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90_SB1065
SEE INDEX
Amends the Workers' Compensation Act and the Workers'
Occupational Diseases Act. Creates the State Compensation
Insurance Fund as an independent public corporation to insure
employers against liabilities for certain injuries and
occupational diseases for which their employees may be
entitled to benefits. Provides full coverage under the
Workers' Compensation Act for Chicago firefighters. Adds
provisions regarding: limits on charges by health care
providers; resolution of disputes concerning those charges;
disclosure of provider self-referral; limits on collection
efforts by providers; and fees for medical records. Makes
numerous changes in relation to compensation levels,
limitations on claims, liability of parties, penalties for
failure to comply with the Acts, presumptions relating to
certain injuries and diseases, obligations of workers'
compensation insurers, and other matters. Amends the
Business Corporation Act to require corporations to submit
proof of workers' compensation coverage to the Secretary of
State.
LRB9002213DJcd
LRB9002213DJcd
1 AN ACT to amend certain Acts in relation to compensation
2 for workplace injuries and diseases.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Business Corporation Act of 1983 is
6 amended by changing Sections 2.10 and 2.15 as follows:
7 (805 ILCS 5/2.10) (from Ch. 32, par. 2.10)
8 Sec. 2.10. Articles of Incorporation. The articles of
9 incorporation shall be executed and filed in duplicate in
10 accordance with Section 1.10 of this Act. The executed
11 articles of incorporation shall in all instances be
12 accompanied by certified proof of insurance or a certificate
13 of compliance issued by the Industrial Commission to the
14 proposed corporation in accordance with Section 4 of the
15 Workers' Compensation Act, or both.
16 (a) The articles of incorporation must set forth:
17 (1) a corporate name for the corporation that satisfies
18 the requirements of this Act;
19 (2) the purpose or purposes for which the corporation is
20 organized, which may be stated to be, or to include, the
21 transaction of any or all lawful businesses for which
22 corporations may be incorporated under this Act;
23 (3) the address of the corporation's initial registered
24 office and the name of its initial registered agent at that
25 office;
26 (4) the name and address of each incorporator;
27 (5) the number of shares of each class the corporation
28 is authorized to issue;
29 (6) the number and class of shares which the corporation
30 proposes to issue without further report to the Secretary of
31 State, and the consideration to be received, less expenses,
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1 including commissions, paid or incurred in connection with
2 the issuance of shares, by the corporation therefor. If
3 shares of more than one class are to be issued, the
4 consideration for shares of each class shall be separately
5 stated;
6 (7) if the shares are divided into classes, the
7 designation of each class and a statement of the
8 designations, preferences, qualifications, limitations,
9 restrictions, and special or relative rights with respect to
10 the shares of each class; and
11 (8) if the corporation may issue the shares of any
12 preferred or special class in series, then the designation of
13 each series and a statement of the variations in the relative
14 rights and preferences of the different series, if the same
15 are fixed in the articles of incorporation, or a statement of
16 the authority vested in the board of directors to establish
17 series and determine the variations in the relative rights
18 and preferences of the different series.
19 (b) The articles of incorporation may set forth:
20 (1) the names and residential addresses of the
21 individuals who are to serve as the initial directors;
22 (2) provisions not inconsistent with law with respect
23 to:
24 (i) managing the business and regulating the affairs of
25 the corporation;
26 (ii) defining, limiting, and regulating the rights,
27 powers and duties of the corporation, its officers, directors
28 and shareholders;
29 (iii) authorizing and limiting the preemptive right of a
30 shareholder to acquire shares, whether then or thereafter
31 authorized;
32 (iv) an estimate, expressed in dollars, of the value of
33 all the property to be owned by the corporation for the
34 following year, wherever located, and an estimate of the
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1 value of the property to be located within this State during
2 such year, and an estimate, expressed in dollars, of the
3 gross amount of business which will be transacted by it
4 during such year and an estimate of the gross amount thereof
5 which will be transacted by it at or from places of business
6 in this State during such year; or
7 (v) superseding any provision of this Act that requires
8 for approval of corporate action a two-thirds vote of the
9 shareholders by specifying any smaller or larger vote
10 requirement not less than a majority of the outstanding
11 shares entitled to vote on the matter and not less than a
12 majority of the outstanding shares of each class of shares
13 entitled to vote as a class on the matter.
14 (3) a provision eliminating or limiting the personal
15 liability of a director to the corporation or its
16 shareholders for monetary damages for breach of fiduciary
17 duty as a director, provided that the provision does not
18 eliminate or limit the liability of a director (i) for any
19 breach of the director's duty of loyalty to the corporation
20 or its shareholders, (ii) for acts or omissions not in good
21 faith or that involve intentional misconduct or a knowing
22 violation of law, (iii) under Section 8.65 of this Act, or
23 (iv) for any transaction from which the director derived an
24 improper personal benefit. No such provision shall eliminate
25 or limit the liability of a director for any act or omission
26 occurring before the date when the provision becomes
27 effective.
28 (4) any provision that under this Act is required or
29 permitted to be set forth in the articles of incorporation or
30 by-laws.
31 (c) The articles of incorporation need not set forth any
32 of the corporate powers enumerated in this Act.
33 (d) The duration of a corporation is perpetual unless
34 otherwise specified in the articles of incorporation.
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1 (e) If the data to which reference is made in
2 subparagraph (iv) of paragraph (2) of subsection (b) of this
3 Section is not included in the articles of incorporation, the
4 franchise tax provided for in this Act shall be computed on
5 the basis of the entire paid-in capital as set forth pursuant
6 to paragraph (6) of subsection (a) of this Section, until
7 such time as the data to which reference is made in
8 subparagraph (iv) of paragraph (2) of subsection (b) is
9 provided in accordance with either Section 14.05 or Section
10 14.25 of this Act.
11 When the provisions of this Section have been complied
12 with, the Secretary of State shall issue a certificate of
13 incorporation; however, the Secretary of State may not issue
14 a certificate of incorporation unless and until the proposed
15 corporation has filed certified proof of insurance of its
16 workers' compensation risk or a certificate of compliance
17 issued by the Industrial Commission in accordance with
18 Section 4 of the Workers' Compensation Act.
19 (Source: P.A. 88-43; 88-151; 88-670, eff. 12-2-94.)
20 (805 ILCS 5/2.15) (from Ch. 32, par. 2.15)
21 Sec. 2.15. Effect of issuance of certificate of
22 incorporation. Upon the issuance of the certificate of
23 incorporation by the Secretary of State, the corporate
24 existence shall begin, and such certificate of incorporation
25 shall be conclusive evidence, except as against the State,
26 that all conditions precedent required to be performed by the
27 incorporators have been complied with and that the
28 corporation has been incorporated under this Act; however,
29 the corporation shall file with the Secretary of State,
30 within 60 days of the issuance of the certificate of
31 incorporation, proof of satisfaction of the corporation's
32 obligations under Section 4 of the Workers' Compensation Act
33 in the form of either a certified proof that insurance has
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1 been secured or a certified certificate of compliance issued
2 by the Industrial Commission establishing that the
3 corporation's workers' compensation obligations have been met
4 pursuant to Section 4 of the Workers' Compensation Act.
5 Failure to file this proof within 60 days shall result in the
6 dissolution of the corporation pursuant to Section 12.4 of
7 this Act.
8 (Source: P.A. 83-1025.)
9 Section 10. The Workers' Compensation Act is amended by
10 changing Sections 1, 4, 5, 6, 7, 8, 10, 16, and 19 and adding
11 Sections 3a, 4a-10, 8a, 8b, 8c, 8d, 16b, 16c, 16d, 16e, and
12 16f as follows:
13 (820 ILCS 305/1) (from Ch. 48, par. 138.1)
14 Sec. 1. This Act may be cited as the Workers'
15 Compensation Act.
16 (a) The term "employer" as used in this Act means:
17 1. The State and each county, city, town, township,
18 incorporated village, school district, body politic, or
19 municipal corporation therein.
20 2. Every person, firm, public or private corporation,
21 including hospitals, public service, eleemosynary, religious
22 or charitable corporations or associations who has any person
23 in service or under any contract for hire, express or
24 implied, oral or written, and who is engaged in any of the
25 enterprises or businesses enumerated in Section 3 of this
26 Act, or who at or prior to the time of the accident to the
27 employee for which compensation under this Act may be
28 claimed, has in the manner provided in this Act elected to
29 become subject to the provisions of this Act, and who has
30 not, prior to such accident, effected a withdrawal of such
31 election in the manner provided in this Act.
32 3. Any one engaging in any business or enterprise
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1 referred to in subsections 1 and 2 of Section 3 of this Act
2 who undertakes to do any work enumerated therein, is liable
3 to pay compensation to his own immediate employees in
4 accordance with the provisions of this Act, and in addition
5 thereto if he directly or indirectly engages any contractor
6 whether principal or sub-contractor to do any such work, he
7 is liable to pay compensation to the employees of any such
8 contractor or sub-contractor unless such contractor or
9 sub-contractor has insured, in any company or association
10 authorized under the laws of this State to insure the
11 liability to pay compensation under this Act, or guaranteed
12 his liability to pay such compensation. With respect to any
13 time limitation on the filing of claims provided by this Act,
14 the timely filing of a claim against a contractor or
15 subcontractor, as the case may be, shall be deemed to be a
16 timely filing with respect to all persons upon whom liability
17 is imposed by this paragraph.
18 In the event any such person pays compensation under this
19 subsection he may recover the amount thereof from the
20 contractor or sub-contractor, if any, and in the event the
21 contractor pays compensation under this subsection he may
22 recover the amount thereof from the sub-contractor, if any.
23 This subsection does not apply in any case where the
24 accident occurs elsewhere than on, in or about the immediate
25 premises on which the principal has contracted that the work
26 be done.
27 4. Where an employer operating under and subject to the
28 provisions of this Act loans an employee to another such
29 employer and such loaned employee sustains a compensable
30 accidental injury in the employment of such borrowing
31 employer and where such borrowing employer does not provide
32 or pay the benefits or payments due such injured employee,
33 such loaning employer is liable to provide or pay all
34 benefits or payments due such employee under this Act and as
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1 to such employee the liability of such loaning and borrowing
2 employers is joint and several, provided that such loaning
3 employer is in the absence of agreement to the contrary
4 entitled to receive from such borrowing employer full
5 reimbursement for all sums paid or incurred pursuant to this
6 paragraph together with reasonable attorneys' fees and
7 expenses in any hearings before the Industrial Commission or
8 in any action to secure such reimbursement. Where any
9 benefit is provided or paid by such loaning employer the
10 employee has the duty of rendering reasonable cooperation in
11 any hearings, trials or proceedings in the case, including
12 such proceedings for reimbursement.
13 Where an employee files an Application for Adjustment of
14 Claim with the Industrial Commission alleging that his claim
15 is covered by the provisions of the preceding paragraph, and
16 joining both the alleged loaning and borrowing employers,
17 they and each of them, upon written demand by the employee
18 and within 7 days after receipt of such demand, shall have
19 the duty of filing with the Industrial Commission a written
20 admission or denial of the allegation that the claim is
21 covered by the provisions of the preceding paragraph and in
22 default of such filing or if any such denial be ultimately
23 determined not to have been bona fide then the provisions of
24 Paragraph K of Section 19 of this Act shall apply.
25 An employer whose business or enterprise or a substantial
26 part thereof consists of hiring, procuring or furnishing
27 employees to or for other employers operating under and
28 subject to the provisions of this Act for the performance of
29 the work of such other employers and who pays such employees
30 their salary or wages notwithstanding that they are doing the
31 work of such other employers shall be deemed a loaning
32 employer within the meaning and provisions of this Section.
33 (b) The term "employee" as used in this Act means:
34 1. Every person in the service of the State, including
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1 members of the General Assembly, members of the Commerce
2 Commission, members of the Industrial Commission, and all
3 persons in the service of the University of Illinois, county,
4 including deputy sheriffs and assistant state's attorneys,
5 city, town, township, incorporated village or school
6 district, body politic, or municipal corporation therein,
7 whether by election, under appointment or contract of hire,
8 express or implied, oral or written, including all members of
9 the Illinois National Guard while on active duty in the
10 service of the State, and all probation personnel of the
11 Juvenile Court appointed pursuant to Article VI of the
12 Juvenile Court Act of 1987, and including any official of the
13 State, any county, city, town, township, incorporated
14 village, school district, body politic or municipal
15 corporation therein except any duly appointed member of a
16 police department in any city whose population exceeds
17 200,000 according to the last Federal or State census, and
18 except any member of a fire insurance patrol maintained by a
19 board of underwriters in this State. A duly appointed member
20 of a fire department in any city, the population of which
21 exceeds 200,000 according to the last federal or State
22 census, is an employee under this Act only with respect to
23 claims brought under paragraph (c) of Section 8.
24 One employed by a contractor who has contracted with the
25 State, or a county, city, town, township, incorporated
26 village, school district, body politic or municipal
27 corporation therein, through its representatives, is not
28 considered as an employee of the State, county, city, town,
29 township, incorporated village, school district, body politic
30 or municipal corporation which made the contract.
31 2. Every person in the service of another under any
32 contract of hire, express or implied, oral or written,
33 including persons whose employment is outside of the State of
34 Illinois where the contract of hire is made within the State
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1 of Illinois, persons whose employment results in fatal or
2 non-fatal injuries within the State of Illinois where the
3 contract of hire is made outside of the State of Illinois,
4 and persons whose employment is principally localized within
5 the State of Illinois, regardless of the place of the
6 accident or the place where the contract of hire was made,
7 and including aliens, and minors who, for the purpose of this
8 Act are considered the same and have the same power to
9 contract, receive payments and give quittances therefor, as
10 adult employees.
11 3. Every sole proprietor and every partner of a business
12 may elect to be covered by this Act.
13 An employee or his dependents under this Act who shall
14 have a cause of action by reason of any injury, disablement
15 or death arising out of and in the course of his employment
16 may elect to pursue his remedy in the State where injured or
17 disabled, or in the State where the contract of hire is made,
18 or in the State where the employment is principally
19 localized.
20 However, any employer may elect to provide and pay
21 compensation to any employee other than those engaged in the
22 usual course of the trade, business, profession or occupation
23 of the employer by complying with Sections 2 and 4 of this
24 Act. Employees are not included within the provisions of
25 this Act when excluded by the laws of the United States
26 relating to liability of employers to their employees for
27 personal injuries where such laws are held to be exclusive.
28 The term "employee" does not include persons performing
29 services as real estate broker, broker-salesman, or salesman
30 when such persons are paid by commission only.
31 (c) "Commission" means the Industrial Commission created
32 by Section 5 of "The Civil Administrative Code of Illinois",
33 approved March 7, 1917, as amended, or the Industrial
34 Commission created by Section 13 of this Act.
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1 (Source: P.A. 85-1209.)
2 (820 ILCS 305/3a new)
3 Sec. 3a. State Compensation Insurance Fund.
4 (a) As used in this Section:
5 (1) "Manager" means the manager of the State
6 Compensation Insurance Fund.
7 (2) "Fund" means the State Compensation Insurance
8 Fund.
9 (3) "Board" means the board of directors of the
10 State Compensation Insurance Fund.
11 (b) The State Compensation Insurance Fund is created as
12 an independent public corporation and the purpose of the
13 State Compensation Insurance Fund is to insure employers
14 against liability for injuries and occupational diseases for
15 which their employees may be entitled to benefits under the
16 Workers' Compensation Act, the Workers' Occupational Diseases
17 Act, the federal Employers' Liability Act, and the federal
18 Longshoremen's and Harbor Workers' Compensation Act.
19 (c) (1) The State Compensation Insurance Fund shall be
20 under the direct supervision of a board of directors which
21 shall consist of 5 members to be appointed by the Governor.
22 After the Fund has operated for a period of one year, each
23 member appointed shall be a policyholder or an employee of a
24 policyholder of the Fund and at least one of the members of
25 the board of directors shall be an employee of a policyholder
26 of the Fund.
27 (2) One member of the board of the directors shall be
28 appointed for a term ending December 31, 1998, and each other
29 director for a term expiring one, 2, 3 and 4 years
30 thereafter. Upon expiration of any of the terms, the
31 appointee or his or her successor shall be appointed for a
32 term of 4 years. Appointment to fill a vacancy caused by
33 other than expiration of the term shall be for the unexpired
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1 portion of the term.
2 (3) Each appointed member of the board shall receive as
3 compensation $100 per day while in actual attendance at
4 meetings of the board and shall be reimbursed for mileage and
5 expenses.
6 (4) The chairman shall be elected annually by the
7 members of the board. The board may adopt rules and
8 regulations as it deems proper for the conduct of its
9 business. The board may from time to time amend or change the
10 rules and regulations and may cause them to be published and
11 distributed.
12 (5) The board shall meet at least once every 3 months.
13 Board meetings may be called at any time by the chairman of
14 the board or the manager of the Fund.
15 (6) The board shall be responsible for setting forth the
16 general policy for the operation of the Fund.
17 (7) There shall not be any liability in a private
18 capacity on the part of the board of directors or any member
19 thereof or any officer or employee of the Fund for or on
20 account of any act performed or obligation entered into in
21 any official capacity in connection with the administration,
22 management or conduct of the Fund or affairs relating
23 thereto.
24 (8) The board of directors is hereby vested with full
25 power, authority and jurisdiction over the Fund. The board of
26 directors may perform all acts necessary or convenient in the
27 exercise of any power, authority or jurisdiction over the
28 Fund, either in the administration thereof or in connection
29 with the insurance business to be carried on by it under the
30 provisions of this Section, as fully and completely as the
31 governing body of a private insurance carrier to fulfill the
32 objectives and intent of this Section.
33 (d)(1) The board of directors of the Fund shall appoint
34 a manager of the Fund who shall be in charge of the
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1 day-to-day operation of the Fund. The manager shall have
2 proven successful experience as an executive at the general
3 management level. The manager shall be appointed for a term
4 of 6 years. The manager shall receive compensation as set by
5 the board, and may be removed only for cause by the board.
6 (2) Before entering on the duties of the office, the
7 manager shall qualify by giving an official bond in an amount
8 and with sureties approved by the Board. The manager shall
9 file the bond with the State Treasurer. The premium for the
10 bond shall be paid by the Fund.
11 (e) The manager, subject to the authority of the board
12 of directors, has full power, authority, and jurisdiction
13 over the Fund. The manager may perform all acts necessary or
14 convenient in the exercise of any power, authority or
15 jurisdiction over the Fund, either in the administration of
16 the Fund or in connection with the insurance business to be
17 carried on by the Fund under the provisions of this Section,
18 including the establishment of premium rates.
19 (f) The manager, subject to the approval of the board of
20 directors, may adopt rules and regulations relating to the
21 conduct of the business of the Fund.
22 (g) In conducting the business of the Fund, the manager
23 may:
24 (1) contract with physicians, surgeons, hospitals,
25 and rehabilitation facilities for medical, surgical, and
26 rehabilitation evaluation and treatment and the care and
27 nursing of injured persons entitled to benefits from the
28 Fund;
29 (2) make safety inspections with risks and furnish
30 advisory service to employers on safety and health
31 measures;
32 (3) act for the Fund in collecting and disbursing
33 money necessary to administer the Fund and conduct the
34 business of the Fund.
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1 (h) Annually the board shall report to the Governor and
2 the General Assembly the business done by the Fund during the
3 previous year and shall submit to the Governor a statement of
4 the resources and liabilities of the Fund.
5 (i) The Fund may:
6 (1) insure an employer against any workers'
7 compensation and employer's liability such employer may
8 have on account of bodily injury or occupational diseases
9 to his or her workers arising out of and in the course of
10 employment, as fully as any other insurer;
11 (2) insure employers against their liability for
12 compensation or damages under the federal Longshoremen's
13 and Harbor Workers' Compensation Act or any extension of
14 that Act, as fully as any other insurer;
15 (3) furnish advice, services and excess workers'
16 compensation and employer liability insurance to any
17 employer qualified as a self-insured employer; and
18 (4) reinsure any risk or any part thereof.
19 (j) The monies and assets belonging to the Fund are:
20 (1) all premiums and other monies paid to the Fund;
21 (2) all property and securities acquired through
22 the use of money belonging to the Fund; and
23 (3) all interest and dividends earned upon money
24 belonging to the Fund and deposited or invested as
25 provided in this Section.
26 (k) (1) The State Treasurer is the ex-officio custodian
27 of the Fund and shall keep all monies and assets belonging to
28 the Fund in a separate account outside of the State Treasury
29 and all interest earnings shall be credited to the Fund.
30 This separate account shall be known as the Workers'
31 Compensation Insurance Fund. The State Treasurer shall be
32 liable under his or her bond for the safe keeping of such
33 monies and assets.
34 (2) The manager shall deliver all receipts collected or
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1 received under this Section to the State Treasurer.
2 (3) The moneys and assets of the Fund shall not be
3 moneys and assets of the State but shall be used exclusively
4 for the operations and obligations of the Fund.
5 (4)(A) Except as provided in subparagraph (B) of this
6 paragraph, no money may be expended from the separate account
7 except by a warrant drawn by the State Comptroller and
8 presented by him or her to the State Treasurer to be
9 countersigned. No warrant for the payment of money from the
10 separate account by the State Treasurer may be drawn by the
11 State Comptroller without the presentation of itemized
12 vouchers by the manager indicating that the expenditure is
13 pursuant to law and is authorized.
14 (B) Money may be expended from the separate account from
15 a checking account maintained by the Fund, by checks signed
16 by the manager, but only for the payment of obligations for:
17 (i) first-aid, medical, hospital and surgical
18 services required under subsection (a) of Section 8
19 of this Act; and
20 (ii) weekly compensation payments for
21 temporary total incapacity provided under subsection
22 (b) of Section 8 of this Act; and
23 (iii) the operations of the State Compensation
24 Insurance Fund.
25 The Comptroller shall provide in his or her rules and
26 regulations for periodic transfers, with the State
27 Treasurer's approval, to the checking account of the State
28 Compensation Insurance Fund for use in accordance with the
29 imprest system.
30 (5) For any obligations in connection therewith the
31 liability of the State shall at no time exceed the amount of
32 the assets of the State Compensation Insurance Fund.
33 (l) The Fund may:
34 (1) use its assets to pay medical expenses,
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1 rehabilitation expenses, compensation due claimants of
2 insured employers, and to pay salaries, administrative
3 and other expenses;
4 (2) declare a dividend when there is an excess of
5 assets over liabilities, necessary reserves, and a
6 reasonable surplus for catastrophic hazards;
7 (3) rent, lease, buy and sell property in its own
8 name, construct and repair buildings as necessary to
9 provide office space for its operations;
10 (4) sue and be sued in its own name;
11 (5) enter into contracts relating to the
12 administration of the Fund;
13 (6) perform all the functions which are necessary
14 or appropriate to carry out the administration of the
15 Fund; and
16 (7) hire personnel, subject to the provisions of
17 the Personnel Code, and set salaries and compensation to
18 accomplish the purposes of its existence and operations.
19 (m) The premium rates established by the manager shall
20 be that percentage of the payroll of any employer which, on
21 the average, shall produce a sufficient sum to:
22 (1) carry all claims to maturity such that rates
23 shall be based upon the reserve and not upon the
24 assessment plan; and
25 (2) produce a reasonable surplus so as to cover
26 catastrophic hazards and to insure the payment to
27 employees and their dependents of the compensation
28 provided in this Act.
29 In determining the amount of reserve to be laid aside to
30 meet deferred payments according to compensation awards, the
31 reserves may be ascertained by finding the present worth of
32 the deferred payments calculated at a rate of interest not
33 higher than 3% per annum and such calculations shall be made
34 according to a table of mortality not lower than the American
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1 Experience Table of Mortality and, in the discretion of the
2 Board, by such other and further methods as will result in
3 the establishment of adequate reserves.
4 (n) (1) The State Compensation Insurance Fund shall be
5 open to visitation by the Director of Insurance at all
6 reasonable times, and the Director of Insurance shall require
7 from the manager reports as to the condition of the Fund and
8 such other reports as may be required by law to be made by
9 other insurance carriers doing business in this State insofar
10 as applicable to the Fund.
11 (2) The manager shall have an annual audit of the books
12 and records of the Fund made by a duly qualified independent
13 certified accountant, and have an abstract summary of this
14 audit prepared for public use.
