11 of
21    the Regional Transportation Authority Act or the St. Clair
22    County Transit District under the Bi-State Transit Safety
23    Act.
24        (q) Information prohibited from being disclosed by the
25    Personnel Records Review Act.
26        (r) Information prohibited from being disclosed by the

 

 

HB5470- 7 -LRB100 18092 JLS 33285 b

1    Illinois School Student Records Act.
2        (s) Information the disclosure of which is restricted
3    under Section 5-108 of the Public Utilities Act.
4        (t) All identified or deidentified health information
5    in the form of health data or medical records contained in,
6    stored in, submitted to, transferred by, or released from
7    the Illinois Health Information Exchange, and identified
8    or deidentified health information in the form of health
9    data and medical records of the Illinois Health Information
10    Exchange in the possession of the Illinois Health
11    Information Exchange Authority due to its administration
12    of the Illinois Health Information Exchange. The terms
13    "identified" and "deidentified" shall be given the same
14    meaning as in the Health Insurance Portability and
15    Accountability Act of 1996, Public Law 104-191, or any
16    subsequent amendments thereto, and any regulations
17    promulgated thereunder.
18        (u) Records and information provided to an independent
19    team of experts under Brian's Law.
20        (v) Names and information of people who have applied
21    for or received Firearm Owner's Identification Cards under
22    the Firearm Owners Identification Card Act or applied for
23    or received a concealed carry license under the Firearm
24    Concealed Carry Act, unless otherwise authorized by the
25    Firearm Concealed Carry Act; and databases under the
26    Firearm Concealed Carry Act, records of the Concealed Carry

 

 

HB5470- 8 -LRB100 18092 JLS 33285 b

1    Licensing Review Board under the Firearm Concealed Carry
2    Act, and law enforcement agency objections under the
3    Firearm Concealed Carry Act.
4        (w) Personally identifiable information which is
5    exempted from disclosure under subsection (g) of Section
6    19.1 of the Toll Highway Act.
7        (x) Information which is exempted from disclosure
8    under Section 5-1014.3 of the Counties Code or Section
9    8-11-21 of the Illinois Municipal Code.
10        (y) Confidential information under the Adult
11    Protective Services Act and its predecessor enabling
12    statute, the Elder Abuse and Neglect Act, including
13    information about the identity and administrative finding
14    against any caregiver of a verified and substantiated
15    decision of abuse, neglect, or financial exploitation of an
16    eligible adult maintained in the Registry established
17    under Section 7.5 of the Adult Protective Services Act.
18        (z) Records and information provided to a fatality
19    review team or the Illinois Fatality Review Team Advisory
20    Council under Section 15 of the Adult Protective Services
21    Act.
22        (aa) Information which is exempted from disclosure
23    under Section 2.37 of the Wildlife Code.
24        (bb) Information which is or was prohibited from
25    disclosure by the Juvenile Court Act of 1987.
26        (cc) Recordings made under the Law Enforcement

 

 

HB5470- 9 -LRB100 18092 JLS 33285 b

1    Officer-Worn Body Camera Act, except to the extent
2    authorized under that Act.
3        (dd) Information that is prohibited from being
4    disclosed under Section 45 of the Condominium and Common
5    Interest Community Ombudsperson Act.
6        (ee) Information that is exempted from disclosure
7    under Section 30.1 of the Pharmacy Practice Act.
8        (ff) Information that is exempted from disclosure
9    under the Revised Uniform Unclaimed Property Act.
10        (gg) (ff) Information that is prohibited from being
11    disclosed under Section 7-603.5 of the Illinois Vehicle
12    Code.
13        (hh) (ff) Records that are exempt from disclosure under
14    Section 1A-16.7 of the Election Code.
15        (ii) (ff) Information which is exempted from
16    disclosure under Section 2505-800 of the Department of
17    Revenue Law of the Civil Administrative Code of Illinois.
18(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
19eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
2099-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
21100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
228-28-17; 100-465, eff. 8-31-17; revised 11-2-17.)
 
23    (Text of Section after amendment by P.A. 100-517 but before
24amendment by P.A. 100-512)
25    Sec. 7.5. Statutory exemptions. To the extent provided for

 

 

HB5470- 10 -LRB100 18092 JLS 33285 b

1by the statutes referenced below, the following shall be exempt
2from inspection and copying:
3        (a) All information determined to be confidential
4    under Section 4002 of the Technology Advancement and
5    Development Act.
6        (b) Library circulation and order records identifying
7    library users with specific materials under the Library
8    Records Confidentiality Act.
9        (c) Applications, related documents, and medical
10    records received by the Experimental Organ Transplantation
11    Procedures Board and any and all documents or other records
12    prepared by the Experimental Organ Transplantation
13    Procedures Board or its staff relating to applications it
14    has received.
15        (d) Information and records held by the Department of
16    Public Health and its authorized representatives relating
17    to known or suspected cases of sexually transmissible
18    disease or any information the disclosure of which is
19    restricted under the Illinois Sexually Transmissible
20    Disease Control Act.
21        (e) Information the disclosure of which is exempted
22    under Section 30 of the Radon Industry Licensing Act.
23        (f) Firm performance evaluations under Section 55 of
24    the Architectural, Engineering, and Land Surveying
25    Qualifications Based Selection Act.
26        (g) Information the disclosure of which is restricted

 

 

HB5470- 11 -LRB100 18092 JLS 33285 b

1    and exempted under Section 50 of the Illinois Prepaid
2    Tuition Act.
3        (h) Information the disclosure of which is exempted
4    under the State Officials and Employees Ethics Act, and
5    records of any lawfully created State or local inspector
6    general's office that would be exempt if created or
7    obtained by an Executive Inspector General's office under
8    that Act.
9        (i) Information contained in a local emergency energy
10    plan submitted to a municipality in accordance with a local
11    emergency energy plan ordinance that is adopted under
12    Section 11-21.5-5 of the Illinois Municipal Code.
13        (j) Information and data concerning the distribution
14    of surcharge moneys collected and remitted by carriers
15    under the Emergency Telephone System Act.
16        (k) Law enforcement officer identification information
17    or driver identification information compiled by a law
18    enforcement agency or the Department of Transportation
19    under Section 11-212 of the Illinois Vehicle Code.
20        (l) Records and information provided to a residential
21    health care facility resident sexual assault and death
22    review team or the Executive Council under the Abuse
23    Prevention Review Team Act.
24        (m) Information provided to the predatory lending
25    database created pursuant to Article 3 of the Residential
26    Real Property Disclosure Act, except to the extent

 

 

HB5470- 12 -LRB100 18092 JLS 33285 b

1    authorized under that Article.
2        (n) Defense budgets and petitions for certification of
3    compensation and expenses for court appointed trial
4    counsel as provided under Sections 10 and 15 of the Capital
5    Crimes Litigation Act. This subsection (n) shall apply
6    until the conclusion of the trial of the case, even if the
7    prosecution chooses not to pursue the death penalty prior
8    to trial or sentencing.
9        (o) Information that is prohibited from being
10    disclosed under Section 4 of the Illinois Health and
11    Hazardous Substances Registry Act.
12        (p) Security portions of system safety program plans,
13    investigation reports, surveys, schedules, lists, data, or
14    information compiled, collected, or prepared by or for the
15    Regional Transportation Authority under Section 2.11 of
16    the Regional Transportation Authority Act or the St. Clair
17    County Transit District under the Bi-State Transit Safety
18    Act.
19        (q) Information prohibited from being disclosed by the
20    Personnel Records Review Act.
21        (r) Information prohibited from being disclosed by the
22    Illinois School Student Records Act.
23        (s) Information the disclosure of which is restricted
24    under Section 5-108 of the Public Utilities Act.
25        (t) All identified or deidentified health information
26    in the form of health data or medical records contained in,

 

 

HB5470- 13 -LRB100 18092 JLS 33285 b

1    stored in, submitted to, transferred by, or released from
2    the Illinois Health Information Exchange, and identified
3    or deidentified health information in the form of health
4    data and medical records of the Illinois Health Information
5    Exchange in the possession of the Illinois Health
6    Information Exchange Authority due to its administration
7    of the Illinois Health Information Exchange. The terms
8    "identified" and "deidentified" shall be given the same
9    meaning as in the Health Insurance Portability and
10    Accountability Act of 1996, Public Law 104-191, or any
11    subsequent amendments thereto, and any regulations
12    promulgated thereunder.
13        (u) Records and information provided to an independent
14    team of experts under Brian's Law.
15        (v) Names and information of people who have applied
16    for or received Firearm Owner's Identification Cards under
17    the Firearm Owners Identification Card Act or applied for
18    or received a concealed carry license under the Firearm
19    Concealed Carry Act, unless otherwise authorized by the
20    Firearm Concealed Carry Act; and databases under the
21    Firearm Concealed Carry Act, records of the Concealed Carry
22    Licensing Review Board under the Firearm Concealed Carry
23    Act, and law enforcement agency objections under the
24    Firearm Concealed Carry Act.
25        (w) Personally identifiable information which is
26    exempted from disclosure under subsection (g) of Section

 

 

HB5470- 14 -LRB100 18092 JLS 33285 b

1    19.1 of the Toll Highway Act.
2        (x) Information which is exempted from disclosure
3    under Section 5-1014.3 of the Counties Code or Section
4    8-11-21 of the Illinois Municipal Code.
5        (y) Confidential information under the Adult
6    Protective Services Act and its predecessor enabling
7    statute, the Elder Abuse and Neglect Act, including
8    information about the identity and administrative finding
9    against any caregiver of a verified and substantiated
10    decision of abuse, neglect, or financial exploitation of an
11    eligible adult maintained in the Registry established
12    under Section 7.5 of the Adult Protective Services Act.
13        (z) Records and information provided to a fatality
14    review team or the Illinois Fatality Review Team Advisory
15    Council under Section 15 of the Adult Protective Services
16    Act.
17        (aa) Information which is exempted from disclosure
18    under Section 2.37 of the Wildlife Code.
19        (bb) Information which is or was prohibited from
20    disclosure by the Juvenile Court Act of 1987.
21        (cc) Recordings made under the Law Enforcement
22    Officer-Worn Body Camera Act, except to the extent
23    authorized under that Act.
24        (dd) Information that is prohibited from being
25    disclosed under Section 45 of the Condominium and Common
26    Interest Community Ombudsperson Act.

 

 

HB5470- 15 -LRB100 18092 JLS 33285 b

1        (ee) Information that is exempted from disclosure
2    under Section 30.1 of the Pharmacy Practice Act.
3        (ff) Information that is exempted from disclosure
4    under the Revised Uniform Unclaimed Property Act.
5        (gg) (ff) Information that is prohibited from being
6    disclosed under Section 7-603.5 of the Illinois Vehicle
7    Code.
8        (hh) (ff) Records that are exempt from disclosure under
9    Section 1A-16.7 of the Election Code.
10        (ii) (ff) Information which is exempted from
11    disclosure under Section 2505-800 of the Department of
12    Revenue Law of the Civil Administrative Code of Illinois.
13        (jj) (ff) Information and reports that are required to
14    be submitted to the Department of Labor by registering day
15    and temporary labor service agencies but are exempt from
16    disclosure under subsection (a-1) of Section 45 of the Day
17    and Temporary Labor Services Act.
18(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
19eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
2099-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
21100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
228-28-17; 100-465, eff. 8-31-17; 100-517, eff. 6-1-18; revised
2311-2-17.)
 
24    (Text of Section after amendment by P.A. 100-512)
25    Sec. 7.5. Statutory exemptions. To the extent provided for

 

 

HB5470- 16 -LRB100 18092 JLS 33285 b

1by the statutes referenced below, the following shall be exempt
2from inspection and copying:
3        (a) All information determined to be confidential
4    under Section 4002 of the Technology Advancement and
5    Development Act.
6        (b) Library circulation and order records identifying
7    library users with specific materials under the Library
8    Records Confidentiality Act.
9        (c) Applications, related documents, and medical
10    records received by the Experimental Organ Transplantation
11    Procedures Board and any and all documents or other records
12    prepared by the Experimental Organ Transplantation
13    Procedures Board or its staff relating to applications it
14    has received.
15        (d) Information and records held by the Department of
16    Public Health and its authorized representatives relating
17    to known or suspected cases of sexually transmissible
18    disease or any information the disclosure of which is
19    restricted under the Illinois Sexually Transmissible
20    Disease Control Act.
21        (e) Information the disclosure of which is exempted
22    under Section 30 of the Radon Industry Licensing Act.
23        (f) Firm performance evaluations under Section 55 of
24    the Architectural, Engineering, and Land Surveying
25    Qualifications Based Selection Act.
26        (g) Information the disclosure of which is restricted

 

 

HB5470- 17 -LRB100 18092 JLS 33285 b

1    and exempted under Section 50 of the Illinois Prepaid
2    Tuition Act.
3        (h) Information the disclosure of which is exempted
4    under the State Officials and Employees Ethics Act, and
5    records of any lawfully created State or local inspector
6    general's office that would be exempt if created or
7    obtained by an Executive Inspector General's office under
8    that Act.
9        (i) Information contained in a local emergency energy
10    plan submitted to a municipality in accordance with a local
11    emergency energy plan ordinance that is adopted under
12    Section 11-21.5-5 of the Illinois Municipal Code.
13        (j) Information and data concerning the distribution
14    of surcharge moneys collected and remitted by carriers
15    under the Emergency Telephone System Act.
16        (k) Law enforcement officer identification information
17    or driver identification information compiled by a law
18    enforcement agency or the Department of Transportation
19    under Section 11-212 of the Illinois Vehicle Code.
20        (l) Records and information provided to a residential
21    health care facility resident sexual assault and death
22    review team or the Executive Council under the Abuse
23    Prevention Review Team Act.
24        (m) Information provided to the predatory lending
25    database created pursuant to Article 3 of the Residential
26    Real Property Disclosure Act, except to the extent

 

 

HB5470- 18 -LRB100 18092 JLS 33285 b

1    authorized under that Article.
2        (n) Defense budgets and petitions for certification of
3    compensation and expenses for court appointed trial
4    counsel as provided under Sections 10 and 15 of the Capital
5    Crimes Litigation Act. This subsection (n) shall apply
6    until the conclusion of the trial of the case, even if the
7    prosecution chooses not to pursue the death penalty prior
8    to trial or sentencing.
9        (o) Information that is prohibited from being
10    disclosed under Section 4 of the Illinois Health and
11    Hazardous Substances Registry Act.
12        (p) Security portions of system safety program plans,
13    investigation reports, surveys, schedules, lists, data, or
14    information compiled, collected, or prepared by or for the
15    Regional Transportation Authority under Section 2.11 of
16    the Regional Transportation Authority Act or the St. Clair
17    County Transit District under the Bi-State Transit Safety
18    Act.
19        (q) Information prohibited from being disclosed by the
20    Personnel Records Review Act.
21        (r) Information prohibited from being disclosed by the
22    Illinois School Student Records Act.
23        (s) Information the disclosure of which is restricted
24    under Section 5-108 of the Public Utilities Act.
25        (t) All identified or deidentified health information
26    in the form of health data or medical records contained in,

 

 

HB5470- 19 -LRB100 18092 JLS 33285 b

1    stored in, submitted to, transferred by, or released from
2    the Illinois Health Information Exchange, and identified
3    or deidentified health information in the form of health
4    data and medical records of the Illinois Health Information
5    Exchange in the possession of the Illinois Health
6    Information Exchange Authority due to its administration
7    of the Illinois Health Information Exchange. The terms
8    "identified" and "deidentified" shall be given the same
9    meaning as in the Health Insurance Portability and
10    Accountability Act of 1996, Public Law 104-191, or any
11    subsequent amendments thereto, and any regulations
12    promulgated thereunder.
13        (u) Records and information provided to an independent
14    team of experts under Brian's Law.
15        (v) Names and information of people who have applied
16    for or received Firearm Owner's Identification Cards under
17    the Firearm Owners Identification Card Act or applied for
18    or received a concealed carry license under the Firearm
19    Concealed Carry Act, unless otherwise authorized by the
20    Firearm Concealed Carry Act; and databases under the
21    Firearm Concealed Carry Act, records of the Concealed Carry
22    Licensing Review Board under the Firearm Concealed Carry
23    Act, and law enforcement agency objections under the
24    Firearm Concealed Carry Act.
25        (w) Personally identifiable information which is
26    exempted from disclosure under subsection (g) of Section

 

 

HB5470- 20 -LRB100 18092 JLS 33285 b

1    19.1 of the Toll Highway Act.
2        (x) Information which is exempted from disclosure
3    under Section 5-1014.3 of the Counties Code or Section
4    8-11-21 of the Illinois Municipal Code.
5        (y) Confidential information under the Adult
6    Protective Services Act and its predecessor enabling
7    statute, the Elder Abuse and Neglect Act, including
8    information about the identity and administrative finding
9    against any caregiver of a verified and substantiated
10    decision of abuse, neglect, or financial exploitation of an
11    eligible adult maintained in the Registry established
12    under Section 7.5 of the Adult Protective Services Act.
13        (z) Records and information provided to a fatality
14    review team or the Illinois Fatality Review Team Advisory
15    Council under Section 15 of the Adult Protective Services
16    Act.
17        (aa) Information which is exempted from disclosure
18    under Section 2.37 of the Wildlife Code.
19        (bb) Information which is or was prohibited from
20    disclosure by the Juvenile Court Act of 1987.
21        (cc) Recordings made under the Law Enforcement
22    Officer-Worn Body Camera Act, except to the extent
23    authorized under that Act.
24        (dd) Information that is prohibited from being
25    disclosed under Section 45 of the Condominium and Common
26    Interest Community Ombudsperson Act.

 

 

HB5470- 21 -LRB100 18092 JLS 33285 b

1        (ee) Information that is exempted from disclosure
2    under Section 30.1 of the Pharmacy Practice Act.
3        (ff) Information that is exempted from disclosure
4    under the Revised Uniform Unclaimed Property Act.
5        (gg) (ff) Information that is prohibited from being
6    disclosed under Section 7-603.5 of the Illinois Vehicle
7    Code.
8        (hh) (ff) Records that are exempt from disclosure under
9    Section 1A-16.7 of the Election Code.
10        (ii) (ff) Information which is exempted from
11    disclosure under Section 2505-800 of the Department of
12    Revenue Law of the Civil Administrative Code of Illinois.
13        (jj) (ff) Information and reports that are required to
14    be submitted to the Department of Labor by registering day
15    and temporary labor service agencies but are exempt from
16    disclosure under subsection (a-1) of Section 45 of the Day
17    and Temporary Labor Services Act.
18        (kk) (ff) Information prohibited from disclosure under
19    the Seizure and Forfeiture Reporting Act.
20        (ll) Information the disclosure of which is restricted
21    and exempted under Sections 25.5 and 29.2 of the Workers'
22    Compensation Act.
23(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
24eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
2599-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
26100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.

 

 

HB5470- 22 -LRB100 18092 JLS 33285 b

18-28-17; 100-465, eff. 8-31-17; 100-512, eff. 7-1-18; 100-517,
2eff. 6-1-18; revised 11-2-17.)
 