15 (3) The Auditor General shall conduct a financial audit
16 of the Fund at least once every 2 years. The Auditor General
17 shall conduct a management or program audit when so directed
18 by either house of the General Assembly, in a resolution
19 identifying the subject, parties and scope.
20 (4) At least once every 3 years, the Director of
21 Insurance shall conduct an examination of the Fund. The
22 examination shall be conducted in the same manner as an
23 examination of a private insurance carrier. The Director of
24 Insurance shall transmit a copy of his or her examination to
25 the Governor, the General Assembly, the Auditor General, the
26 manager and the board.
27 (o) (1) Startup costs and beginning balance for the Fund
28 shall be provided by funds appropriated by the General
29 Assembly.
30 (2) In no case may the total amount advanced to the Fund
31 from the State under this Section exceed $10,000,000.
32 (3) State advances to the Fund shall not extend beyond
33 December 31, 2002, and any funds advanced to the Fund shall
34 be repaid, 20% each year for 5 years, beginning with calendar
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1 year 2003 and continuing through calendar year 2007.
2 (p) An employer who intentionally misrepresents any
3 material fact upon which his or her premium under this
4 Section is based is liable to the Fund for 3 times the amount
5 of the difference of the premium paid and the amount the
6 employer should have paid if his or her payroll had been
7 correctly computed. The penalty shall be collected in a
8 civil action.
9 (820 ILCS 305/4) (from Ch. 48, par. 138.4)
10 Sec. 4. (a) Any employer who shall come within the
11 provisions of Section 3 of this Act, and any other employer
12 who shall elect to provide and pay the compensation provided
13 for in this Act shall:
14 (1) File with the Commission annually an
15 application for approval as a self-insurer which shall
16 include a current financial statement, and annually,
17 thereafter, an application for renewal of self-insurance,
18 which shall include a current financial statement. Said
19 application and financial statement shall be signed and
20 sworn to by the president or vice president and secretary
21 or assistant secretary of the employer if it be a
22 corporation, or by all of the partners, if it be a
23 copartnership, or by the owner if it be neither a
24 copartnership nor a corporation. All initial applications
25 and all applications for renewal of self-insurance must
26 be submitted at least 60 days prior to the requested
27 effective date of self-insurance.
28 If the sworn application and financial statement of
29 any such employer does not satisfy the Commission of the
30 financial ability of the employer who has filed it, the
31 Commission shall require such employer to,
32 (2) Furnish security, indemnity or a bond
33 guaranteeing the payment by the employer of the
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1 compensation provided for in this Act, provided that any
2 such employer whose application and financial statement
3 shall not have satisfied the commission of his or her
4 financial ability and who shall have secured his
5 liability in part by excess liability insurance shall be
6 required to furnish to the Commission security, indemnity
7 or bond guaranteeing his or her payment up to the
8 effective limits of the excess coverage, or
9 (3) Insure his entire liability to pay such
10 compensation in some insurance carrier authorized,
11 licensed, or permitted to do such insurance business in
12 this State. Every policy of an insurance carrier,
13 insuring the payment of compensation under this Act shall
14 cover all the employees and the entire compensation
15 liability of the insured: Provided, however, that any
16 employer may insure his or her compensation liability
17 with 2 or more insurance carriers or may insure a part
18 and qualify under subsection 1, 2, or 4 for the remainder
19 of his or her liability to pay such compensation, subject
20 to the following two provisions:
21 Firstly, the entire compensation liability of
22 the employer to employees working at or from one
23 location shall be insured in one such insurance
24 carrier or shall be self-insured, and
25 Secondly, the employer shall submit evidence
26 satisfactorily to the Commission that his or her
27 entire liability for the compensation provided for
28 in this Act will be secured. Any provisions in any
29 policy, or in any endorsement attached thereto,
30 attempting to limit or modify in any way, the
31 liability of the insurance carriers issuing the same
32 except as otherwise provided herein shall be wholly
33 void.
34 Nothing herein contained shall apply to policies of
-19- LRB9002213DJcd
1 excess liability carriage secured by employers who have
2 been approved by the Commission as self-insurers, or
3 (4) Make some other provision, satisfactory to the
4 Commission, for the securing of the payment of
5 compensation provided for in this Act; provided, however,
6 that: , and
7 (A) the State and all departments thereof must
8 insure against their liability to pay that
9 compensation in the State Compensation Insurance
10 Fund; and
11 (B) each county, city, town, township,
12 incorporated village, school district, body politic
13 or municipal corporation must insure against its
14 liability to pay that compensation by either:
15 (i) securing the approval of the
16 Commission to be a self-insurer or a
17 participant in a self-insurance plan; or
18 (ii) insuring its liability to pay that
19 compensation in the State Compensation
20 Insurance Fund; or
21 (iii) insuring its liability to pay that
22 compensation by any other alternative
23 authorized by this Section if the premium which
24 would be required under the alternative is less
25 than can be otherwise provided by the State
26 Compensation Insurance Fund; however, any city,
27 village or incorporated town may by a majority
28 vote of the members of its governing body
29 present and voting remove itself from the
30 requirements of this subdivision (iii) and
31 thereafter such city, village or incorporated
32 town shall not be bound by the provisions of
33 this subdivision (iii) unless its governing
34 body by a majority vote of those present and
-20- LRB9002213DJcd
1 voting elects to avail itself of the provisions
2 hereof; and
3 (5) Upon becoming subject to this Act and
4 thereafter as often as the Commission may in writing
5 demand, file with the Commission in form prescribed by it
6 evidence of his or her compliance with the provision of
7 this Section.
8 (b) The sworn application and financial statement, or
9 security, indemnity or bond, or amount of insurance, or other
10 provisions, filed, furnished, carried, or made by the
11 employer, as the case may be, shall be subject to the
12 approval of the Commission.
13 Deposits under escrow agreements shall be cash,
14 negotiable United States government bonds or negotiable
15 general obligation bonds of the State of Illinois. Such cash
16 or bonds shall be deposited in escrow with any State or
17 National Bank or Trust Company having trust authority in the
18 State of Illinois.
19 Upon the approval of the sworn application and financial
20 statement, security, indemnity or bond or amount of
21 insurance, filed, furnished or carried, as the case may be,
22 the Commission shall send to the employer written notice of
23 its approval thereof. The certificate of compliance by the
24 employer with the provisions of subparagraphs (2) and (3) of
25 paragraph (a) of this Section shall be delivered by the
26 insurance carrier to the Industrial Commission within five
27 days after the effective date of the policy so certified.
28 The insurance so certified shall cover all compensation
29 liability occurring during the time that the insurance is in
30 effect and no further certificate need be filed in case such
31 insurance is renewed, extended or otherwise continued by such
32 carrier. The insurance so certified shall not be cancelled
33 or in the event that such insurance is not renewed, extended
34 or otherwise continued, such insurance shall not be
-21- LRB9002213DJcd
1 terminated until at least 10 days after receipt by the
2 Industrial Commission of notice of the cancellation or
3 termination of said insurance; provided, however, that if the
4 employer has secured insurance from another insurance
5 carrier, or has otherwise secured the payment of compensation
6 in accordance with this Section, and such insurance or other
7 security becomes effective prior to the expiration of the 10
8 days, cancellation or termination may, at the option of the
9 insurance carrier indicated in such notice, be effective as
10 of the effective date of such other insurance or security.
11 (c) Whenever the Commission shall find that any
12 corporation, company, association, aggregation of
13 individuals, reciprocal or interinsurers exchange, or other
14 insurer effecting workers' compensation insurance in this
15 State shall be insolvent, financially unsound, or unable to
16 fully meet all payments and liabilities assumed or to be
17 assumed for compensation insurance in this State, or shall
18 practice a policy of delay or unfairness toward employees in
19 the adjustment, settlement, or payment of benefits due such
20 employees, the Commission may after reasonable notice and
21 hearing order and direct that such corporation, company,
22 association, aggregation of individuals, reciprocal or
23 interinsurers exchange, or insurer, shall from and after a
24 date fixed in such order discontinue the writing of any such
25 workers' compensation insurance in this State. Subject to
26 such modification of the order as the Commission may later
27 make on review of the order, as herein provided, it shall
28 thereupon be unlawful for any such corporation, company,
29 association, aggregation of individuals, reciprocal or
30 interinsurers exchange, or insurer to effect any workers'
31 compensation insurance in this State. A copy of the order
32 shall be served upon the Director of Insurance by registered
33 mail. Whenever the Commission finds that any service or
34 adjustment company used or employed by a self-insured
-22- LRB9002213DJcd
1 employer or by an insurance carrier to process, adjust,
2 investigate, compromise or otherwise handle claims under this
3 Act, has practiced or is practicing a policy of delay or
4 unfairness toward employees in the adjustment, settlement or
5 payment of benefits due such employees, the Commission may
6 after reasonable notice and hearing order and direct that
7 such service or adjustment company shall from and after a
8 date fixed in such order be prohibited from processing,
9 adjusting, investigating, compromising or otherwise handling
10 claims under this Act.
11 Whenever the Commission finds that any self-insured
12 employer has practiced or is practicing delay or unfairness
13 toward employees in the adjustment, settlement or payment of
14 benefits due such employees, the Commission may, after
15 reasonable notice and hearing, order and direct that after a
16 date fixed in the order such self-insured employer shall be
17 disqualified to operate as a self-insurer and shall be
18 required to insure his entire liability to pay compensation
19 in some insurance carrier authorized, licensed and permitted
20 to do such insurance business in this State, as provided in
21 subparagraph 3 of paragraph (a) of this Section.
22 All orders made by the Commission under this Section
23 shall be subject to review by the courts, said review to be
24 taken in the same manner and within the same time as provided
25 by Section 19 of this Act for review of awards and decisions
26 of the Commission, upon the party seeking the review filing
27 with the clerk of the court to which said review is taken a
28 bond in an amount to be fixed and approved by the court to
29 which the review is taken, conditioned upon the payment of
30 all compensation awarded against the person taking said
31 review pending a decision thereof and further conditioned
32 upon such other obligations as the court may impose. Upon
33 the review the Circuit Court shall have power to review all
34 questions of fact as well as of law. The penalty hereinafter
-23- LRB9002213DJcd
1 provided for in this paragraph shall not attach and shall not
2 begin to run until the final determination of the order of
3 the Commission.
4 (d) Upon a finding by the Commission, after reasonable
5 notice and hearing, of the knowing and wilful failure of an
6 employer to comply with any of the provisions of paragraph
7 (a) of this Section or the failure or refusal of an employer,
8 service or adjustment company, or an insurance carrier to
9 comply with any order of the Industrial Commission pursuant
10 to paragraph (c) of this Section disqualifying him or her to
11 operate as a self-insurer and requiring him or her to insure
12 his or her liability, the Commission may assess a civil
13 penalty of up to $500 per day for each day of such failure or
14 refusal after the effective date of this amendatory Act of
15 1989. Each day of such failure or refusal shall constitute a
16 separate offense. Civil penalties recovered under this
17 subsection (d) shall be deposited into the Second Injury
18 Fund.
19 Upon the failure or refusal of any employer, service or
20 adjustment company or insurance carrier to comply with the
21 provisions of this Section and with the orders of the
22 Commission under this Section, or the order of the court on
23 review after final adjudication, the Commission may bring a
24 civil action to recover the amount of the penalty in Cook
25 County or in Sangamon County in which litigation the
26 Commission shall be represented by the Attorney General. The
27 Commission shall send notice of its finding of non-compliance
28 and assessment of the civil penalty to the Attorney General.
29 It shall be the duty of the Attorney General within 30 days
30 after receipt of the notice, to institute prosecutions and
31 promptly prosecute all reported violations of this Section.
32 (e) This Act shall not affect or disturb the continuance
33 of any existing insurance, mutual aid, benefit, or relief
34 association or department, whether maintained in whole or in
-24- LRB9002213DJcd
1 part by the employer or whether maintained by the employees,
2 the payment of benefits of such association or department
3 being guaranteed by the employer or by some person, firm or
4 corporation for him or her: Provided, the employer
5 contributes to such association or department an amount not
6 less than the full compensation herein provided, exclusive of
7 the cost of the maintenance of such association or department
8 and without any expense to the employee. This Act shall not
9 prevent the organization and maintaining under the insurance
10 laws of this State of any benefit or insurance company for
11 the purpose of insuring against the compensation provided for
12 in this Act, the expense of which is maintained by the
13 employer. This Act shall not prevent the organization or
14 maintaining under the insurance laws of this State of any
15 voluntary mutual aid, benefit or relief association among
16 employees for the payment of additional accident or sick
17 benefits.
18 (f) No existing insurance, mutual aid, benefit or relief
19 association or department shall, by reason of anything herein
20 contained, be authorized to discontinue its operation without
21 first discharging its obligations to any and all persons
22 carrying insurance in the same or entitled to relief or
23 benefits therein.
24 (g) Any contract, oral, written or implied, of
25 employment providing for relief benefit, or insurance or any
26 other device whereby the employee is required to pay any
27 premium or premiums for insurance against the compensation
28 provided for in this Act shall be null and void. Any
29 employer withholding from the wages of any employee any
30 amount for the purpose of paying any such premium shall be
31 guilty of a Class B misdemeanor.
32 In the event the employer does not pay the compensation
33 for which he or she is liable, then an insurance company,
34 association or insurer which may have insured such employer
-25- LRB9002213DJcd
1 against such liability shall become primarily liable to pay
2 to the employee, his or her personal representative or
3 beneficiary the compensation required by the provisions of
4 this Act to be paid by such employer. The insurance carrier
5 may be made a party to the proceedings in which the employer
6 is a party and an award may be entered jointly against the
7 employer and the insurance carrier.
8 (h) It shall be unlawful for any employer, insurance
9 company or service or adjustment company to interfere with,
10 restrain or coerce an employee in any manner whatsoever in
11 the exercise of the rights or remedies granted to him or her
12 by this Act or to discriminate, attempt to discriminate, or
13 threaten to discriminate against an employee in any way
14 because of his or her exercise of the rights or remedies
15 granted to him or her by this Act.
16 The arbitrator and Commission shall hear evidence and
17 make written findings on the employee's petition for
18 sanctions based upon the prohibitions of this Section. If
19 the arbitrator or Commission finds that the employer or its
20 agent has engaged in such proscribed activities, the employee
21 shall be allowed additional compensation in the amount of
22 $5,000. The employee shall retain his or her common law
23 rights against the employer.
24 It shall be unlawful for any employer, individually or
25 through any insurance company or service or adjustment
26 company, to discharge or to threaten to discharge, or to
27 refuse to rehire or recall to active service in a suitable
28 capacity an employee because of the exercise of his or her
29 rights or remedies granted to him or her by this Act.
30 (i) If an employer elects to obtain a life insurance
31 policy on his employees, he may also elect to apply such
32 benefits in satisfaction of all or a portion of the death
33 benefits payable under this Act, in which case, the
34 employer's compensation premium shall be reduced accordingly.
-26- LRB9002213DJcd
1 (j) Within 45 days of receipt of an initial application
2 or application to renew self-insurance privileges the
3 Self-Insurers Advisory Board shall review and submit for
4 approval by the Chairman of the Commission recommendations of
5 disposition of all initial applications to self-insure and
6 all applications to renew self-insurance privileges filed by
7 private self-insurers pursuant to the provisions of this
8 Section and Section 4a-9 of this Act. Each private
9 self-insurer shall submit with its initial and renewal
10 applications the application fee required by Section 4a-4 of
11 this Act.
12 The Chairman of the Commission shall promptly act upon
13 all initial applications and applications for renewal in full
14 accordance with the recommendations of the Board or, should
15 the Chairman disagree with any recommendation of disposition
16 of the Self-Insurer's Advisory Board, he shall within 30 days
17 of receipt of such recommendation provide to the Board in
18 writing the reasons supporting his decision. The Chairman
19 shall also promptly notify the employer of his decision
20 within 15 days of receipt of the recommendation of the Board.
21 If an employer is denied a renewal of self-insurance
22 privileges pursuant to application it shall retain said
23 privilege for 120 days after receipt of a notice of
24 cancellation of the privilege from the Chairman of the
25 Commission.
26 All orders made by the Chairman under this Section shall
27 be subject to review by the courts, such review to be taken
28 in the same manner and within the same time as provided by
29 subsection (f) of Section 19 of this Act for review of awards
30 and decisions of the Commission, upon the party seeking the
31 review filing with the clerk of the court to which such
32 review is taken a bond in an amount to be fixed and approved
33 by the court to which the review is taken, conditioned upon
34 the payment of all compensation awarded against the person
-27- LRB9002213DJcd
1 taking such review pending a decision thereof and further
2 conditioned upon such other obligations as the court may
3 impose. Upon the review the Circuit Court shall have power
4 to review all questions of fact as well as of law.
5 (Source: P.A. 86-998; 86-1405.)
6 (820 ILCS 305/4a-10 new)
7 Sec. 4a-10. Failure to insure or self-insure. If an
8 employer fails to insure or self-insure as required by this
9 Act, the State Treasurer, as ex-officio custodian of the
10 Second Injury Fund, may be joined with the employer as a
11 party respondent in the application for adjustment of claim.
12 Upon a finding by the arbitrator that the employer has failed
13 to insure or self-insure as required by this Act, the State
14 Treasurer, as ex-officio custodian of the Second Injury Fund,
15 shall assume the liability of the employer to pay all
16 benefits as provided by this Act. The State Treasurer shall
17 have the same defenses to such claims as would the insured
18 employer. The office of the Attorney General of the State of
19 Illinois shall bring suit in the circuit court of the county
20 in which the accident occurred against any employer for which
21 payment has been made pursuant to this Section. The penalty
22 under this Section shall be the amount withdrawn from the
23 Second Injury Fund for the employer's employee or his or her
24 dependents, plus a fine of $500 a day from the date of the
25 injury up to a maximum of $25,000, and any amount so
26 collected shall be paid into the Second Injury Fund.
27 (820 ILCS 305/5) (from Ch. 48, par. 138.5)
28 Sec. 5. (a) No common law or statutory right to recover
29 damages from the employer, his insurer, his broker, any
30 service organization retained by the employer, his insurer or
31 his broker, or the union, its agents, employees, or members
32 of its safety committee to provide safety service, advice or
-28- LRB9002213DJcd
1 recommendations for the employer or the agents or employees
2 of any of them for injury or death sustained by any employee
3 while engaged in the line of his duty as such employee, other
4 than the compensation herein provided, is available to any
5 employee who is covered by the provisions of this Act, to any
6 one wholly or partially dependent upon him, the legal
7 representatives of his estate, or any one otherwise entitled
8 to recover damages for such injury.
9 However, in any action now pending or hereafter begun to
10 enforce a common law or statutory right to recover damages
11 for negligently causing the injury or death of any employee
12 it is not necessary to allege in the complaint that either
13 the employee or the employer or both were not governed by the
14 provisions of this Act or of any similar Act in force in this
15 or any other State.
16 Any illegally employed minor or his legal representatives
17 shall, except as hereinafter provided, have the right within
18 6 months after the time of injury or death, or within 6
19 months after the appointment of a legal representative,
20 whichever shall be later, to file with the Commission a
21 rejection of his right to the benefits under this Act, in
22 which case such illegally employed minor or his legal
23 representatives shall have the right to pursue his or their
24 common law or statutory remedies to recover damages for such
25 injury or death.
26 No payment of compensation under this Act shall be made
27 to an illegally employed minor, or his legal representatives,
28 unless such payment and the waiver of his right to reject the
29 benefits of this Act has first been approved by the
30 Commission or any member thereof, and if such payment and the
31 waiver of his right of rejection has been so approved such
32 payment is a bar to a subsequent rejection of the provisions
33 of this Act.
34 (b) Where the injury or death for which compensation is
-29- LRB9002213DJcd
1 payable under this Act was caused under circumstances
2 creating a legal liability for damages on the part of some
3 person other than his employer to pay damages, then legal
4 proceedings may be taken against such other person to recover
5 damages notwithstanding such employer's payment of or
6 liability to pay compensation under this Act. In such case,
7 however, if the action against such other person is brought
8 by the injured employee or his personal representative and
9 judgment is obtained and paid, or settlement is made with
10 such other person, either with or without suit, then from the
11 amount received by such employee or personal representative
12 there shall be paid to the employer the amount of
13 compensation paid or to be paid by him to such employee or
14 personal representative including amounts paid or to be paid
15 pursuant to paragraph (a) of Section 8 of this Act. If the
16 employee or personal representative brings an action against
17 another person and the other person then brings an action for
18 contribution against the employer, the amount, if any, that
19 shall be paid to the employer by the employee or personal
20 representative pursuant to this Section shall be reduced by
21 an amount equal to the amount found by the trier of fact to
22 be the employer's pro rata share of the common liability in
23 the action.
24 Out of any reimbursement received by the employer
25 pursuant to this Section the employer shall pay his pro rata
26 share of all costs and reasonably necessary expenses in
27 connection with such third-party claim, action or suit and
28 where the services of an attorney at law of the employee or
29 dependents have resulted in or substantially contributed to
30 the procurement by suit, settlement or otherwise of the
31 proceeds out of which the employer is reimbursed, then, in
32 the absence of other agreement, the employer shall pay such
33 attorney 25% of the gross amount of such reimbursement.
34 If the injured employee or his personal representative
-30- LRB9002213DJcd
1 agrees to receive compensation from the employer or accept
2 from the employer any payment on account of such
3 compensation, or to institute proceedings to recover the
4 same, the employer may have or claim a lien upon any award,
5 judgment or fund out of which such employee might be
6 compensated from such third party.
7 In such actions brought by the employee or his personal
8 representative, he shall forthwith notify his employer by
9 personal service or registered mail, of such fact and of the
10 name of the court in which the suit is brought, filing proof
11 thereof in the action. The employer may, at any time
12 thereafter join in the action upon his motion so that all
13 orders of court after hearing and judgment shall be made for
14 his protection. No release or settlement of claim for
15 damages by reason of such injury or death, and no
16 satisfaction of judgment in such proceedings shall be valid
17 without the written consent of both employer and employee or
18 his personal representative, except in the case of the
19 employers, such consent is not required where the employer
20 has been fully indemnified or protected by Court order.
21 In the event the employee or his personal representative
22 fails to institute a proceeding against such third person at
23 any time prior to 3 months before such action would be
24 barred, the employer may in his own name or in the name of
25 the employee, or his personal representative, commence a
26 proceeding against such other person for the recovery of
27 damages on account of such injury or death to the employee,
28 and out of any amount recovered the employer shall pay over
29 to the injured employee or his personal representatives all
30 sums collected from such other person by judgment or
31 otherwise in excess of the amount of such compensation paid
32 or to be paid under this Act, including amounts paid or to be
33 paid pursuant to paragraph (a) of Section 8 of this Act, and
34 costs, attorney's fees and reasonable expenses as may be
-31- LRB9002213DJcd
1 incurred by such employer in making such collection or in
2 enforcing such liability.
3 This amendatory Act of 1995 applies to causes of action
4 accruing on or after its effective date.
5 (Source: P.A. 89-7, eff. 3-9-95.)
6 (820 ILCS 305/6) (from Ch. 48, par. 138.6)
7 Sec. 6. (a) Every employer within the provisions of this
8 Act, shall, under the rules and regulations prescribed by the
9 Commission, post printed notices in their respective places
10 of employment in such number and at such places as may be
11 determined by the Commission, containing such information
12 relative to this Act as in the judgment of the Commission may
13 be necessary to aid employees to safeguard their rights under
14 this Act in event of injury.
15 In addition thereto, the employer shall post in a
16 conspicuous place on the place of the employment a printed or
17 typewritten notice stating whether he is insured or whether
18 he has qualified and is operating as a self-insured employer.
19 In the event the employer is insured, the notice shall state
20 the name and address of his insurance carrier, the number of
21 the insurance policy, its effective date and the date of
22 termination. In the event of the termination of the policy
23 for any reason prior to the termination date stated, the
24 posted notice shall promptly be corrected accordingly. In
25 the event the employer is operating as a self-insured
26 employer the notice shall state the name and address of the
27 company, if any, servicing the compensation payments of the
28 employer, and the name and address of the person in charge of
29 making compensation payments.