3    Section 92. The Criminal Code of 2012 is amended by adding
4Section 17-10.4 as follows:
 
5    (720 ILCS 5/17-10.4 new)
6    Sec. 17-10.4. Workers' compensation fraud.
7    (a) It is unlawful for any person, company, corporation,
8insurance carrier, health care provider, or other entity to:
9        (1) Intentionally present or cause to be presented any
10    false or fraudulent claim for the payment of any workers'
11    compensation benefit.
12        (2) Intentionally make or cause to be made any false or
13    fraudulent material statement or material representation
14    for the purpose of obtaining or denying any workers'
15    compensation benefit.
16        (3) Intentionally make or cause to be made any false or
17    fraudulent statements with regard to entitlement to
18    workers' compensation benefits with the intent to prevent
19    an injured worker from making a legitimate claim for any
20    workers' compensation benefit.
21        (4) Intentionally prepare or provide an invalid,
22    false, or counterfeit certificate of insurance as proof of
23    workers' compensation insurance.
24        (5) Intentionally make or cause to be made any false or

 

 

HB5470- 23 -LRB100 18092 JLS 33285 b

1    fraudulent material statement or material representation
2    for the purpose of obtaining workers' compensation
3    insurance at less than the proper amount for that
4    insurance.
5        (6) Intentionally make or cause to be made any false or
6    fraudulent material statement or material representation
7    on an initial or renewal self-insurance application or
8    accompanying financial statement for the purpose of
9    obtaining self-insurance status or reducing the amount of
10    security that may be required to be furnished pursuant to
11    Section 4 of the Workers' Compensation Act.
12        (7) Intentionally make or cause to be made any false or
13    fraudulent material statement to the Department of
14    Insurance's fraud and insurance non-compliance unit in the
15    course of an investigation of fraud or insurance
16    non-compliance.
17        (8) Intentionally present a bill or statement for the
18    payment for medical services that were not provided.
19        (9) Intentionally assist, abet, solicit, or conspire
20    with any person, company, or other entity to commit any of
21    the acts in paragraph (1), (2), (3), (4), (5), (6), (7), or
22    (8) of this subsection (a).
23    As used in paragraphs (2), (3), (5), (6), (7), and (8),
24"statement" includes any writing, notice, proof of injury, bill
25for services, hospital and doctor records and reports, and
26X-ray and test results.

 

 

HB5470- 24 -LRB100 18092 JLS 33285 b

1    (b) Sentence.
2        (1) A violation of paragraph (a)(3) is a Class 4
3    felony.
4        (2) A violation of paragraph (a)(4) or (a)(7) is a
5    Class 3 felony.
6        (3) A violation of paragraph (a)(1), (a)(2), (a)(5),
7    (a)(6), or (a)(8) in which the value of the property
8    obtained or attempted to be obtained is $500 or less is a
9    Class A misdemeanor.
10        (4) A violation of paragraph (a)(1), (a)(2), (a)(5),
11    (a)(6), or (a)(8) in which the value of the property
12    obtained or attempted to be obtained is more than $500 but
13    not more than $10,000 is a Class 3 felony.
14        (5) A violation of paragraph (a)(1), (a)(2), (a)(5),
15    (a)(6), or (a)(8) in which the value of the property
16    obtained or attempted to be obtained is more than $10,000
17    but not more than $100,000 is a Class 2 felony.
18        (6) A violation of paragraph (a)(1), (a)(2), (a)(5),
19    (a)(6), or (a)(8) in which the value of the property
20    obtained or attempted to be obtained is more than $100,000
21    is a Class 1 felony.
22        (7) A violation of paragraph (9) of subsection (a)
23    shall be punishable as the Class of offense for which the
24    person convicted assisted, abetted, solicited, or
25    conspired to commit, as set forth in paragraphs (1) through
26    (6) of this subsection.

 

 

HB5470- 25 -LRB100 18092 JLS 33285 b

1        (8) A person convicted under this Section shall be
2    ordered to pay monetary restitution to the insurance
3    company or self-insured entity or any other person for any
4    financial loss sustained as a result of a violation of this
5    Section, including any court costs and attorney fees. An
6    order of restitution also includes expenses incurred and
7    paid by the State of Illinois or an insurance company or
8    self-insured entity in connection with any medical
9    evaluation or treatment services.
10    For a violation of paragraph (a)(1) or (a)(2), the value of
11the property obtained or attempted to be obtained includes
12payments pursuant to the provisions of the Workers'
13Compensation Act as well as the amount paid for medical
14expenses. For a violation of paragraph (a)(5), the value of the
15property obtained or attempted to be obtained is the difference
16between the proper amount for the coverage sought or provided
17and the actual amount billed for workers' compensation
18insurance. For a violation of paragraph (a)(6), the value of
19the property obtained or attempted to be obtained is the
20difference between the proper amount of security required
21pursuant to Section 4 of the Workers' Compensation Act and the
22amount furnished pursuant to the false or fraudulent statements
23or representations. Notwithstanding the foregoing, an
24insurance company, self-insured entity, or any other person
25suffering financial loss sustained as a result of violation of
26this Section may seek restitution, including court costs and

 

 

HB5470- 26 -LRB100 18092 JLS 33285 b

1attorney's fees, in a civil action in a court of competent
2jurisdiction.
 
3    Section 93. The Workers' Compensation Act is amended by
4changing Sections 1, 8, 8.1b, 8.2, 8.2a, 14, 19, 25.5, and 29.2
5as follows:
 
6    (820 ILCS 305/1)  (from Ch. 48, par. 138.1)
7    Sec. 1. This Act may be cited as the Workers' Compensation
8Act.
9    (a) The term "employer" as used in this Act means:
10    1. The State and each county, city, town, township,
11incorporated village, school district, body politic, or
12municipal corporation therein.
13    2. Every person, firm, public or private corporation,
14including hospitals, public service, eleemosynary, religious
15or charitable corporations or associations who has any person
16in service or under any contract for hire, express or implied,
17oral or written, and who is engaged in any of the enterprises
18or businesses enumerated in Section 3 of this Act, or who at or
19prior to the time of the accident to the employee for which
20compensation under this Act may be claimed, has in the manner
21provided in this Act elected to become subject to the
22provisions of this Act, and who has not, prior to such
23accident, effected a withdrawal of such election in the manner
24provided in this Act.

 

 

HB5470- 27 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 28 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 29 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 30 -LRB100 18092 JLS 33285 b

1the service of the State, and all probation personnel of the
2Juvenile Court appointed pursuant to Article VI of the Juvenile
3Court Act of 1987, and including any official of the State, any
4county, city, town, township, incorporated village, school
5district, body politic or municipal corporation therein except
6any duly appointed member of a police department in any city
7whose population exceeds 500,000 according to the last Federal
8or State census, and except any member of a fire insurance
9patrol maintained by a board of underwriters in this State. A
10duly appointed member of a fire department in any city, the
11population of which exceeds 500,000 according to the last
12federal or State census, is an employee under this Act only
13with respect to claims brought under paragraph (c) of Section
148.
15    One employed by a contractor who has contracted with the
16State, or a county, city, town, township, incorporated village,
17school district, body politic or municipal corporation
18therein, through its representatives, is not considered as an
19employee of the State, county, city, town, township,
20incorporated village, school district, body politic or
21municipal corporation which made the contract.
22    2. Every person in the service of another under any
23contract of hire, express or implied, oral or written,
24including persons whose employment is outside of the State of
25Illinois where the contract of hire is made within the State of
26Illinois, persons whose employment results in fatal or

 

 

HB5470- 31 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 32 -LRB100 18092 JLS 33285 b

1services as real estate broker, broker-salesman, or salesman
2when such persons are paid by commission only.
3    (c) "Commission" means the Industrial Commission created
4by Section 5 of "The Civil Administrative Code of Illinois",
5approved March 7, 1917, as amended, or the Illinois Workers'
6Compensation Commission created by Section 13 of this Act.
7    (d) To obtain compensation under this Act, an employee
8bears the burden of showing, by a preponderance of the
9evidence, that he or she has sustained accidental injuries
10arising out of and in the course of the employment.
11    (e) The provisions of this subsection (e) apply only to
12traveling employees.
13        (1) Without limitation, an accidental injury shall not
14    be considered to be "arising out of and in the course of
15    employment" if the accidental injury or medical condition
16    for which compensation is sought occurred while the
17    claimant was traveling away from the employer's premises
18    and the travel was not required for the performance of job
19    duties.
20        (2) In determining whether an employee is required to
21    travel for the performance of job duties, the following
22    factors shall be considered: whether the employer had
23    knowledge that the employee may be required to travel to
24    perform the job; whether the employer furnished any mode of
25    transportation to or from the employee; whether the
26    employee received, or the employer paid or agreed to pay,

 

 

HB5470- 33 -LRB100 18092 JLS 33285 b

1    any remuneration or reimbursement for costs or expenses of
2    any form of travel; whether the employer in any way
3    directed the course or method of travel; whether the
4    employer in any way assisted the employee in making any
5    travel arrangements; whether the employer furnished
6    lodging or in any way reimbursed the employee for lodging;
7    and whether the employer received any benefit from the
8    employee traveling.
9(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,
10eff. 7-13-12.)
 
11    (820 ILCS 305/8)  (from Ch. 48, par. 138.8)
12    Sec. 8. The amount of compensation which shall be paid to
13the employee for an accidental injury not resulting in death
14is:
15    (a) The employer shall provide and pay the negotiated rate,
16if applicable, or the lesser of the health care provider's
17actual charges or according to a fee schedule, subject to
18Section 8.2, in effect at the time the service was rendered for
19all the necessary first aid, medical and surgical services, and
20all necessary medical, surgical and hospital services
21thereafter incurred, limited, however, to that which is
22reasonably required to cure or relieve from the effects of the
23accidental injury, even if a health care provider sells,
24transfers, or otherwise assigns an account receivable for
25procedures, treatments, or services covered under this Act. If

 

 

HB5470- 34 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 35 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 36 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 37 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 38 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 39 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 40 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 41 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 42 -LRB100 18092 JLS 33285 b

1    the accident was under 18 years of age and not emancipated.
2    The term "children" means the plural of "child".
3        4. All weekly compensation rates provided under
4    subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
5    Section shall be subject to the following limitations:
6        The maximum weekly compensation rate from July 1, 1975,
7    except as hereinafter provided, shall be 100% of the
8    State's average weekly wage in covered industries under the
9    Unemployment Insurance Act, that being the wage that most
10    closely approximates the State's average weekly wage.
11        The maximum weekly compensation rate, for the period
12    July 1, 1984, through June 30, 1987, except as hereinafter
13    provided, shall be $293.61. Effective July 1, 1987 and on
14    July 1 of each year thereafter the maximum weekly
15    compensation rate, except as hereinafter provided, shall
16    be determined as follows: if during the preceding 12 month
17    period there shall have been an increase in the State's
18    average weekly wage in covered industries under the
19    Unemployment Insurance Act, the weekly compensation rate
20    shall be proportionately increased by the same percentage
21    as the percentage of increase in the State's average weekly
22    wage in covered industries under the Unemployment
23    Insurance Act during such period.
24        The maximum weekly compensation rate, for the period
25    January 1, 1981 through December 31, 1983, except as
26    hereinafter provided, shall be 100% of the State's average

 

 

HB5470- 43 -LRB100 18092 JLS 33285 b

1    weekly wage in covered industries under the Unemployment
2    Insurance Act in effect on January 1, 1981. Effective
3    January 1, 1984 and on January 1, of each year thereafter
4    the maximum weekly compensation rate, except as
5    hereinafter provided, shall be determined as follows: if
6    during the preceding 12 month period there shall have been
7    an increase in the State's average weekly wage in covered
8    industries under the Unemployment Insurance Act, the
9    weekly compensation rate shall be proportionately
10    increased by the same percentage as the percentage of
11    increase in the State's average weekly wage in covered
12    industries under the Unemployment Insurance Act during
13    such period.
14        The maximum compensation rate for the period July 1,
15    2018 through June 30, 2022, except as hereinafter provided,
16    shall be $775.18. Effective July 1, 2022 and on July 1 of
17    each year thereafter the maximum weekly compensation rate,
18    except as hereinafter provided, shall be determined as
19    follows: if during the preceding 12-month period there
20    shall have been an increase in the State's average weekly
21    wage in covered industries under the Unemployment
22    Insurance Act, the weekly compensation rate shall be
23    proportionately increased by the same percentage as the
24    percentage of increase in the State's average weekly wage
25    in covered industries under the Unemployment Insurance Act
26    during such period.

 

 

HB5470- 44 -LRB100 18092 JLS 33285 b

1        From July 1, 1977 and thereafter such maximum weekly
2    compensation rate in death cases under Section 7, and
3    permanent total disability cases under paragraph (f) or
4    subparagraph 18 of paragraph (3) of this Section and for
5    temporary total disability under paragraph (b) of this
6    Section and for amputation of a member or enucleation of an
7    eye under paragraph (e) of this Section shall be increased
8    to 133-1/3% of the State's average weekly wage in covered
9    industries under the Unemployment Insurance Act.
10        For injuries occurring on or after February 1, 2006,
11    the maximum weekly benefit under paragraph (d)1 of this
12    Section shall be 100% of the State's average weekly wage in
13    covered industries under the Unemployment Insurance Act.
14        4.1. Any provision herein to the contrary
15    notwithstanding, the weekly compensation rate for
16    compensation payments under subparagraph 18 of paragraph
17    (e) of this Section and under paragraph (f) of this Section
18    and under paragraph (a) of Section 7 and for amputation of
19    a member or enucleation of an eye under paragraph (e) of
20    this Section, shall in no event be less than 50% of the
21    State's average weekly wage in covered industries under the
22    Unemployment Insurance Act.
23        4.2. Any provision to the contrary notwithstanding,
24    the total compensation payable under Section 7 shall not
25    exceed the greater of $500,000 or 25 years.
26        5. For the purpose of this Section this State's average

 

 

HB5470- 45 -LRB100 18092 JLS 33285 b

1    weekly wage in covered industries under the Unemployment
2    Insurance Act on July 1, 1975 is hereby fixed at $228.16
3    per week and the computation of compensation rates shall be
4    based on the aforesaid average weekly wage until modified
5    as hereinafter provided.
6        6. The Department of Employment Security of the State
7    shall on or before the first day of December, 1977, and on
8    or before the first day of June, 1978, and on the first day
9    of each December and June of each year thereafter, publish
10    the State's average weekly wage in covered industries under
11    the Unemployment Insurance Act and the Illinois Workers'
12    Compensation Commission shall on the 15th day of January,
13    1978 and on the 15th day of July, 1978 and on the 15th day
14    of each January and July of each year thereafter, post and
15    publish the State's average weekly wage in covered
16    industries under the Unemployment Insurance Act as last
17    determined and published by the Department of Employment
18    Security. The amount when so posted and published shall be
19    conclusive and shall be applicable as the basis of
20    computation of compensation rates until the next posting
21    and publication as aforesaid.
22        7. The payment of compensation by an employer or his
23    insurance carrier to an injured employee shall not
24    constitute an admission of the employer's liability to pay
25    compensation.
26    (c) For any serious and permanent disfigurement to the

 

 

HB5470- 46 -LRB100 18092 JLS 33285 b

1hand, head, face, neck, arm, leg below the knee or the chest
2above the axillary line, the employee is entitled to
3compensation for such disfigurement, the amount determined by
4agreement at any time or by arbitration under this Act, at a
5hearing not less than 6 months after the date of the accidental
6injury, which amount shall not exceed 150 weeks (if the
7accidental injury occurs on or after the effective date of this
8amendatory Act of the 94th General Assembly but before February
91, 2006) or 162 weeks (if the accidental injury occurs on or
10after February 1, 2006) at the applicable rate provided in
11subparagraph 2.1 of paragraph (b) of this Section.
12    No compensation is payable under this paragraph where
13compensation is payable under paragraphs (d), (e) or (f) of
14this Section.
15    A duly appointed member of a fire department in a city, the
16population of which exceeds 500,000 according to the last
17federal or State census, is eligible for compensation under
18this paragraph only where such serious and permanent
19disfigurement results from burns.
20    (d) 1. If, after the accidental injury has been sustained,
21the employee as a result thereof becomes partially
22incapacitated from pursuing his usual and customary line of
23employment, he shall, except in cases compensated under the
24specific schedule set forth in paragraph (e) of this Section,
25receive compensation for the duration of his disability,
26subject to the limitations as to maximum amounts fixed in

 

 

HB5470- 47 -LRB100 18092 JLS 33285 b

1paragraph (b) of this Section, equal to 66-2/3% of the
2difference between the average amount which he would be able to
3earn in the full performance of his duties in the occupation in
4which he was engaged at the time of the accident and the
5average amount which he is earning or is able to earn in some
6suitable employment or business after the accident. For
7accidental injuries that occur on or after September 1, 2011,
8an award for wage differential under this subsection shall be
9effective only until the employee reaches the age of 67 or 5
10years from the date the award becomes final, whichever is
11later.
12    2. If, as a result of the accident, the employee sustains
13serious and permanent injuries not covered by paragraphs (c)
14and (e) of this Section or having sustained injuries covered by
15the aforesaid paragraphs (c) and (e), he shall have sustained
16in addition thereto other injuries which injuries do not
17incapacitate him from pursuing the duties of his employment but
18which would disable him from pursuing other suitable
19occupations, or which have otherwise resulted in physical
20impairment; or if such injuries partially incapacitate him from
21pursuing the duties of his usual and customary line of
22employment but do not result in an impairment of earning
23capacity, or having resulted in an impairment of earning
24capacity, the employee elects to waive his right to recover
25under the foregoing subparagraph 1 of paragraph (d) of this
26Section then in any of the foregoing events, he shall receive

 

 

HB5470- 48 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 49 -LRB100 18092 JLS 33285 b

1total incapacity for work resulting from such accidental
2injury, under subparagraph 1 of paragraph (b) of this Section,
3and shall receive in addition thereto compensation for a
4further period for the specific loss herein mentioned, but
5shall not receive any compensation under any other provisions
6of this Act. The following listed amounts apply to either the
7loss of or the permanent and complete loss of use of the member
8specified, such compensation for the length of time as follows:
9        1. Thumb-
10            70 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            76 weeks if the accidental injury occurs on or
14        after February 1, 2006.
15        2. First, or index finger-
16            40 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            43 weeks if the accidental injury occurs on or
20        after February 1, 2006.
21        3. Second, or middle finger-
22            35 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            38 weeks if the accidental injury occurs on or
26        after February 1, 2006.

 

 

HB5470- 50 -LRB100 18092 JLS 33285 b

1        4. Third, or ring finger-
2            25 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            27 weeks if the accidental injury occurs on or
6        after February 1, 2006.
7        5. Fourth, or little finger-
8            20 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            22 weeks if the accidental injury occurs on or
12        after February 1, 2006.
13        6. Great toe-
14            35 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            38 weeks if the accidental injury occurs on or
18        after February 1, 2006.
19        7. Each toe other than great toe-
20            12 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            13 weeks if the accidental injury occurs on or
24        after February 1, 2006.
25        8. The loss of the first or distal phalanx of the thumb
26    or of any finger or toe shall be considered to be equal to

 

 

HB5470- 51 -LRB100 18092 JLS 33285 b

1    the loss of one-half of such thumb, finger or toe and the
2    compensation payable shall be one-half of the amount above
3    specified. The loss of more than one phalanx shall be
4    considered as the loss of the entire thumb, finger or toe.
5    In no case shall the amount received for more than one
6    finger exceed the amount provided in this schedule for the
7    loss of a hand.
8        9. Hand-
9            190 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            205 weeks if the accidental injury occurs on or
13        after February 1, 2006.
14            190 weeks if the accidental injury occurs on or
15        after June 28, 2011 (the effective date of Public Act
16        97-18) and if the accidental injury involves carpal
17        tunnel syndrome due to repetitive or cumulative
18        trauma, in which case the permanent partial disability
19        shall not exceed 15% loss of use of the hand, except
20        for cause shown by clear and convincing evidence and in
21        which case the award shall not exceed 30% loss of use
22        of the hand.
23        The loss of 2 or more digits, or one or more phalanges
24    of 2 or more digits, of a hand may be compensated on the
25    basis of partial loss of use of a hand, provided, further,
26    that the loss of 4 digits, or the loss of use of 4 digits,

 

 

HB5470- 52 -LRB100 18092 JLS 33285 b

1    in the same hand shall constitute the complete loss of a
2    hand.
3        10. Arm-
4            235 weeks if the accidental injury occurs on or
5        after the effective date of this amendatory Act of the
6        94th General Assembly but before February 1, 2006.
7            253 weeks if the accidental injury occurs on or
8        after February 1, 2006.
9        Where an accidental injury results in the amputation of
10    an arm below the elbow, such injury shall be compensated as
11    a loss of an arm. Where an accidental injury results in the
12    amputation of an arm above the elbow, compensation for an
13    additional 15 weeks (if the accidental injury occurs on or
14    after the effective date of this amendatory Act of the 94th
15    General Assembly but before February 1, 2006) or an
16    additional 17 weeks (if the accidental injury occurs on or
17    after February 1, 2006) shall be paid, except where the
18    accidental injury results in the amputation of an arm at
19    the shoulder joint, or so close to shoulder joint that an
20    artificial arm cannot be used, or results in the
21    disarticulation of an arm at the shoulder joint, in which
22    case compensation for an additional 65 weeks (if the
23    accidental injury occurs on or after the effective date of
24    this amendatory Act of the 94th General Assembly but before
25    February 1, 2006) or an additional 70 weeks (if the
26    accidental injury occurs on or after February 1, 2006)

 

 

HB5470- 53 -LRB100 18092 JLS 33285 b

1    shall be paid.
2        For purposes of awards under this subdivision (e),
3    injuries to the shoulder shall be considered injuries to
4    part of the arm. The foregoing change made by this
5    amendatory Act of the 100th General Assembly to this
6    subdivision (e)10 of this Section 8 is declarative of
7    existing law and is not a new enactment.
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

 

 

HB5470- 54 -LRB100 18092 JLS 33285 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        For purposes of awards under this subdivision (e),
13    injuries to the hip shall be considered injuries to part of
14    the leg. The foregoing change made by this amendatory Act
15    of the 100th General Assembly to this subdivision (e)12 of
16    this Section 8 is declarative of existing law and is not a
17    new enactment.
18        13. Eye-
19            150 weeks if the accidental injury occurs on or
20        after the effective date of this amendatory Act of the
21        94th General Assembly but before February 1, 2006.
22            162 weeks if the accidental injury occurs on or
23        after February 1, 2006.
24        Where an accidental injury results in the enucleation
25    of an eye, compensation for an additional 10 weeks (if the
26    accidental injury occurs on or after the effective date of

 

 

HB5470- 55 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 56 -LRB100 18092 JLS 33285 b

1            162 weeks if the accidental injury occurs on or
2        after February 1, 2006.
3        16. For the permanent partial loss of use of a member
4    or sight of an eye, or hearing of an ear, compensation
5    during that proportion of the number of weeks in the
6    foregoing schedule provided for the loss of such member or
7    sight of an eye, or hearing of an ear, which the partial
8    loss of use thereof bears to the total loss of use of such
9    member, or sight of eye, or hearing of an ear.
10            (a) Loss of hearing for compensation purposes
11        shall be confined to the frequencies of 1,000, 2,000
12        and 3,000 cycles per second. Loss of hearing ability
13        for frequency tones above 3,000 cycles per second are
14        not to be considered as constituting disability for
15        hearing.
16            (b) The percent of hearing loss, for purposes of
17        the determination of compensation claims for
18        occupational deafness, shall be calculated as the
19        average in decibels for the thresholds of hearing for
20        the frequencies of 1,000, 2,000 and 3,000 cycles per
21        second. Pure tone air conduction audiometric
22        instruments, approved by nationally recognized
23        authorities in this field, shall be used for measuring
24        hearing loss. If the losses of hearing average 30
25        decibels or less in the 3 frequencies, such losses of
26        hearing shall not then constitute any compensable

 

 

HB5470- 57 -LRB100 18092 JLS 33285 b

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

 

 

HB5470- 58 -LRB100 18092 JLS 33285 b

1Slow ResponseHours Per Day
2908
3926
4954
5973
61002
71021-1/2
81051
91101/2
101151/4
11        This subparagraph (f) shall not be applied in cases of
12    hearing loss resulting from trauma or explosion.
13        17. In computing the compensation to be paid to any
14    employee who, before the accident for which he claims
15    compensation, had before that time sustained an injury
16    resulting in the loss by amputation or partial loss by
17    amputation of any member, including hand, arm, thumb or
18    fingers, leg, foot, or any toes, or loss under Section
19    8(d)2 due to accidental injuries to the same part of the
20    spine, such loss or partial loss of any such member or loss
21    under Section 8(d)2 due to accidental injuries to the same
22    part of the spine shall be deducted from any award made for
23    the subsequent injury. For the permanent loss of use or the
24    permanent partial loss of use of any such member or the
25    partial loss of sight of an eye or loss under Section 8(d)2
26    due to accidental injuries to the same part of the spine,

 

 

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1    for which compensation has been paid, then such loss shall
2    be taken into consideration and deducted from any award for
3    the subsequent injury. For purposes of this subdivision
4    (e)17 only, "same part of the spine" means: (1) cervical
5    spine and thoracic spine from vertebra C1 through T12 and
6    (2) lumbar and sacral spine and coccyx from vertebra L1
7    through S5.
8        18. The specific case of loss of both hands, both arms,
9    or both feet, or both legs, or both eyes, or of any two
10    thereof, or the permanent and complete loss of the use
11    thereof, constitutes total and permanent disability, to be
12    compensated according to the compensation fixed by
13    paragraph (f) of this Section. These specific cases of
14    total and permanent disability do not exclude other cases.
15        Any employee who has previously suffered the loss or
16    permanent and complete loss of the use of any of such
17    members, and in a subsequent independent accident loses
18    another or suffers the permanent and complete loss of the
19    use of any one of such members the employer for whom the
20    injured employee is working at the time of the last
21    independent accident is liable to pay compensation only for
22    the loss or permanent and complete loss of the use of the
23    member occasioned by the last independent accident.
24        19. In a case of specific loss and the subsequent death
25    of such injured employee from other causes than such injury
26    leaving a widow, widower, or dependents surviving before

 

 

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1    payment or payment in full for such injury, then the amount
2    due for such injury is payable to the widow or widower and,
3    if there be no widow or widower, then to such dependents,
4    in the proportion which such dependency bears to total
5    dependency.
6    Beginning July 1, 1980, and every 6 months thereafter, the
7Commission shall examine the Second Injury Fund and when, after
8deducting all advances or loans made to such Fund, the amount
9therein is $500,000 then the amount required to be paid by
10employers pursuant to paragraph (f) of Section 7 shall be
11reduced by one-half. When the Second Injury Fund reaches the
12sum of $600,000 then the payments shall cease entirely.
13However, when the Second Injury Fund has been reduced to
14$400,000, payment of one-half of the amounts required by
15paragraph (f) of Section 7 shall be resumed, in the manner
16herein provided, and when the Second Injury Fund has been
17reduced to $300,000, payment of the full amounts required by
18paragraph (f) of Section 7 shall be resumed, in the manner
19herein provided. The Commission shall make the changes in
20payment effective by general order, and the changes in payment
21become immediately effective for all cases coming before the
22Commission thereafter either by settlement agreement or final
23order, irrespective of the date of the accidental injury.
24    On August 1, 1996 and on February 1 and August 1 of each
25subsequent year, the Commission shall examine the special fund
26designated as the "Rate Adjustment Fund" and when, after

 

 

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1deducting all advances or loans made to said fund, the amount
2therein is $4,000,000, the amount required to be paid by
3employers pursuant to paragraph (f) of Section 7 shall be
4reduced by one-half. When the Rate Adjustment Fund reaches the
5sum of $5,000,000 the payment therein shall cease entirely.
6However, when said Rate Adjustment Fund has been reduced to
7$3,000,000 the amounts required by paragraph (f) of Section 7
8shall be resumed in the manner herein provided.
9    (f) In case of complete disability, which renders the
10employee wholly and permanently incapable of work, or in the
11specific case of total and permanent disability as provided in
12subparagraph 18 of paragraph (e) of this Section, compensation
13shall be payable at the rate provided in subparagraph 2 of
14paragraph (b) of this Section for life.
15    An employee entitled to benefits under paragraph (f) of
16this Section shall also be entitled to receive from the Rate
17Adjustment Fund provided in paragraph (f) of Section 7 of the
18supplementary benefits provided in paragraph (g) of this
19Section 8.
20    If any employee who receives an award under this paragraph
21afterwards returns to work or is able to do so, and earns or is
22able to earn as much as before the accident, payments under
23such award shall cease. If such employee returns to work, or is
24able to do so, and earns or is able to earn part but not as much
25as before the accident, such award shall be modified so as to
26conform to an award under paragraph (d) of this Section. If

 

 

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1such award is terminated or reduced under the provisions of
2this paragraph, such employees have the right at any time
3within 30 months after the date of such termination or
4reduction to file petition with the Commission for the purpose
5of determining whether any disability exists as a result of the
6original accidental injury and the extent thereof.
7    Disability as enumerated in subdivision 18, paragraph (e)
8of this Section is considered complete disability.
9    If an employee who had previously incurred loss or the
10permanent and complete loss of use of one member, through the
11loss or the permanent and complete loss of the use of one hand,
12one arm, one foot, one leg, or one eye, incurs permanent and
13complete disability through the loss or the permanent and
14complete loss of the use of another member, he shall receive,
15in addition to the compensation payable by the employer and
16after such payments have ceased, an amount from the Second
17Injury Fund provided for in paragraph (f) of Section 7, which,
18together with the compensation payable from the employer in
19whose employ he was when the last accidental injury was
20incurred, will equal the amount payable for permanent and
21complete disability as provided in this paragraph of this
22Section.
23    The custodian of the Second Injury Fund provided for in
24paragraph (f) of Section 7 shall be joined with the employer as
25a party respondent in the application for adjustment of claim.
26The application for adjustment of claim shall state briefly and

 

 

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1in general terms the approximate time and place and manner of
2the loss of the first member.
3    In its award the Commission or the Arbitrator shall
4specifically find the amount the injured employee shall be
5weekly paid, the number of weeks compensation which shall be
6paid by the employer, the date upon which payments begin out of
7the Second Injury Fund provided for in paragraph (f) of Section
87 of this Act, the length of time the weekly payments continue,
9the date upon which the pension payments commence and the
10monthly amount of the payments. The Commission shall 30 days
11after the date upon which payments out of the Second Injury
12Fund have begun as provided in the award, and every month
13thereafter, prepare and submit to the State Comptroller a
14voucher for payment for all compensation accrued to that date
15at the rate fixed by the Commission. The State Comptroller
16shall draw a warrant to the injured employee along with a
17receipt to be executed by the injured employee and returned to
18the Commission. The endorsed warrant and receipt is a full and
19complete acquittance to the Commission for the payment out of
20the Second Injury Fund. No other appropriation or warrant is
21necessary for payment out of the Second Injury Fund. The Second
22Injury Fund is appropriated for the purpose of making payments
23according to the terms of the awards.
24    As of July 1, 1980 to July 1, 1982, all claims against and
25obligations of the Second Injury Fund shall become claims
26against and obligations of the Rate Adjustment Fund to the

 

 

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1extent there is insufficient money in the Second Injury Fund to
2pay such claims and obligations. In that case, all references
3to "Second Injury Fund" in this Section shall also include the
4Rate Adjustment Fund.
5    (g) Every award for permanent total disability entered by
6the Commission on and after July 1, 1965 under which
7compensation payments shall become due and payable after the
8effective date of this amendatory Act, and every award for
9death benefits or permanent total disability entered by the
10Commission on and after the effective date of this amendatory
11Act shall be subject to annual adjustments as to the amount of
12the compensation rate therein provided. Such adjustments shall
13first be made on July 15, 1977, and all awards made and entered
14prior to July 1, 1975 and on July 15 of each year thereafter.
15In all other cases such adjustment shall be made on July 15 of
16the second year next following the date of the entry of the
17award and shall further be made on July 15 annually thereafter.
18If during the intervening period from the date of the entry of
19the award, or the last periodic adjustment, there shall have
20been an increase in the State's average weekly wage in covered
21industries under the Unemployment Insurance Act, the weekly
22compensation rate shall be proportionately increased by the
23same percentage as the percentage of increase in the State's
24average weekly wage in covered industries under the
25Unemployment Insurance Act. The increase in the compensation
26rate under this paragraph shall in no event bring the total

 

 

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1compensation rate to an amount greater than the prevailing
2maximum rate at the time that the annual adjustment is made.
3Such increase shall be paid in the same manner as herein
4provided for payments under the Second Injury Fund to the
5injured employee, or his dependents, as the case may be, out of
6the Rate Adjustment Fund provided in paragraph (f) of Section 7
7of this Act. Payments shall be made at the same intervals as
8provided in the award or, at the option of the Commission, may
9be made in quarterly payment on the 15th day of January, April,
10July and October of each year. In the event of a decrease in
11such average weekly wage there shall be no change in the then
12existing compensation rate. The within paragraph shall not
13apply to cases where there is disputed liability and in which a
14compromise lump sum settlement between the employer and the
15injured employee, or his dependents, as the case may be, has
16been duly approved by the Illinois Workers' Compensation
17Commission.
18    Provided, that in cases of awards entered by the Commission
19for injuries occurring before July 1, 1975, the increases in
20the compensation rate adjusted under the foregoing provision of
21this paragraph (g) shall be limited to increases in the State's
22average weekly wage in covered industries under the
23Unemployment Insurance Act occurring after July 1, 1975.
24    For every accident occurring on or after July 20, 2005 but
25before the effective date of this amendatory Act of the 94th
26General Assembly (Senate Bill 1283 of the 94th General

 

 

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1Assembly), the annual adjustments to the compensation rate in
2awards for death benefits or permanent total disability, as
3provided in this Act, shall be paid by the employer. The
4adjustment shall be made by the employer on July 15 of the
5second year next following the date of the entry of the award
6and shall further be made on July 15 annually thereafter. If
7during the intervening period from the date of the entry of the
8award, or the last periodic adjustment, there shall have been
9an increase in the State's average weekly wage in covered
10industries under the Unemployment Insurance Act, the employer
11shall increase the weekly compensation rate proportionately by
12the same percentage as the percentage of increase in the
13State's average 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. In
18the event of a decrease in such average weekly wage there shall
19be no change in the then existing compensation rate. Such
20increase shall be paid by the employer in the same manner and
21at the same intervals as the payment of compensation in the
22award. This paragraph shall not apply to cases where there is
23disputed liability and in which a compromise lump sum
24settlement between the employer and the injured employee, or
25his or her dependents, as the case may be, has been duly
26approved by the Illinois Workers' Compensation Commission.

 

 

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1    The annual adjustments for every award of death benefits or
2permanent total disability involving accidents occurring
3before July 20, 2005 and accidents occurring on or after the
4effective date of this amendatory Act of the 94th General
5Assembly (Senate Bill 1283 of the 94th General Assembly) shall
6continue to be paid from the Rate Adjustment Fund pursuant to
7this paragraph and Section 7(f) of this Act.
8    (h) In case death occurs from any cause before the total
9compensation to which the employee would have been entitled has
10been paid, then in case the employee leaves any widow, widower,
11child, parent (or any grandchild, grandparent or other lineal
12heir or any collateral heir dependent at the time of the
13accident upon the earnings of the employee to the extent of 50%
14or more of total dependency) such compensation shall be paid to
15the beneficiaries of the deceased employee and distributed as
16provided in paragraph (g) of Section 7.
17    (h-1) In case an injured employee is under legal disability
18at the time when any right or privilege accrues to him or her
19under this Act, a guardian may be appointed pursuant to law,
20and may, on behalf of such person under legal disability, claim
21and exercise any such right or privilege with the same effect
22as if the employee himself or herself had claimed or exercised
23the right or privilege. No limitations of time provided by this
24Act run so long as the employee who is under legal disability
25is without a conservator or guardian.
26    (i) In case the injured employee is under 16 years of age

 

 

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1at the time of the accident and is illegally employed, the
2amount of compensation payable under paragraphs (b), (c), (d),
3(e) and (f) of this Section is increased 50%.
4    However, where an employer has on file an employment
5certificate issued pursuant to the Child Labor Law or work
6permit issued pursuant to the Federal Fair Labor Standards Act,
7as amended, or a birth certificate properly and duly issued,
8such certificate, permit or birth certificate is conclusive
9evidence as to the age of the injured minor employee for the
10purposes of this Section.
11    Nothing herein contained repeals or amends the provisions
12of the Child Labor Law relating to the employment of minors
13under the age of 16 years.
14    (j) 1. In the event the injured employee receives benefits,
15including medical, surgical or hospital benefits under any
16group plan covering non-occupational disabilities contributed
17to wholly or partially by the employer, which benefits should
18not have been payable if any rights of recovery existed under
19this Act, then such amounts so paid to the employee from any
20such group plan as shall be consistent with, and limited to,
21the provisions of paragraph 2 hereof, shall be credited to or
22against any compensation payment for temporary total
23incapacity for work or any medical, surgical or hospital
24benefits made or to be made under this Act. In such event, the
25period of time for giving notice of accidental injury and
26filing application for adjustment of claim does not commence to

 

 

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1run until the termination of such payments. This paragraph does
2not apply to payments made under any group plan which would
3have been payable irrespective of an accidental injury under
4this Act. Any employer receiving such credit shall keep such
5employee safe and harmless from any and all claims or
6liabilities that may be made against him by reason of having
7received such payments only to the extent of such credit.
8    Any excess benefits paid to or on behalf of a State
9employee by the State Employees' Retirement System under
10Article 14 of the Illinois Pension Code on a death claim or
11disputed disability claim shall be credited against any
12payments made or to be made by the State of Illinois to or on
13behalf of such employee under this Act, except for payments for
14medical expenses which have already been incurred at the time
15of the award. The State of Illinois shall directly reimburse
16the State Employees' Retirement System to the extent of such
17credit.
18    2. Nothing contained in this Act shall be construed to give
19the employer or the insurance carrier the right to credit for
20any benefits or payments received by the employee other than
21compensation payments provided by this Act, and where the
22employee receives payments other than compensation payments,
23whether as full or partial salary, group insurance benefits,
24bonuses, annuities or any other payments, the employer or
25insurance carrier shall receive credit for each such payment
26only to the extent of the compensation that would have been

 

 

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1payable during the period covered by such payment.
2    3. The extension of time for the filing of an Application
3for Adjustment of Claim as provided in paragraph 1 above shall
4not apply to those cases where the time for such filing had
5expired prior to the date on which payments or benefits
6enumerated herein have been initiated or resumed. Provided
7however that this paragraph 3 shall apply only to cases wherein
8the payments or benefits hereinabove enumerated shall be
9received after July 1, 1969.
10(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,
11eff. 7-13-12.)
 