30 (b) Every employer subject to this Act shall maintain
31 accurate records of work-related deaths, injuries and illness
32 other than minor injuries requiring only first aid treatment
33 and which do not involve medical treatment, loss of
-32- LRB9002213DJcd
1 consciousness, restriction of work or motion, or transfer to
2 another job and file with the Commission, in writing, a
3 report of all accidental deaths, injuries and illnesses
4 arising out of and in the course of the employment resulting
5 in the loss of more than 3 scheduled work days. In the case
6 of death such report shall be made no later than 2 working
7 days following the accidental death. In all other cases such
8 report shall be made between the 15th and 25th of each month
9 unless required to be made sooner by rule of the Commission.
10 In case the injury results in permanent disability, a further
11 report shall be made as soon as it is determined that such
12 permanent disability has resulted or will result from the
13 injury. All reports shall state the date of the injury,
14 including the time of day or night, the nature of the
15 employer's business, the name, address, age, sex, conjugal
16 condition of the injured person, the specific occupation of
17 the injured person, the direct cause of the injury and the
18 nature of the accident, the character of the injury, the
19 length of disability, and in case of death the length of
20 disability before death, the wages of the injured person,
21 whether compensation has been paid to the injured person, or
22 to his or her legal representative or his heirs or next of
23 kin, the amount of compensation paid, the amount paid for
24 physicians', surgeons' and hospital bills, and by whom paid,
25 and the amount paid for funeral or burial expenses if known.
26 The reports shall be made on forms and in the manner as
27 prescribed by the Commission and shall contain such further
28 information as the Commission shall deem necessary and
29 require. The making of these reports releases the employer
30 from making such reports to any other officer of the State
31 and shall satisfy the reporting provisions as contained in
32 the "Health and Safety Act" and "An Act in relation to safety
33 inspections and education in industrial and commercial
34 establishments and to repeal an Act therein named", approved
-33- LRB9002213DJcd
1 July 18, 1955, as now or hereafter amended. The reports
2 filed with the Commission pursuant to this Section shall be
3 made available by the Commission to the Director of Labor or
4 his representatives and to all other departments of the State
5 of Illinois which shall require such information for the
6 proper discharge of their official duties. Failure to file
7 with the Commission any of the reports required in this
8 Section is a petty offense.
9 Except as provided in this paragraph, all reports filed
10 hereunder shall be confidential and any person having access
11 to such records filed with the Industrial Commission as
12 herein required, who shall release any information therein
13 contained including the names or otherwise identify any
14 persons sustaining injuries or disabilities, or give access
15 to such information to any unauthorized person, shall be
16 subject to discipline or discharge, and in addition shall be
17 guilty of a Class B misdemeanor. The Commission shall compile
18 and distribute to interested persons aggregate statistics,
19 taken from the reports filed hereunder. The aggregate
20 statistics shall not give the names or otherwise identify
21 persons sustaining injuries or disabilities or the employer
22 of any injured or disabled person.
23 (c) Notice of the accident shall be given to the
24 employer as soon as practicable, but not later than 45 days
25 after the accident. Provided:
26 (1) In case of the legal disability of the employee or
27 any dependent of a deceased employee who may be entitled to
28 compensation under the provisions of this Act, the
29 limitations of time by this Act provided do not begin to run
30 against such person under legal disability until a guardian
31 has been appointed.
32 (2) In cases of injuries sustained by exposure to
33 radiological materials or equipment, notice shall be given to
34 the employer within 90 days subsequent to the time that the
-34- LRB9002213DJcd
1 employee knows or suspects that he has received an excessive
2 dose of radiation.
3 No defect or inaccuracy of such notice shall be a bar to
4 the maintenance of proceedings on arbitration or otherwise by
5 the employee unless the employer proves that he is unduly
6 prejudiced in such proceedings by such defect or inaccuracy.
7 Notice of the accident shall give the approximate date
8 and place of the accident, if known, and may be given orally
9 or in writing.
10 (d) Every employer shall notify each injured employee
11 who has been granted compensation under the provisions of
12 Section 8 of this Act of his rights to rehabilitation
13 services and advise him of the locations of available public
14 rehabilitation centers and any other such services of which
15 the employer has knowledge.
16 In any case, other than one where the injury was caused
17 by exposure to radiological materials or equipment or
18 asbestos or the injury results from repetitive trauma, unless
19 the application for compensation is filed with the Commission
20 within 3 years after the date of the accident, where no
21 compensation has been paid, or within 2 years after the date
22 of the last payment of compensation, where any has been paid,
23 whichever shall be later, the right to file such application
24 shall be barred.
25 In any case of injury caused by exposure to radiological
26 materials or equipment or asbestos, unless application for
27 compensation is filed with the Commission within 25 years
28 after the last day that the employee was employed in an
29 environment of hazardous radiological activity or asbestos,
30 the right to file such application shall be barred.
31 If in any case except one where the injury was caused by
32 exposure to radiological materials or equipment or asbestos,
33 the accidental injury results in death application for
34 compensation for death may be filed with the Commission
-35- LRB9002213DJcd
1 within 3 years after the date of death where no compensation
2 has been paid or within 2 years after the date of the last
3 payment of compensation where any has been paid, whichever
4 shall be later, but not thereafter.
5 In any case of injury caused by repetitive trauma, unless
6 an application for compensation is filed with the Commission
7 within 3 years from the date of reasonable discovery or 2
8 years from the date of disablement, whichever is greater, the
9 right to file the application shall be barred.
10 If an accidental injury caused by exposure to
11 radiological material or equipment or asbestos results in
12 death within 25 years after the last day that the employee
13 was so exposed application for compensation for death may be
14 filed with the Commission within 3 years after the date of
15 death, where no compensation has been paid, or within 2 years
16 after the date of the last payment of compensation where any
17 has been paid, whichever shall be later, but not thereafter.
18 (e) Any contract or agreement made by any employer or
19 his agent or attorney with any employee or any other
20 beneficiary of any claim under the provisions of this Act
21 within 7 days after the injury shall be presumed to be
22 fraudulent.
23 (f) Any condition or impairment of health of an employee
24 employed as a firefighter, emergency medical technician (EMT)
25 or paramedic which results directly or indirectly from any
26 lung or respiratory disease or condition, heart or vascular
27 disease or condition, hypertension, tuberculosis or cancer
28 resulting in any disability (temporary, permanent, total or
29 partial) to the employee shall be conclusively presumed to
30 arise out of and in the course of the employee's
31 firefighting, EMT or paramedic employment and, further, shall
32 be conclusively presumed to be causally connected to the
33 hazards or exposures of such employment. This presumption
34 shall also apply to any hernia or hearing loss suffered by an
-36- LRB9002213DJcd
1 employee employed as a firefighter, EMT or paramedic.
2 However, this presumption shall not apply to any employee who
3 has been employed as a firefighter, EMT or paramedic for less
4 than 5 years at the time the condition or impairment is
5 discovered.
6 (Source: P.A. 84-981.)
7 (820 ILCS 305/7) (from Ch. 48, par. 138.7)
8 Sec. 7. The amount of compensation which shall be paid
9 for an accidental injury to the employee resulting in death
10 is:
11 (a) If the employee leaves surviving a widow, widower,
12 child or children, the applicable weekly compensation rate
13 computed in accordance with subparagraph 2 of paragraph (b)
14 of Section 8, shall be payable during the life of the widow
15 or widower and if any surviving child or children shall not
16 be physically or mentally incapacitated then until the death
17 of the widow or widower or until the youngest child shall
18 reach the age of 18, whichever shall come later; provided
19 that if such child or children shall be enrolled as a full
20 time student in any accredited educational institution, the
21 payments shall continue until such child has attained the age
22 of 25. In the event any surviving child or children shall be
23 physically or mentally incapacitated, the payments shall
24 continue for the duration of such incapacity.
25 The term "child" means a child whom the deceased employee
26 left surviving, including a posthumous child, a child legally
27 adopted, a child whom the deceased employee was legally
28 obligated to support or a child to whom the deceased employee
29 stood in loco parentis. The term "children" means the plural
30 of "child".
31 The term "physically or mentally incapacitated child or
32 children" means a child or children incapable of engaging in
33 regular and substantial gainful employment.
-37- LRB9002213DJcd
1 In the event of the remarriage of a widow or widower,
2 where the decedent did not leave surviving any child or
3 children who, at the time of such remarriage, are entitled to
4 compensation benefits under this Act, the surviving spouse
5 shall be paid a lump sum equal to 2 years compensation
6 benefits and all further rights of such widow or widower
7 shall be extinguished.
8 If the employee leaves surviving any child or children
9 under 18 years of age who at the time of death shall be
10 entitled to compensation under this paragraph (a) of this
11 Section, the weekly compensation payments herein provided for
12 such child or children shall in any event continue for a
13 period of not less than 6 years.
14 Any beneficiary entitled to compensation under this
15 paragraph (a) of this Section shall receive from the special
16 fund provided in paragraph (f) of this Section, in addition
17 to the compensation herein provided, supplemental benefits in
18 accordance with paragraph (g) of Section 8.
19 (b) If no compensation is payable under paragraph (a) of
20 this Section and the employee leaves surviving a parent or
21 parents who at the time of the accident were totally
22 dependent upon the earnings of the employee then weekly
23 payments equal to the compensation rate payable in the case
24 where the employee leaves surviving a widow or widower, shall
25 be paid to such parent or parents for the duration of their
26 lives, and in the event of the death of either, for the life
27 of the survivor.
28 (c) If no compensation is payable under paragraphs (a)
29 or (b) of this Section and the employee leaves surviving any
30 child or children who are not entitled to compensation under
31 the foregoing paragraph (a) but who at the time of the
32 accident were nevertheless in any manner dependent upon the
33 earnings of the employee, or leaves surviving a parent or
34 parents who at the time of the accident were partially
-38- LRB9002213DJcd
1 dependent upon the earnings of the employee, then there shall
2 be paid to such dependent or dependents for a period of 8
3 years weekly compensation payments at such proportion of the
4 applicable rate if the employee had left surviving a widow or
5 widower as such dependency bears to total dependency. In the
6 event of the death of any such beneficiary the share of such
7 beneficiary shall be divided equally among the surviving
8 beneficiaries and in the event of the death of the last such
9 beneficiary all the rights under this paragraph shall be
10 extinguished.
11 (d) If no compensation is payable under paragraphs (a),
12 (b) or (c) of this Section and the employee leaves surviving
13 any grandparent, grandparents, grandchild or grandchildren or
14 collateral heirs dependent upon the employee's earnings to
15 the extent of 50% or more of total dependency, then there
16 shall be paid to such dependent or dependents for a period of
17 5 years weekly compensation payments at such proportion of
18 the applicable rate if the employee had left surviving a
19 widow or widower as such dependency bears to total
20 dependency. In the event of the death of any such
21 beneficiary the share of such beneficiary shall be divided
22 equally among the surviving beneficiaries and in the event of
23 the death of the last such beneficiary all rights hereunder
24 shall be extinguished.
25 (e) The compensation to be paid for accidental injury
26 which results in death, as provided in this Section, shall be
27 paid to the persons who form the basis for determining the
28 amount of compensation to be paid by the employer, the
29 respective shares to be in the proportion of their respective
30 dependency at the time of the accident on the earnings of the
31 deceased. The Commission or an Arbitrator thereof may, in
32 its or his discretion, order or award the payment to the
33 parent or grandparent of a child for the latter's support the
34 amount of compensation which but for such order or award
-39- LRB9002213DJcd
1 would have been paid to such child as its share of the
2 compensation payable, which order or award may be modified
3 from time to time by the Commission in its discretion with
4 respect to the person to whom shall be paid the amount of the
5 order or award remaining unpaid at the time of the
6 modification.
7 The payments of compensation by the employer in
8 accordance with the order or award of the Commission
9 discharges such employer from all further obligation as to
10 such compensation.
11 (f) The sum of $4200 for burial expenses shall be paid
12 by the employer to the widow or widower, other dependent, or
13 to the estate of the employee next of kin or to the person or
14 persons incurring the expense of burial.
15 In the event the employer failed to provide necessary
16 first aid, medical, surgical or hospital service, he shall
17 pay the cost thereof to the person or persons entitled to
18 compensation under paragraphs (a), (b), (c) or (d) of this
19 Section, or to the person or persons incurring the obligation
20 therefore, or providing the same.
21 In no event shall the total amount of compensation to be
22 paid to the persons entitled to compensation under subsection
23 (a), (b), (c), or (d) of this Section be less than $50,000.
24 If there are no persons entitled to compensation under
25 subsections (a), (b), (c), or (d) of this Section, $50,000
26 shall be payable to the estate of the deceased employee in
27 addition to any other compensation under this Act to which he
28 or she may have been entitled at the time of his or her
29 death.
30 On January 15 and July 15, 1981, and on January 15 and
31 July 15 of each year thereafter the employer shall within 60
32 days pay a sum equal to 1/8 of 1% of all compensation
33 payments made by him after July 1, 1980, either under this
34 Act or the Workers' Occupational Diseases Act, whether by
-40- LRB9002213DJcd
1 lump sum settlement or weekly compensation payments, but not
2 including hospital, surgical or rehabilitation payments, made
3 during the first 6 months and during the second 6 months
4 respectively of the fiscal year next preceding the date of
5 the payments, into a special fund which shall be designated
6 the "Second Injury Fund", of which the State Treasurer is
7 ex-officio custodian, such special fund to be held and
8 disbursed for the purposes hereinafter stated in paragraphs
9 (f) and (g) of Section 8, either upon the order of the
10 Commission or of a competent court. Said special fund shall
11 be deposited the same as are State funds and any interest
12 accruing thereon shall be added thereto every 6 months. It
13 is subject to audit the same as State funds and accounts and
14 is protected by the General bond given by the State
15 Treasurer. It is considered always appropriated for the
16 purposes of disbursements as provided in Section 8, paragraph
17 (f), of this Act, and shall be paid out and disbursed as
18 therein provided and shall not at any time be appropriated or
19 diverted to any other use or purpose.
20 On January 15, 1991, the employer shall further pay a sum
21 equal to one half of 1% of all compensation payments made by
22 him from January 1, 1990 through June 30, 1990 either under
23 this Act or under the Workers' Occupational Diseases Act,
24 whether by lump sum settlement or weekly compensation
25 payments, but not including hospital, surgical or
26 rehabilitation payments, into an additional Special Fund
27 which shall be designated as the "Rate Adjustment Fund". On
28 March 15, 1991, the employer shall pay into the Rate
29 Adjustment Fund a sum equal to one half of 1% of all such
30 compensation payments made from July 1, 1990 through December
31 31, 1990. Within 60 days after July 15, 1991, the employer
32 shall pay into the Rate Adjustment Fund a sum equal to one
33 half of 1% of all such compensation payments made from
34 January 1, 1991 through June 30, 1991. Within 60 days after
-41- LRB9002213DJcd
1 January 15 of 1992 and each subsequent year through 1996, the
2 employer shall pay into the Rate Adjustment Fund a sum equal
3 to one half of 1% of all such compensation payments made in
4 the last 6 months of the preceding calendar year. Within 60
5 days after July 15 of 1992 and each subsequent year through
6 1995, the employer shall pay into the Rate Adjustment Fund a
7 sum equal to one half of 1% of all such compensation payments
8 made in the first 6 months of the same calendar year. Within
9 60 days after January 15 of 1997 and each subsequent year,
10 the employer shall pay into the Rate Adjustment Fund a sum
11 equal to three-fourths of 1% of all such compensation
12 payments made in the last 6 months of the preceding calendar
13 year. Within 60 days after July 15 of 1996 and each
14 subsequent year, the employer shall pay into the Rate
15 Adjustment Fund a sum equal to three-fourths of 1% of all
16 such compensation payments made in the first 6 months of the
17 same calendar year. The administrative costs of collecting
18 assessments from employers for the Rate Adjustment Fund shall
19 be paid from the Rate Adjustment Fund. The cost of an
20 actuarial audit of the Fund shall be paid from the Rate
21 Adjustment Fund and the audit shall be completed no later
22 than July 1, 1997. The State Treasurer is ex officio
23 custodian of such Special Fund and the same shall be held and
24 disbursed for the purposes hereinafter stated in paragraphs
25 (f) and (g) of Section 8 upon the order of the Commission or
26 of a competent court. The Rate Adjustment Fund shall be
27 deposited the same as are State funds and any interest
28 accruing thereon shall be added thereto every 6 months. It
29 shall be subject to audit the same as State funds and
30 accounts and shall be protected by the general bond given by
31 the State Treasurer. It is considered always appropriated
32 for the purposes of disbursements as provided in paragraphs
33 (f) and (g) of Section 8 of this Act and shall be paid out
34 and disbursed as therein provided and shall not at any time
-42- LRB9002213DJcd
1 be appropriated or diverted to any other use or purpose.
2 Within 5 days after the effective date of this amendatory Act
3 of 1990, the Comptroller and the State Treasurer shall
4 transfer $1,000,000 from the General Revenue Fund to the Rate
5 Adjustment Fund. By February 15, 1991, the Comptroller and
6 the State Treasurer shall transfer $1,000,000 from the Rate
7 Adjustment Fund to the General Revenue Fund. From the
8 effective date of this amendatory Act of 1993 to October 1,
9 1997, the Comptroller and Treasurer are authorized to make
10 transfers at the request of the Chairman up to a total of
11 $7,000,000 from the Second Injury Fund, the General Revenue
12 Fund, and the Workers' Compensation Benefit Trust Fund to the
13 Rate Adjustment Fund to the extent that there is insufficient
14 money in the Rate Adjustment Fund to pay claims and
15 obligations. Amounts may be transferred from the General
16 Revenue Fund only if the funds in the Second Injury Fund or
17 the Workers' Compensation Benefit Trust Fund are insufficient
18 to pay claims and obligations of the Rate Adjustment Fund.
19 All amounts transferred from the Second Injury Fund, the
20 General Revenue Fund, and the Workers' Compensation Benefit
21 Trust Fund shall be repaid from the Rate Adjustment Fund
22 within 270 days of a transfer, together with interest at the
23 rate earned by moneys on deposit in the Fund or Funds from
24 which the moneys were transferred.
25 Upon a finding by the Commission, after reasonable notice
26 and hearing, that any employer has willfully and knowingly
27 failed to pay the proper amounts into the Second Injury Fund
28 or the Rate Adjustment Fund required by this Section or if
29 such payments are not made within the time periods prescribed
30 by this Section, the employer shall, in addition to such
31 payments, pay a penalty of 20% of the amount required to be
32 paid or $2,500, whichever is greater, for each year or part
33 thereof of such failure to pay. This penalty shall only
34 apply to obligations of an employer to the Second Injury Fund
-43- LRB9002213DJcd
1 or the Rate Adjustment Fund accruing after the effective date
2 of this amendatory Act of 1989. All or part of such a penalty
3 may be waived by the Commission for good cause shown.
4 Any obligations of an employer to the Second Injury Fund
5 and Rate Adjustment Fund accruing prior to the effective date
6 of this amendatory Act of 1989 shall be paid in full by such
7 employer within 5 years of the effective date of this
8 amendatory Act of 1989, with at least one-fifth of such
9 obligation to be paid during each year following the
10 effective date of this amendatory Act of 1989. If the
11 Commission finds, following reasonable notice and hearing,
12 that an employer has failed to make timely payment of any
13 obligation accruing under the preceding sentence, the
14 employer shall, in addition to all other payments required by
15 this Section, be liable for a penalty equal to 20% of the
16 overdue obligation or $2,500, whichever is greater, for each
17 year or part thereof that obligation is overdue. All or part
18 of such a penalty may be waived by the Commission for good
19 cause shown.
20 The Chairman of the Industrial Commission shall,
21 annually, furnish to the Director of the Department of
22 Insurance a list of the amounts paid into the Second Injury
23 Fund and the Rate Adjustment Fund by each insurance company
24 on behalf of their insured employers. The Director shall
25 verify to the Chairman that the amounts paid by each
26 insurance company are accurate as best as the Director can
27 determine from the records available to the Director. The
28 Chairman shall verify that the amounts paid by each
29 self-insurer are accurate as best as the Chairman can
30 determine from records available to the Chairman. The
31 Chairman may require each self-insurer to provide information
32 concerning the total compensation payments made upon which
33 contributions to the Second Injury Fund and the Rate
34 Adjustment Fund are predicated and any additional information
-44- LRB9002213DJcd
1 establishing that such payments have been made into these
2 funds. Any deficiencies in payments noted by the Director or
3 Chairman shall be subject to the penalty provisions of this
4 Act.
5 The State Treasurer, or his duly authorized
6 representative, shall be named as a party to all proceedings
7 in all cases involving claim for the loss of, or the
8 permanent and complete loss of the use of one eye, one foot,
9 one leg, one arm or one hand.
10 The State Treasurer or his duly authorized agent shall
11 have the same rights as any other party to the proceeding,
12 including the right to petition for review of any award. The
13 reasonable expenses of litigation, such as medical
14 examinations, testimony, and transcript of evidence, incurred
15 by the State Treasurer or his duly authorized representative,
16 shall be borne by the Second Injury Fund.
17 If the award is not paid within 30 days after the date
18 the award has become final, the Commission shall proceed to
19 take judgment thereon in its own name as is provided for
20 other awards by paragraph (g) of Section 19 of this Act and
21 take the necessary steps to collect the award.
22 Any person, corporation or organization who has paid or
23 become liable for the payment of burial expenses of the
24 deceased employee may in his or its own name institute
25 proceedings before the Commission for the collection thereof.
26 For the purpose of administration, receipts and
27 disbursements, the Special Fund provided for in paragraph (f)
28 of this Section shall be administered jointly with the
29 Special Fund provided for in Section 7, paragraph (f) of the
30 Workers' Occupational Diseases Act.
31 (g) All compensation, except for burial expenses
32 provided in this Section to be paid in case accident results
33 in death, shall be paid in installments equal to the
34 percentage of the average earnings as provided for in Section
-45- LRB9002213DJcd
1 8, paragraph (b) of this Act, at the same intervals at which
2 the wages or earnings of the employees were paid. If this is
3 not feasible, then the installments shall be paid weekly.
4 Such compensation may be paid in a lump sum upon petition as
5 provided in Section 9 of this Act. However, in addition to
6 the benefits provided by Section 9 of this Act where
7 compensation for death is payable to the deceased's widow,
8 widower or to the deceased's widow, widower and one or more
9 children, and where a partial lump sum is applied for by such
10 beneficiary or beneficiaries within 18 months after the
11 deceased's death, the Commission may, in its discretion,
12 grant a partial lump sum of not to exceed 100 weeks of the
13 compensation capitalized at their present value upon the
14 basis of interest calculated at 3% per annum with annual
15 rests, upon a showing that such partial lump sum is for the
16 best interest of such beneficiary or beneficiaries.
17 (h) In case the injured employee is under 16 years of
18 age at the time of the accident and is illegally employed,
19 the amount of compensation payable under paragraphs (a), (b),
20 (c), (d) and (f) of this Section shall be increased 50%.
21 Nothing herein contained repeals or amends the provisions
22 of the Child Labor Law relating to the employment of minors
23 under the age of 16 years.
24 However, where an employer has on file an employment
25 certificate issued pursuant to the Child Labor Law or work
26 permit issued pursuant to the Federal Fair Labor Standards
27 Act, as amended, or a birth certificate properly and duly
28 issued, such certificate, permit or birth certificate is
29 conclusive evidence as to the age of the injured minor
30 employee for the purposes of this Section only.
31 (i) Whenever the dependents of a deceased employee are
32 aliens not residing in the United States, Mexico or Canada,
33 the amount of compensation payable is limited to the
34 beneficiaries described in paragraphs (a), (b) and (c) of
-46- LRB9002213DJcd
1 this Section and is 50% of the compensation provided in
2 paragraphs (a), (b) and (c) of this Section, except as
3 otherwise provided by treaty.
4 In a case where any of the persons who would be entitled
5 to compensation is living at any place outside of the United
6 States, then payment shall be made to the personal
7 representative of the deceased employee. The distribution by
8 such personal representative to the persons entitled shall be
9 made to such persons and in such manner as the Commission
10 orders.
11 (Source: P.A. 88-672, eff. 12-14-94; 89-470, eff. 6-13-96.)
12 (820 ILCS 305/8) (from Ch. 48, par. 138.8)
13 Sec. 8. The amount of compensation which shall be paid
14 to the employee for an accidental injury not resulting in
15 death is:
16 (a) The employer shall provide and pay for all the
17 necessary first aid, medical and surgical services, and all
18 necessary medical, surgical and hospital services thereafter
19 incurred, limited, however, to that which is reasonably
20 required to cure or relieve from the effects of the
21 accidental injury. The employer shall also pay for treatment,
22 instruction and training necessary for the physical, mental
23 and vocational rehabilitation of the employee, including all
24 maintenance costs and expenses incidental thereto. The
25 employee shall have the right to choose the providers of
26 treatment, instruction, and training necessary for his or her
27 physical, mental, and vocational rehabilitation, unless the
28 Commission finds the provider selected by the employee is
29 rendering improper or inadequate treatment, instruction or
30 training, in which case the Commission may order the employee
31 to select another provider. If as a result of the injury the
32 employee is unable to be self-sufficient the employer shall
33 further pay for such maintenance or institutional care as
-47- LRB9002213DJcd
1 shall be required. If an employee has sustained an accidental
2 injury and as a result becomes temporarily and totally
3 disabled from pursuing his or her usual and customary line of
4 work, the employer shall maintain such medical insurance as
5 the employee enjoyed when previously working for the
6 employer.
7 The employee may at any time elect to secure his own
8 physician, surgeon and hospital services at the employer's
9 expense, or,
10 Upon agreement between the employer and the employees, or
11 the employees' exclusive representative, and subject to the
12 approval of the Industrial Commission, the employer shall
13 maintain a list of physicians, to be known as a Panel of
14 Physicians, who are accessible to the employees. The employer
15 shall post this list in a place or places easily accessible
16 to his employees. The employee shall have the right to make
17 an alternative choice of physician from such Panel if he is
18 not satisfied with the physician first selected. If, due to
19 the nature of the injury or its occurrence away from the
20 employer's place of business, the employee is unable to make
21 a selection from the Panel, the selection process from the
22 Panel shall not apply. The physician selected from the Panel
23 may arrange for any consultation, referral or other
24 specialized medical services outside the Panel at the
25 employer's expense. Provided that, in the event the
26 Commission shall find that a doctor selected by the employee
27 is rendering improper or inadequate care, the Commission may
28 order the employee to select another doctor certified or
29 qualified in the medical field for which treatment is
30 required. If the employee refuses to make such change the
31 Commission may relieve the employer of his obligation to pay
32 the doctor's charges from the date of refusal to the date of
33 compliance.
34 Every hospital, physician, surgeon or other person
-48- LRB9002213DJcd
1 rendering treatment or services in accordance with the
2 provisions of this Section shall upon written request furnish
3 full and complete reports thereof to, and permit their
4 records to be copied by, the employer, the employee or his
5 dependents, as the case may be, or any other party to any
6 proceeding for compensation before the Commission, or their
7 attorneys.
8 Notwithstanding the foregoing, the employer's liability
9 to pay for such medical services selected by the employee
10 shall be limited to:
11 (1) all first aid and emergency treatment; plus
12 (2) all medical, surgical and hospital services
13 provided by the physician, surgeon or hospital initially
14 chosen by the employee or by any other physician,
15 consultant, expert, institution or other provider of
16 services recommended by said initial service provider or
17 any subsequent provider of medical services in the chain
18 of referrals from said initial service provider; plus
19 (3) all medical, surgical and hospital services
20 provided by any second physician, surgeon or hospital
21 subsequently chosen by the employee or by any other
22 physician, consultant, expert, institution or other
23 provider of services recommended by said second service
24 provider or any subsequent provider of medical services
25 in the chain of referrals from said second service
26 provider. Thereafter the employer shall select and pay
27 for all necessary medical, surgical and hospital
28 treatment and the employee may not select a provider of
29 medical services at the employer's expense unless the
30 employer agrees to such selection. At any time the
31 employee may obtain any medical treatment he desires at
32 his own expense. This paragraph shall not affect the duty
33 to pay for rehabilitation referred to above.
34 When an employer and employee so agree in writing,
-49- LRB9002213DJcd
1 nothing in this Act prevents an employee whose injury or
2 disability has been established under this Act, from relying
3 in good faith, on treatment by prayer or spiritual means
4 alone, in accordance with the tenets and practice of a
5 recognized church or religious denomination, by a duly
6 accredited practitioner thereof, and having nursing services
7 appropriate therewith, without suffering loss or diminution
8 of the compensation benefits under this Act. However, the
9 employee shall submit to all physical examinations required
10 by this Act. The cost of such treatment and nursing care
11 shall be paid by the employee unless the employer agrees to
12 make such payment.
13 Where the accidental injury results in the amputation of
14 an arm, hand, leg or foot, or the enucleation of an eye, or
15 the loss of any of the natural teeth, the employer shall
16 furnish an artificial of any such members lost or damaged in
17 accidental injury arising out of and in the course of
18 employment, and shall also furnish the necessary braces in
19 all proper and necessary cases. In cases of the loss of a
20 member or members by amputation, the employer shall, whenever
21 necessary, maintain in good repair, refit or replace the
22 artificial limbs during the lifetime of the employee. Where
23 the accidental injury accompanied by physical injury results
24 in damage to a denture, eye glasses or contact eye lenses, or
25 where the accidental injury results in damage to an
26 artificial member, the employer shall replace or repair such
27 denture, glasses, lenses, or artificial member.
28 The furnishing by the employer of any such services or
29 appliances is not an admission of liability on the part of
30 the employer to pay compensation.
31 The furnishing of any such services or appliances or the
32 servicing thereof by the employer is not the payment of
33 compensation.
34 (b) If the period of temporary total incapacity for work
-50- LRB9002213DJcd
1 lasts more than 3 working days, weekly compensation as
2 hereinafter provided shall be paid beginning on the 4th day
3 of such temporary total incapacity and continuing as long as
4 the total temporary incapacity lasts. In cases where the
5 temporary total incapacity for work continues for a period of
6 14 days or more from the day of the accident compensation
7 shall commence on the day after the accident.
8 If the employee is receiving benefits awarded for
9 temporary total incapacity, the employer shall not, except in
10 cases where the employee has actually returned to gainful
11 employment, discontinue the payment of those benefits unless
12 so ordered by the Industrial Commission or an arbitrator
13 thereof pursuant to subsection (e) of Section 19. Temporary
14 total disability benefits may be terminated by the arbitrator
15 or the Commission only if the employee refuses to accept
16 suitable work offered to him or her by any employer which the
17 employee has the capacity to perform. Temporary total
18 disability benefits are payable under this Section even after
19 the issuance of an award or decision of permanent disability
20 under this Section. The payment of temporary total
21 disability benefits due to periods of temporary total
22 incapacity for work that occur as a result of a work-related
23 injury after the issuance of an award or decision shall be
24 secured in accordance with subsection (h) of Section 19 of
25 this Act.
26 Capacity to perform work shall be determined in the same
27 manner as for individuals who come under the provisions of
28 subsection (d) of this Section. In determining whether work
29 is suitable for an individual, consideration shall be given
30 to the degree of risk involved to his or her health, safety,
31 and morals, his or her physical fitness and prior training,
32 his or her experience and prior earnings, his or her length
33 of employment and prospects for securing local work in his or
34 her customary occupation, the stability of the local labor
-51- LRB9002213DJcd
1 market for performance of services substantially similar to
2 those to be performed in the work offered, and the distance
3 of available work from his or her residence.
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 the following amounts in the
9 following cases:
10 $100.90 in case of a single person;
11 $105.50 in case of a married person with no
12 children;
13 $108.30 in case of one child;
14 $113.40 in case of 2 children;
15 $117.40 in case of 3 children;
16 $124.30 in case of 4 or more children;
17 nor exceed the employee's average weekly wage computed in
18 accordance with the provisions of Section 10, whichever
19 is less.
20 2. The compensation rate in all cases other than
21 for temporary total disability under this paragraph (b),
22 and other than for serious and permanent disfigurement
23 under paragraph (c) and other than for permanent partial
24 disability under subparagraph (2) of paragraph (d) or
25 under paragraph (e), of this Section shall be equal to 66
26 2/3% of the employee's average weekly wage computed in
27 accordance with the provisions of Section 10, provided
28 that it shall be not less than the following amounts in
29 the following cases:
30 $80.90 in case of a single person;
31 $83.20 in case of a married person with no
32 children;
33 $86.10 in case of one child;
34 $88.90 in case of 2 children;
-52- LRB9002213DJcd
1 $91.80 in case of 3 children;
2 $96.90 in case of 4 or more children;
3 nor exceed the employee's average weekly wage computed in
4 accordance with the provisions of Section 10, whichever
5 is less.
6 2.1. The compensation rate in all cases of serious
7 and permanent disfigurement under paragraph (c) and of
8 permanent partial disability under subparagraph (2) of
9 paragraph (d) or under paragraph (e) of this Section
10 shall be equal to 60% of the employee's average weekly
11 wage computed in accordance with the provisions of
12 Section 10, provided that it shall be not less than the
13 following amounts in the following cases:
14 $80.90 in case of a single person;
15 $83.20 in case of a married person with no
16 children;
17 $86.10 in case of one child;
18 $88.90 in case of 2 children;
19 $91.80 in case of 3 children;
20 $96.90 in case of 4 or more children;
21 nor exceed the employee's average weekly wage computed in
22 accordance with the provisions of Section 10, whichever
23 is less.
24 3. As used in this Section the term "child" means a
25 child of the employee including any child legally adopted
26 before the accident or whom at the time of the accident
27 the employee was under legal obligation to support or to
28 whom the employee stood in loco parentis, and who at the
29 time of the accident was under 18 years of age and not
30 emancipated. The term "children" means the plural of
31 "child".
32 4. All weekly compensation rates provided under
33 subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
34 Section shall be subject to the following limitations:
-53- LRB9002213DJcd
1 The maximum weekly compensation rate from July 1,
2 1975, except as hereinafter provided, shall be 100% of
3 the State's average weekly wage in covered industries
4 under the Unemployment Insurance Act, that being the wage
5 that most closely approximates the State's average weekly
6 wage.
7 The maximum weekly compensation rate, for the period
8 July 1, 1984, through June 30, 1987, except as
9 hereinafter provided, shall be $293.61. Effective July 1,
10 1987 and on July 1 of each year thereafter the maximum
11 weekly compensation rate, except as hereinafter provided,
12 shall be determined as follows: if during the preceding
13 12 month period there shall have been an increase in the
14 State's average weekly wage in covered industries under
15 the Unemployment Insurance Act, the weekly compensation
16 rate shall be proportionately increased by the same
17 percentage as the percentage of increase in the State's
18 average weekly wage in covered industries under the
19 Unemployment Insurance Act during such period.
20 The maximum weekly compensation rate, for the period
21 January 1, 1981 through December 31, 1983, except as
22 hereinafter provided, shall be 100% of the State's
23 average weekly wage in covered industries under the
24 Unemployment Insurance Act in effect on January 1, 1981.
25 Effective January 1, 1984 and on January 1, of each year
26 thereafter the maximum weekly compensation rate, except
27 as hereinafter provided, shall be determined as follows:
28 if during the preceding 12 month period there shall have
29 been an increase in the State's average weekly wage in
30 covered industries under the Unemployment Insurance Act,
31 the weekly compensation rate shall be proportionately
32 increased by the same percentage as the percentage of
33 increase in the State's average weekly wage in covered
34 industries under the Unemployment Insurance Act during
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1 such period.
2 From July 1, 1977 and thereafter such maximum weekly
3 compensation rate in death cases under Section 7, and
4 permanent total disability cases under paragraph (f) or
5 subparagraph 18 of paragraph (3) of this Section and for
6 temporary total disability under paragraph (b) of this
7 Section and for amputation of a member or enucleation of
8 an eye under paragraph (e) of this Section shall be
9 increased to 133-1/3% of the State's average weekly wage
10 in covered industries under the Unemployment Insurance
11 Act.
12 4.1. Any provision herein to the contrary
13 notwithstanding, the weekly compensation rate for
14 compensation payments under subparagraph 18 of paragraph
15 (e) of this Section and under paragraph (f) of this
16 Section and under paragraph (a) of Section 7, shall in no
17 event be less than 50% of the State's average weekly wage
18 in covered industries under the Unemployment Insurance
19 Act.
20 4.2. Any provision to the contrary notwithstanding,
21 the total compensation payable under Section 7 shall not
22 exceed the greater of $250,000 or 20 years.
23 5. For the purpose of this Section this State's
24 average weekly wage in covered industries under the
25 Unemployment Insurance Act on July 1, 1975 is hereby
26 fixed at $228.16 per week and the computation of
27 compensation rates shall be based on the aforesaid
28 average weekly wage until modified as hereinafter
29 provided.
30 6. The Department of Employment Security of the
31 State shall on or before the first day of December, 1977,
32 and on or before the first day of June, 1978, and on the
33 first day of each December and June of each year
34 thereafter, publish the State's average weekly wage in
-55- LRB9002213DJcd
1 covered industries under the Unemployment Insurance Act
2 and the Industrial Commission shall on the 15th day of
3 January, 1978 and on the 15th day of July, 1978 and on
4 the 15th day of each January and July of each year
5 thereafter, post and publish the State's average weekly
6 wage in covered industries under the Unemployment
7 Insurance Act as last determined and published by the
8 Department of Employment Security. The amount when so
9 posted and published shall be conclusive and shall be
10 applicable as the basis of computation of compensation
11 rates until the next posting and publication as
12 aforesaid.
13 7. The payment of compensation by an employer or
14 his insurance carrier to an injured employee shall not
15 constitute an admission of the employer's liability to
16 pay compensation.
17 (c) For any serious and permanent disfigurement to the
18 hand, head, face, neck, arm, leg below the knee or the chest
19 above the axillary line, the employee is entitled to
20 compensation for such disfigurement, the amount determined by
21 agreement at any time or by arbitration under this Act, at a
22 hearing not less than 6 months after the date of the
23 accidental injury, which amount shall not exceed 150 weeks at
24 the applicable rate provided in subparagraph 2.1 of paragraph
25 (b) of this Section.
26 No compensation is payable under this paragraph where
27 compensation is payable under paragraphs (d), (e) or (f) of
28 this Section.
29 A duly appointed member of a fire department in a city,
30 the population of which exceeds 200,000 according to the last
31 federal or State census, is eligible for compensation under
32 this paragraph only where such serious and permanent
33 disfigurement results from burns.
34 (d) 1. If, after the accidental injury has been
-56- LRB9002213DJcd
1 sustained, the employee as a result thereof becomes partially
2 incapacitated from pursuing his usual and customary line of
3 employment, he shall, until such time as the employee elects
4 to proceed to hearing and makes an election to pursue
5 compensation except in cases compensated under the specific
6 schedule set forth in paragraph (e) of this Section, receive
7 compensation for the duration of his disability, subject to
8 the limitations as to maximum amounts fixed in paragraph (b)
9 of this Section, equal to 66-2/3% of the difference between
10 the average amount which he would be able to earn in the full
11 performance of his duties in the occupation in which he was
12 engaged at the time of the accident and the average amount
13 which he is earning or is able to earn in some suitable
14 employment or business after the accident.
15 2. If, as a result of the accident, the employee
16 sustains serious and permanent injuries not covered by
17 paragraphs (c) and (e) of this Section or having sustained
18 injuries covered by the aforesaid paragraphs (c) and (e), he
19 shall have sustained in addition thereto other injuries which
20 injuries do not incapacitate him from pursuing the duties of
21 his employment but which would disable him from pursuing
22 other suitable occupations, or which have otherwise resulted
23 in physical impairment; or if such injuries partially
24 incapacitate him from pursuing the duties of his usual and
25 customary line of employment but do not result in an
26 impairment of earning capacity, or having resulted in an
27 impairment of earning capacity, the employee elects to waive
28 his right to recover under the foregoing subparagraph 1 of
29 paragraph (d) of this Section then in any of the foregoing
30 events, he shall receive in addition to compensation for
31 temporary total disability under paragraph (b) of this
32 Section, compensation at the rate provided in subparagraph
33 2.1 of paragraph (b) of this Section for that percentage of
34 500 weeks that the partial disability resulting from the
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1 injuries covered by this paragraph bears to total disability.
2 If the employee shall have sustained a fracture of one or
3 more vertebra or fracture of the skull, the amount of
4 compensation allowed under this Section shall be not less
5 than 6 weeks for a fractured skull and 6 weeks for each
6 fractured vertebra, and in the event the employee shall have
7 sustained a fracture of any of the following facial bones:
8 nasal, lachrymal, vomer, zygoma, maxilla, palatine or
9 mandible, the amount of compensation allowed under this
10 Section shall be not less than 2 weeks for each such
11 fractured bone, and for a fracture of each transverse process
12 not less than 3 weeks. In the event such injuries shall
13 result in the loss of a kidney, spleen or lung, the amount of
14 compensation allowed under this Section shall be not less
15 than 10 weeks for each such organ. Compensation awarded
16 under this subparagraph 2 shall not take into consideration
17 injuries covered under paragraphs (c) and (e) of this Section
18 and the compensation provided in this paragraph shall not
19 affect the employee's right to compensation payable under
20 paragraphs (b), (c) and (e) of this Section for the
21 disabilities therein covered.
22 (e) For accidental injuries in the following schedule,
23 the employee shall receive compensation for the period of
24 temporary total incapacity for work resulting from such
25 accidental injury, under subparagraph 1 of paragraph (b) of
26 this Section, and shall receive in addition thereto
27 compensation for a further period for the specific loss
28 herein mentioned, but shall not receive any compensation
29 under any other provisions of this Act. The following
30 listed amounts apply to either the loss of or the permanent
31 and complete loss of use of the member specified, such
32 compensation for the length of time as follows:
33 1. Thumb-70 weeks.
34 2. First, or index finger-40 weeks.
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1 3. Second, or middle finger-35 weeks.
2 4. Third, or ring finger-25 weeks.
3 5. Fourth, or little finger-20 weeks.
4 6. Great toe-35 weeks.
5 7. Each toe other than great toe-12 weeks.
6 8. The loss of the first or distal phalanx of the
7 thumb or of any finger or toe shall be considered to be
8 equal to the loss of one-half of such thumb, finger or
9 toe and the compensation payable shall be one-half of the
10 amount above specified. The loss of more than one
11 phalanx shall be considered as the loss of the entire
12 thumb, finger or toe. In no case shall the amount
13 received for more than one finger exceed the amount
14 provided in this schedule for the loss of a hand.
15 9. Hand-190 weeks. The loss of 2 or more digits,
16 or one or more phalanges of 2 or more digits, of a hand
17 may be compensated on the basis of partial loss of use of
18 a hand, provided, further, that the loss of 4 digits, or
19 the loss of use of 4 digits, in the same hand shall
20 constitute the complete loss of a hand.
21 10. Arm-235 weeks. Where an accidental injury
22 results in the amputation of an arm below the elbow, such
23 injury shall be compensated as a loss of an arm. Where
24 an accidental injury results in the amputation of an arm
25 above the elbow, compensation for an additional 15 weeks
26 shall be paid, except where the accidental injury results
27 in the amputation of an arm at the shoulder joint, or so
28 close to shoulder joint that an artificial arm cannot be
29 used, or results in the disarticulation of an arm at the
30 shoulder joint, in which case compensation for an
31 additional 65 weeks shall be paid.
32 11. Foot-155 weeks.
33 12. Leg-200 weeks. Where an accidental injury
34 results in the amputation of a leg below the knee, such
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1 injury shall be compensated as loss of a leg. Where an
2 accidental injury results in the amputation of a leg
3 above the knee, compensation for an additional 25 weeks
4 shall be paid, except where the accidental injury results
5 in the amputation of a leg at the hip joint, or so close
6 to the hip joint that an artificial leg cannot be used,
7 or results in the disarticulation of a leg at the hip
8 joint, in which case compensation for an additional 75
9 weeks shall be paid.
10 13. Eye-150 weeks. Where an accidental injury
11 results in the enucleation of an eye, compensation for an
12 additional 10 weeks shall be paid.
13 14. Loss of hearing of one ear-50 weeks; total and
14 permanent loss of hearing of both ears-200 weeks.
15 15. Testicle-50 weeks; both testicles-150 weeks.
16 16. For the permanent partial loss of use of a
17 member or sight of an eye, or hearing of an ear,
18 compensation during that proportion of the number of
19 weeks in the foregoing schedule provided for the loss of
20 such member or sight of an eye, or hearing of an ear,
21 which the partial loss of use thereof bears to the total
22 loss of use of such member, or sight of eye, or hearing
23 of an ear.
24 (a) Loss of hearing for compensation purposes
25 shall be confined to the frequencies of 1,000, 2,000
26 and 3,000 cycles per second. Loss of hearing ability
27 for frequency tones above 3,000 cycles per second
28 are not to be considered as constituting disability
29 for hearing.
30 (b) The percent of hearing loss, for purposes
31 of the determination of compensation claims for
32 occupational deafness, shall be calculated as the
33 average in decibels for the thresholds of hearing
34 for the frequencies of 1,000, 2,000 and 3,000 cycles
-60- LRB9002213DJcd
1 per second. Pure tone air conduction audiometric
2 instruments, approved by nationally recognized
3 authorities in this field, shall be used for
4 measuring hearing loss. If the losses of hearing
5 average 30 decibels or less in the 3 frequencies,
6 such losses of hearing shall not then constitute any
7 compensable hearing disability. If the losses of
8 hearing average 85 decibels or more in the 3
9 frequencies, then the same shall constitute and be
10 total or 100% compensable hearing loss.
11 (c) In measuring hearing impairment, the
12 lowest measured losses in each of the 3 frequencies
13 shall be added together and divided by 3 to
14 determine the average decibel loss. For every
15 decibel of loss exceeding 30 decibels an allowance
16 of 1.82% shall be made up to the maximum of 100%
17 which is reached at 85 decibels.
18 (d) If a hearing loss is established to have
19 existed on July 1, 1975 by audiometric testing the
20 employer shall not be liable for the previous loss
21 so established nor shall he be liable for any loss
22 for which compensation has been paid or awarded.
23 (e) No consideration shall be given to the
24 question of whether or not the ability of an
25 employee to understand speech is improved by the use
26 of a hearing aid.
27 (f) No claim for loss of hearing due to
28 industrial noise shall be brought against an
29 employer or allowed unless the employee has been
30 exposed for a period of time sufficient to cause
31 permanent impairment to noise levels in excess of
32 the following:
33 Sound Level DBA
34 Slow Response Hours Per Day
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1 90 8
2 92 6
3 95 4
4 97 3
5 100 2
6 102 1-1/2
7 105 1
8 110 1/2
9 115 1/4
10 This subparagraph (f) shall not be applied in cases
11 of hearing loss resulting from trauma or explosion.
12 Notwithstanding this subparagraph (f), the
13 Industrial Commission or arbitrator may award disability
14 for hearing loss when an employee has been exposed to
15 noise levels which the Commission or arbitrator deems are
16 sufficient to cause permanent impairment.
17 17. In computing the compensation to be paid to any
18 employee who, before the accident for which he claims
19 compensation, had before that time sustained an injury
20 resulting in the loss by amputation or partial loss by
21 amputation of any member, including hand, arm, thumb or
22 fingers, leg, foot or any toes, such loss or partial loss
23 of any such member shall be deducted from any award made
24 for the subsequent injury. For the permanent loss of use
25 or the permanent partial loss of use of any such member
26 or the partial loss of sight of an eye, for which
27 compensation has been paid, then such loss shall be taken
28 into consideration and deducted from any award for the
29 subsequent injury.
30 18. The specific case of loss of both hands, both
31 arms, or both feet, or both legs, or both eyes, or of any
32 two thereof, or the permanent and complete loss of the
33 use thereof, constitutes total and permanent disability,
34 to be compensated according to the compensation fixed by
-62- LRB9002213DJcd
1 paragraph (f) of this Section. These specific cases of
2 total and permanent disability do not exclude other
3 cases.