12    (820 ILCS 305/8.1b)
13    Sec. 8.1b. Determination of permanent partial disability.
14For accidental injuries that occur on or after September 1,
152011, permanent partial disability shall be established using
16the following criteria:
17    (a) A physician licensed to practice medicine in all of its
18branches preparing a permanent partial disability impairment
19report shall report the level of impairment in writing. The
20report shall include an evaluation of medically defined and
21professionally appropriate measurements of impairment that
22include, but are not limited to: loss of range of motion; loss
23of strength; measured atrophy of tissue mass consistent with
24the injury; and any other measurements that establish the
25nature and extent of the impairment. The most current edition

 

 

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1of the American Medical Association's "Guides to the Evaluation
2of Permanent Impairment" shall be used by the physician in
3determining the level of impairment.
4    (b) Where an impairment report pursuant to subsection (a)
5exists, it must be considered by the Commission in its
6determination of the level of permanent partial disability.
7    In determining the level of permanent partial disability,
8the Commission shall base its determination on the reported
9level of impairment pursuant to subsection (a). In addition to
10any impairment report submitted, the Commission shall, by a
11preponderance of credible evidence, consider the following
12additional factors to determine disability: (i) the occupation
13of the injured employee; (ii) the age of the employee at the
14time of the injury; (iii) the employee's future earning
15capacity; and (iv) evidence of disability at maximum medical
16improvement corroborated by findings in the treating medical
17records and independent medical exams. In determining the level
18of permanent partial disability, the Commission shall base its
19determination on a report of impairment, after considering by a
20preponderance of credible evidence, the additional factors to
21determine disability. No single enumerated factor shall be the
22sole determinant of disability. In determining the level of
23disability, the relevance and weight of any factors used in
24addition to the level of impairment as reported by the
25physician must be explained in a written order.
26    (c) A report of impairment prepared pursuant to subsection

 

 

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1(a) is not required for the arbitrator or Commission to approve
2a Settlement Contract Lump Sum Petition.
3    (b) In determining the level of permanent partial
4disability, the Commission shall base its determination on the
5following factors: (i) the reported level of impairment
6pursuant to subsection (a); (ii) the occupation of the injured
7employee; (iii) the age of the employee at the time of the
8injury; (iv) the employee's future earning capacity; and (v)
9evidence of disability corroborated by the treating medical
10records. No single enumerated factor shall be the sole
11determinant of disability. In determining the level of
12disability, the relevance and weight of any factors used in
13addition to the level of impairment as reported by the
14physician must be explained in a written order.
15(Source: P.A. 97-18, eff. 6-28-11.)
 
16    (820 ILCS 305/8.2)
17    Sec. 8.2. Fee schedule.
18    (a) Except as provided for in subsection (c), for
19procedures, treatments, or services covered under this Act and
20rendered or to be rendered on and after February 1, 2006, the
21maximum allowable payment shall be 90% of the 80th percentile
22of charges and fees as determined by the Commission utilizing
23information provided by employers' and insurers' national
24databases, with a minimum of 12,000,000 Illinois line item
25charges and fees comprised of health care provider and hospital

 

 

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1charges and fees as of August 1, 2004 but not earlier than
2August 1, 2002. These charges and fees are provider billed
3amounts and shall not include discounted charges. The 80th
4percentile is the point on an ordered data set from low to high
5such that 80% of the cases are below or equal to that point and
6at most 20% are above or equal to that point. The Commission
7shall adjust these historical charges and fees as of August 1,
82004 by the Consumer Price Index-U for the period August 1,
92004 through September 30, 2005. The Commission shall establish
10fee schedules for procedures, treatments, or services for
11hospital inpatient, hospital outpatient, emergency room and
12trauma, ambulatory surgical treatment centers, and
13professional services. These charges and fees shall be
14designated by geozip or any smaller geographic unit. The data
15shall in no way identify or tend to identify any patient,
16employer, or health care provider. As used in this Section,
17"geozip" means a three-digit zip code based on data
18similarities, geographical similarities, and frequencies. A
19geozip does not cross state boundaries. As used in this
20Section, "three-digit zip code" means a geographic area in
21which all zip codes have the same first 3 digits. If a geozip
22does not have the necessary number of charges and fees to
23calculate a valid percentile for a specific procedure,
24treatment, or service, the Commission may combine data from the
25geozip with up to 4 other geozips that are demographically and
26economically similar and exhibit similarities in data and

 

 

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1frequencies until the Commission reaches 9 charges or fees for
2that specific procedure, treatment, or service. In cases where
3the compiled data contains less than 9 charges or fees for a
4procedure, treatment, or service, reimbursement shall occur at
576% of charges and fees as determined by the Commission in a
6manner consistent with the provisions of this paragraph.
7Providers of out-of-state procedures, treatments, services,
8products, or supplies shall be reimbursed at the lesser of that
9state's fee schedule amount or the fee schedule amount for the
10region in which the employee resides. If no fee schedule exists
11in that state, the provider shall be reimbursed at the lesser
12of the actual charge or the fee schedule amount for the region
13in which the employee resides. Not later than September 30 in
142006 and each year thereafter, the Commission shall
15automatically increase or decrease the maximum allowable
16payment for a procedure, treatment, or service established and
17in effect on January 1 of that year by the percentage change in
18the Consumer Price Index-U for the 12 month period ending
19August 31 of that year. The increase or decrease shall become
20effective on January 1 of the following year. As used in this
21Section, "Consumer Price Index-U" means the index published by
22the Bureau of Labor Statistics of the U.S. Department of Labor,
23that measures the average change in prices of all goods and
24services purchased by all urban consumers, U.S. city average,
25all items, 1982-84=100.
26    The provisions of this subsection (a), other than this

 

 

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1sentence, are inoperative after August 31, 2018.
2    (a-1) Notwithstanding the provisions of subsection (a) and
3unless otherwise indicated, the following provisions shall
4apply to the medical fee schedule starting on September 1,
52011:
6        (1) The Commission shall establish and maintain fee
7    schedules for procedures, treatments, products, services,
8    or supplies for hospital inpatient, hospital outpatient,
9    emergency room, ambulatory surgical treatment centers,
10    accredited ambulatory surgical treatment facilities,
11    prescriptions filled and dispensed outside of a licensed
12    pharmacy, dental services, and professional services. This
13    fee schedule shall be based on the fee schedule amounts
14    already established by the Commission pursuant to
15    subsection (a) of this Section. However, starting on
16    January 1, 2012, these fee schedule amounts shall be
17    grouped into geographic regions in the following manner:
18            (A) Four regions for non-hospital fee schedule
19        amounts shall be utilized:
20                (i) Cook County;
21                (ii) DuPage, Kane, Lake, and Will Counties;
22                (iii) Bond, Calhoun, Clinton, Jersey,
23            Macoupin, Madison, Monroe, Montgomery, Randolph,
24            St. Clair, and Washington Counties; and
25                (iv) All other counties of the State.
26            (B) Fourteen regions for hospital fee schedule

 

 

HB5470- 76 -LRB100 18092 JLS 33285 b

1        amounts shall be utilized:
2                (i) Cook, DuPage, Will, Kane, McHenry, DeKalb,
3            Kendall, and Grundy Counties;
4                (ii) Kankakee County;
5                (iii) Madison, St. Clair, Macoupin, Clinton,
6            Monroe, Jersey, Bond, and Calhoun Counties;
7                (iv) Winnebago and Boone Counties;
8                (v) Peoria, Tazewell, Woodford, Marshall, and
9            Stark Counties;
10                (vi) Champaign, Piatt, and Ford Counties;
11                (vii) Rock Island, Henry, and Mercer Counties;
12                (viii) Sangamon and Menard Counties;
13                (ix) McLean County;
14                (x) Lake County;
15                (xi) Macon County;
16                (xii) Vermilion County;
17                (xiii) Alexander County; and
18                (xiv) All other counties of the State.
19        (2) If a geozip, as defined in subsection (a) of this
20    Section, overlaps into one or more of the regions set forth
21    in this Section, then the Commission shall average or
22    repeat the charges and fees in a geozip in order to
23    designate charges and fees for each region.
24        (3) In cases where the compiled data contains less than
25    9 charges or fees for a procedure, treatment, product,
26    supply, or service or where the fee schedule amount cannot

 

 

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1    be determined by the non-discounted charge data,
2    non-Medicare relative values and conversion factors
3    derived from established fee schedule amounts, coding
4    crosswalks, or other data as determined by the Commission,
5    reimbursement shall occur at 76% of charges and fees until
6    September 1, 2011 and 53.2% of charges and fees thereafter
7    as determined by the Commission in a manner consistent with
8    the provisions of this paragraph.
9        (4) To establish additional fee schedule amounts, the
10    Commission shall utilize provider non-discounted charge
11    data, non-Medicare relative values and conversion factors
12    derived from established fee schedule amounts, and coding
13    crosswalks. The Commission may establish additional fee
14    schedule amounts based on either the charge or cost of the
15    procedure, treatment, product, supply, or service.
16        (5) Implants shall be reimbursed at 25% above the net
17    manufacturer's invoice price less rebates, plus actual
18    reasonable and customary shipping charges whether or not
19    the implant charge is submitted by a provider in
20    conjunction with a bill for all other services associated
21    with the implant, submitted by a provider on a separate
22    claim form, submitted by a distributor, or submitted by the
23    manufacturer of the implant. "Implants" include the
24    following codes or any substantially similar updated code
25    as determined by the Commission: 0274
26    (prosthetics/orthotics); 0275 (pacemaker); 0276 (lens

 

 

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1    implant); 0278 (implants); 0540 and 0545 (ambulance); 0624
2    (investigational devices); and 0636 (drugs requiring
3    detailed coding). Non-implantable devices or supplies
4    within these codes shall be reimbursed at 65% of actual
5    charge, which is the provider's normal rates under its
6    standard chargemaster. A standard chargemaster is the
7    provider's list of charges for procedures, treatments,
8    products, supplies, or services used to bill payers in a
9    consistent manner.
10        (6) The Commission shall automatically update all
11    codes and associated rules with the version of the codes
12    and rules valid on January 1 of that year.
13    The provisions of this subsection (a-1), other than this
14sentence, are inoperative after August 31, 2018.
15    (a-1.5) The following provisions apply to procedures,
16treatments, services, products, and supplies covered under
17this Act and rendered or to be rendered on or after September
181, 2018:
19        (1) In this Section:
20        "CPT code" means each Current Procedural Terminology
21    code, for each geographic region specified in subsection
22    (b) of this Section, included on the most recent medical
23    fee schedule established by the Commission pursuant to this
24    Section.
25        "DRG code" means each current diagnosis related group
26    code, for each geographic region specified in subsection

 

 

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1    (b) of this Section, included on the most recent medical
2    fee schedule established by the Commission pursuant to this
3    Section.
4        "Geozip" means a three-digit zip code based on data
5    similarities, geographical similarities, and frequencies.
6        "Health care services" means those CPT and DRG codes
7    for procedures, treatments, products, services or supplies
8    for hospital inpatient, hospital outpatient, emergency
9    room, ambulatory surgical treatment centers, accredited
10    ambulatory surgical treatment facilities, and professional
11    services. It does not include codes classified as
12    healthcare common procedure coding systems or dental.
13        "Medicare maximum fee" means, for each CPT and DRG
14    code, the current maximum fee for that CPT or DRG code
15    allowed to be charged by the Centers for Medicare and
16    Medicaid Services for Medicare patients in that geographic
17    region. The Medicare maximum fee shall be the greater of
18    (i) the current maximum fee allowed to be charged by the
19    Centers for Medicare and Medicaid Services for Medicare
20    patients in the geographic region or (ii) the maximum fee
21    charged by the Centers for Medicare and Medicaid Services
22    for Medicare patients in the geographic region on January
23    1, 2018.
24        "Medicare percentage amount" means, for each CPT and
25    DRG code, the workers' compensation maximum fee as a
26    percentage of the Medicare maximum fee.

 

 

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1        "Workers' compensation maximum fee" means, for each
2    CPT and DRG code, the current maximum fee allowed to be
3    charged under the medical fee schedule established by the
4    Commission for that CPT or DRG code in that geographic
5    region.
6        (2) The Commission shall establish and maintain fee
7    schedules for procedures, treatments, products, services,
8    or supplies for hospital inpatient, hospital outpatient,
9    emergency room, ambulatory surgical treatment centers,
10    accredited ambulatory surgical treatment facilities,
11    prescriptions filled and dispensed outside of a licensed
12    pharmacy, dental services, and professional services.
13    These fee schedule amounts shall be grouped into geographic
14    regions in the following manner:
15            (A) Four regions for non-hospital fee schedule
16        amounts shall be utilized:
17                (i) Cook County;
18                (ii) DuPage, Kane, Lake, and Will Counties;
19                (iii) Bond, Calhoun, Clinton, Jersey,
20            Macoupin, Madison, Monroe, Montgomery, Randolph,
21            St. Clair, and Washington Counties; and
22                (iv) All other counties of the State.
23            (B) Fourteen regions for hospital fee schedule
24        amounts shall be utilized:
25                (i) Cook, DuPage, Will, Kane, McHenry, DeKalb,
26            Kendall, and Grundy Counties;

 

 

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1                (ii) Kankakee County;
2                (iii) Madison, St. Clair, Macoupin, Clinton,
3            Monroe, Jersey, Bond, and Calhoun Counties;
4                (iv) Winnebago and Boone Counties;
5                (v) Peoria, Tazewell, Woodford, Marshall, and
6            Stark Counties;
7                (vi) Champaign, Piatt, and Ford Counties;
8                (vii) Rock Island, Henry, and Mercer Counties;
9                (viii) Sangamon and Menard Counties;
10                (ix) McLean County;
11                (x) Lake County;
12                (xi) Macon County;
13                (xii) Vermilion County;
14                (xiii) Alexander County; and
15                (xiv) All other counties of the State.
16        If a geozip overlaps into one or more of the regions
17    set forth in this Section, then the Commission shall
18    average or repeat the charges and fees in a geozip in order
19    to designate charges and fees for each region.
20        (3) The initial workers' compensation maximum fee for
21    each CPT and DRG code as of September 1, 2018 shall be
22    determined as follows:
23            (A) Within 45 days after the effective date of this
24        amendatory Act of the 100th General Assembly, the
25        Commission shall determine the Medicare percentage
26        amount for each CPT and DRG code using the most recent

 

 

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1        data available.
2            CPT or DRG codes which have a value, but are not
3        covered expenses under Medicare, are still compensable
4        under the medical fee schedule according to the rate
5        described in Section (B).
6            (B) Within 30 days after the Commission makes the
7        determinations required by subdivision (3)(A) of this
8        subsection (a-1.5), the Commission shall determine an
9        adjustment to be made to the workers' compensation
10        maximum fee for each CPT and DRG code as follows:
11                (i) If the Medicare percentage amount for that
12            CPT or DRG code is equal to or less than 125%, then
13            the workers' compensation maximum fee for that CPT
14            or DRG code shall be adjusted so that it equals
15            125% of the most recent Medicare maximum fee for
16            that CPT or DRG code.
17                (ii) If the Medicare percentage amount for
18            that CPT or DRG code is greater than 125% but less
19            than 150%, then the workers' compensation maximum
20            fee for that CPT or DRG code shall not be adjusted.
21                (iii) If the Medicare percentage amount for
22            that CPT or DRG code is greater than 150% but less
23            than or equal to 225%, then the workers'
24            compensation maximum fee for that CPT or DRG code
25            shall be adjusted so that it equals the greater of
26            (I) 150% of the most recent Medicare maximum fee

 

 

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1            for that CPT or DRG code or (II) 85% of the most
2            recent workers' compensation maximum amount for
3            that CPT or DRG code.
4                (iv) If the Medicare percentage amount for
5            that CPT or DRG code is greater than 225% but less
6            than or equal to 428.57%, then the workers'
7            compensation maximum fee for that CPT or DRG code
8            shall be adjusted so that it equals the greater of
9            (I) 191.25% of the most recent Medicare maximum fee
10            for that CPT or DRG code or (II) 70% of the most
11            recent workers' compensation maximum amount for
12            that CPT or DRG code.
13                (v) If the Medicare percentage amount for that
14            CPT or DRG code is greater than 428.57%, then the
15            workers' compensation maximum fee for that CPT or
16            DRG code shall be adjusted so that it equals 300%
17            of the most recent Medicare maximum fee for that
18            CPT or DRG code.
19            The Commission shall promptly publish the
20        adjustments determined pursuant to this subdivision
21        (3)(B) on its website.
22            (C) The initial workers' compensation maximum fee
23        for each CPT and DRG code as of September 1, 2018 shall
24        be equal to the workers' compensation maximum fee for
25        that code as determined and adjusted pursuant to
26        subdivision (3)(B) of this subsection, subject to any

 

 

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1        further adjustments pursuant to subdivision (5) of
2        this subsection.
3        (4) The Commission, as of September 1, 2019 and
4    September 1 of each year thereafter, shall adjust the
5    workers' compensation maximum fee for each CPT or DRG code
6    to exactly half of the most recent annual increase in the
7    Consumer Price Index-U.
8        (5) A person who believes that the workers'
9    compensation maximum fee for a CPT or DRG code, as
10    otherwise determined pursuant to this subsection, creates
11    or would create upon implementation a significant
12    limitation on access to quality health care in either a
13    specific field of health care services or a specific
14    geographic limitation on access to health care may petition
15    the Commission to modify the workers' compensation maximum
16    fee for that CPT or DRG code so as to not create that
17    significant limitation.
18        The petitioner bears the burden of demonstrating, by a
19    preponderance of the credible evidence, that the workers'
20    compensation maximum fee that would otherwise apply would
21    create a significant limitation on access to quality health
22    care in either a specific field of health care services or
23    a specific geographic limitation on access to health care.
24    Petitions shall be made publicly available. Such credible
25    evidence shall include empirical data demonstrating a
26    significant limitation on access to quality health care.

 

 

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1    Other interested persons may file comments or responses to
2    a petition within 30 days of the filing of a petition.
3        The Commission shall take final action on each petition
4    within 180 days of filing. The Commission may, but is not
5    required to, seek the recommendation of the Medical Fee
6    Advisory Board to assist with this determination. If the
7    Commission grants the petition, the Commission shall
8    further increase the workers' compensation maximum fee for
9    that CPT or DRG code by the amount minimally necessary to
10    avoid creating a significant limitation on access to
11    quality health care in either a specific field of health
12    care services or a specific geographic limitation on access
13    to health care. The increased workers' compensation
14    maximum fee shall take effect upon entry of the
15    Commission's final action.
16    (a-2) For procedures, treatments, services, or supplies
17covered under this Act and rendered or to be rendered on or
18after September 1, 2011, the maximum allowable payment shall be
1970% of the fee schedule amounts, which shall be adjusted yearly
20by the Consumer Price Index-U, as described in subsection (a)
21of this Section. The provisions of this subsection (a-2), other
22than this sentence, are inoperative after August 31, 2018.
23    (a-3) Prescriptions filled and dispensed outside of a
24licensed pharmacy shall be subject to a fee schedule that shall
25not exceed the Average Wholesale Price (AWP) plus a dispensing
26fee of $4.18. AWP or its equivalent as registered by the

 

 

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1National Drug Code shall be set forth for that drug on that
2date as published in Medi-Span Medispan.
3    (a-4) The Commission, in consultation with the Workers'
4Compensation Medical Fee Advisory Board, shall promulgate by
5rule an evidence-based drug formulary and any rules necessary
6for its administration. Prescriptions prescribed for workers'
7compensation cases shall be limited to those prescription drugs
8and doses on the closed formulary.
9    A request for a prescription that is not on the closed
10formulary shall be reviewed pursuant to Section 8.7 of this
11Act.
12    (b) Notwithstanding the provisions of subsection (a), if
13the Commission finds that there is a significant limitation on
14access to quality health care in either a specific field of
15health care services or a specific geographic limitation on
16access to health care, it may change the Consumer Price Index-U
17increase or decrease for that specific field or specific
18geographic limitation on access to health care to address that
19limitation.
20    (c) The Commission shall establish by rule a process to
21review those medical cases or outliers that involve
22extra-ordinary treatment to determine whether to make an
23additional adjustment to the maximum payment within a fee
24schedule for a procedure, treatment, or service.
25    (d) When a patient notifies a provider that the treatment,
26procedure, or service being sought is for a work-related

 

 

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1illness or injury and furnishes the provider the name and
2address of the responsible employer, the provider shall bill
3the employer directly. The employer shall make payment and
4providers shall submit bills and records in accordance with the
5provisions of this Section.
6        (1) All payments to providers for treatment provided
7    pursuant to this Act shall be made within 30 days of
8    receipt of the bills as long as the claim contains
9    substantially all the required data elements necessary to
10    adjudicate the bills.
11        (2) If the claim does not contain substantially all the
12    required data elements necessary to adjudicate the bill, or
13    the claim is denied for any other reason, in whole or in
14    part, the employer or insurer shall provide written
15    notification, explaining the basis for the denial and
16    describing any additional necessary data elements, to the
17    provider within 30 days of receipt of the bill.
18        (3) In the case of nonpayment to a provider within 30
19    days of receipt of the bill which contained substantially
20    all of the required data elements necessary to adjudicate
21    the bill or nonpayment to a provider of a portion of such a
22    bill up to the lesser of the actual charge or the payment
23    level set by the Commission in the fee schedule established
24    in this Section, the bill, or portion of the bill, shall
25    incur interest at a rate of 1% per month payable to the
26    provider. Any required interest payments shall be made

 

 

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1    within 30 days after payment.
2    (e) Except as provided in subsections (e-5), (e-10), and
3(e-15), a provider shall not hold an employee liable for costs
4related to a non-disputed procedure, treatment, or service
5rendered in connection with a compensable injury. The
6provisions of subsections (e-5), (e-10), (e-15), and (e-20)
7shall not apply if an employee provides information to the
8provider regarding participation in a group health plan. If the
9employee participates in a group health plan, the provider may
10submit a claim for services to the group health plan. If the
11claim for service is covered by the group health plan, the
12employee's responsibility shall be limited to applicable
13deductibles, co-payments, or co-insurance. Except as provided
14under subsections (e-5), (e-10), (e-15), and (e-20), a provider
15shall not bill or otherwise attempt to recover from the
16employee the difference between the provider's charge and the
17amount paid by the employer or the insurer on a compensable
18injury, or for medical services or treatment determined by the
19Commission to be excessive or unnecessary.
20    (e-5) If an employer notifies a provider that the employer
21does not consider the illness or injury to be compensable under
22this Act, the provider may seek payment of the provider's
23actual charges from the employee for any procedure, treatment,
24or service rendered. Once an employee informs the provider that
25there is an application filed with the Commission to resolve a
26dispute over payment of such charges, the provider shall cease

 

 

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1any and all efforts to collect payment for the services that
2are the subject of the dispute. Any statute of limitations or
3statute of repose applicable to the provider's efforts to
4collect payment from the employee shall be tolled from the date
5that the employee files the application with the Commission
6until the date that the provider is permitted to resume
7collection efforts under the provisions of this Section.
8    (e-10) If an employer notifies a provider that the employer
9will pay only a portion of a bill for any procedure, treatment,
10or service rendered in connection with a compensable illness or
11disease, the provider may seek payment from the employee for
12the remainder of the amount of the bill up to the lesser of the
13actual charge, negotiated rate, if applicable, or the payment
14level set by the Commission in the fee schedule established in
15this Section. Once an employee informs the provider that there
16is an application filed with the Commission to resolve a
17dispute over payment of such charges, the provider shall cease
18any and all efforts to collect payment for the services that
19are the subject of the dispute. Any statute of limitations or
20statute of repose applicable to the provider's efforts to
21collect payment from the employee shall be tolled from the date
22that the employee files the application with the Commission
23until the date that the provider is permitted to resume
24collection efforts under the provisions of this Section.
25    (e-15) When there is a dispute over the compensability of
26or amount of payment for a procedure, treatment, or service,

 

 

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1and a case is pending or proceeding before an Arbitrator or the
2Commission, the provider may mail the employee reminders that
3the employee will be responsible for payment of any procedure,
4treatment or service rendered by the provider. The reminders
5must state that they are not bills, to the extent practicable
6include itemized information, and state that the employee need
7not pay until such time as the provider is permitted to resume
8collection efforts under this Section. The reminders shall not
9be provided to any credit rating agency. The reminders may
10request that the employee furnish the provider with information
11about the proceeding under this Act, such as the file number,
12names of parties, and status of the case. If an employee fails
13to respond to such request for information or fails to furnish
14the information requested within 90 days of the date of the
15reminder, the provider is entitled to resume any and all
16efforts to collect payment from the employee for the services
17rendered to the employee and the employee shall be responsible
18for payment of any outstanding bills for a procedure,
19treatment, or service rendered by a provider.
20    (e-20) Upon a final award or judgment by an Arbitrator or
21the Commission, or a settlement agreed to by the employer and
22the employee, a provider may resume any and all efforts to
23collect payment from the employee for the services rendered to
24the employee and the employee shall be responsible for payment
25of any outstanding bills for a procedure, treatment, or service
26rendered by a provider as well as the interest awarded under

 

 

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1subsection (d) of this Section. In the case of a procedure,
2treatment, or service deemed compensable, the provider shall
3not require a payment rate, excluding the interest provisions
4under subsection (d), greater than the lesser of the actual
5charge or the payment level set by the Commission in the fee
6schedule established in this Section. Payment for services
7deemed not covered or not compensable under this Act is the
8responsibility of the employee unless a provider and employee
9have agreed otherwise in writing. Services not covered or not
10compensable under this Act are not subject to the fee schedule
11in this Section.
12    (f) Nothing in this Act shall prohibit an employer or
13insurer from contracting with a health care provider or group
14of health care providers for reimbursement levels for benefits
15under this Act different from those provided in this Section.
16    (g) On or before January 1, 2010 the Commission shall
17provide to the Governor and General Assembly a report regarding
18the implementation of the medical fee schedule and the index
19used for annual adjustment to that schedule as described in
20this Section.
21(Source: P.A. 97-18, eff. 6-28-11.)
 
22    (820 ILCS 305/8.2a)
23    Sec. 8.2a. Electronic claims.
24    (a) The Director of Insurance shall adopt rules to do all
25of the following:

 

 

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1        (1) Ensure that all health care providers and
2    facilities submit medical bills for payment on
3    standardized forms.
4        (2) Require acceptance by employers and insurers of
5    electronic claims for payment of medical services.
6        (3) Ensure confidentiality of medical information
7    submitted on electronic claims for payment of medical
8    services.
9        (4) Ensure that health care providers have at least 15
10    business days to comply with records requested by employers
11    and insurers for the authorization of the payment of
12    workers' compensation claims.
13        (5) Ensure that health care providers are responsible
14    for supplying only those medical records pertaining to the
15    provider's own claims that are minimally necessary.
16        (6) Provide that any electronically submitted bill
17    determined to be complete but not paid or objected to
18    within 30 days shall be subject to penalties pursuant to
19    Section 8.2(d)(3) of this Act to be entered by the
20    Commission.
21        (7) Provide that the Department of Insurance may impose
22    an administrative fine if it determines that an employer or
23    insurer has failed to comply with the electronic claims
24    acceptance and response process. The amount of the
25    administrative fine shall be no greater than $1,000 per
26    each violation, but shall not exceed $10,000 for identical

 

 

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1    violations during a calendar year.
2    (b) To the extent feasible, standards adopted pursuant to
3subdivision (a) shall be consistent with existing standards
4under the federal Health Insurance Portability and
5Accountability Act of 1996 and standards adopted under the
6Illinois Health Information Exchange and Technology Act.
7    (c) The rules requiring employers and insurers to accept
8electronic claims for payment of medical services shall be
9proposed on or before October 1, 2018 January 1, 2012, and
10shall require all employers and insurers to accept electronic
11claims for payment of medical services on or before April 1,
122019 June 30, 2012.
13    (d) The Director of Insurance shall by rule establish
14criteria for granting exceptions to employers, insurance
15carriers, and health care providers who are unable to submit or
16accept medical bills electronically.
17(Source: P.A. 97-18, eff. 6-28-11.)
 
18    (820 ILCS 305/14)  (from Ch. 48, par. 138.14)
19    Sec. 14. The Commission shall appoint a secretary, an
20assistant secretary, and arbitrators and shall employ such
21assistants and clerical help as may be necessary. Arbitrators
22shall be appointed pursuant to this Section, notwithstanding
23any provision of the Personnel Code.
24    Each arbitrator appointed after June 28, 2011 shall be
25required to demonstrate in writing his or her knowledge of and

 

 

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1expertise in the law of and judicial processes of the Workers'
2Compensation Act and the Workers' Occupational Diseases Act.
3    A formal training program for newly-hired arbitrators
4shall be implemented. The training program shall include the
5following:
6        (a) substantive and procedural aspects of the
7    arbitrator position;
8        (b) current issues in workers' compensation law and
9    practice;
10        (c) medical lectures by specialists in areas such as
11    orthopedics, ophthalmology, psychiatry, rehabilitation
12    counseling;
13        (d) orientation to each operational unit of the
14    Illinois Workers' Compensation Commission;
15        (e) observation of experienced arbitrators conducting
16    hearings of cases, combined with the opportunity to discuss
17    evidence presented and rulings made;
18        (f) the use of hypothetical cases requiring the trainee
19    to issue judgments as a means to evaluating knowledge and
20    writing ability;
21        (g) writing skills;
22        (h) professional and ethical standards pursuant to
23    Section 1.1 of this Act;
24        (i) detection of workers' compensation fraud and
25    reporting obligations of Commission employees and
26    appointees;

 

 

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1        (j) standards of evidence-based medical treatment and
2    best practices for measuring and improving quality and
3    health care outcomes in the workers' compensation system,
4    including but not limited to the use of the American
5    Medical Association's "Guides to the Evaluation of
6    Permanent Impairment" and the practice of utilization
7    review; and
8        (k) substantive and procedural aspects of coal
9    workers' pneumoconiosis (black lung) cases.
10    A formal and ongoing professional development program
11including, but not limited to, the above-noted areas shall be
12implemented to keep arbitrators informed of recent
13developments and issues and to assist them in maintaining and
14enhancing their professional competence. Each arbitrator shall
15complete 20 hours of training in the above-noted areas during
16every 2 years such arbitrator shall remain in office.
17    Each arbitrator shall devote full time to his or her duties
18and shall serve when assigned as an acting Commissioner when a
19Commissioner is unavailable in accordance with the provisions
20of Section 13 of this Act. Any arbitrator who is an
21attorney-at-law shall not engage in the practice of law, nor
22shall any arbitrator hold any other office or position of
23profit under the United States or this State or any municipal
24corporation or political subdivision of this State.
25Notwithstanding any other provision of this Act to the
26contrary, an arbitrator who serves as an acting Commissioner in

 

 

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1accordance with the provisions of Section 13 of this Act shall
2continue to serve in the capacity of Commissioner until a
3decision is reached in every case heard by that arbitrator
4while serving as an acting Commissioner.
5    Notwithstanding any other provision of this Section, the
6term of all arbitrators serving on June 28, 2011 (the effective
7date of Public Act 97-18), including any arbitrators on
8administrative leave, shall terminate at the close of business
9on July 1, 2011, but the incumbents shall continue to exercise
10all of their duties until they are reappointed or their
11successors are appointed.
12    On and after June 28, 2011 (the effective date of Public
13Act 97-18), arbitrators shall be appointed to 3-year terms as
14follows:
15        (1) All appointments shall be made by the Governor with
16    the advice and consent of the Senate.
17        (2) For their initial appointments, 12 arbitrators
18    shall be appointed to terms expiring July 1, 2012; 12
19    arbitrators shall be appointed to terms expiring July 1,
20    2013; and all additional arbitrators shall be appointed to
21    terms expiring July 1, 2014. Thereafter, all arbitrators
22    shall be appointed to 3-year terms.
23    Upon the expiration of a term, the Chairman shall evaluate
24the performance of the arbitrator and may recommend to the
25Governor that he or she be reappointed to a second or
26subsequent term by the Governor with the advice and consent of

 

 

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1the Senate.
2    Each arbitrator appointed on or after June 28, 2011 (the
3effective date of Public Act 97-18) and who has not previously
4served as an arbitrator for the Commission shall be required to
5be authorized to practice law in this State by the Supreme
6Court, and to maintain this authorization throughout his or her
7term of employment.
8    The performance of all arbitrators shall be reviewed by the
9Chairman on an annual basis. The Chairman shall allow input
10from the Commissioners in all such reviews.
11    The Commission shall assign no fewer than 3 arbitrators to
12each hearing site. The Commission shall establish a procedure
13to ensure that the arbitrators assigned to each hearing site
14are assigned cases on a random basis. The Chairman of the
15Illinois Workers' Compensation Commission shall have
16discretion to assign and reassign arbitrators to each hearing
17site as needed. No arbitrator shall hear cases in any county,
18other than Cook County, for more than 2 years in each 3-year
19term.
20    The Secretary and each arbitrator shall receive a per annum
21salary of $4,000 less than the per annum salary of members of
22The Illinois Workers' Compensation Commission as provided in
23Section 13 of this Act, payable in equal monthly installments.
24    The members of the Commission, Arbitrators and other
25employees whose duties require them to travel, shall have
26reimbursed to them their actual traveling expenses and

 

 

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1disbursements made or incurred by them in the discharge of
2their official duties while away from their place of residence
3in the performance of their duties.
4    The Commission shall provide itself with a seal for the
5authentication of its orders, awards and proceedings upon which
6shall be inscribed the name of the Commission and the words
7"Illinois--Seal".
8    The Secretary or Assistant Secretary, under the direction
9of the Commission, shall have charge and custody of the seal of
10the Commission and also have charge and custody of all records,
11files, orders, proceedings, decisions, awards and other
12documents on file with the Commission. He shall furnish
13certified copies, under the seal of the Commission, of any such
14records, files, orders, proceedings, decisions, awards and
15other documents on file with the Commission as may be required.
16Certified copies so furnished by the Secretary or Assistant
17Secretary shall be received in evidence before the Commission
18or any Arbitrator thereof, and in all courts, provided that the
19original of such certified copy is otherwise competent and
20admissible in evidence. The Secretary or Assistant Secretary
21shall perform such other duties as may be prescribed from time
22to time by the Commission.
23(Source: P.A. 98-40, eff. 6-28-13; 99-642, eff. 7-28-16.)
 
24    (820 ILCS 305/19)  (from Ch. 48, par. 138.19)
25    Sec. 19. Any disputed questions of law or fact shall be

 

 

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1determined as herein provided.
2    (a) It shall be the duty of the Commission upon
3notification that the parties have failed to reach an
4agreement, to designate an Arbitrator.
5        1. Whenever any claimant misconceives his remedy and
6    files an application for adjustment of claim under this Act
7    and it is subsequently discovered, at any time before final
8    disposition of such cause, that the claim for disability or
9    death which was the basis for such application should
10    properly have been made under the Workers' Occupational
11    Diseases Act, then the provisions of Section 19, paragraph
12    (a-1) of the Workers' Occupational Diseases Act having
13    reference to such application shall apply.
14        2. Whenever any claimant misconceives his remedy and
15    files an application for adjustment of claim under the
16    Workers' Occupational Diseases Act and it is subsequently
17    discovered, at any time before final disposition of such
18    cause that the claim for injury or death which was the
19    basis for such application should properly have been made
20    under this Act, then the application so filed under the
21    Workers' Occupational Diseases Act may be amended in form,
22    substance or both to assert claim for such disability or
23    death under this Act and it shall be deemed to have been so
24    filed as amended on the date of the original filing
25    thereof, and such compensation may be awarded as is
26    warranted by the whole evidence pursuant to this Act. When

 

 

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1    such amendment is submitted, further or additional
2    evidence may be heard by the Arbitrator or Commission when
3    deemed necessary. Nothing in this Section contained shall
4    be construed to be or permit a waiver of any provisions of
5    this Act with reference to notice but notice if given shall
6    be deemed to be a notice under the provisions of this Act
7    if given within the time required herein.
8        3. When an Arbitrator conducts a status call of cases
9    that appear on the Arbitrator's docket in accordance with
10    the rules of the Commission, parties or their attorneys may
11    appear by telephone, video conference, or other remote
12    electronic means as prescribed by the Commission.
13    (b) The Arbitrator shall make such inquiries and
14investigations as he or they shall deem necessary and may
15examine and inspect all books, papers, records, places, or
16premises relating to the questions in dispute and hear such
17proper evidence as the parties may submit.
18    The hearings before the Arbitrator shall be held in the
19vicinity where the injury occurred after 10 days' notice of the
20time and place of such hearing shall have been given to each of
21the parties or their attorneys of record.
22    The Arbitrator may find that the disabling condition is
23temporary and has not yet reached a permanent condition and may
24order the payment of compensation up to the date of the
25hearing, which award shall be reviewable and enforceable in the
26same manner as other awards, and in no instance be a bar to a

 

 

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1further hearing and determination of a further amount of
2temporary total compensation or of compensation for permanent
3disability, but shall be conclusive as to all other questions
4except the nature and extent of said disability.
5    The decision of the Arbitrator shall be filed with the
6Commission which Commission shall immediately send to each
7party or his attorney a copy of such decision, together with a
8notification of the time when it was filed. As of the effective
9date of this amendatory Act of the 94th General Assembly, all
10decisions of the Arbitrator shall set forth in writing findings
11of fact and conclusions of law, separately stated, if requested
12by either party. Unless a petition for review is filed by
13either party within 30 days after the receipt by such party of
14the copy of the decision and notification of time when filed,
15and unless such party petitioning for a review shall within 35
16days after the receipt by him of the copy of the decision, file
17with the Commission either an agreed statement of the facts
18appearing upon the hearing before the Arbitrator, or if such
19party shall so elect a correct transcript of evidence of the
20proceedings at such hearings, then the decision shall become
21the decision of the Commission and in the absence of fraud
22shall be conclusive. The Petition for Review shall contain a
23statement of the petitioning party's specific exceptions to the
24decision of the arbitrator. The jurisdiction of the Commission
25to review the decision of the arbitrator shall not be limited
26to the exceptions stated in the Petition for Review. The

 

 