4 Any employee who has previously suffered the loss or
5 permanent and complete loss of the use of any of such
6 members, and in a subsequent independent accident loses
7 another or suffers the permanent and complete loss of the
8 use of any one of such members the employer for whom the
9 injured employee is working at the time of the last
10 independent accident is liable to pay compensation only
11 for the loss or permanent and complete loss of the use of
12 the member occasioned by the last independent accident.
13 19. In a case of specific loss and the subsequent
14 death of such injured employee from other causes than
15 such injury leaving a widow, widower, or dependents
16 surviving before payment or payment in full for such
17 injury, then the amount due for such injury is payable to
18 the widow or widower and, if there be no widow or
19 widower, then to such dependents, in the proportion which
20 such dependency bears to total dependency.
21 Beginning July 1, 1980, and every 6 months thereafter,
22 the Commission shall examine the Second Injury Fund and when,
23 after deducting all advances or loans made to such Fund, the
24 amount therein is $500,000 then the amount required to be
25 paid by employers pursuant to paragraph (f) of Section 7
26 shall be reduced by one-half. When the Second Injury Fund
27 reaches the sum of $600,000 then the payments shall cease
28 entirely. However, when the Second Injury Fund has been
29 reduced to $400,000, payment of one-half of the amounts
30 required by paragraph (f) of Section 7 shall be resumed, in
31 the manner herein provided, and when the Second Injury Fund
32 has been reduced to $300,000, payment of the full amounts
33 required by paragraph (f) of Section 7 shall be resumed, in
34 the manner herein provided. The Commission shall make the
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1 changes in payment effective by general order, and the
2 changes in payment become immediately effective for all cases
3 coming before the Commission thereafter either by settlement
4 agreement or final order, irrespective of the date of the
5 accidental injury.
6 On August 1, 1996 and on February 1 and August 1 of each
7 subsequent year, the Commission shall examine the special
8 fund designated as the "Rate Adjustment Fund" and when, after
9 deducting all advances or loans made to said fund, the amount
10 therein is $4,000,000, the amount required to be paid by
11 employers pursuant to paragraph (f) of Section 7 shall be
12 reduced by one-half. When the Rate Adjustment Fund reaches
13 the sum of $5,000,000 the payment therein shall cease
14 entirely. However, when said Rate Adjustment Fund has been
15 reduced to $3,000,000 the amounts required by paragraph (f)
16 of Section 7 shall be resumed in the manner herein provided.
17 (f) In case of complete disability, which renders the
18 employee wholly and permanently incapable of work, or in the
19 specific case of total and permanent disability as provided
20 in subparagraph 18 of paragraph (e) of this Section,
21 compensation shall be payable at the rate provided in
22 subparagraph 2 of paragraph (b) of this Section for life.
23 An employee entitled to benefits under paragraph (f) of
24 this Section shall also be entitled to receive from the Rate
25 Adjustment Fund provided in paragraph (f) of Section 7 of the
26 supplementary benefits provided in paragraph (g) of this
27 Section 8.
28 If any employee who receives an award under this
29 paragraph afterwards returns to work or is able to do so, and
30 earns or is able to earn as much as before the accident,
31 payments under such award shall cease. If such employee
32 returns to work, or is able to do so, and earns or is able to
33 earn part but not as much as before the accident, such award
34 shall be modified so as to conform to an award under
-64- LRB9002213DJcd
1 paragraph (d) of this Section. If such award is terminated
2 or reduced under the provisions of this paragraph, such
3 employees have the right at any time within 30 months after
4 the date of such termination or reduction to file petition
5 with the Commission for the purpose of determining whether
6 any disability exists as a result of the original accidental
7 injury and the extent thereof.
8 Disability as enumerated in subdivision 18, paragraph (e)
9 of this Section is considered complete disability.
10 If an employee who had previously incurred loss or the
11 permanent and complete loss of use of one member, through the
12 loss or the permanent and complete loss of the use of one
13 hand, one arm, one foot, one leg, or one eye, incurs
14 permanent and complete disability through the loss or the
15 permanent and complete loss of the use of another member, he
16 shall receive, in addition to the compensation payable by the
17 employer and after such payments have ceased, an amount from
18 the Second Injury Fund provided for in paragraph (f) of
19 Section 7, which, together with the compensation payable from
20 the employer in whose employ he was when the last accidental
21 injury was incurred, will equal the amount payable for
22 permanent and complete disability as provided in this
23 paragraph of this Section.
24 The custodian of the Second Injury Fund provided for in
25 paragraph (f) of Section 7 shall be joined with the employer
26 as a party respondent in the application for adjustment of
27 claim. The application for adjustment of claim shall state
28 briefly and in general terms the approximate time and place
29 and manner of the loss of the first member.
30 In its award the Commission or the Arbitrator shall
31 specifically find the amount the injured employee shall be
32 weekly paid, the number of weeks compensation which shall be
33 paid by the employer, the date upon which payments begin out
34 of the Second Injury Fund provided for in paragraph (f) of
-65- LRB9002213DJcd
1 Section 7 of this Act, the length of time the weekly payments
2 continue, the date upon which the pension payments commence
3 and the monthly amount of the payments. The Commission shall
4 30 days after the date upon which payments out of the Second
5 Injury Fund have begun as provided in the award, and every
6 month thereafter, prepare and submit to the State Comptroller
7 a voucher for payment for all compensation accrued to that
8 date at the rate fixed by the Commission. The State
9 Comptroller shall draw a warrant to the injured employee
10 along with a receipt to be executed by the injured employee
11 and returned to the Commission. The endorsed warrant and
12 receipt is a full and complete acquittance to the Commission
13 for the payment out of the Second Injury Fund. No other
14 appropriation or warrant is necessary for payment out of the
15 Second Injury Fund. The Second Injury Fund is appropriated
16 for the purpose of making payments according to the terms of
17 the awards.
18 As of July 1, 1980 to July 1, 1982, all claims against
19 and obligations of the Second Injury Fund shall become claims
20 against and obligations of the Rate Adjustment Fund to the
21 extent there is insufficient money in the Second Injury Fund
22 to pay such claims and obligations. In that case, all
23 references to "Second Injury Fund" in this Section shall also
24 include the Rate Adjustment Fund.
25 (g) Every award for permanent total disability entered
26 by the Commission on and after July 1, 1965 under which
27 compensation payments shall become due and payable after the
28 effective date of this amendatory Act, and every award for
29 death benefits or permanent total disability entered by the
30 Commission on and after the effective date of this amendatory
31 Act shall be subject to annual adjustments as to the amount
32 of the compensation rate therein provided. Such adjustments
33 shall first be made on July 15, 1977, and all awards made and
34 entered prior to July 1, 1975 and on July 15 of each year
-66- LRB9002213DJcd
1 thereafter. In all other cases such adjustment shall be made
2 on July 15 of the second year next following the date of the
3 entry of the award and shall further be made on July 15
4 annually thereafter. The adjustment shall be made retroactive
5 to the date permanent and total disability began or to the
6 date of death. If during the intervening period from the
7 date of the entry of the award, or the last periodic
8 adjustment, there shall have been an increase in the State's
9 average weekly wage in covered industries under the
10 Unemployment Insurance Act, the weekly compensation rate
11 shall be proportionately increased by the same percentage as
12 the percentage of increase in the State's average weekly wage
13 in covered industries under the Unemployment Insurance Act.
14 The increase in the compensation rate under this paragraph
15 shall in no event bring the total compensation rate to an
16 amount greater than the prevailing maximum rate. Such
17 increase shall be paid in the same manner as herein provided
18 for payments under the Second Injury Fund to the injured
19 employee, or his dependents, as the case may be, out of the
20 Rate Adjustment Fund provided in paragraph (f) of Section 7
21 of this Act. Payments shall be made at the same intervals as
22 provided in the award or, at the option of the Commission,
23 may be made in quarterly payment on the 15th day of January,
24 April, July and October of each year. In the event of a
25 decrease in such average weekly wage there shall be no change
26 in the then existing compensation rate. The within paragraph
27 shall not apply to cases where there is disputed liability
28 and in which a compromise lump sum settlement between the
29 employer and the injured employee, or his dependents, as the
30 case may be, has been duly approved by the Industrial
31 Commission.
32 Provided, that in cases of awards entered by the
33 Commission for injuries occurring before July 1, 1975, the
34 increases in the compensation rate adjusted under the
-67- LRB9002213DJcd
1 foregoing provision of this paragraph (g) shall be limited to
2 increases in the State's average weekly wage in covered
3 industries under the Unemployment Insurance Act occurring
4 after July 1, 1975.
5 (h) In case death occurs from any cause before the total
6 compensation to which the employee would have been entitled
7 has been paid, then in case the employee leaves any widow,
8 widower, child, parent (or any grandchild, grandparent or
9 other lineal heir or any collateral heir dependent at the
10 time of the accident upon the earnings of the employee to the
11 extent of 50% or more of total dependency) such compensation
12 shall be paid to the beneficiaries of the deceased employee
13 and distributed as provided in paragraph (g) of Section 7.
14 (h-1) In case an injured employee is under legal
15 disability at the time when any right or privilege accrues to
16 him or her under this Act, a guardian may be appointed
17 pursuant to law, and may, on behalf of such person under
18 legal disability, claim and exercise any such right or
19 privilege with the same effect as if the employee himself or
20 herself had claimed or exercised the right or privilege. No
21 limitations of time provided by this Act run so long as the
22 employee who is under legal disability is without a
23 conservator or guardian.
24 (i) In case the injured employee is under 16 years of
25 age at the time of the accident and is illegally employed,
26 the amount of compensation payable under paragraphs (b), (c),
27 (d), (e) and (f) of this Section is increased 50%.
28 However, where an employer has on file an employment
29 certificate issued pursuant to the Child Labor Law or work
30 permit issued pursuant to the Federal Fair Labor Standards
31 Act, as amended, or a birth certificate properly and duly
32 issued, such certificate, permit or birth certificate is
33 conclusive evidence as to the age of the injured minor
34 employee for the purposes of this Section.
-68- LRB9002213DJcd
1 Nothing herein contained repeals or amends the provisions
2 of the Child Labor Law relating to the employment of minors
3 under the age of 16 years.
4 (j) 1. In the event the injured employee receives
5 benefits, including medical, surgical or hospital benefits
6 under any group plan covering non-occupational disabilities
7 contributed to wholly or partially by the employer, which
8 benefits should not have been payable if any rights of
9 recovery existed under this Act, then such amounts so paid to
10 the employee from any such group plan as shall be consistent
11 with, and limited to, the provisions of paragraph 2 hereof,
12 shall be credited to or against any compensation payment for
13 temporary total incapacity for work or any medical, surgical
14 or hospital benefits made or to be made under this Act. The
15 amount of such credit shall not include any amounts deducted
16 for federal, State or local taxes, social security, union
17 dues, contributions by the employees toward fringe benefits,
18 or any other deductions made by the employer. In such event,
19 the period of time for giving notice of accidental injury and
20 filing application for adjustment of claim does not commence
21 to run until the termination of such payments. This
22 paragraph does not apply to payments made under any group
23 plan which would have been payable irrespective of an
24 accidental injury under this Act. Any employer receiving
25 such credit shall keep such employee safe and harmless from
26 any and all claims or liabilities that may be made against
27 him by reason of having received such payments only to the
28 extent of such credit.
29 Any excess benefits paid to or on behalf of a State
30 employee by the State Employees' Retirement System under
31 Article 14 of the Illinois Pension Code on a death claim or
32 disputed disability claim shall be credited against any
33 payments made or to be made by the State of Illinois to or on
34 behalf of such employee under this Act, except for payments
-69- LRB9002213DJcd
1 for medical expenses which have already been incurred at the
2 time of the award. The State of Illinois shall directly
3 reimburse the State Employees' Retirement System to the
4 extent of such credit.
5 2. Nothing contained in this Act shall be construed to
6 give the employer or the insurance carrier the right to
7 credit for any benefits or payments received by the employee
8 other than compensation payments provided by this Act, and
9 where the employee receives payments other than compensation
10 payments, whether as full or partial salary, group insurance
11 benefits, bonuses, annuities or any other payments, the
12 employer or insurance carrier shall receive credit for each
13 such payment only to the extent of the compensation that
14 would have been payable during the period covered by such
15 payment.
16 3. The extension of time for the filing of an
17 Application for Adjustment of Claim as provided in paragraph
18 1 above shall not apply to those cases where the time for
19 such filing had expired prior to the date on which payments
20 or benefits enumerated herein have been initiated or resumed.
21 Provided however that this paragraph 3 shall apply only to
22 cases wherein the payments or benefits hereinabove enumerated
23 shall be received after July 1, 1969.
24 (k) Notwithstanding any other provision of this Act,
25 when the employee suffers injury resulting in death, the
26 complete and permanent loss of use of any member listed in
27 subsection (e), or total and permanent disability,
28 compensation, other than compensation for temporary total
29 incapacity for work, shall be based on the State's average
30 weekly wage or the employee's average weekly wage, whichever
31 is greater.
32 (Source: P.A. 89-470, eff. 6-13-96.)
33 (820 ILCS 305/8a new)
-70- LRB9002213DJcd
1 Sec. 8a. Cumulative injuries. As a guide to the
2 interpretation and application of this Section, the policy
3 and intent of the General Assembly is declared to be as
4 follows:
5 That every person in this State who works for a
6 living is entitled to a reasonable opportunity to
7 maintain his or her independence and self-respect through
8 self-support even if that person has a physical or mental
9 handicap;
10 That any plan which will reasonably, equitably and
11 practically operate to break down hindrances and to
12 remove obstacles to the employment of partially disabled
13 persons honorably discharged from our armed forces or any
14 other persons having physical or mental handicaps is of
15 vital importance to this State and its people and is of
16 concern to this General Assembly;
17 That it is the considered judgment of this General
18 Assembly that the system embodied in this Section, which
19 makes a logical and equitable adjustment of the liability
20 under this Act which an employer must assume in hiring
21 employees, constitutes a practical and reasonable
22 approach to a solution of the problem for the employment
23 of persons with physical or mental handicaps.
24 (a) Commencing January 1, 1998 and thereafter, if an
25 employee who has a physical or mental handicap, as
26 hereinafter defined, sustains a compensable accidental injury
27 resulting in additional permanent disability so that the
28 degree or percentage of disability caused by the combination
29 of the previous disability and the compensable accident is
30 substantially greater than that which would have resulted
31 from the compensable accident, considered alone and of
32 itself, the employer shall pay all medical and hospital
33 expenses and compensation based on the combined disabilities,
34 but the employer shall be reimbursed from the Cumulative
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1 Injury Fund for all compensation payments subsequent to those
2 payable for the first 104 weeks of disability.
3 (b) If an employee who has a physical or mental handicap
4 sustains a compensable accidental injury resulting in death
5 and it has been determined that the death would not have
6 occurred but for the previous disability, the employer shall
7 pay all medical and hospital expenses and compensation, but
8 the employer shall be reimbursed from the Cumulative Injury
9 Fund for all compensation payments in excess of 250 weeks.
10 (c) "Physical or mental handicap" means any physical or
11 mental impairment resulting from or manifested by anatomical,
12 physiological, neurological or psychological conditions,
13 demonstrable by medically accepted clinical or laboratory
14 diagnostic techniques, and which is or is regarded as being a
15 substantial hindrance or obstacle to obtaining employment.
16 (820 ILCS 320/8b new)
17 Sec. 8b. Hearings for reimbursement.
18 (a) The State Treasurer shall be the ex-officio
19 custodian of the Cumulative Injury Fund created in Section
20 8c. The custodian shall be named as a defendant by an
21 employer seeking reimbursement as provided in Section 8a in a
22 petition filed with the Commission. The Commission shall
23 hold a hearing to determine the extent, if any, to which the
24 employer is entitled to reimbursement. The employer and the
25 custodian shall be notified of the date of hearing at least
26 30 days in advance. The employer and the custodian may
27 introduce evidence in accordance with the rules of evidence
28 and the rules of the Commission. The decision of the
29 Commission regarding the petition may be appealed in the same
30 manner as any other decision of the Commission.
31 (b) No reimbursement shall be made to any employer
32 unless the employer files a petition for reimbursement within
33 3 years of the date of the last payment of compensation by
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1 the employer to the employee or the employee's dependents.
2 (c) In its award the Commission shall specifically find
3 the amount the injured employee shall be paid as provided
4 under Section 8a, the date upon which payments shall be made
5 from the Cumulative Injury Fund, and the manner in which
6 payments shall be made. The Commission shall, 30 days after
7 the date upon which payments out of the Cumulative Injury
8 Fund have begun as provided in the award and every month
9 thereafter, prepare and submit to the State Comptroller a
10 voucher for payment for all compensation accrued to that date
11 at the rate fixed by the Commission. The State Comptroller
12 shall draw a warrant to the employer along with a receipt to
13 be executed by the employer and returned to the Commission.
14 The endorsed warrant and its receipt is a full and complete
15 acquittance to the Commission for the payment out of the
16 Cumulative Injury Fund. No other appropriation or warrant is
17 necessary for payment out of the Cumulative Injury Fund. The
18 Cumulative Injury Fund is appropriated for the purpose of
19 making payments according to the terms of the awards.
20 (820 ILCS 305/8c new)
21 Sec. 8c. Cumulative Injury Fund created. There is
22 created the Cumulative Injury Fund. Each employer subject to
23 this Act shall in 1998, in 2 equal installments to be paid by
24 April 1 and July 1, respectively, pay to the State Treasurer,
25 as ex-officio custodian of the Fund, a sum equal to .5% of
26 the total amount of all compensation payments made by him or
27 her during the preceding calendar year under this Act and the
28 Workers' Occupational Diseases Act, not including hospital,
29 surgical or rehabilitation payments.
30 In 1998, and in each year thereafter, the several
31 employers subject to this Act or the Workers' Occupational
32 Diseases Act shall pay into the Cumulative Injury Fund by
33 July 1 assessments which, when combined, equal 125% of the
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1 expenditures from the Cumulative Injury Fund in the preceding
2 calendar year, reduced by the amount of income earned by the
3 Fund during the preceding year, and further reduced by the
4 amount of the special State contribution paid in the
5 preceding calendar year in accordance with this Section.
6 Each employer's assessment shall be a percentage, determined
7 by the Commission by April 1 each year, of the total amount
8 of all compensation payments made by him or her during the
9 preceding calendar year under this Act and the Workers'
10 Occupational Diseases Act, not including hospital, surgical
11 or rehabilitation payments.
12 When reimbursement is made under Section 8a, the
13 Commission shall also determine whether the pre-existing
14 permanent disability or physical impairment had been
15 previously compensated under this Act or the Workers'
16 Occupational Diseases Act. Each year the State shall make a
17 special contribution to the Cumulative Injury Fund of an
18 amount equal to 25% of the amount paid out of the Fund in the
19 preceding year relative to those persons whose pre-existing
20 permanent disability or physical impairment attributable to a
21 physical or mental handicap had not been compensated.
22 Moneys in the Fund shall be paid out only as provided in
23 Sections 8a and 8b.
24 The moneys in the Fund may be invested by the Treasurer
25 jointly with moneys in the Rate Adjustment Fund, the interest
26 being apportioned between the 2 funds every 6 months.
27 (820 ILCS 305/8d new)
28 Sec. 8d. Cases involving insurance or self-insurance.
29 Where an employer has either insured or self-insured his
30 liability under paragraph (1) or (3) of subsection (a) of
31 Section 4, the insurance company or plan, whether insurance
32 or not, shall be the primary insurer or source of
33 compensation with respect to any injury covered under this
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1 Act. On a form to be furnished by the Industrial Commission,
2 an employee claiming medical expenses under subsection (a) of
3 Section 8 shall indicate whether he needs medical attention
4 and present the form to his employer. The employer shall
5 indicate in writing within 30 days after receiving the form
6 whether he is contesting the issue of whether the injury is
7 covered under this Act.
8 If the employer or his workers' compensation insurance
9 carrier, administrator, or other self-insurance or security
10 arrangement denies coverage or indicates that the employer is
11 contesting the claim on the grounds that the injury is not
12 covered by this Act, the employee's medical insurer shall
13 pay, according to its contract terms, any medical cost
14 incurred by the employee up to the limits of the applicable
15 coverage. The employee's medical insurer may not delay or
16 deny payment of benefits due to the employee by claiming that
17 treatment for the employee's injury or disease is the
18 responsibility of the employer's workers' compensation
19 carrier, administrator or other self-insurance or security
20 arrangement, regardless of any language in its contract to
21 the contrary.
22 If any injury is subsequently determined to be
23 compensable under this Act, the employer's workers'
24 compensation carrier, administrator or other self-insurance
25 or security arrangement shall be ordered to reimburse the
26 employee's medical insurer for all payment and to reimburse
27 the employee for any deductible or co-payment amounts made by
28 the employee for medical expenses covered under subsection
29 (a) of Section 8. The employee's medical insurer and
30 employee shall be entitled to interest on such payments
31 calculated under subsection (n) of Section 19.
32 It is the public policy of this State to encourage
33 compromise settlements of disputed cases. In the event the
34 Commission approves a compromise settlement of a disputed
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1 case, the order approving said settlement does not constitute
2 an adjudication on the merits of any claimed medical expenses
3 under subsection (a) of Section 8. In such a case,
4 subsequent proceedings may be brought in the Circuit Court of
5 the county where the employer is principally localized by the
6 employee's medical insurer to adjudicate any rights it may
7 have against the employer's workers' compensation carrier or,
8 if none, the employer itself, for benefits paid under this
9 Act.
10 For purposes of this Section, the "employee's medical
11 insurer" includes any individual or group health insurance
12 policy or contract, including certificates issued thereunder,
13 or any other plan, arrangement or evidence of coverage which
14 provides for payment of and furnishes accident, health,
15 hospital or medical benefits or services to the employee
16 through the policy, contract, plan, program, arrangement or
17 other evidence of coverage, whether by insurance or not, with
18 one or more insurers, including pools and reciprocals,
19 medical or health care service plans and other not-for-profit
20 corporations, health maintenance organizations, pre-paid
21 health care plans, preferred provider organizations, or any
22 other professional corporations, plans, programs, contracts
23 or other arrangements under which one or more employers,
24 unions, or other organizations pay for, reimburse, furnish or
25 otherwise provide to their employees or members, either
26 directly or indirectly through a trust or third party
27 administrator, medical or health care services or benefits,
28 whether by insurance or not, and whether the cost of such
29 services or benefits is borne by the employer or employee.
30 (820 ILCS 305/10) (from Ch. 48, par. 138.10)
31 Sec. 10. The basis for computing the compensation
32 provided for in Sections 7 and 8 of the Act shall be as
33 follows:
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1 The compensation shall be computed on the basis of the
2 "Average weekly wage" which shall mean the actual earnings of
3 the employee in the employment in which he was working at the
4 time of the injury during the period of 52 weeks ending with
5 the last day of the employee's last full pay period
6 immediately preceding the date of injury, illness or
7 disablement including overtime, bonuses, tips and anything
8 else of value received by the employee as consideration for
9 the work, including but not limited to room, board and the
10 reasonable value of any benefits provided or available to the
11 employee, such as health insurance, life insurance and
12 pension plan excluding overtime, and bonus divided by 52; but
13 if the injured employee lost 5 or more calendar days during
14 such period, whether or not in the same week, then the
15 earnings for the remainder of such 52 weeks shall be divided
16 by the number of weeks and parts thereof remaining after the
17 time so lost has been deducted. Where the employment prior
18 to the injury extended over a period of less than 52 weeks,
19 the method of dividing the earnings during that period by the
20 number of weeks and parts thereof during which the employee
21 actually earned wages shall be followed. Where by reason of
22 the shortness of the time during which the employee has been
23 in the employment of his employer or of the casual nature or
24 terms of the employment, it is impractical to compute the
25 average weekly wages as above defined, regard shall be had to
26 the average weekly amount which during the 52 weeks previous
27 to the injury, illness or disablement was being or would have
28 been earned by a person in the same grade employed at the
29 same work for each of such 52 weeks for the same number of
30 hours per week by the same employer. In the case of
31 volunteer firemen, police and civil defense members or
32 trainees, the income benefits shall be based on the average
33 weekly wage in their regular employment. Where the employee
34 is paid on an hourly basis, the average weekly wage shall not
-77- LRB9002213DJcd
1 be less than 40 times the hourly rate. When the employee is
2 working concurrently with two or more employers and the
3 respondent employer has knowledge of such employment prior to
4 the injury, his wages from all such employers shall be
5 considered as if earned from the employer liable for
6 compensation.
7 (Source: P.A. 81-1482.)
8 (820 ILCS 305/16) (from Ch. 48, par. 138.16)
9 Sec. 16. The Commission shall make and publish
10 procedural rules and orders for carrying out the duties
11 imposed upon it by law and for determining the extent of
12 disability sustained, which rules and orders shall be deemed
13 prima facie reasonable and valid.
14 The process and procedure before the Commission shall be
15 as simple and summary as reasonably may be.
16 The Commission upon application of either party may issue
17 dedimus potestatem directed to a commissioner, notary public,
18 justice of the peace or any other officer authorized by law
19 to administer oaths, to take the depositions of such witness
20 or witnesses as may be necessary in the judgment of such
21 applicant. Such dedimus potestatem may issue to any of the
22 officers aforesaid in any state or territory of the United
23 States. When the deposition of any witness resident of a
24 foreign country is desired to be taken, the dedimus shall be
25 directed to and the deposition taken before a consul, vice
26 consul or other authorized representative of the government
27 of the United States of America, whose station is in the
28 country where the witness whose deposition is to be taken
29 resides. In countries where the government of the United
30 States has no consul or other diplomatic representative, then
31 depositions in such case shall be taken through the
32 appropriate judicial authority of that country; or where
33 treaties provide for other methods of taking depositions,
-78- LRB9002213DJcd
1 then the same may be taken as in such treaties provided. The
2 Commission shall have the power to adopt necessary rules to
3 govern the issue of such dedimus potestatem.
4 The Commission, or any member thereof, or any Arbitrator
5 designated by the Commission shall have the power to
6 administer oaths, subpoena and examine witnesses; to issue
7 subpoenas duces tecum, requiring the production of such
8 books, papers, records and documents as may be evidence of
9 any matter under inquiry and to examine and inspect the same
10 and such places or premises as may relate to the question in
11 dispute. The Commission, or any member thereof, or any
12 Arbitrator designated by the Commission, shall on written
13 request of either party to the dispute, issue subpoenas for
14 the attendance of such witnesses and production of such
15 books, papers, records and documents as shall be designated
16 in the applications, and the parties applying for such
17 subpoena shall advance the officer and witness fees provided
18 for in civil actions pending in circuit courts of this State,
19 except as otherwise provided by Section 20 of this Act.
20 Service of such subpoena shall be made by any sheriff or
21 other person. In case any person refuses to comply with an
22 order of the Commission or subpoenas issued by it or by any
23 member thereof, or any Arbitrator designated by the
24 Commission or to permit an inspection of places or premises,
25 or to produce any books, papers, records or documents, or any
26 witness refuses to testify to any matters regarding which he
27 or she may be lawfully interrogated, the Circuit Court of the
28 county in which the hearing or matter is pending, on
29 application of any member of the Commission or any Arbitrator
30 designated by the Commission, shall compel obedience by
31 attachment proceedings, as for contempt, as in a case of
32 disobedience of the requirements of a subpoena from such
33 court on a refusal to testify therein.
34 The records kept by a hospital, certified to as true and
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1 correct by the superintendent or other officer in charge,
2 showing the medical and surgical treatment given an injured
3 employee in such hospital, shall be admissible without any
4 further proof as evidence of the medical and surgical matters
5 stated therein, but shall not be conclusive proof of such
6 matters.
7 The Commission at its expense shall provide an official
8 court reporter to take the testimony and record of
9 proceedings at the hearings before an Arbitrator or the
10 Commission, who shall furnish a transcript of such testimony
11 or proceedings to either party requesting it, upon payment
12 therefor at the rate of $1.00 per page for the original and
13 35 cents per page for each copy of such transcript. Payment
14 for photostatic copies of exhibits shall be extra. If the
15 Commission has determined, as provided in Section 20 of this
16 Act, that the employee is a poor person, a transcript of such
17 testimony and proceedings, including photostatic copies of
18 exhibits, shall be furnished to such employee at the
19 Commission's expense.
20 The Commission shall have the power to determine the
21 reasonableness and fix the amount of any fee of compensation
22 charged by any person, including attorneys, physicians,
23 surgeons and hospitals, for any service performed in
24 connection with this Act, or for which payment is to be made
25 under this Act or rendered in securing any right under this
26 Act.
27 Whenever the Commission shall find that the employer, his
28 or her agent, service company or insurance carrier has been
29 guilty of delay or unfairness towards an employee in the
30 adjustment, settlement or payment of benefits due such
31 employee within the purview of the provisions of paragraph
32 (c) of Section 4 of this Act; or has been guilty of
33 unreasonable or vexatious delay, intentional under-payment of
34 compensation benefits, or has engaged in frivolous defenses
-80- LRB9002213DJcd
1 which do not present a real controversy, within the purview
2 of the provisions of paragraph (k) of Section 19 of this Act,
3 the Commission may assess all or any part of the attorney's
4 fees and costs against such employer and his or her insurance
5 carrier.
6 (Source: P.A. 86-998.)
7 (820 ILCS 305/16b new)
8 Sec. 16b. Fees of health care providers. A health care
9 provider shall not charge a fee for treatment and care which
10 is governed by the provisions of this Act that is greater
11 than the usual and customary fee the provider receives for
12 the same treatment or service when the payor for the
13 treatment or service is a health maintenance organization, a
14 preferred provider organization, or a private health
15 insurance carrier. The charge shall be the lesser of the
16 amounts charged to either the health maintenance
17 organization, the preferred provider organization, or the
18 private health insurance carrier. At the request of either
19 the employee, employer, or insurer, the health care provider
20 shall provide an affidavit of his or her customary and usual
21 charges billed to health maintenance organizations, preferred
22 provider organizations, and private health insurance
23 carriers.
24 (820 ILCS 305/16c new)
25 Sec. 16c. Resolution of disputes by Commission. The
26 Commission shall, no later than 180 days following the
27 effective date of this amendatory Act of 1995, by rule,
28 establish methods to resolve disputes between employers and
29 health care providers concerning the reasonableness of
30 medical charges (regardless of whether a fee has been paid)
31 or services. The employee shall not be a party to a dispute
32 over medical charges, nor shall the employee's recovery in
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1 any way be jeopardized because of a dispute. However,
2 nothing in this Section shall be construed to limit an
3 employee's right to seek reimbursement, payment, or approval
4 of a medical provider's bill, at arbitration or before the
5 Industrial Commission, pursuant to subsection (a) of Section
6 8 of the Workers' Compensation Act.
7 (820 ILCS 305/16d new)
8 Sec. 16d. Disclosure of financial interest. Any
9 physician or other health care provider who orders, directs
10 or renders treatment, testing, therapy or rehabilitation to a
11 patient at any institution or facility shall, at or prior to
12 the time of the referral, disclose in writing if such health
13 care provider, or any of his partners or his employer has a
14 financial interest in the institution or facility to which
15 the patient is being referred. This disclosure shall be made
16 to the patient, the patient's employer, the workers'
17 compensation insurer of such employer, and the workers'
18 compensation adjusting company for the insurer or
19 self-insured employer. Violation of this Section is a Class
20 A misdemeanor.
21 (820 ILCS 305/16e new)
22 Sec. 16e. Prohibited practices. No hospital, physician
23 or other health care provider shall bill or attempt to
24 collect from the employee, or his or her assignees, any fee
25 for services rendered to an employee due to an alleged work
26 related injury or report to any credit reporting agency any
27 failure of the employee to make any such payment, if the
28 hospital, physician or health care provider has received a
29 notice stating that the injury to the employee was a work
30 related injury covered under this Act. The notice shall be
31 actual notice given by the employee, the employer or the
32 employer's insurer to the hospital, physician or health care
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1 provider verbally or in writing signed by the employee, the
2 employer, or the employer's insurer. The notice shall be
3 deemed received by the hospital, physician or health care
4 provider 5 days after mailing by certified mail by the
5 employee, employer, or insurer to the hospital, physician, or
6 health care provider. If a hospital, physician, or health
7 care provider or debt collector on behalf of a hospital,
8 physician, or health care provider pursues any action to
9 collect from an employee after such notice is properly given,
10 the employee shall have a cause of action against the
11 hospital, physician, or health care provider for actual
12 damages sustained plus $1,000 in additional damages, and
13 costs and reasonable attorney fees.
14 (820 ILCS 305/16f new)
15 Sec. 16f. Medical records; testimony. Any physician,
16 surgeon, hospital, or other health care provider who performs
17 any services in connection with this Act shall provide the
18 patient, his employer, and the insurer with copies of medical
19 records and reports at a reasonable fee. The fee for medical
20 records shall not exceed a cost of $5 per request for
21 administrative cost and 10 cents per copy for the cost of
22 duplication. The fees charged for medical reports and
23 testimony shall not exceed the usual and customary amount for
24 such service. Upon request of the employer, the employee, or
25 the beneficiary affected, the arbitrator or the Commission
26 shall determine the fee to be authorized.
27 Any physician, surgeon, hospital employee, or any other
28 health care provider who is required to testify at the
29 request of the patient, his or her employer, or the insurer
30 shall charge a reasonable fee for the time required to
31 testify. The charge may not exceed $200 per hour. Amounts
32 over the first hour shall be billed in 10 minute increments
33 not to exceed $34.
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1 (820 ILCS 305/19) (from Ch. 48, par. 138.19)
2 Sec. 19. Any disputed questions of law or fact shall be
3 determined as herein provided.
4 (a) It shall be the duty of the Commission upon
5 notification that the parties have failed to reach an
6 agreement, to designate an Arbitrator.
7 1. Whenever any claimant misconceives his remedy
8 and files an application for adjustment of claim under
9 this Act and it is subsequently discovered, at any time
10 before final disposition of such cause, that the claim
11 for disability or death which was the basis for such
12 application should properly have been made under the
13 Workers' Occupational Diseases Act, then the provisions
14 of Section 19, paragraph (a-1) of the Workers'
15 Occupational Diseases Act having reference to such
16 application shall apply.
17 2. Whenever any claimant misconceives his remedy
18 and files an application for adjustment of claim under
19 the Workers' Occupational Diseases Act and it is
20 subsequently discovered, at any time before final
21 disposition of such cause that the claim for injury or
22 death which was the basis for such application should
23 properly have been made under this Act, then the
24 application so filed under the Workers' Occupational
25 Diseases Act may be amended in form, substance or both to
26 assert claim for such disability or death under this Act
27 and it shall be deemed to have been so filed as amended
28 on the date of the original filing thereof, and such
29 compensation may be awarded as is warranted by the whole
30 evidence pursuant to this Act. When such amendment is
31 submitted, further or additional evidence may be heard by
32 the Arbitrator or Commission when deemed necessary.
33 Nothing in this Section contained shall be construed to
34 be or permit a waiver of any provisions of this Act with
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1 reference to notice but notice if given shall be deemed
2 to be a notice under the provisions of this Act if given
3 within the time required herein.
4 (b) The Arbitrator shall make such inquiries and
5 investigations as he or they shall deem necessary and may
6 examine and inspect all books, papers, records, places, or
7 premises relating to the questions in dispute and hear such
8 proper evidence as the parties may submit.
9 The hearings before the Arbitrator shall be held in the
10 vicinity where the injury occurred after 10 days' notice of
11 the time and place of such hearing shall have been given to
12 each of the parties or their attorneys of record.
13 The Arbitrator may find that the disabling condition is
14 temporary and has not yet reached a permanent condition and
15 may order the payment of compensation up to the date of the
16 hearing, which award shall be reviewable and enforceable in
17 the same manner as other awards, and in no instance be a bar
18 to a further hearing and determination of a further amount of
19 temporary total compensation or of compensation for permanent
20 disability, but shall be conclusive as to all other questions
21 except the nature and extent of said disability.
22 The decision of the Arbitrator shall be filed with the
23 Commission which Commission shall immediately send to each
24 party or his attorney a copy of such decision, together with
25 a notification of the time when it was filed. Beginning
26 January 1, 1981, all decisions of the Arbitrator shall set
27 forth in writing findings of fact and conclusions of law,
28 separately stated. Unless a petition for review is filed by
29 either party within 30 days after the receipt by such party
30 of the copy of the decision and notification of time when
31 filed, and unless such party petitioning for a review shall
32 within 35 days after the receipt by him of the copy of the
33 decision, file with the Commission either an agreed statement
34 of the facts appearing upon the hearing before the
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1 Arbitrator, or if such party shall so elect a correct
2 transcript of evidence of the proceedings at such hearings,
3 then the decision shall become the decision of the Commission
4 and in the absence of fraud shall be conclusive. The Petition
5 for Review shall contain a statement of the petitioning
6 party's specific exceptions to the decision of the
7 arbitrator. The jurisdiction of the Commission to review the
8 decision of the arbitrator shall not be limited to the
9 exceptions stated in the Petition for Review. The Commission,
10 or any member thereof, may grant further time not exceeding
11 30 days, in which to file such agreed statement or transcript
12 of evidence. Such agreed statement of facts or correct
13 transcript of evidence, as the case may be, shall be
14 authenticated by the signatures of the parties or their
15 attorneys, or by the official court reporter, and in the
16 event they do not agree as to the correctness of the
17 transcript of evidence it shall be authenticated by the
18 signature of the Arbitrator designated by the Commission.
19 (b-1) If the employee is not receiving medical, surgical
20 or hospital services as provided in paragraph (a) of Section
21 8 or compensation as provided in paragraph (b) of Section 8,
22 the employee, in accordance with Commission Rules, may file a
23 petition for an emergency hearing by an Arbitrator on the
24 issue of whether or not he is entitled to receive payment of
25 such compensation or services as provided therein. Such
26 petition shall have priority over all other petitions and
27 shall be heard by the Arbitrator and Commission with all
28 convenient speed.
29 Such petition shall contain the following information and
30 shall be served on the employer at least 15 days before it is
31 filed:
32 (i) the date and approximate time of accident;
33 (ii) the approximate location of the accident;
34 (iii) a description of the accident;
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1 (iv) the nature of the injury incurred by the
2 employee;
3 (v) the identity of the person, if known, to whom
4 the accident was reported and the date on which it was
5 reported;
6 (vi) the name and title of the person, if known,
7 representing the employer with whom the employee
8 conferred in any effort to obtain compensation pursuant
9 to paragraph (b) of Section 8 of this Act or medical,
10 surgical or hospital services pursuant to paragraph (a)
11 of Section 8 of this Act and the date of such conference;
12 (vii) a statement that the employer has refused to
13 pay compensation pursuant to paragraph (b) of Section 8
14 of this Act or for medical, surgical or hospital services
15 pursuant to paragraph (a) of Section 8 of this Act;
16 (viii) the name and address, if known, of each
17 witness to the accident and of each other person upon
18 whom the employee will rely to support his allegations;
19 (ix) the dates of treatment related to the accident
20 by medical practitioners, and the names and addresses of
21 such practitioners, including the dates of treatment
22 related to the accident at any hospitals and the names
23 and addresses of such hospitals, and a signed
24 authorization permitting the employer to examine all
25 medical records of all practitioners and hospitals named
26 pursuant to this paragraph;
27 (x) a copy of a signed report by a medical
28 practitioner, relating to the employee's current
29 inability to return to work because of the injuries
30 incurred as a result of the accident or such other
31 documents or affidavits which show that the employee is
32 entitled to receive compensation pursuant to paragraph
33 (b) of Section 8 of this Act or medical, surgical or
34 hospital services pursuant to paragraph (a) of Section 8
-87- LRB9002213DJcd
1 of this Act. Such reports, documents or affidavits shall
2 state, if possible, the history of the accident given by
3 the employee, and describe the injury and medical
4 diagnosis, the medical services for such injury which the
5 employee has received and is receiving, the physical
6 activities which the employee cannot currently perform as
7 a result of any impairment or disability due to such
8 injury, and the prognosis for recovery;
9 (xi) complete copies of any reports, records,
10 documents and affidavits in the possession of the
11 employee on which the employee will rely to support his
12 allegations, provided that the employer shall pay the
13 reasonable cost of reproduction thereof;
14 (xii) a list of any reports, records, documents and
15 affidavits which the employee has demanded by subpoena
16 and on which he intends to rely to support his
17 allegations;
18 (xiii) a certification signed by the employee or
19 his representative that the employer has received the
20 petition with the required information 15 days before
21 filing.
22 Fifteen days after receipt by the employer of the
23 petition with the required information the employee may file
24 said petition and required information and shall serve notice
25 of the filing upon the employer. The employer may file a
26 motion addressed to the sufficiency of the petition. If an
27 objection has been filed to the sufficiency of the petition,
28 the arbitrator shall rule on the objection within 2 working
29 days. If such an objection is filed, the time for filing the
30 final decision of the Commission as provided in this
31 paragraph shall be tolled until the arbitrator has determined
32 that the petition is sufficient.
33 The employer shall, within 15 days after receipt of the
34 notice that such petition is filed, file with the Commission
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1 and serve on the employee or his representative a written
2 response to each claim set forth in the petition, including
3 the legal and factual basis for each disputed allegation and
4 the following information: (i) complete copies of any
5 reports, records, documents and affidavits in the possession
6 of the employer on which the employer intends to rely in
7 support of his response, (ii) a list of any reports, records,
8 documents and affidavits which the employer has demanded by
9 subpoena and on which the employer intends to rely in support
10 of his response, (iii) the name and address of each witness
11 on whom the employer will rely to support his response, and
12 (iv) the names and addresses of any medical practitioners
13 selected by the employer pursuant to Section 12 of this Act
14 and the time and place of any examination scheduled to be
15 made pursuant to such Section.
16 Any employer who does not timely file and serve a written
17 response without good cause may not introduce any evidence to
18 dispute any claim of the employee but may cross examine the
19 employee or any witness brought by the employee and otherwise
20 be heard.
21 No document or other evidence not previously identified
22 by either party with the petition or written response, or by
23 any other means before the hearing, may be introduced into
24 evidence without good cause. If, at the hearing, material
25 information is discovered which was not previously disclosed,
26 the Arbitrator may extend the time for closing proof on the
27 motion of a party for a reasonable period of time which may
28 be more than 30 days. No evidence may be introduced pursuant
29 to this paragraph as to permanent disability. No award may
30 be entered for permanent disability pursuant to this
31 paragraph. Either party may introduce into evidence the
32 testimony taken by deposition of any medical practitioner.
33 The Commission shall adopt rules, regulations and
34 procedures whereby the final decision of the Commission is
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1 filed not later than 90 days from the date the petition for
2 review is filed but in no event later than 180 days from the
3 date the petition for an emergency hearing is filed with the
4 Industrial Commission.
5 All service required pursuant to this paragraph (b-1)
6 must be by personal service or by certified mail and with
7 evidence of receipt. In addition for the purposes of this
8 paragraph, all service on the employer must be at the
9 premises where the accident occurred if the premises are
10 owned or operated by the employer. Otherwise service must be
11 at the employee's principal place of employment by the
12 employer. If service on the employer is not possible at
13 either of the above, then service shall be at the employer's
14 principal place of business. After initial service in each
15 case, service shall be made on the employer's attorney or
16 designated representative.
17 (c) (1) At a reasonable time in advance of and in
18 connection with the hearing under Section 19(e) or 19(h), the
19 Commission may on its own motion order an impartial physical
20 or mental examination of a petitioner whose mental or
21 physical condition is in issue, when in the Commission's
22 discretion it appears that such an examination will
23 materially aid in the just determination of the case. The
24 examination shall be made by a member or members of a panel
25 of physicians chosen for their special qualifications by the
26 Illinois State Medical Society. The Commission shall
27 establish procedures by which a physician shall be selected
28 from such list.
29 (2) Should the Commission at any time during the hearing
30 find that compelling considerations make it advisable to have
31 an examination and report at that time, the commission may in
32 its discretion so order.
33 (3) A copy of the report of examination shall be given
34 to the Commission and to the attorneys for the parties.
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1 (4) Either party or the Commission may call the
2 examining physician or physicians to testify. Any physician
3 so called shall be subject to cross-examination.
4 (5) The examination shall be made, and the physician or
5 physicians, if called, shall testify, without cost to the
6 parties. The Commission shall determine the compensation and
7 the pay of the physician or physicians. The compensation for
8 this service shall not exceed the usual and customary amount
9 for such service.
10 (6) The fees and payment thereof of all attorneys and
11 physicians for services authorized by the Commission under
12 this Act shall, upon request of either the employer or the
13 employee or the beneficiary affected, be subject to the
14 review and decision of the Commission.
15 (d) If any employee shall persist in insanitary or
16 injurious practices which tend to either imperil or retard
17 his recovery or shall refuse to submit to such medical,
18 surgical, or hospital treatment as is reasonably essential to
19 promote his recovery, the Commission may, in its discretion,
20 reduce or suspend the compensation of any such injured
21 employee. However, when an employer and employee so agree in
22 writing, the foregoing provision shall not be construed to
23 authorize the reduction or suspension of compensation of an
24 employee who is relying in good faith, on treatment by prayer
25 or spiritual means alone, in accordance with the tenets and
26 practice of a recognized church or religious denomination, by
27 a duly accredited practitioner thereof.
28 (e) This paragraph shall apply to all hearings before
29 the Commission. Such hearings may be held in its office or
30 elsewhere as the Commission may deem advisable. The taking
31 of testimony on such hearings may be had before any member of
32 the Commission. If a petition for review and agreed statement
33 of facts or transcript of evidence is filed, as provided
34 herein, the Commission shall promptly review the decision of
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1 the Arbitrator and all questions of law or fact which appear
2 from the statement of facts or transcript of evidence.
3 In all cases in which the hearing before the arbitrator
4 is held after December 18, 1989, no additional evidence shall
5 be introduced by the parties before the Commission on review
6 of the decision of the Arbitrator. In reviewing decisions of
7 an arbitrator the Commission shall award such temporary
8 compensation, permanent compensation and other payments as
9 are due under this Act. The Commission shall file in its
10 office its decision thereon, and shall immediately send to
11 each party or his attorney a copy of such decision and a
12 notification of the time when it was filed. Decisions shall
13 be filed within 60 days after the Statement of Exceptions and
14 Supporting Brief and Response thereto are required to be
15 filed or oral argument whichever is later.
16 In the event either party requests oral argument, such
17 argument shall be had before a panel of 3 members of the
18 Commission (or before all available members pursuant to the
19 determination of 5 members of the Commission that such
20 argument be held before all available members of the
21 Commission) pursuant to the rules and regulations of the
22 Commission. A panel of 3 members, which shall be comprised
23 of not more than one representative citizen of the employing
24 class and not more than one representative citizen of the
25 employee class, shall hear the argument; provided that if all
26 the issues in dispute are solely the nature and extent of the
27 permanent partial disability, if any, a majority of the panel
28 may deny the request for such argument and such argument
29 shall not be held; and provided further that 5 members of the
30 Commission may determine that the argument be held before all
31 available members of the Commission. A decision of the
32 Commission shall be approved by a majority of Commissioners
33 present at such hearing if any; provided, if no such hearing
34 is held, a decision of the Commission shall be approved by a
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1 majority of a panel of 3 members of the Commission as
2 described in this Section. The Commission shall give 10
3 days' notice to the parties or their attorneys of the time
4 and place of such taking of testimony and of such argument.
5 In any case the Commission in its decision may find
6 specially upon any question or questions of law or fact which
7 shall be submitted in writing by either party whether
8 ultimate or otherwise; provided that on issues other than
9 nature and extent of the disability, if any, the Commission
10 in its decision shall find specially upon any question or
11 questions of law or fact, whether ultimate or otherwise,
12 which are submitted in writing by either party; provided
13 further that not more than 5 such questions may be submitted
14 by either party. Any party may, within 20 days after receipt
15 of notice of the Commission's decision, or within such
16 further time, not exceeding 30 days, as the Commission may
17 grant, file with the Commission either an agreed statement of
18 the facts appearing upon the hearing, or, if such party shall
19 so elect, a correct transcript of evidence of the additional
20 proceedings presented before the Commission, in which report
21 the party may embody a correct statement of such other
22 proceedings in the case as such party may desire to have
23 reviewed, such statement of facts or transcript of evidence
24 to be authenticated by the signature of the parties or their
25 attorneys, and in the event that they do not agree, then the
26 authentication of such transcript of evidence shall be by the
27 signature of any member of the Commission.