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1Commission, or any member thereof, may grant further time not
2exceeding 30 days, in which to file such agreed statement or
3transcript of evidence. Such agreed statement of facts or
4correct transcript of evidence, as the case may be, shall be
5authenticated by the signatures of the parties or their
6attorneys, and in the event they do not agree as to the
7correctness of the transcript of evidence it shall be
8authenticated by the signature of the Arbitrator designated by
9the Commission.
10    Whether the employee is working or not, if the employee is
11not receiving or has not received medical, surgical, or
12hospital services or other services or compensation as provided
13in paragraph (a) of Section 8, or compensation as provided in
14paragraph (b) of Section 8, or if the employer has refused or
15failed to respond to a written request for authorization of
16medical care and treatment, the employee may at any time
17petition for an expedited hearing by an Arbitrator on the issue
18of whether or not he or she is entitled to receive payment of
19the services or compensation or authorization of medical care.
20Provided the employer continues to pay compensation pursuant to
21paragraph (b) of Section 8, the employer may at any time
22petition for an expedited hearing on the issue of whether or
23not the employee is entitled to receive medical, surgical, or
24hospital services or other services or compensation as provided
25in paragraph (a) of Section 8, whether or not the employee is
26entitled to authorization of medical care and treatment, or

 

 

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1compensation as provided in paragraph (b) of Section 8. When an
2employer has petitioned for an expedited hearing, the employer
3shall continue to pay compensation as provided in paragraph (b)
4of Section 8 unless the arbitrator renders a decision that the
5employee is not entitled to the benefits that are the subject
6of the expedited hearing or unless the employee's treating
7physician has released the employee to return to work at his or
8her regular job with the employer or the employee actually
9returns to work at any other job. If the arbitrator renders a
10decision that the employee is not entitled to the benefits or
11medical care that is are the subject of the expedited hearing,
12a petition for review filed by the employee shall receive the
13same priority as if the employee had filed a petition for an
14expedited hearing by an Arbitrator. Neither party shall be
15entitled to an expedited hearing when the employee has returned
16to work and the sole issue in dispute amounts to less than 12
17weeks of unpaid compensation pursuant to paragraph (b) of
18Section 8.
19    Expedited hearings shall have priority over all other
20petitions and shall be heard by the Arbitrator and Commission
21with all convenient speed. Any party requesting an expedited
22hearing shall give notice of a request for an expedited hearing
23under this paragraph. A copy of the Application for Adjustment
24of Claim shall be attached to the notice. The Commission shall
25adopt rules and procedures under which the final decision of
26the Commission under this paragraph is filed not later than 180

 

 

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1days from the date that the Petition for Review is filed with
2the Commission.
3    Where 2 or more insurance carriers, private self-insureds,
4or a group workers' compensation pool under Article V 3/4 of
5the Illinois Insurance Code dispute coverage for the same
6injury, any such insurance carrier, private self-insured, or
7group workers' compensation pool may request an expedited
8hearing pursuant to this paragraph to determine the issue of
9coverage, provided coverage is the only issue in dispute and
10all other issues are stipulated and agreed to and further
11provided that all compensation benefits including medical
12benefits pursuant to Section 8(a) continue to be paid to or on
13behalf of petitioner. Any insurance carrier, private
14self-insured, or group workers' compensation pool that is
15determined to be liable for coverage for the injury in issue
16shall reimburse any insurance carrier, private self-insured,
17or group workers' compensation pool that has paid benefits to
18or on behalf of petitioner for the injury.
19    (b-1) If the employee is not receiving medical, surgical or
20hospital services as provided in paragraph (a) of Section 8 or
21compensation as provided in paragraph (b) of Section 8, the
22employee, in accordance with Commission Rules, may file a
23petition for an emergency hearing by an Arbitrator on the issue
24of whether or not he is entitled to receive payment of such
25compensation or services as provided therein. Such petition
26shall have priority over all other petitions and shall be heard

 

 

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1by the Arbitrator and Commission with all convenient speed.
2    Such petition shall contain the following information and
3shall be served on the employer at least 15 days before it is
4filed:
5        (i) the date and approximate time of accident;
6        (ii) the approximate location of the accident;
7        (iii) a description of the accident;
8        (iv) the nature of the injury incurred by the employee;
9        (v) the identity of the person, if known, to whom the
10    accident was reported and the date on which it was
11    reported;
12        (vi) the name and title of the person, if known,
13    representing the employer with whom the employee conferred
14    in any effort to obtain compensation pursuant to paragraph
15    (b) of Section 8 of this Act or medical, surgical or
16    hospital services pursuant to paragraph (a) of Section 8 of
17    this Act and the date of such conference;
18        (vii) a statement that the employer has refused to pay
19    compensation pursuant to paragraph (b) of Section 8 of this
20    Act or for medical, surgical or hospital services pursuant
21    to paragraph (a) of Section 8 of this Act;
22        (viii) the name and address, if known, of each witness
23    to the accident and of each other person upon whom the
24    employee will rely to support his allegations;
25        (ix) the dates of treatment related to the accident by
26    medical practitioners, and the names and addresses of such

 

 

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1    practitioners, including the dates of treatment related to
2    the accident at any hospitals and the names and addresses
3    of such hospitals, and a signed authorization permitting
4    the employer to examine all medical records of all
5    practitioners and hospitals named pursuant to this
6    paragraph;
7        (x) a copy of a signed report by a medical
8    practitioner, relating to the employee's current inability
9    to return to work because of the injuries incurred as a
10    result of the accident or such other documents or
11    affidavits which show that the employee is entitled to
12    receive compensation pursuant to paragraph (b) of Section 8
13    of this Act or medical, surgical or hospital services
14    pursuant to paragraph (a) of Section 8 of this Act. Such
15    reports, documents or affidavits shall state, if possible,
16    the history of the accident given by the employee, and
17    describe the injury and medical diagnosis, the medical
18    services for such injury which the employee has received
19    and is receiving, the physical activities which the
20    employee cannot currently perform as a result of any
21    impairment or disability due to such injury, and the
22    prognosis for recovery;
23        (xi) complete copies of any reports, records,
24    documents and affidavits in the possession of the employee
25    on which the employee will rely to support his allegations,
26    provided that the employer shall pay the reasonable cost of

 

 

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1    reproduction thereof;
2        (xii) a list of any reports, records, documents and
3    affidavits which the employee has demanded by subpoena and
4    on which he intends to rely to support his allegations;
5        (xiii) a certification signed by the employee or his
6    representative that the employer has received the petition
7    with the required information 15 days before filing.
8    Fifteen days after receipt by the employer of the petition
9with the required information the employee may file said
10petition and required information and shall serve notice of the
11filing upon the employer. The employer may file a motion
12addressed to the sufficiency of the petition. If an objection
13has been filed to the sufficiency of the petition, the
14arbitrator shall rule on the objection within 2 working days.
15If such an objection is filed, the time for filing the final
16decision of the Commission as provided in this paragraph shall
17be tolled until the arbitrator has determined that the petition
18is sufficient.
19    The employer shall, within 15 days after receipt of the
20notice that such petition is filed, file with the Commission
21and serve on the employee or his representative a written
22response to each claim set forth in the petition, including the
23legal and factual basis for each disputed allegation and the
24following information: (i) complete copies of any reports,
25records, documents and affidavits in the possession of the
26employer on which the employer intends to rely in support of

 

 

HB5470- 108 -LRB100 18092 JLS 33285 b

1his response, (ii) a list of any reports, records, documents
2and affidavits which the employer has demanded by subpoena and
3on which the employer intends to rely in support of his
4response, (iii) the name and address of each witness on whom
5the employer will rely to support his response, and (iv) the
6names and addresses of any medical practitioners selected by
7the employer pursuant to Section 12 of this Act and the time
8and place of any examination scheduled to be made pursuant to
9such Section.
10    Any employer who does not timely file and serve a written
11response without good cause may not introduce any evidence to
12dispute any claim of the employee but may cross examine the
13employee or any witness brought by the employee and otherwise
14be heard.
15    No document or other evidence not previously identified by
16either party with the petition or written response, or by any
17other means before the hearing, may be introduced into evidence
18without good cause. If, at the hearing, material information is
19discovered which was not previously disclosed, the Arbitrator
20may extend the time for closing proof on the motion of a party
21for a reasonable period of time which may be more than 30 days.
22No evidence may be introduced pursuant to this paragraph as to
23permanent disability. No award may be entered for permanent
24disability pursuant to this paragraph. Either party may
25introduce into evidence the testimony taken by deposition of
26any medical practitioner.

 

 

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1    The Commission shall adopt rules, regulations and
2procedures whereby the final decision of the Commission is
3filed not later than 90 days from the date the petition for
4review is filed but in no event later than 180 days from the
5date the petition for an emergency hearing is filed with the
6Illinois Workers' Compensation Commission.
7    All service required pursuant to this paragraph (b-1) must
8be by personal service or by certified mail and with evidence
9of receipt. In addition for the purposes of this paragraph, all
10service on the employer must be at the premises where the
11accident occurred if the premises are owned or operated by the
12employer. Otherwise service must be at the employee's principal
13place of employment by the employer. If service on the employer
14is not possible at either of the above, then service shall be
15at the employer's principal place of business. After initial
16service in each case, service shall be made on the employer's
17attorney or designated representative.
18    (c)(1) At a reasonable time in advance of and in connection
19with the hearing under Section 19(e) or 19(h), the Commission
20may on its own motion order an impartial physical or mental
21examination of a petitioner whose mental or physical condition
22is in issue, when in the Commission's discretion it appears
23that such an examination will materially aid in the just
24determination of the case. The examination shall be made by a
25member or members of a panel of physicians chosen for their
26special qualifications by the Illinois State Medical Society.

 

 

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1The Commission shall establish procedures by which a physician
2shall be selected from such list.
3    (2) Should the Commission at any time during the hearing
4find that compelling considerations make it advisable to have
5an examination and report at that time, the commission may in
6its discretion so order.
7    (3) A copy of the report of examination shall be given to
8the Commission and to the attorneys for the parties.
9    (4) Either party or the Commission may call the examining
10physician or physicians to testify. Any physician so called
11shall be subject to cross-examination.
12    (5) The examination shall be made, and the physician or
13physicians, if called, shall testify, without cost to the
14parties. The Commission shall determine the compensation and
15the pay of the physician or physicians. The compensation for
16this service shall not exceed the usual and customary amount
17for such service.
18    (6) The fees and payment thereof of all attorneys and
19physicians for services authorized by the Commission under this
20Act shall, upon request of either the employer or the employee
21or the beneficiary affected, be subject to the review and
22decision of the Commission.
23    (d) If any employee shall persist in insanitary or
24injurious practices which tend to either imperil or retard his
25recovery or shall refuse to submit to such medical, surgical,
26or hospital treatment as is reasonably essential to promote his

 

 

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1recovery, the Commission may, in its discretion, reduce or
2suspend the compensation of any such injured employee. However,
3when an employer and employee so agree in writing, the
4foregoing provision shall not be construed to authorize the
5reduction or suspension of compensation of an employee who is
6relying in good faith, on treatment by prayer or spiritual
7means alone, in accordance with the tenets and practice of a
8recognized church or religious denomination, by a duly
9accredited practitioner thereof.
10    (e) This paragraph shall apply to all hearings before the
11Commission. Such hearings may be held in its office or
12elsewhere as the Commission may deem advisable. The taking of
13testimony on such hearings may be had before any member of the
14Commission. If a petition for review and agreed statement of
15facts or transcript of evidence is filed, as provided herein,
16the Commission shall promptly review the decision of the
17Arbitrator and all questions of law or fact which appear from
18the statement of facts or transcript of evidence.
19    In all cases in which the hearing before the arbitrator is
20held after December 18, 1989, no additional evidence shall be
21introduced by the parties before the Commission on review of
22the decision of the Arbitrator. In reviewing decisions of an
23arbitrator the Commission shall award such temporary
24compensation, permanent compensation and other payments as are
25due under this Act. The Commission shall file in its office its
26decision thereon, and shall immediately send to each party or

 

 

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1his attorney a copy of such decision and a notification of the
2time when it was filed. Decisions shall be filed within 60 days
3after the Statement of Exceptions and Supporting Brief and
4Response thereto are required to be filed or oral argument
5whichever is later.
6    In the event either party requests oral argument, such
7argument shall be had before a panel of 3 members of the
8Commission (or before all available members pursuant to the
9determination of 7 members of the Commission that such argument
10be held before all available members of the Commission)
11pursuant to the rules and regulations of the Commission. A
12panel of 3 members, which shall be comprised of not more than
13one representative citizen of the employing class and not more
14than one representative citizen of the employee class, shall
15hear the argument; provided that if all the issues in dispute
16are solely the nature and extent of the permanent partial
17disability, if any, a majority of the panel may deny the
18request for such argument and such argument shall not be held;
19and provided further that 7 members of the Commission may
20determine that the argument be held before all available
21members of the Commission. A decision of the Commission shall
22be approved by a majority of Commissioners present at such
23hearing if any; provided, if no such hearing is held, a
24decision of the Commission shall be approved by a majority of a
25panel of 3 members of the Commission as described in this
26Section. The Commission shall give 10 days' notice to the

 

 

HB5470- 113 -LRB100 18092 JLS 33285 b

1parties or their attorneys of the time and place of such taking
2of testimony and of such argument.
3    In any case the Commission in its decision may find
4specially upon any question or questions of law or fact which
5shall be submitted in writing by either party whether ultimate
6or otherwise; provided that on issues other than nature and
7extent of the disability, if any, the Commission in its
8decision shall find specially upon any question or questions of
9law or fact, whether ultimate or otherwise, which are submitted
10in writing by either party; provided further that not more than
115 such questions may be submitted by either party. Any party
12may, within 20 days after receipt of notice of the Commission's
13decision, or within such further time, not exceeding 30 days,
14as the Commission may grant, file with the Commission either an
15agreed statement of the facts appearing upon the hearing, or,
16if such party shall so elect, a correct transcript of evidence
17of the additional proceedings presented before the Commission,
18in which report the party may embody a correct statement of
19such other proceedings in the case as such party may desire to
20have reviewed, such statement of facts or transcript of
21evidence to be authenticated by the signature of the parties or
22their attorneys, and in the event that they do not agree, then
23the authentication of such transcript of evidence shall be by
24the signature of any member of the Commission.
25    If a reporter does not for any reason furnish a transcript
26of the proceedings before the Arbitrator in any case for use on

 

 

HB5470- 114 -LRB100 18092 JLS 33285 b

1a hearing for review before the Commission, within the
2limitations of time as fixed in this Section, the Commission
3may, in its discretion, order a trial de novo before the
4Commission in such case upon application of either party. The
5applications for adjustment of claim and other documents in the
6nature of pleadings filed by either party, together with the
7decisions of the Arbitrator and of the Commission and the
8statement of facts or transcript of evidence hereinbefore
9provided for in paragraphs (b) and (c) shall be the record of
10the proceedings of the Commission, and shall be subject to
11review as hereinafter provided.
12    At the request of either party or on its own motion, the
13Commission shall set forth in writing the reasons for the
14decision, including findings of fact and conclusions of law
15separately stated. The Commission shall by rule adopt a format
16for written decisions for the Commission and arbitrators. The
17written decisions shall be concise and shall succinctly state
18the facts and reasons for the decision. The Commission may
19adopt in whole or in part, the decision of the arbitrator as
20the decision of the Commission. When the Commission does so
21adopt the decision of the arbitrator, it shall do so by order.
22Whenever the Commission adopts part of the arbitrator's
23decision, but not all, it shall include in the order the
24reasons for not adopting all of the arbitrator's decision. When
25a majority of a panel, after deliberation, has arrived at its
26decision, the decision shall be filed as provided in this

 

 

HB5470- 115 -LRB100 18092 JLS 33285 b

1Section without unnecessary delay, and without regard to the
2fact that a member of the panel has expressed an intention to
3dissent. Any member of the panel may file a dissent. Any
4dissent shall be filed no later than 10 days after the decision
5of the majority has been filed.
6    Decisions rendered by the Commission and dissents, if any,
7shall be published together by the Commission. The conclusions
8of law set out in such decisions shall be regarded as
9precedents by arbitrators for the purpose of achieving a more
10uniform administration of this Act.
11    (f) The decision of the Commission acting within its
12powers, according to the provisions of paragraph (e) of this
13Section shall, in the absence of fraud, be conclusive unless
14reviewed as in this paragraph hereinafter provided. However,
15the Arbitrator or the Commission may on his or its own motion,
16or on the motion of either party, correct any clerical error or
17errors in computation within 15 days after the date of receipt
18of any award by such Arbitrator or any decision on review of
19the Commission and shall have the power to recall the original
20award on arbitration or decision on review, and issue in lieu
21thereof such corrected award or decision. Where such correction
22is made the time for review herein specified shall begin to run
23from the date of the receipt of the corrected award or
24decision.
25        (1) Except in cases of claims against the State of
26    Illinois other than those claims under Section 18.1, in

 

 

HB5470- 116 -LRB100 18092 JLS 33285 b

1    which case the decision of the Commission shall not be
2    subject to judicial review, the Circuit Court of the county
3    where any of the parties defendant may be found, or if none
4    of the parties defendant can be found in this State then
5    the Circuit Court of the county where the accident
6    occurred, shall by summons to the Commission have power to
7    review all questions of law and fact presented by such
8    record.
9        A proceeding for review shall be commenced within 20
10    days of the receipt of notice of the decision of the
11    Commission. The summons shall be issued by the clerk of
12    such court upon written request returnable on a designated
13    return day, not less than 10 or more than 60 days from the
14    date of issuance thereof, and the written request shall
15    contain the last known address of other parties in interest
16    and their attorneys of record who are to be served by
17    summons. Service upon any member of the Commission or the
18    Secretary or the Assistant Secretary thereof shall be
19    service upon the Commission, and service upon other parties
20    in interest and their attorneys of record shall be by
21    summons, and such service shall be made upon the Commission
22    and other parties in interest by mailing notices of the
23    commencement of the proceedings and the return day of the
24    summons to the office of the Commission and to the last
25    known place of residence of other parties in interest or
26    their attorney or attorneys of record. The clerk of the

 

 

HB5470- 117 -LRB100 18092 JLS 33285 b

1    court issuing the summons shall on the day of issue mail
2    notice of the commencement of the proceedings which shall
3    be done by mailing a copy of the summons to the office of
4    the Commission, and a copy of the summons to the other
5    parties in interest or their attorney or attorneys of
6    record and the clerk of the court shall make certificate
7    that he has so sent said notices in pursuance of this
8    Section, which shall be evidence of service on the
9    Commission and other parties in interest.
10        The Commission shall not be required to certify the
11    record of their proceedings to the Circuit Court, unless
12    the party commencing the proceedings for review in the
13    Circuit Court as above provided, shall file with the
14    Commission notice of intent to file for review in Circuit
15    Court. It shall be the duty of the Commission upon such
16    filing of notice of intent to file for review in the
17    Circuit Court to prepare a true and correct copy of such
18    testimony and a true and correct copy of all other matters
19    contained in such record and certified to by the Secretary
20    or Assistant Secretary thereof. The changes made to this
21    subdivision (f)(1) by this amendatory Act of the 98th
22    General Assembly apply to any Commission decision entered
23    after the effective date of this amendatory Act of the 98th
24    General Assembly.
25        No request for a summons may be filed and no summons
26    shall issue unless the party seeking to review the decision

 

 

HB5470- 118 -LRB100 18092 JLS 33285 b

1    of the Commission shall exhibit to the clerk of the Circuit
2    Court proof of filing with the Commission of the notice of
3    the intent to file for review in the Circuit Court or an
4    affidavit of the attorney setting forth that notice of
5    intent to file for review in the Circuit Court has been
6    given in writing to the Secretary or Assistant Secretary of
7    the Commission.
8        (2) No such summons shall issue unless the one against
9    whom the Commission shall have rendered an award for the
10    payment of money shall upon the filing of his written
11    request for such summons file with the clerk of the court a
12    bond conditioned that if he shall not successfully
13    prosecute the review, he will pay the award and the costs
14    of the proceedings in the courts. The amount of the bond
15    shall be fixed by any member of the Commission and the
16    surety or sureties of the bond shall be approved by the
17    clerk of the court. The acceptance of the bond by the clerk
18    of the court shall constitute evidence of his approval of
19    the bond.
20        The State of Illinois, including its constitutional
21    officers, boards, commissions, agencies, public
22    institutions of higher learning, and funds administered by
23    the treasurer ex officio, and every Every county, city,
24    town, township, incorporated village, school district,
25    body politic or municipal corporation against whom the
26    Commission shall have rendered an award for the payment of

 

 

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1    money shall not be required to file a bond to secure the
2    payment of the award and the costs of the proceedings in
3    the court to authorize the court to issue such summons.
4        The court may confirm or set aside the decision of the
5    Commission. If the decision is set aside and the facts
6    found in the proceedings before the Commission are
7    sufficient, the court may enter such decision as is
8    justified by law, or may remand the cause to the Commission
9    for further proceedings and may state the questions
10    requiring further hearing, and give such other
11    instructions as may be proper. Appeals shall be taken to
12    the Appellate Court in accordance with Supreme Court Rules
13    22(g) and 303. Appeals shall be taken from the Appellate
14    Court to the Supreme Court in accordance with Supreme Court
15    Rule 315.
16        It shall be the duty of the clerk of any court
17    rendering a decision affecting or affirming an award of the
18    Commission to promptly furnish the Commission with a copy
19    of such decision, without charge.
20        The decision of a majority of the members of the panel
21    of the Commission, shall be considered the decision of the
22    Commission.
23    (g) Except in the case of a claim against the State of
24Illinois, either party may present a certified copy of the
25award of the Arbitrator, or a certified copy of the decision of
26the Commission when the same has become final, when no

 

 

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1proceedings for review are pending, providing for the payment
2of compensation according to this Act, to the Circuit Court of
3the county in which such accident occurred or either of the
4parties are residents, whereupon the court shall enter a
5judgment in accordance therewith. In a case where the employer
6refuses to pay compensation according to such final award or
7such final decision upon which such judgment is entered the
8court shall in entering judgment thereon, tax as costs against
9him the reasonable costs and attorney fees in the arbitration
10proceedings and in the court entering the judgment for the
11person in whose favor the judgment is entered, which judgment
12and costs taxed as therein provided shall, until and unless set
13aside, have the same effect as though duly entered in an action
14duly tried and determined by the court, and shall with like
15effect, be entered and docketed. The Circuit Court shall have
16power at any time upon application to make any such judgment
17conform to any modification required by any subsequent decision
18of the Supreme Court upon appeal, or as the result of any
19subsequent proceedings for review, as provided in this Act.
20    Judgment shall not be entered until 15 days' notice of the
21time and place of the application for the entry of judgment
22shall be served upon the employer by filing such notice with
23the Commission, which Commission shall, in case it has on file
24the address of the employer or the name and address of its
25agent upon whom notices may be served, immediately send a copy
26of the notice to the employer or such designated agent.

 

 

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1    (h) An agreement or award under this Act providing for
2compensation in installments, may at any time within 18 months
3after such agreement or award be reviewed by the Commission at
4the request of either the employer or the employee, on the
5ground that the disability of the employee has subsequently
6recurred, increased, diminished or ended.
7    However, as to accidents occurring subsequent to July 1,
81955, which are covered by any agreement or award under this
9Act providing for compensation in installments made as a result
10of such accident, such agreement or award may at any time
11within 30 months, or 60 months in the case of an award under
12Section 8(d)1, after such agreement or award be reviewed by the
13Commission at the request of either the employer or the
14employee on the ground that the disability of the employee has
15subsequently recurred, increased, diminished or ended.
16    On such review, compensation payments may be
17re-established, increased, diminished or ended. The Commission
18shall give 15 days' notice to the parties of the hearing for
19review. Any employee, upon any petition for such review being
20filed by the employer, shall be entitled to one day's notice
21for each 100 miles necessary to be traveled by him in attending
22the hearing of the Commission upon the petition, and 3 days in
23addition thereto. Such employee shall, at the discretion of the
24Commission, also be entitled to 5 cents per mile necessarily
25traveled by him within the State of Illinois in attending such
26hearing, not to exceed a distance of 300 miles, to be taxed by

 

 

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1the Commission as costs and deposited with the petition of the
2employer.
3    When compensation which is payable in accordance with an
4award or settlement contract approved by the Commission, is
5ordered paid in a lump sum by the Commission, no review shall
6be had as in this paragraph mentioned.
7    (i) Each party, upon taking any proceedings or steps
8whatsoever before any Arbitrator, Commission or court, shall
9file with the Commission his address, or the name and address
10of any agent upon whom all notices to be given to such party
11shall be served, either personally or by registered mail,
12addressed to such party or agent at the last address so filed
13with the Commission. In the event such party has not filed his
14address, or the name and address of an agent as above provided,
15service of any notice may be had by filing such notice with the
16Commission.
17    (j) Whenever in any proceeding testimony has been taken or
18a final decision has been rendered and after the taking of such
19testimony or after such decision has become final, the injured
20employee dies, then in any subsequent proceedings brought by
21the personal representative or beneficiaries of the deceased
22employee, such testimony in the former proceeding may be
23introduced with the same force and effect as though the witness
24having so testified were present in person in such subsequent
25proceedings and such final decision, if any, shall be taken as
26final adjudication of any of the issues which are the same in

 

 

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1both proceedings.
2    (k) In a case where there has been any unreasonable or
3vexatious delay of payment or intentional underpayment of
4compensation, or proceedings have been instituted or carried on
5by the one liable to pay the compensation, which do not present
6a real controversy, but are merely frivolous or for delay, then
7the Commission may award compensation additional to that
8otherwise payable under this Act equal to 50% of the amount
9payable at the time of such award. Failure to pay compensation
10in accordance with the provisions of Section 8, paragraph (b)
11of this Act, shall be considered unreasonable delay.
12    When determining whether this subsection (k) shall apply,
13the Commission shall consider whether an Arbitrator has
14determined that the claim is not compensable or whether the
15employer has made payments under Section 8(j).
16    (l) If the employee has made written demand for payment of
17benefits under Section 8(a) or Section 8(b), the employer shall
18have 14 days after receipt of the demand to set forth in
19writing the reason for the delay. In the case of demand for
20payment of medical benefits under Section 8(a), the time for
21the employer to respond shall not commence until the expiration
22of the allotted 30 days specified under Section 8.2(d). In case
23the employer or his or her insurance carrier shall without good
24and just cause fail, neglect, refuse, or unreasonably delay the
25payment of benefits under Section 8(a) or Section 8(b), the
26Arbitrator or the Commission shall allow to the employee

 

 

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1additional compensation in the sum of $30 per day for each day
2that the benefits under Section 8(a) or Section 8(b) have been
3so withheld or refused, not to exceed $10,000. A delay in
4payment of 14 days or more shall create a rebuttable
5presumption of unreasonable delay.
6    (m) If the commission finds that an accidental injury was
7directly and proximately caused by the employer's wilful
8violation of a health and safety standard under the Health and
9Safety Act or the Occupational Safety and Health Act in force
10at the time of the accident, the arbitrator or the Commission
11shall allow to the injured employee or his dependents, as the
12case may be, additional compensation equal to 25% of the amount
13which otherwise would be payable under the provisions of this
14Act exclusive of this paragraph. The additional compensation
15herein provided shall be allowed by an appropriate increase in
16the applicable weekly compensation rate.
17    (n) After June 30, 1984, decisions of the Illinois Workers'
18Compensation Commission reviewing an award of an arbitrator of
19the Commission shall draw interest at a rate equal to the yield
20on indebtedness issued by the United States Government with a
2126-week maturity next previously auctioned on the day on which
22the decision is filed. Said rate of interest shall be set forth
23in the Arbitrator's Decision. Interest shall be drawn from the
24date of the arbitrator's award on all accrued compensation due
25the employee through the day prior to the date of payments.
26However, when an employee appeals an award of an Arbitrator or

 

 

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1the Commission, and the appeal results in no change or a
2decrease in the award, interest shall not further accrue from
3the date of such appeal.
4    The employer or his insurance carrier may tender the
5payments due under the award to stop the further accrual of
6interest on such award notwithstanding the prosecution by
7either party of review, certiorari, appeal to the Supreme Court
8or other steps to reverse, vacate or modify the award.
9    (o) By the 15th day of each month each insurer providing
10coverage for losses under this Act shall notify each insured
11employer of any compensable claim incurred during the preceding
12month and the amounts paid or reserved on the claim including a
13summary of the claim and a brief statement of the reasons for
14compensability. A cumulative report of all claims incurred
15during a calendar year or continued from the previous year
16shall be furnished to the insured employer by the insurer
17within 30 days after the end of that calendar year.
18    The insured employer may challenge, in proceeding before
19the Commission, payments made by the insurer without
20arbitration and payments made after a case is determined to be
21noncompensable. If the Commission finds that the case was not
22compensable, the insurer shall purge its records as to that
23employer of any loss or expense associated with the claim,
24reimburse the employer for attorneys' fees arising from the
25challenge and for any payment required of the employer to the
26Rate Adjustment Fund or the Second Injury Fund, and may not

 

 

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1reflect the loss or expense for rate making purposes. The
2employee shall not be required to refund the challenged
3payment. The decision of the Commission may be reviewed in the
4same manner as in arbitrated cases. No challenge may be
5initiated under this paragraph more than 3 years after the
6payment is made. An employer may waive the right of challenge
7under this paragraph on a case by case basis.
8    (p) After filing an application for adjustment of claim but
9prior to the hearing on arbitration the parties may voluntarily
10agree to submit such application for adjustment of claim for
11decision by an arbitrator under this subsection (p) where such
12application for adjustment of claim raises only a dispute over
13temporary total disability, permanent partial disability or
14medical expenses. Such agreement shall be in writing in such
15form as provided by the Commission. Applications for adjustment
16of claim submitted for decision by an arbitrator under this
17subsection (p) shall proceed according to rule as established
18by the Commission. The Commission shall promulgate rules
19including, but not limited to, rules to ensure that the parties
20are adequately informed of their rights under this subsection
21(p) and of the voluntary nature of proceedings under this
22subsection (p). The findings of fact made by an arbitrator
23acting within his or her powers under this subsection (p) in
24the absence of fraud shall be conclusive. However, the
25arbitrator may on his own motion, or the motion of either
26party, correct any clerical errors or errors in computation

 

 

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1within 15 days after the date of receipt of such award of the
2arbitrator and shall have the power to recall the original
3award on arbitration, and issue in lieu thereof such corrected
4award. The decision of the arbitrator under this subsection (p)
5shall be considered the decision of the Commission and
6proceedings for review of questions of law arising from the
7decision may be commenced by either party pursuant to
8subsection (f) of Section 19. The Advisory Board established
9under Section 13.1 shall compile a list of certified Commission
10arbitrators, each of whom shall be approved by at least 7
11members of the Advisory Board. The chairman shall select 5
12persons from such list to serve as arbitrators under this
13subsection (p). By agreement, the parties shall select one
14arbitrator from among the 5 persons selected by the chairman
15except that if the parties do not agree on an arbitrator from
16among the 5 persons, the parties may, by agreement, select an
17arbitrator of the American Arbitration Association, whose fee
18shall be paid by the State in accordance with rules promulgated
19by the Commission. Arbitration under this subsection (p) shall
20be voluntary.
21(Source: P.A. 97-18, eff. 6-28-11; 98-40, eff. 6-28-13; 98-874,
22eff. 1-1-15.)
 
23    (820 ILCS 305/25.5)
24    Sec. 25.5. Unlawful acts; penalties.
25    (a) It is unlawful for any person, company, corporation,

 

 

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1insurance carrier, healthcare provider, or other entity to:
2        (1) Intentionally present or cause to be presented any
3    false or fraudulent claim for the payment of any workers'
4    compensation benefit.
5        (2) Intentionally make or cause to be made any false or
6    fraudulent material statement or material representation
7    for the purpose of obtaining or denying any workers'
8    compensation benefit.
9        (3) Intentionally make or cause to be made any false or
10    fraudulent statements with regard to entitlement to
11    workers' compensation benefits with the intent to prevent
12    an injured worker from making a legitimate claim for any
13    workers' compensation benefits.
14        (4) Intentionally prepare or provide an invalid,
15    false, or counterfeit certificate of insurance as proof of
16    workers' compensation insurance.
17        (5) Intentionally make or cause to be made any false or
18    fraudulent material statement or material representation
19    for the purpose of obtaining workers' compensation
20    insurance at less than the proper amount rate for that
21    insurance.
22        (6) Intentionally make or cause to be made any false or
23    fraudulent material statement or material representation
24    on an initial or renewal self-insurance application or
25    accompanying financial statement for the purpose of
26    obtaining self-insurance status or reducing the amount of

 

 

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1    security that may be required to be furnished pursuant to
2    Section 4 of this Act.
3        (7) Intentionally make or cause to be made any false or
4    fraudulent material statement to the Department of
5    Insurance's fraud and insurance non-compliance unit in the
6    course of an investigation of fraud or insurance
7    non-compliance.
8        (8) Intentionally assist, abet, solicit, or conspire
9    with any person, company, or other entity to commit any of
10    the acts in paragraph (1), (2), (3), (4), (5), (6), or (7)
11    of this subsection (a).
12        (9) Intentionally present a bill or statement for the
13    payment for medical services that were not provided.
14    For the purposes of paragraphs (2), (3), (5), (6), (7), and
15(9), the term "statement" includes any writing, notice, proof
16of injury, bill for services, hospital or doctor records and
17reports, or X-ray and test results.
18    (b) Sentence. Sentences for violations of subsection (a)
19are as follows:
20        (1) A violation of paragraph (a)(3) is a Class 4
21    felony.
22        (2) A violation of paragraph (a)(4) or (a)(7) is a
23    Class 3 felony.
24        (3) A violation of paragraph (a)(1), (a)(2), (a)(5),
25    (a)(6), or (a)(9) in which the value of the property
26    obtained or attempted to be obtained is $500 or less is a

 

 

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1    Class A misdemeanor.
2        (4) A violation of paragraph (a)(1), (a)(2), (a)(5),
3    (a)(6), or (a)(9) in which the value of the property
4    obtained or attempted to be obtained is more than $500 but
5    not more than $10,000 is a Class 3 felony.
6        (5) A violation of paragraph (a)(1), (a)(2), (a)(5),
7    (a)(6), or (a)(9) in which the value of the property
8    obtained or attempted to be obtained is more than $10,000
9    but not more than $100,000 is a Class 2 felony.
10        (6) A violation of paragraph (a)(1), (a)(2), (a)(5),
11    (a)(6), or (a)(9) in which the value of the property
12    obtained or attempted to be obtained is more than $100,000
13    is a Class 1 felony.
14        (7) A violation of paragraph (8) of subsection (a)
15    shall be punishable as the class of offense for which the
16    person convicted assisted, abetted, solicited, or
17    conspired to commit, as set forth in paragraphs (1) through
18    (6) of this subsection.
19        (1) A violation in which the value of the property
20    obtained or attempted to be obtained is $300 or less is a
21    Class A misdemeanor.
22        (2) A violation in which the value of the property
23    obtained or attempted to be obtained is more than $300 but
24    not more than $10,000 is a Class 3 felony.
25        (3) A violation in which the value of the property
26    obtained or attempted to be obtained is more than $10,000

 

 

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1    but not more than $100,000 is a Class 2 felony.
2        (4) A violation in which the value of the property
3    obtained or attempted to be obtained is more than $100,000
4    is a Class 1 felony.
5        (8) (5) A person convicted under this Section shall be
6    ordered to pay monetary restitution to the insurance
7    company or self-insured entity or any other person for any
8    financial loss sustained as a result of a violation of this
9    Section, including any court costs and attorney fees. An
10    order of restitution also includes expenses incurred and
11    paid by the State of Illinois or an insurance company or
12    self-insured entity in connection with any medical
13    evaluation or treatment services.
14    For a violation of paragraph (a)(1) or (a)(2), the value of
15the property obtained or attempted to be obtained shall include
16payments pursuant to the provisions of this Act as well as the
17amount paid for medical expenses. For a violation of paragraph
18(a)(5), the value of the property obtained or attempted to be
19obtained shall be the difference between the proper amount for
20the coverage sought or provided and the actual amount billed
21for workers' compensation insurance. For a violation of
22paragraph (a)(6), the value of the property obtained or
23attempted to be obtained shall be the difference between the
24proper amount of security required pursuant to Section 4 of
25this Act and the amount furnished pursuant to the false or
26fraudulent statements or representations For the purposes of

 

 

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1this Section, where the exact value of property obtained or
2attempted to be obtained is either not alleged or is not
3specifically set by the terms of a policy of insurance, the
4value of the property shall be the fair market replacement
5value of the property claimed to be lost, the reasonable costs
6of reimbursing a vendor or other claimant for services to be
7rendered, or both. Notwithstanding the foregoing, an insurance
8company, self-insured entity, or any other person suffering
9financial loss sustained as a result of violation of this
10Section may seek restitution, including court costs and
11attorney's fees in a civil action in a court of competent
12jurisdiction.
13    (c) The Department of Insurance shall establish a fraud and
14insurance non-compliance unit responsible for investigating
15incidences of fraud and insurance non-compliance pursuant to
16this Section. The size of the staff of the unit shall be
17subject to appropriation by the General Assembly. It shall be
18the duty of the fraud and insurance non-compliance unit to
19determine the identity of insurance carriers, employers,
20employees, or other persons or entities who have violated the
21fraud and insurance non-compliance provisions of this Section.
22The fraud and insurance non-compliance unit shall report
23violations of the fraud and insurance non-compliance
24provisions of this Section to the Special Prosecutions Bureau
25of the Criminal Division of the Office of the Attorney General
26or to the State's Attorney of the county in which the offense

 

 

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1allegedly occurred, either of whom has the authority to
2prosecute violations under this Section.
3    With respect to the subject of any investigation being
4conducted, the fraud and insurance non-compliance unit shall
5have the general power of subpoena of the Department of
6Insurance, including the authority to issue a subpoena to a
7medical provider, pursuant to Section 8-802 of the Code of
8Civil Procedure.
9    (d) Any person may report allegations of insurance
10non-compliance and fraud pursuant to this Section to the
11Department of Insurance's fraud and insurance non-compliance
12unit whose duty it shall be to investigate the report. The unit
13shall notify the Commission of reports of insurance
14non-compliance. Any person reporting an allegation of
15insurance non-compliance or fraud against either an employee or
16employer under this Section must identify himself. Except as
17provided in this subsection and in subsection (e), all reports
18shall remain confidential except to refer an investigation to
19the Attorney General or State's Attorney for prosecution or if
20the fraud and insurance non-compliance unit's investigation
21reveals that the conduct reported may be in violation of other
22laws or regulations of the State of Illinois, the unit may
23report such conduct to the appropriate governmental agency
24charged with administering such laws and regulations. Any
25person who intentionally makes a false report under this
26Section to the fraud and insurance non-compliance unit is