28 If a reporter does not for any reason furnish a
29 transcript of the proceedings before the Arbitrator in any
30 case for use on a hearing for review before the Commission,
31 within the limitations of time as fixed in this Section, the
32 Commission may, in its discretion, order a trial de novo
33 before the Commission in such case upon application of either
34 party. The applications for adjustment of claim and other
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1 documents in the nature of pleadings filed by either party,
2 together with the decisions of the Arbitrator and of the
3 Commission and the statement of facts or transcript of
4 evidence hereinbefore provided for in paragraphs (b) and (c)
5 shall be the record of the proceedings of the Commission, and
6 shall be subject to review as hereinafter provided.
7 At the request of either party or on its own motion, the
8 Commission shall set forth in writing the reasons for the
9 decision, including findings of fact and conclusions of law
10 separately stated. The Commission shall by rule adopt a
11 format for written decisions for the Commission and
12 arbitrators. The written decisions shall be concise and shall
13 succinctly state the facts and reasons for the decision. The
14 Commission may adopt in whole or in part, the decision of the
15 arbitrator as the decision of the Commission. When the
16 Commission does so adopt the decision of the arbitrator, it
17 shall do so by order. Whenever the Commission adopts part of
18 the arbitrator's decision, but not all, it shall include in
19 the order the reasons for not adopting all of the
20 arbitrator's decision. When a majority of a panel, after
21 deliberation, has arrived at its decision, the decision shall
22 be filed as provided in this Section without unnecessary
23 delay, and without regard to the fact that a member of the
24 panel has expressed an intention to dissent. Any member of
25 the panel may file a dissent. Any dissent shall be filed no
26 later than 10 days after the decision of the majority has
27 been filed.
28 Decisions rendered by the Commission and dissents, if
29 any, shall be published together by the Commission. The
30 conclusions of law set out in such decisions shall be
31 regarded as precedents by arbitrators for the purpose of
32 achieving a more uniform administration of this Act.
33 (f) The decision of the Commission acting within its
34 powers, according to the provisions of paragraph (e) of this
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1 Section shall, in the absence of fraud, be conclusive unless
2 reviewed as in this paragraph hereinafter provided. However,
3 the Arbitrator or the Commission may on his or its own
4 motion, or on the motion of either party, correct any
5 clerical error or errors in computation within 15 days after
6 the date of receipt of any award by such Arbitrator or any
7 decision on review of the Commission and shall have the power
8 to recall the original award on arbitration or decision on
9 review, and issue in lieu thereof such corrected award or
10 decision. Where such correction is made the time for review
11 herein specified shall begin to run from the date of the
12 receipt of the corrected award or decision.
13 (1) Except in cases of claims against the State of
14 Illinois, in which case the decision of the Commission
15 shall not be subject to judicial review, the Circuit
16 Court of the county where any of the parties defendant
17 may be found, or if none of the parties defendant can be
18 found in this State then the Circuit Court of the county
19 where the accident occurred, shall by summons to the
20 Commission have power to review all questions of law and
21 fact presented by such record.
22 A proceeding for review shall be commenced within 20
23 days of the receipt of notice of the decision of the
24 Commission. The summons shall be issued by the clerk of
25 such court upon written request returnable on a
26 designated return day, not less than 10 or more than 60
27 days from the date of issuance thereof, and the written
28 request shall contain the last known address of other
29 parties in interest and their attorneys of record who are
30 to be served by summons. Service upon any member of the
31 Commission or the Secretary or the Assistant Secretary
32 thereof shall be service upon the Commission, and service
33 upon other parties in interest and their attorneys of
34 record shall be by summons, and such service shall be
-95- LRB9002213DJcd
1 made upon the Commission and other parties in interest by
2 mailing notices of the commencement of the proceedings
3 and the return day of the summons to the office of the
4 Commission and to the last known place of residence of
5 other parties in interest or their attorney or attorneys
6 of record. The clerk of the court issuing the summons
7 shall on the day of issue mail notice of the commencement
8 of the proceedings which shall be done by mailing a copy
9 of the summons to the office of the Commission, and a
10 copy of the summons to the other parties in interest or
11 their attorney or attorneys of record and the clerk of
12 the court shall make certificate that he has so sent said
13 notices in pursuance of this Section, which shall be
14 evidence of service on the Commission and other parties
15 in interest.
16 The Commission shall not be required to certify the
17 record of their proceedings to the Circuit Court, unless
18 the party commencing the proceedings for review in the
19 Circuit Court as above provided, shall pay to the
20 Commission the sum of 80¢ per page of testimony taken
21 before the Commission, and 35¢ per page of all other
22 matters contained in such record, except as otherwise
23 provided by Section 20 of this Act. Payment for
24 photostatic copies of exhibit shall be extra. It shall
25 be the duty of the Commission upon such payment, or
26 failure to pay as permitted under Section 20 of this Act,
27 to prepare a true and correct typewritten copy of such
28 testimony and a true and correct copy of all other
29 matters contained in such record and certified to by the
30 Secretary or Assistant Secretary thereof.
31 In its decision on review the Commission shall
32 determine in each particular case the amount of the
33 probable cost of the record to be filed as a part of the
34 summons in that case and no request for a summons may be
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1 filed and no summons shall issue unless the party seeking
2 to review the decision of the Commission shall exhibit to
3 the clerk of the Circuit Court proof of payment by filing
4 a receipt showing payment or an affidavit of the attorney
5 setting forth that payment has been made of the sums so
6 determined to the Secretary or Assistant Secretary of the
7 Commission, except as otherwise provided by Section 20 of
8 this Act.
9 (2) No such summons shall issue unless the one
10 against whom the Commission shall have rendered an award
11 for the payment of money shall upon the filing of his
12 written request for such summons file with the clerk of
13 the court a bond conditioned that if he shall not
14 successfully prosecute the review, he will pay the award
15 and the costs of the proceedings in the courts. The
16 amount of the bond shall be fixed by any member of the
17 Commission and the surety or sureties of the bond shall
18 be approved by the clerk of the court. The acceptance of
19 the bond by the clerk of the court shall constitute
20 evidence of his approval of the bond.
21 Every county, city, town, township, incorporated
22 village, school district, body politic or municipal
23 corporation against whom the Commission shall have
24 rendered an award for the payment of money shall not be
25 required to file a bond to secure the payment of the
26 award and the costs of the proceedings in the court to
27 authorize the court to issue such summons.
28 The court may confirm or set aside the decision of
29 the Commission. If the decision is set aside and the
30 facts found in the proceedings before the Commission are
31 sufficient, the court may enter such decision as is
32 justified by law, or may remand the cause to the
33 Commission for further proceedings and may state the
34 questions requiring further hearing, and give such other
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1 instructions as may be proper. Appeals shall be taken to
2 the Industrial Commission Division of the Appellate Court
3 in accordance with Supreme Court Rules 22(g) and 303.
4 Appeals shall be taken from the Industrial Commission
5 Division of the Appellate Court to the Supreme Court in
6 accordance with Supreme Court Rule 315.
7 It shall be the duty of the clerk of any court
8 rendering a decision affecting or affirming an award of
9 the Commission to promptly furnish the Commission with a
10 copy of such decision, without charge.
11 The decision of a majority of the members of the
12 panel of the Commission, shall be considered the decision
13 of the Commission.
14 (g) Except in the case of a claim against the State of
15 Illinois, either party may present a certified copy of the
16 award of the Arbitrator, or a certified copy of the decision
17 of the Commission when the same has become final, when no
18 proceedings for review are pending, providing for the payment
19 of compensation according to this Act, to the Circuit Court
20 of the county in which such accident occurred or either of
21 the parties are residents, whereupon the court shall enter a
22 judgment in accordance therewith. In a case where the
23 employer refuses to pay compensation according to such final
24 award or such final decision upon which such judgment is
25 entered the court shall in entering judgment thereon, tax as
26 costs against him the reasonable costs and attorney fees in
27 the arbitration proceedings and in the court entering the
28 judgment for the person in whose favor the judgment is
29 entered, which judgment and costs taxed as therein provided
30 shall, until and unless set aside, have the same effect as
31 though duly entered in an action duly tried and determined by
32 the court, and shall with like effect, be entered and
33 docketed. The Circuit Court shall have power at any time
34 upon application to make any such judgment conform to any
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1 modification required by any subsequent decision of the
2 Supreme Court upon appeal, or as the result of any subsequent
3 proceedings for review, as provided in this Act.
4 Judgment shall not be entered until 15 days' notice of
5 the time and place of the application for the entry of
6 judgment shall be served upon the employer by filing such
7 notice with the Commission, which Commission shall, in case
8 it has on file the address of the employer or the name and
9 address of its agent upon whom notices may be served,
10 immediately send a copy of the notice to the employer or such
11 designated agent.
12 (h) An agreement or award under this Act providing for
13 compensation in installments, may at any time within 18
14 months after such agreement or award be reviewed by the
15 Commission at the request of either the employer or the
16 employee, on the ground that the disability of the employee
17 has subsequently recurred, increased, diminished or ended.
18 However, as to accidents occurring subsequent to July 1,
19 1955, which are covered by any agreement or award under this
20 Act providing for compensation in installments made as a
21 result of such accident, such agreement or award may at any
22 time within 30 months after such agreement or award be
23 reviewed by the Commission at the request of either the
24 employer or the employee on the ground that the disability of
25 the employee has subsequently recurred, increased, diminished
26 or ended.
27 Compensation for the purposes of this subsection shall
28 include temporary total disability benefits payable under
29 subsection (b) of Section 8. An employee whose disability
30 recurs, increases, or is re-established after the issuance of
31 an award or decision of an Arbitrator or the Commission for
32 permanent disability benefits under Section 8 of this Act
33 shall not under any circumstances be barred from receiving
34 temporary, total disability compensation benefits for any
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1 periods of temporary total incapacity for work under
2 subsection (b) of Section 8 even if those periods occur after
3 the award or decision and even if the recurrence of the
4 disability does not increase the permanent disability already
5 awarded.
6 On such review, compensation payments may be
7 re-established, increased, diminished or ended. The
8 Commission shall give 15 days' notice to the parties of the
9 hearing for review. Any employee, upon any petition for such
10 review being filed by the employer, shall be entitled to one
11 day's notice for each 100 miles necessary to be traveled by
12 him in attending the hearing of the Commission upon the
13 petition, and 3 days in addition thereto. Such employee
14 shall, at the discretion of the Commission, also be entitled
15 to 5 cents per mile necessarily traveled by him within the
16 State of Illinois in attending such hearing, not to exceed a
17 distance of 300 miles, to be taxed by the Commission as costs
18 and deposited with the petition of the employer.
19 When compensation which is payable in accordance with an
20 award or settlement contract approved by the Commission, is
21 ordered paid in a lump sum by the Commission, no review shall
22 be had as in this paragraph mentioned.
23 (i) Each party, upon taking any proceedings or steps
24 whatsoever before any Arbitrator, Commission or court, shall
25 file with the Commission his address, or the name and address
26 of any agent upon whom all notices to be given to such party
27 shall be served, either personally or by registered mail,
28 addressed to such party or agent at the last address so filed
29 with the Commission. In the event such party has not filed
30 his address, or the name and address of an agent as above
31 provided, service of any notice may be had by filing such
32 notice with the Commission.
33 (j) Whenever in any proceeding testimony has been taken
34 or a final decision has been rendered and after the taking of
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1 such testimony or after such decision has become final, the
2 injured employee dies, then in any subsequent proceedings
3 brought by the personal representative or beneficiaries of
4 the deceased employee, such testimony in the former
5 proceeding may be introduced with the same force and effect
6 as though the witness having so testified were present in
7 person in such subsequent proceedings and such final
8 decision, if any, shall be taken as final adjudication of any
9 of the issues which are the same in both proceedings.
10 (j-5) When an employer begins payment of temporary total
11 compensation and later terminates or suspends further payment
12 before an employee in fact has returned to work, the employer
13 shall provide the employee with a written explanation of the
14 basis for the termination or suspension of further payment no
15 later than the date of the last payment of temporary total
16 compensation. Failure to comply with the provisions of this
17 subsection (j-5) without good and just cause shall be
18 considered by the Commission or an Arbitrator when
19 adjudicating a petition for additional compensation pursuant
20 to subsection (k) or (l) of this Section, or a petition for
21 assessment of attorneys' fees and costs pursuant to Section
22 16 of this Act.
23 (k) In case where there has been any unreasonable or
24 vexatious delay of payment or intentional underpayment of
25 compensation, or proceedings have been instituted or carried
26 on by the one liable to pay the compensation, which do not
27 present a real controversy, but are merely frivolous or for
28 delay, then the Commission may award compensation additional
29 to that otherwise payable under this Act equal to 50% of the
30 amount payable at the time of such award. Failure to pay
31 compensation in accordance with the provisions of Section 8,
32 paragraph (b) of this Act, shall be considered unreasonable
33 delay.
34 (l) In any case where the employer or his insurance
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1 carrier shall without good and just cause fail, neglect,
2 refuse or unreasonably delay the payment of any benefits due
3 under Section 8 of this Act weekly compensation benefits due
4 to an injured employee, during the period of temporary total
5 disability the arbitrator or the Commission shall allow to
6 the employee additional benefits compensation in the sum of
7 $100 $10 per day for each day that the benefits were a weekly
8 compensation payment has been so withheld or refused,
9 provided that such additional compensation shall not exceed
10 the sum of $25,000 or 50% of the benefits, whichever is
11 greater. In addition, the arbitrator or Commission shall
12 assess attorney's fees and costs against the employer and his
13 insurance carrier $2,500. A delay in payment of 14 days or
14 more shall create a rebuttable presumption of unreasonable
15 delay.
16 (m) If the arbitrator or the commission finds that an
17 accidental injury was directly and proximately caused by the
18 employer's wilful violation of a health and safety standard
19 under either the Health and Safety Act or the federal
20 Occupational Safety and Health Act of 1970 in force at the
21 time of the accident, the arbitrator or the Commission shall
22 allow to the injured employee or his dependents, as the case
23 may be, additional compensation equal to 25% of the amount
24 which otherwise would be payable under the provisions of this
25 Act exclusive of this paragraph. The additional compensation
26 herein provided shall be allowed by an appropriate increase
27 in the applicable weekly compensation rate.
28 (n) After June 30, 1984, decisions of the Industrial
29 Commission reviewing an award of an arbitrator of the
30 Commission shall draw interest at a rate equal to the yield
31 on indebtedness issued by the United States Government with a
32 26-week maturity next previously auctioned on the day on
33 which the decision is filed. Said rate of interest shall be
34 set forth in the Arbitrator's Decision. Interest shall be
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1 drawn from the date awarded payments are due the employee
2 through the day of payment on all amounts not timely paid.
3 Interest shall be drawn from the date of the arbitrator's
4 award on all accrued compensation due the employee through
5 the day prior to the date of payments. However, when an
6 employee appeals an award of an Arbitrator or the Commission,
7 and the appeal results in no change or a decrease in the
8 award, interest shall not further accrue from the date of
9 such appeal.
10 The employer or his insurance carrier may tender the
11 payments due under the award to stop the further accrual of
12 interest on such award notwithstanding the prosecution by
13 either party of review, certiorari, appeal to the Supreme
14 Court or other steps to reverse, vacate or modify the award.
15 (o) By the 15th day of each month each insurer providing
16 coverage for losses under this Act shall notify each insured
17 employer of any compensable claim incurred during the
18 preceding month and the amounts paid or reserved on the claim
19 including a summary of the claim and a brief statement of the
20 reasons for compensability. A cumulative report of all
21 claims incurred during a calendar year or continued from the
22 previous year shall be furnished to the insured employer by
23 the insurer within 30 days after the end of that calendar
24 year.
25 The insured employer may challenge, in proceeding before
26 the Commission, payments made by the insurer without
27 arbitration and payments made after a case is determined to
28 be noncompensable. If the Commission finds that the case was
29 not compensable, the insurer shall purge its records as to
30 that employer of any loss or expense associated with the
31 claim, reimburse the employer for attorneys' fees arising
32 from the challenge and for any payment required of the
33 employer to the Rate Adjustment Fund or the Second Injury
34 Fund, and may not reflect the loss or expense for rate making
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1 purposes. The employee shall not be required to refund the
2 challenged payment. The decision of the Commission may be
3 reviewed in the same manner as in arbitrated cases. No
4 challenge may be initiated under this paragraph more than 3
5 years after the payment is made. An employer may waive the
6 right of challenge under this paragraph on a case by case
7 basis.
8 (p) After filing an application for adjustment of claim
9 but prior to the hearing on arbitration the parties may
10 voluntarily agree to submit such application for adjustment
11 of claim for decision by an arbitrator under this subsection
12 (p) where such application for adjustment of claim raises
13 only a dispute over temporary total disability, permanent
14 partial disability or medical expenses. Such agreement shall
15 be in writing in such form as provided by the Commission.
16 Applications for adjustment of claim submitted for decision
17 by an arbitrator under this subsection (p) shall proceed
18 according to rule as established by the Commission. The
19 Commission shall promulgate rules including, but not limited
20 to, rules to ensure that the parties are adequately informed
21 of their rights under this subsection (p) and of the
22 voluntary nature of proceedings under this subsection (p).
23 The findings of fact made by an arbitrator acting within his
24 or her powers under this subsection (p) in the absence of
25 fraud shall be conclusive. However, the arbitrator may on
26 his own motion, or the motion of either party, correct any
27 clerical errors or errors in computation within 15 days after
28 the date of receipt of such award of the arbitrator and shall
29 have the power to recall the original award on arbitration,
30 and issue in lieu thereof such corrected award. The decision
31 of the arbitrator under this subsection (p) shall be
32 considered the decision of the Commission and proceedings for
33 review of questions of law arising from the decision may be
34 commenced by either party pursuant to subsection (f) of
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1 Section 19. The Advisory Board established under Section
2 13.1 shall compile a list of certified Commission
3 arbitrators, each of whom shall be approved by at least 7
4 members of the Advisory Board. The chairman shall select 5
5 persons from such list to serve as arbitrators under this
6 subsection (p). By agreement, the parties shall select one
7 arbitrator from among the 5 persons selected by the chairman
8 except that if the parties do not agree on an arbitrator from
9 among the 5 persons, the parties may, by agreement, select an
10 arbitrator of the American Arbitration Association, whose fee
11 shall be paid by the State in accordance with rules
12 promulgated by the Commission. Arbitration under this
13 subsection (p) shall be voluntary.
14 (Source: P.A. 86-998; 87-435; 87-799.)
15 Section 15. The Workers' Occupational Diseases Act is
16 amended by changing Sections 1, 4, 6, 7, 8, and 19 and by
17 adding Sections 4c, 16b, 16c, 16d, 16e, and 16f as follows:
18 (820 ILCS 310/1) (from Ch. 48, par. 172.36)
19 Sec. 1. This Act shall be known and may be cited as the
20 "Workers' Occupational Diseases Act".
21 (a) The term "employer" as used in this Act shall be
22 construed to be:
23 1. The State and each county, city, town, township,
24 incorporated village, school district, body politic, or
25 municipal corporation therein.
26 2. Every person, firm, public or private corporation,
27 including hospitals, public service, eleemosynary, religious
28 or charitable corporations or associations, who has any
29 person in service or under any contract for hire, express or
30 implied, oral or written.
31 3. Where an employer operating under and subject to the
32 provisions of this Act loans an employee to another such
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1 employer and such loaned employee sustains a compensable
2 occupational disease in the employment of such borrowing
3 employer and where such borrowing employer does not provide
4 or pay the benefits or payments due such employee, such
5 loaning employer shall be liable to provide or pay all
6 benefits or payments due such employee under this Act and as
7 to such employee the liability of such loaning and borrowing
8 employers shall be joint and several, provided that such
9 loaning employer shall in the absence of agreement to the
10 contrary be entitled to receive from such borrowing employer
11 full reimbursement for all sums paid or incurred pursuant to
12 this paragraph together with reasonable attorneys' fees and
13 expenses in any hearings before the Industrial Commission or
14 in any action to secure such reimbursement. Where any
15 benefit is provided or paid by such loaning employer, the
16 employee shall have the duty of rendering reasonable
17 co-operation in any hearings, trials or proceedings in the
18 case, including such proceedings for reimbursement.
19 Where an employee files an Application for Adjustment of
20 Claim with the Industrial Commission alleging that his or her
21 claim is covered by the provisions of the preceding
22 paragraph, and joining both the alleged loaning and borrowing
23 employers, they and each of them, upon written demand by the
24 employee and within 7 days after receipt of such demand,
25 shall have the duty of filing with the Industrial Commission
26 a written admission or denial of the allegation that the
27 claim is covered by the provisions of the preceding paragraph
28 and in default of such filing or if any such denial be
29 ultimately determined not to have been bona fide then the
30 provisions of Paragraph K of Section 19 of this Act shall
31 apply.
32 An employer whose business or enterprise or a substantial
33 part thereof consists of hiring, procuring or furnishing
34 employees to or for other employers operating under and
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1 subject to the provisions of this Act for the performance of
2 the work of such other employers and who pays such employees
3 their salary or wage notwithstanding that they are doing the
4 work of such other employers shall be deemed a loaning
5 employer within the meaning and provisions of this Section.
6 (b) The term "employee" as used in this Act, shall be
7 construed to mean:
8 1. Every person in the service of the State, county,
9 city, town, township, incorporated village or school
10 district, body politic or municipal corporation therein,
11 whether by election, appointment or contract of hire, express
12 or implied, oral or written, including any official of the
13 State, or of any county, city, town, township, incorporated
14 village, school district, body politic or municipal
15 corporation therein and except any duly appointed member of
16 the fire department in any city whose population exceeds
17 500,000 according to the last Federal or State census, and
18 except any member of a fire insurance patrol maintained by a
19 board of underwriters in this State. One employed by a
20 contractor who has contracted with the State, or a county,
21 city, town, township, incorporated village, school district,
22 body politic or municipal corporation therein, through its
23 representatives, shall not be considered as an employee of
24 the State, county, city, town, township, incorporated
25 village, school district, body politic or municipal
26 corporation which made the contract.
27 2. Every person in the service of another under any
28 contract of hire, express or implied, oral or written, who
29 contracts an occupational disease while working in the State
30 of Illinois, or who contracts an occupational disease while
31 working outside of the State of Illinois but where the
32 contract of hire is made within the State of Illinois, and
33 any person whose employment is principally localized within
34 the State of Illinois, regardless of the place where the
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1 disease was contracted or place where the contract of hire
2 was made, including aliens, and minors who, for the purpose
3 of this Act, except Section 3 hereof, shall be considered the
4 same and have the same power to contract, receive payments
5 and give quittances therefor, as adult employees. An employee
6 or his or her dependents under this Act who shall have a
7 cause of action by reason of an occupational disease,
8 disablement or death arising out of and in the course of his
9 or her employment may elect or pursue his or her remedy in
10 the State where the disease was contracted, or in the State
11 where the contract of hire is made, or in the State where the
12 employment is principally localized.
13 (c) "Commission" means the Industrial Commission created
14 by the Workers' Compensation Act, approved July 9, 1951, as
15 amended.
16 (d) In this Act the term "Occupational Disease" means a
17 disease arising out of and in the course of the employment or
18 which has become aggravated and rendered disabling as a
19 result of the exposure of the employment. Such aggravation
20 shall arise out of a risk peculiar to or increased by the
21 employment and not common to the general public.
22 A disease shall be deemed to arise out of the employment
23 if there is apparent to the rational mind, upon consideration
24 of all the circumstances, a causal connection between the
25 conditions under which the work is performed and the
26 occupational disease. The disease need not to have been
27 foreseen or expected but after its contraction it must appear
28 to have had its origin or aggravation in a risk connected
29 with the employment and to have flowed from that source as a
30 rational consequence.
31 An employee shall be conclusively deemed to have been
32 exposed to the hazards of an occupational disease when, for
33 any length of time however short, he or she is employed in an
34 occupation or process in which the hazard of the disease
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1 exists; provided however, that in a claim of exposure to
2 atomic radiation, the fact of such exposure must be verified
3 by the records of the central registry of radiation exposure
4 maintained by the Department of Public Health or by some
5 other recognized governmental agency maintaining records of
6 such exposures whenever and to the extent that the records
7 are on file with the Department of Public Health or the
8 agency.