 

 

HB5470- 134 -LRB100 18092 JLS 33285 b

1guilty of a Class A misdemeanor.
2    (e) In order for the fraud and insurance non-compliance
3unit to investigate a report of fraud related to an employee's
4claim, (i) the employee must have filed with the Commission an
5Application for Adjustment of Claim and the employee must have
6either received or attempted to receive benefits under this Act
7that are related to the reported fraud or (ii) the employee
8must have made a written demand for the payment of benefits
9that are related to the reported fraud. There shall be no
10immunity, under this Act or otherwise, for any person who files
11a false report or who files a report without good and just
12cause. Confidentiality of medical information shall be
13strictly maintained. Investigations that are not referred for
14prosecution shall be destroyed upon the expiration of the
15statute of limitations for the acts under investigation and
16shall not be disclosed except that the person making the report
17shall be notified that the investigation is being closed. It is
18unlawful for any employer, insurance carrier, service
19adjustment company, third party administrator, self-insured,
20or similar entity to file or threaten to file a report of fraud
21against an employee because of the exercise by the employee of
22the rights and remedies granted to the employee by this Act.
23    The Department of Insurance's papers, documents, reports,
24or evidence relevant to the subject of an investigation under
25this Section shall be confidential and not subject to subpoena,
26public inspection, or to disclosure under the Freedom of

 

 

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1Information Act for so long as the Director deems reasonably
2necessary to complete the investigation, to protect the person
3investigated from unwarranted injury, or to be in the public
4interest. No officer, agent, or employee of the Department is
5subject to subpoena in any civil or administrative action to
6testify concerning a matter of which they have knowledge under
7a pending fraud or insurance non-compliance investigation by
8the Department.
9    No cause of action exists and no liability may be imposed,
10either civil or criminal, against the State, the Director of
11Insurance, any officer, agent, or employee of the Department of
12Insurance, or individuals employed or retained by the Director
13of Insurance, for an act or omission by them in the performance
14of a power or duty authorized by this Section, unless the act
15or omission was performed in bad faith and with intent to
16injure a particular person.
17    (e-5) The fraud and insurance non-compliance unit shall
18procure and implement a system utilizing advanced analytics
19inclusive of predictive modeling, data mining, social network
20analysis, and scoring algorithms for the detection and
21prevention of fraud, waste, and abuse on or before January 1,
222012. The fraud and insurance non-compliance unit shall procure
23this system using a request for proposals process governed by
24the Illinois Procurement Code and rules adopted under that
25Code. The fraud and insurance non-compliance unit shall provide
26a report to the President of the Senate, Speaker of the House

 

 

HB5470- 136 -LRB100 18092 JLS 33285 b

1of Representatives, Minority Leader of the House of
2Representatives, Minority Leader of the Senate, Governor,
3Chairman of the Commission, and Director of Insurance on or
4before July 1, 2012 and annually thereafter detailing its
5activities and providing recommendations regarding
6opportunities for additional fraud waste and abuse detection
7and prevention.
8    (f) Any person convicted of fraud related to workers'
9compensation pursuant to this Section shall be subject to the
10penalties prescribed in the Criminal Code of 2012 and shall be
11ineligible to receive or retain any compensation, disability,
12or medical benefits as defined in this Act if the compensation,
13disability, or medical benefits were owed or received as a
14result of fraud for which the recipient of the compensation,
15disability, or medical benefit was convicted. This subsection
16applies to accidental injuries or diseases that occur on or
17after the effective date of this amendatory Act of the 94th
18General Assembly.
19    (g) Civil liability. Any person convicted of fraud who
20knowingly obtains, attempts to obtain, or causes to be obtained
21any benefits under this Act by the making of a false claim or
22who knowingly misrepresents any material fact shall be civilly
23liable to the payor of benefits or the insurer or the payor's
24or insurer's subrogee or assignee in an amount equal to 3 times
25the value of the benefits or insurance coverage wrongfully
26obtained or twice the value of the benefits or insurance

 

 

HB5470- 137 -LRB100 18092 JLS 33285 b

1coverage attempted to be obtained, plus reasonable attorney's
2fees and expenses incurred by the payor or the payor's subrogee
3or assignee who successfully brings a claim under this
4subsection. This subsection applies to accidental injuries or
5diseases that occur on or after the effective date of this
6amendatory Act of the 94th General Assembly.
7    (h) The fraud and insurance non-compliance unit shall
8submit a written report on an annual basis to the Chairman of
9the Commission, the Workers' Compensation Advisory Board, the
10General Assembly, the Governor, and the Attorney General by
11January 1 and July 1 of each year. This report shall include,
12at the minimum, the following information:
13        (1) The number of allegations of insurance
14    non-compliance and fraud reported to the fraud and
15    insurance non-compliance unit.
16        (2) The source of the reported allegations
17    (individual, employer, or other).
18        (3) The number of allegations investigated by the fraud
19    and insurance non-compliance unit.
20        (4) The number of criminal referrals made in accordance
21    with this Section and the entity to which the referral was
22    made.
23        (5) All proceedings under this Section.
24(Source: P.A. 97-18, eff. 6-28-11; 97-1150, eff. 1-25-13.)
 
25    (820 ILCS 305/29.2)

 

 

HB5470- 138 -LRB100 18092 JLS 33285 b

1    Sec. 29.2. Insurance and self-insurance oversight.
2    (a) The Department of Insurance shall annually submit to
3the Governor, the Chairman of the Commission, the President of
4the Senate, the Speaker of the House of Representatives, the
5Minority Leader of the Senate, and the Minority Leader of the
6House of Representatives a written report that details the
7state of the workers' compensation insurance market in
8Illinois. The report shall be completed by April 1 of each
9year, beginning in 2012, or later if necessary data or analyses
10are only available to the Department at a later date. The
11report shall be posted on the Department of Insurance's
12Internet website. Information to be included in the report
13shall be for the preceding calendar year. The report shall
14include, at a minimum, the following:
15        (1) Gross premiums collected by workers' compensation
16    carriers in Illinois and the national rank of Illinois
17    based on premium volume.
18        (2) The number of insurance companies actively engaged
19    in Illinois in the workers' compensation insurance market,
20    including both holding companies and subsidiaries or
21    affiliates, and the national rank of Illinois based on
22    number of competing insurers.
23        (3) The total number of insured participants in the
24    Illinois workers' compensation assigned risk insurance
25    pool, and the size of the assigned risk pool as a
26    proportion of the total Illinois workers' compensation

 

 

HB5470- 139 -LRB100 18092 JLS 33285 b

1    insurance market.
2        (4) The advisory organization premium rate for
3    workers' compensation insurance in Illinois for the
4    previous year.
5        (5) The advisory organization prescribed assigned risk
6    pool premium rate.
7        (6) The total amount of indemnity payments made by
8    workers' compensation insurers in Illinois.
9        (7) The total amount of medical payments made by
10    workers' compensation insurers in Illinois, and the
11    national rank of Illinois based on average cost of medical
12    claims per injured worker.
13        (8) The gross profitability of workers' compensation
14    insurers in Illinois, and the national rank of Illinois
15    based on profitability of workers' compensation insurers.
16        (9) The loss ratio of workers' compensation insurers in
17    Illinois and the national rank of Illinois based on the
18    loss ratio of workers' compensation insurers. For purposes
19    of this loss ratio calculation, the denominator shall
20    include all premiums and other fees collected by workers'
21    compensation insurers and the numerator shall include the
22    total amount paid by the insurer for care or compensation
23    to injured workers.
24        (10) The growth of total paid indemnity benefits by
25    temporary total disability, scheduled and non-scheduled
26    permanent partial disability, and total disability.

 

 

HB5470- 140 -LRB100 18092 JLS 33285 b

1        (11) The number of injured workers receiving wage loss
2    differential awards and the average wage loss differential
3    award payout.
4        (12) Illinois' rank, relative to other states, for:
5            (i) the maximum and minimum temporary total
6        disability benefit level;
7            (ii) the maximum and minimum scheduled and
8        non-scheduled permanent partial disability benefit
9        level;
10            (iii) the maximum and minimum total disability
11        benefit level; and
12            (iv) the maximum and minimum death benefit level.
13        (13) The aggregate growth of medical benefit payout by
14    non-hospital providers and hospitals.
15        (14) The aggregate growth of medical utilization for
16    the top 10 most common injuries to specific body parts by
17    non-hospital providers and hospitals.
18        (15) The percentage of injured workers filing claims at
19    the Commission that are represented by an attorney.
20        (16) The total amount paid by injured workers for
21    attorney representation.
22    (a-5) The Commission shall annually submit to the Governor
23and the General Assembly a written report that details the
24state of self-insurance for workers' compensation in Illinois.
25The report shall be based on information currently collected by
26the Commission or the Department of Insurance from

 

 

HB5470- 141 -LRB100 18092 JLS 33285 b

1self-insurers, as of the effective date of this amendatory Act
2of the 100th General Assembly. The report shall be completed by
3April 1 of each year, beginning in 2019. The report shall be
4posted on the Commission's Internet website. Information to be
5included in the report shall be for the preceding calendar
6year. The report shall include, at a minimum, the following in
7the aggregate:
8        (1) The number of employers that self-insure for
9    workers' compensation.
10        (2) The total number of employees covered by
11    self-insurance.
12        (3) The total amount of indemnity payments made by
13    self-insureds.
14        (4) The total amount of medical payments made by
15    self-insureds.
16        (5) The growth of total paid indemnity benefits by
17    temporary total disability, scheduled and non-scheduled
18    permanent partial disability, and total disability.
19        (6) Illinois' rank, relative to other states, for:
20            (i) the maximum and minimum temporary total
21        disability benefit levels;
22            (ii) the maximum and minimum scheduled and
23        non-scheduled permanent partial disability benefit
24        levels;
25            (iii) the maximum and minimum total disability
26        benefit levels; and

 

 

HB5470- 142 -LRB100 18092 JLS 33285 b

1            (iv) the maximum and minimum death benefit levels.
2        (7) The aggregate growth of medical benefit payouts by
3    non-hospital providers and hospitals.
4    Any information collected by the Commission from
5self-insureds shall be exempt from public inspection and
6disclosure under the Freedom of Information Act.
7    (b) The Director of Insurance shall promulgate rules
8requiring each insurer licensed to write workers' compensation
9coverage in the State to record and report the following
10information on an aggregate basis to the Department of
11Insurance before March 1 of each year, relating to claims in
12the State opened within the prior calendar year:
13        (1) The number of claims opened.
14        (2) The number of reported medical only claims.
15        (3) The number of contested claims.
16        (4) The number of claims for which the employee has
17    attorney representation.
18        (5) The number of claims with lost time and the number
19    of claims for which temporary total disability was paid.
20        (6) The number of claim adjusters employed to adjust
21    workers' compensation claims.
22        (7) The number of claims for which temporary total
23    disability was not paid within 14 days from the first full
24    day off, regardless of reason.
25        (8) The number of medical bills paid 60 days or later
26    from date of service and the average days paid on those

 

 

HB5470- 143 -LRB100 18092 JLS 33285 b

1    paid after 60 days for the previous calendar year.
2        (9) The number of claims in which in-house defense
3    counsel participated, and the total amount spent on
4    in-house legal services.
5        (10) The number of claims in which outside defense
6    counsel participated, and the total amount paid to outside
7    defense counsel.
8        (11) The total amount billed to employers for bill
9    review.
10        (12) The total amount billed to employers for fee
11    schedule savings.
12        (13) The total amount charged to employers for any and
13    all managed care fees.
14        (14) The number of claims involving in-house medical
15    nurse case management, and the total amount spent on
16    in-house medical nurse case management.
17        (15) The number of claims involving outside medical
18    nurse case management, and the total amount paid for
19    outside medical nurse case management.
20        (16) The total amount paid for Independent Medical
21    exams.
22        (17) The total amount spent on in-house Utilization
23    Review for the previous calendar year.
24        (18) The total amount paid for outside Utilization
25    Review for the previous calendar year.
26    The Department shall make the submitted information

 

 

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1publicly available on the Department's Internet website or such
2other media as appropriate in a form useful for consumers.
3(Source: P.A. 97-18, eff. 6-28-11.)
 
4    Section 95. The Franchise Disclosure Act of 1987 is amended
5by changing Sections 2 and 44 as follows:
 
6    (815 ILCS 705/2)  (from Ch. 121 1/2, par. 1702)
7    Sec. 2. Findings and purpose.
8    (1) The General Assembly finds and declares that the sale
9of franchises is a widespread business activity. Illinois
10residents have suffered substantial losses where franchisors
11or their representatives have not provided full and complete
12information regarding the franchisor-franchisee relationship,
13the details of the contract between the franchisor and
14franchisee, the prior business experience of the franchisor and
15other factors relevant to the franchise offered for sale.
16    (2) It is the intent of this Act: (a) to provide each
17prospective franchisee with the information necessary to make
18an intelligent decision regarding franchises being offered for
19sale; and (b) to protect the franchisee and the franchisor by
20providing a better understanding of the business and the legal
21relationship between the franchisee and the franchisor.
22    (3) The General Assembly finds and declares that the
23enforceability of federal franchise guidelines in Illinois is
24an essential element in the protection of the franchisor and

 

 

HB5470- 145 -LRB100 18092 JLS 33285 b

1franchisee relationship in Illinois.
2(Source: P.A. 85-551.)
 
3    (815 ILCS 705/44)  (from Ch. 121 1/2, par. 1744)
4    Sec. 44. This Act shall not be construed to repeal any
5right, claim, penalty, offense or punishment existing under The
6Franchise Disclosure Act prior to the date this Act takes
7effect. This Act shall apply only to actions undertaken on and
8subsequent to the date this Act takes effect as well as to all
9resulting rights, claims, penalties, offenses and punishment.
10    This amendatory Act of the 100th General Assembly does not
11abolish any right, claim, penalty, offense, or punishment
12existing prior to the effective date of this amendatory Act of
13the 100th General Assembly under the provisions repealed by
14this amendatory Act of the 100th General Assembly.
15(Source: P.A. 85-551.)
 
16    (815 ILCS 705/4 rep.)
17    (815 ILCS 705/5 rep.)
18    (815 ILCS 705/6 rep.)
19    (815 ILCS 705/7 rep.)
20    (815 ILCS 705/8 rep.)
21    (815 ILCS 705/9 rep.)
22    (815 ILCS 705/10 rep.)
23    (815 ILCS 705/11 rep.)
24    (815 ILCS 705/12 rep.)

 

 

HB5470- 146 -LRB100 18092 JLS 33285 b

1    (815 ILCS 705/14 rep.)
2    (815 ILCS 705/15 rep.)
3    (815 ILCS 705/16 rep.)
4    (815 ILCS 705/17 rep.)
5    (815 ILCS 705/18 rep.)
6    (815 ILCS 705/19 rep.)
7    (815 ILCS 705/20 rep.)
8    (815 ILCS 705/22 rep.)
9    (815 ILCS 705/23 rep.)
10    (815 ILCS 705/24 rep.)
11    (815 ILCS 705/25 rep.)
12    (815 ILCS 705/26 rep.)
13    (815 ILCS 705/27 rep.)
14    (815 ILCS 705/28 rep.)
15    (815 ILCS 705/29 rep.)
16    (815 ILCS 705/31 rep.)
17    (815 ILCS 705/32 rep.)
18    (815 ILCS 705/33 rep.)
19    (815 ILCS 705/34 rep.)
20    (815 ILCS 705/35 rep.)
21    (815 ILCS 705/36 rep.)
22    (815 ILCS 705/37 rep.)
23    (815 ILCS 705/38 rep.)
24    (815 ILCS 705/39 rep.)
25    (815 ILCS 705/41 rep.)
26    (815 ILCS 705/42 rep.)

 

 

HB5470- 147 -LRB100 18092 JLS 33285 b

1    (815 ILCS 705/43 rep.)
2    Section 97. The Franchise Disclosure Act of 1987 is amended
3by repealing Sections 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16,
417, 18, 19, 20, 22, 23, 24, 25, 26, 27, 28, 29, 31, 32, 33, 34,
535, 36, 37, 38, 39, 41, 42, and 43.
 
6    Section 98. No acceleration or delay. Where this Act makes
7changes in a statute that is represented in this Act by text
8that is not yet or no longer in effect (for example, a Section
9represented by multiple versions), the use of that text does
10not accelerate or delay the taking effect of (i) the changes
11made by this Act or (ii) provisions derived from any other
12Public Act.
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.

 

 

HB5470- 148 -LRB100 18092 JLS 33285 b

1 INDEX
2 Statutes amended in order of appearance
3    New Act
4    5 ILCS 140/7.5
5    720 ILCS 5/17-10.4 new
6    820 ILCS 305/1from Ch. 48, par. 138.1
7    820 ILCS 305/8from Ch. 48, par. 138.8
8    820 ILCS 305/8.1b
9    820 ILCS 305/8.2
10    820 ILCS 305/8.2a
11    820 ILCS 305/14from Ch. 48, par. 138.14
12    820 ILCS 305/19from Ch. 48, par. 138.19
13    820 ILCS 305/25.5
14    820 ILCS 305/29.2
15    815 ILCS 705/2from Ch. 121 1/2, par. 1702
16    815 ILCS 705/44from Ch. 121 1/2, par. 1744
17    815 ILCS 705/4 rep.
18    815 ILCS 705/5 rep.
19    815 ILCS 705/6 rep.
20    815 ILCS 705/7 rep.
21    815 ILCS 705/8 rep.
22    815 ILCS 705/9 rep.
23    815 ILCS 705/10 rep.
24    815 ILCS 705/11 rep.
25    815 ILCS 705/12 rep.

 

 

HB5470- 149 -LRB100 18092 JLS 33285 b

1    815 ILCS 705/14 rep.
2    815 ILCS 705/15 rep.
3    815 ILCS 705/16 rep.
4    815 ILCS 705/17 rep.
5    815 ILCS 705/18 rep.
6    815 ILCS 705/19 rep.
7    815 ILCS 705/20 rep.
8    815 ILCS 705/22 rep.
9    815 ILCS 705/23 rep.
10    815 ILCS 705/24 rep.
11    815 ILCS 705/25 rep.
12    815 ILCS 705/26 rep.
13    815 ILCS 705/27 rep.
14    815 ILCS 705/28 rep.
15    815 ILCS 705/29 rep.
16    815 ILCS 705/31 rep.
17    815 ILCS 705/32 rep.
18    815 ILCS 705/33 rep.
19    815 ILCS 705/34 rep.
20    815 ILCS 705/35 rep.
21    815 ILCS 705/36 rep.
22    815 ILCS 705/37 rep.
23    815 ILCS 705/38 rep.
24    815 ILCS 705/39 rep.
25    815 ILCS 705/41 rep.
26    815 ILCS 705/42 rep.

 

 

HB5470- 150 -LRB100 18092 JLS 33285 b

1    815 ILCS 705/43 rep.