9 The employer liable for the compensation in this Act
10 provided shall be the employer in whose employment the
11 employee was last exposed to the hazard of the occupational
12 disease claimed upon regardless of the length of time of such
13 last exposure, except, in cases of silicosis or asbestosis,
14 the only employer liable shall be the last employer in whose
15 employment the employee was last exposed during a period of
16 60 days or more after the effective date of this Act, to the
17 hazard of such occupational disease, and, in such cases, an
18 exposure during a period of less than 60 days, after the
19 effective date of this Act, shall not be deemed a last
20 exposure. If a miner who is suffering or suffered from
21 pneumoconiosis was employed for 10 years or more in one or
22 more coal mines there shall, effective July 1, 1973 be a
23 rebuttable presumption that his or her pneumoconiosis arose
24 out of such employment.
25 If a deceased miner was employed for 10 years or more in
26 one or more coal mines and died from a respirable disease
27 there shall, effective July 1, 1973, be a rebuttable
28 presumption that his or her death was due to pneumoconiosis.
29 Any condition or impairment of health of an employee
30 employed as a firefighter, emergency medical technician (EMT)
31 or paramedic which results directly or indirectly from any
32 lung or respiratory disease or condition, heart or vascular
33 disease or condition, hypertension, tuberculosis or cancer
34 resulting in any disability (temporary, permanent, total or
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1 partial) to the employee shall be conclusively presumed to
2 arise out of and in the course of the employee's
3 firefighting, EMT or paramedic employment and, further, shall
4 be conclusively presumed to be causally connected to the
5 hazards or exposures of such employment. This presumption
6 shall also apply to any hernia or hearing loss suffered by an
7 employee employed as a firefighter, EMT or paramedic.
8 However, this presumption shall not apply to any employee who
9 has been employed as a firefighter, EMT or paramedic for less
10 than 5 years at the time the condition or impairment is
11 discovered.
12 The insurance carrier liable shall be the carrier whose
13 policy was in effect covering the employer liable on the last
14 day of the exposure rendering such employer liable in
15 accordance with the provisions of this Act.
16 (e) "Disablement" means an impairment or partial
17 impairment, temporary or permanent, in the function of the
18 body or any of the members of the body, or the event of
19 becoming disabled from earning full wages at the work in
20 which the employee was engaged when last exposed to the
21 hazards of the occupational disease by the employer from whom
22 he or she claims compensation, or equal wages in other
23 suitable employment; and "disability" means the state of
24 being so incapacitated.
25 (f) No compensation shall be payable for or on account
26 of any occupational disease unless disablement, as herein
27 defined, occurs within two years after the last day of the
28 last exposure to the hazards of the disease, except in cases
29 of occupational disease caused by berylliosis or by the
30 inhalation of silica dust or asbestos dust and, in such
31 cases, within 3 years after the last day of the last exposure
32 to the hazards of such disease and except in the case of
33 occupational disease caused by exposure to radiological
34 materials or equipment, and in such case, within 25 years
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1 after the last day of last exposure to the hazards of such
2 disease.
3 (Source: P.A. 81-992.)
4 (820 ILCS 310/4) (from Ch. 48, par. 172.39)
5 Sec. 4. (a) Any employer required by the terms of this
6 Act or by election to pay the compensation provided for in
7 this Act shall:
8 (1) File with the Commission an application for
9 approval as a self-insurer which shall include a current
10 financial statement. The application and financial
11 statement shall be signed and sworn to by the president
12 or vice-president and secretary or assistant secretary of
13 the employer if it be a corporation, or by all of the
14 partners if it be a copartnership, or by the owner if it
15 be neither a copartnership nor a corporation.
16 If the sworn application and financial statement of
17 any such employer does not satisfy the Commission of the
18 financial ability of the employer who has filed it, the
19 Commission shall require such employer to:
20 (2) Furnish security, indemnity or a bond
21 guaranteeing the payment by the employer of the
22 compensation provided for in this Act, provided that any
23 such employer who shall have secured his or her liability
24 in part by excess liability coverage shall be required to
25 furnish to the Commission security, indemnity or bond
26 guaranteeing his or her payment up to the amount of the
27 effective limits of the excess coverage in accordance
28 with the provisions of this paragraph, or
29 (3) Insure his or her entire liability to pay such
30 compensation in some insurance carrier authorized,
31 licensed or permitted to do such insurance business in
32 this State. All policies of such insurance carriers
33 insuring the payment of compensation under this Act shall
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1 cover all the employees and all such employer's
2 compensation liability in all cases in which the last day
3 of the last exposure to the occupational disease involved
4 is within the effective period of the policy, anything to
5 the contrary in the policy notwithstanding. Provided,
6 however, that any employer may insure his or her
7 compensation liability under this Act with 2 or more
8 insurance carriers or may insure a part and qualify under
9 Subsection 1, 2, or 4 for the remainder of his liability
10 to pay such compensation, subject to the following two
11 provisions:
12 Firstly, the entire liability of the employer
13 to employees working at or from one location shall
14 be insured in one such insurance carrier or shall be
15 self-insured.
16 Secondly, the employer shall submit evidence
17 satisfactory to the Commission that his or her
18 entire liability for the compensation provided for
19 in this Act will be secured.
20 Any provision in a policy or in any endorsement
21 attached thereto attempting to limit or modify in any way
22 the liability of the insurance carrier issuing the same,
23 except as otherwise provided herein, shall be wholly
24 void.
25 The insurance or security in force to cover
26 compensation liability under this Act shall be separate
27 and distinct from the insurance or security under the
28 "Workers' Compensation Act" and any insurance contract
29 covering liability under either Act need not cover any
30 liability under the other. Nothing herein contained
31 shall apply to policies of excess liability carriage
32 secured by employers who have been approved by the
33 Commission as self-insurers, or
34 (4) Make some other provision, satisfactory to the
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1 Commission, for the securing of the payment of
2 compensation provided for in this Act, provided, however,
3 that:
4 (A) the State and all departments thereof must
5 insure against their liability to pay that
6 compensation in the State Compensation Insurance
7 Fund; and
8 (B) each county, city, town, township,
9 incorporated village, school district, body politic
10 or municipal corporation must insure against its
11 liability to pay that compensation by either:
12 (i) securing the approval of the
13 Commission to be a self-insurer or a
14 participant in a self-insurance plan; or
15 (ii) insuring its liability to pay that
16 compensation in the State Compensation
17 Insurance Fund; or
18 (iii) insuring its liability to pay that
19 compensation by any other alternative
20 authorized by this Section if the premium which
21 would be required under the alternative is less
22 than can be otherwise provided by the State
23 Compensation Insurance Fund; however, any city,
24 village or incorporated town may by a majority
25 vote of the members of its governing body
26 present and voting remove itself from the
27 requirements of this subdivision (iii) and
28 thereafter such city, village or incorporated
29 town shall not be bound by the provisions of
30 this subdivision (iii) unless its governing
31 body by a majority vote of those present and
32 voting elects to avail itself of the provisions
33 hereof; and
34 (5) Upon becoming subject to this Act and
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1 thereafter as often as the Commission may in writing
2 demand, file with the Commission in form prescribed by it
3 evidence of his or her compliance with the provision of
4 this section.
5 (b) The sworn application and financial statement, or
6 security, indemnity or bond, or amount of insurance, or other
7 provisions, filed, furnished, carried, or made by the
8 employer, as the case may be, shall be subject to the
9 approval of the Commission.
10 Deposits under escrow agreements shall be cash,
11 negotiable United States government bonds or negotiable
12 general obligation bonds of the State of Illinois. Such cash
13 or bonds shall be deposited in escrow with any State or
14 National Bank or Trust Company having trust authority in the
15 State of Illinois.
16 Upon the approval of the sworn application and financial
17 statement, security, indemnity or bond or amount of
18 insurance, filed, furnished, or carried, as the case may be,
19 the Commission shall send to the employer written notice of
20 its approval thereof. Said certificate of compliance by the
21 employer with the provisions of subparagraphs (2) and (3) of
22 paragraph (a) of this section shall be delivered by the
23 insurance carrier to the Industrial Commission within 5 days
24 after the effective date of the policy so certified. The
25 insurance so certified shall cover all compensation liability
26 occurring during the time that the insurance is in effect and
27 no further certificate need be filed in case such insurance
28 is renewed, extended or otherwise continued by such carrier.
29 The insurance so certified shall not be cancelled or in the
30 event that such insurance is not renewed, extended or
31 otherwise continued, such insurance shall not be terminated
32 until at least 10 days after receipt by the Industrial
33 Commission of notice of the cancellation or termination of
34 said insurance; provided, however, that if the employer has
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1 secured insurance from another insurance carrier, or has
2 otherwise secured the payment of compensation in accordance
3 with this Section, and such insurance or other security
4 becomes effective prior to the expiration of said 10 days,
5 cancellation or termination may, at the option of the
6 insurance carrier indicated in such notice, be effective as
7 of the effective date of such other insurance or security.
8 (c) Whenever the Commission shall find that any
9 corporation, company, association, aggregation of
10 individuals, reciprocal or interinsurers exchange, or other
11 insurer effecting workers' occupational disease compensation
12 insurance in this State shall be insolvent, financially
13 unsound, or unable to fully meet all payments and liabilities
14 assumed or to be assumed for compensation insurance in this
15 State, or shall practice a policy of delay or unfairness
16 toward employees in the adjustment, settlement, or payment of
17 benefits due such employees, the Commission may after
18 reasonable notice and hearing order and direct that such
19 corporation, company, association, aggregation of
20 individuals, reciprocal or interinsurers exchange, or
21 insurer, shall from and after a date fixed in such order
22 discontinue the writing of any such workers' occupational
23 disease compensation insurance in this State. It shall
24 thereupon be unlawful for any such corporation, company,
25 association, aggregation of individuals, reciprocal or
26 interinsurers exchange, or insurer to effect any workers'
27 occupational disease compensation insurance in this State. A
28 copy of the order shall be served upon the Director of
29 Insurance by registered mail. Whenever the Commission finds
30 that any service or adjustment company used or employed by a
31 self-insured employer or by an insurance carrier to process,
32 adjust, investigate, compromise or otherwise handle claims
33 under this Act, has practiced or is practicing a policy of
34 delay or unfairness toward employees in the adjustment,
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1 settlement or payment of benefits due such employees, the
2 Commission may after reasonable notice and hearing order and
3 direct that such service or adjustment company shall from and
4 after a date fixed in such order be prohibited from
5 processing, adjusting, investigating, compromising or
6 otherwise handling claims under this Act.
7 Whenever the Commission finds that any self-insured
8 employer has practiced or is practicing delay or unfairness
9 toward employees in the adjustment, settlement or payment of
10 benefits due such employees, the Commission may after
11 reasonable notice and hearing order and direct that after a
12 date fixed in the order such self-insured employer shall be
13 disqualified to operate as a self-insurer and shall be
14 required to insure his entire liability to pay compensation
15 in some insurance carrier authorized, licensed and permitted
16 to do such insurance business in this State as provided in
17 subparagraph (3) of paragraph (a) of this Section.
18 All orders made by the Commission under this Section
19 shall be subject to review by the courts, the review to be
20 taken in the same manner and within the same time as provided
21 by Section 19 of this Act for review of awards and decisions
22 of the Commission, upon the party seeking the review filing
23 with the clerk of the court to which said review is taken a
24 bond in an amount to be fixed and approved by the court to
25 which said review is taken, conditioned upon the payment of
26 all compensation awarded against the person taking the review
27 pending a decision thereof and further conditioned upon such
28 other obligations as the court may impose. Upon the review
29 the Circuit Court shall have power to review all questions of
30 fact as well as of law. The penalty hereinafter provided for
31 in this paragraph shall not attach and shall not begin to run
32 until the final determination of the order of the Commission.
33 (d) Upon a finding by the Commission, after reasonable
34 notice and hearing, of the knowing and wilful failure of an
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1 employer to comply with any of the provisions of paragraph
2 (a) of this Section or the failure or refusal of an employer,
3 service or adjustment company, or insurance carrier to comply
4 with any order of the Industrial Commission pursuant to
5 paragraph (c) of this Section the Commission may assess a
6 civil penalty of up to $500 per day for each day of such
7 failure or refusal after the effective date of this
8 amendatory Act of 1989. Each day of such failure or refusal
9 shall constitute a separate offense.
10 Upon the failure or refusal of any employer, service or
11 adjustment company or insurance carrier to comply with the
12 provisions of this Section and orders of the Commission under
13 this Section, or the order of the court on review after final
14 adjudication, the Commission may bring a civil action to
15 recover the amount of the penalty in Cook County or in
16 Sangamon County in which litigation the Commission shall be
17 represented by the Attorney General. The Commission shall
18 send notice of its finding of non-compliance and assessment
19 of the civil penalty to the Attorney General. It shall be
20 the duty of the Attorney General within 30 days after receipt
21 of the notice, to institute prosecutions and promptly
22 prosecute all reported violations of this Section.
23 (e) This Act shall not affect or disturb the continuance
24 of any existing insurance, mutual aid, benefit, or relief
25 association or department, whether maintained in whole or in
26 part by the employer or whether maintained by the employees,
27 the payment of benefits of such association or department
28 being guaranteed by the employer or by some person, firm or
29 corporation for him or her: Provided, the employer
30 contributes to such association or department an amount not
31 less than the full compensation herein provided, exclusive of
32 the cost of the maintenance of such association or department
33 and without any expense to the employee. This Act shall not
34 prevent the organization and maintaining under the insurance
-117- LRB9002213DJcd
1 laws of this State of any benefit or insurance company for
2 the purpose of insuring against the compensation provided for
3 in this Act, the expense of which is maintained by the
4 employer. This Act shall not prevent the organization or
5 maintaining under the insurance laws of this State of any
6 voluntary mutual aid, benefit or relief association among
7 employees for the payment of additional accident or sick
8 benefits.
9 (f) No existing insurance, mutual aid, benefit or relief
10 association or department shall, by reason of anything herein
11 contained, be authorized to discontinue its operation without
12 first discharging its obligations to any and all persons
13 carrying insurance in the same or entitled to relief or
14 benefits therein.
15 (g) Any contract, oral, written or implied, of
16 employment providing for relief benefit, or insurance or any
17 other device whereby the employee is required to pay any
18 premium or premiums for insurance against the compensation
19 provided for in this Act shall be null and void. Any
20 employer withholding from the wages of any employee any
21 amount for the purpose of paying any such premium shall be
22 guilty of a Class B misdemeanor.
23 In the event the employer does not pay the compensation
24 for which he or she is liable, then an insurance company,
25 association or insurer which may have insured such employer
26 against such liability shall become primarily liable to pay
27 to the employee, his personal representative or beneficiary
28 the compensation required by the provisions of this Act to be
29 paid by such employer. The insurance carrier may be made a
30 party to the proceedings in which the employer is a party and
31 an award may be entered jointly against the employer and the
32 insurance carrier.
33 (h) It shall be unlawful for any employer, insurance
34 company or service or adjustment company to interfere with,
-118- LRB9002213DJcd
1 restrain or coerce an employee in any manner whatsoever in
2 the exercise of the rights or remedies granted to him or her
3 by this Act or to discriminate, attempt to discriminate, or
4 threaten to discriminate against an employee in any way
5 because of his exercise of the rights or remedies granted to
6 him by this Act.
7 It shall be unlawful for any employer, individually or
8 through any insurance company or service or adjustment
9 company, to discharge or to threaten to discharge, or to
10 refuse to rehire or recall to active service in a suitable
11 capacity an employee because of the exercise of his or her
12 rights or remedies granted to him or her by this Act. The
13 arbitrator and Commission shall hear evidence and make
14 written findings on the employee's petition for sanctions
15 based upon the prohibitions of this Section. Where the
16 arbitrator or Commission finds that the employer or its agent
17 has engaged in such proscribed activities, the employee shall
18 be allowed additional compensation in the amount of $5,000.
19 The employee shall retain his or her common law rights
20 against the employer.
21 (i) If an employer elects to obtain a life insurance
22 policy on his employees, he may also elect to apply such
23 benefits in satisfaction of all or a portion of the death
24 benefits payable under this Act, in which case, the
25 employer's premium for coverage for benefits under this Act
26 shall be reduced accordingly.
27 (Source: P.A. 86-998; 86-1405.)
28 (820 ILCS 310/4c new)
29 Sec. 4c. Failure to insure or self-insure. If an
30 employer fails to insure or self-insure as required by this
31 Act, the State Treasurer, as ex-officio custodian of the
32 Second Injury Fund, may be joined with the employer as a
33 party respondent in the application for adjustment of claim.
-119- LRB9002213DJcd
1 Upon a finding by the arbitrator that the employer has failed
2 to insure or self-insure as required by this Act, the State
3 Treasurer, as ex-officio custodian of the Second Injury Fund,
4 shall assume the liability of the employer to pay all
5 benefits as provided by this Act. The State Treasurer shall
6 have the same defenses to such claims as would the insured
7 employer. The office of the Attorney General of the State of
8 Illinois shall bring suit in the circuit court of the county
9 in which the accident occurred against any employer for which
10 payment has been made pursuant to this paragraph. Penalty
11 under this paragraph shall be the amount withdrawn from the
12 Second Injury Fund for the employer's employee or his or her
13 dependents, plus a fine of $500 a day from the date of the
14 injury up to a maximum of $25,000, and any amount so
15 collected shall be paid into the Second Injury Fund.
16 (820 ILCS 310/6) (from Ch. 48, par. 172.41)
17 Sec. 6. (a) Every employer operating under the
18 compensation provisions of this Act, shall post printed
19 notices in their respective places of employment in
20 conspicuous places and in such number and at such places as
21 may be determined by the Commission, containing such
22 information relative to this Act as in the judgment of the
23 Commission may be necessary to aid employees to safeguard
24 their rights under this Act.
25 In addition thereto, the employer shall post in a
26 conspicuous place on the premises of the employment a printed
27 or typewritten notice stating whether he is insured or
28 whether he has qualified and is operating as a self-insured
29 employer. In the event the employer is insured, the notice
30 shall state the name and address of his or her insurance
31 carrier, the number of the insurance policy, its effective
32 date and the date of termination. In the event of the
33 termination of the policy for any reason prior to the
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1 termination date stated, the posted notice shall promptly be
2 corrected accordingly. In the event the employer is
3 operating as a self-insured employer the notice shall state
4 the name and address of the company, if any, servicing the
5 compensation payments of the employer, and the name and
6 address of the person in charge of making compensation
7 payments.
8 (b) Every employer subject to this Act shall maintain
9 accurate records of work-related deaths, injuries and
10 illnesses other than minor injuries requiring only first aid
11 treatment and which do not involve medical treatment, loss of
12 consciousness, restriction of work or motion or transfer to
13 another job and file with the Industrial Commission, in
14 writing, a report of all occupational diseases arising out of
15 and in the course of the employment and resulting in death,
16 or disablement or illness resulting in the loss of more than
17 3 scheduled work days. In the case of death such report
18 shall be made no later than 2 working days following the
19 occupational death. In all other cases such report shall be
20 made between the 15th and 25th of each month unless required
21 to be made sooner by rule of the Industrial Commission. In
22 case the occupational disease results in permanent
23 disability, a further report shall be made as soon as it is
24 determined that such permanent disability has resulted or
25 will result therefrom. All reports shall state the date of
26 the disablement, the nature of the employer's business, the
27 name, address, the age, sex, conjugal condition of the
28 disabled person, the specific occupation of the person, the
29 nature and character of the occupational disease, the length
30 of disability, and, in case of death, the length of
31 disability before death, the wages of the employee, whether
32 compensation has been paid to the employee, or to his legal
33 representative or his heirs or next of kin, the amount of
34 compensation paid, the amount paid for physicians', surgeons'
-121- LRB9002213DJcd
1 and hospital bills, and by whom paid, and the amount paid for
2 funeral or burial expenses, if known. The reports shall be
3 made on forms and in the manner as prescribed by the
4 Industrial Commission and shall contain such further
5 information as the Commission shall deem necessary and
6 require. The making of such reports releases the employer
7 from making such reports to any other officer of the State
8 and shall satisfy the reporting provisions as contained in
9 the "Health And Safety Act" and "An Act in relation to safety
10 inspections and education in industrial and commercial
11 establishments and to repeal an Act therein named", approved
12 July 18, 1955, as amended. The report filed with the
13 Industrial Commission pursuant to the provisions of this
14 Section shall be made available by the Industrial Commission
15 to the Director of Labor or his representatives, to the
16 Department of Public Health pursuant to the Illinois Health
17 and Hazardous Substances Registry Act, and to all other
18 departments of the State of Illinois which shall require such
19 information for the proper discharge of their official
20 duties. Failure to file with the Commission any of the
21 reports required in this Section is a petty offense.
22 Except as provided in this paragraph, all reports filed
23 hereunder shall be confidential and any person having access
24 to such records filed with the Industrial Commission as
25 herein required, who shall release the names or otherwise
26 identify any persons sustaining injuries or disabilities, or
27 gives access to such information to any unauthorized person,
28 shall be subject to discipline or discharge, and in addition
29 shall be guilty of a Class B misdemeanor. The Commission
30 shall compile and distribute to interested persons aggregate
31 statistics, taken from the reports filed hereunder. The
32 aggregate statistics shall not give the names or otherwise
33 identify persons sustaining injuries or disabilities or the
34 employer of any injured or disabled person.
-122- LRB9002213DJcd
1 (c) There shall be given notice to the employer of
2 disablement arising from an occupational disease as soon as
3 practicable after the date it becomes reasonably discoverable
4 and apparent that a compensable and disabling occupational
5 disease has been sustained of the disablement. If the
6 Commission shall find that the failure to give such notice
7 substantially prejudices the rights of the employer the
8 Commission in its discretion may order that the right of the
9 employee to proceed under this Act shall be barred.
10 In case of legal disability of the employee or any
11 dependent of a deceased employee who may be entitled to
12 compensation, under the provisions of this Act, the
13 limitations of time in this Section of this Act provided
14 shall not begin to run against such person who is under legal
15 disability until a conservator or guardian has been
16 appointed. No defect or inaccuracy of such notice shall be a
17 bar to the maintenance of proceedings on arbitration or
18 otherwise by the employee unless the employer proves that he
19 or she is unduly prejudiced in such proceedings by such
20 defect or inaccuracy. Notice of the disabling compensable
21 disease may be given orally or in writing. In any case, other
22 than injury or death caused by exposure to radiological
23 materials or equipment or asbestos, unless application for
24 compensation is filed with the Commission within 3 years
25 after the date it becomes reasonably discoverable and
26 apparent that a compensable and disabling occupational
27 disease has been sustained, of the disablement, where no
28 compensation has been paid, or within 2 years after the date
29 of the last payment of compensation, where any has been paid,
30 whichever shall be later, the right to file such application
31 shall be barred. If the occupational disease results in
32 death, application for compensation for death may be filed
33 with the Commission within 3 years after the date of death
34 where no compensation has been paid, or within 3 years after
-123- LRB9002213DJcd
1 the last payment of compensation, where any has been paid,
2 whichever is later, but not thereafter.
3 Effective July 1, 1973 in cases of disability caused by
4 coal miners pneumoconiosis unless application for
5 compensation is filed with the Commission within 5 years
6 after it becomes reasonably discoverable and apparent that a
7 compensable and disabling occupational disease has been
8 sustained the employee was last exposed where no compensation
9 has been paid, or within 5 years after the last payment of
10 compensation where any has been paid, the right to file such
11 application shall be barred.
12 In cases of disability caused by exposure to radiological
13 materials or equipment or asbestos, unless application for
14 compensation is filed with the Commission within 25 years
15 after the employee was so exposed or within 5 years after it
16 becomes reasonably discoverable and apparent that a
17 compensable and disabling occupational disease has been
18 sustained, whichever occurs later, the right to file such
19 application shall be barred.
20 In cases of death from occurring within 25 years from the
21 last exposure to radiological material or equipment or
22 asbestos, application for compensation must be filed within 3
23 years of death where no compensation has been paid, or within
24 3 years, after the date of the last payment where any has
25 been paid, but not thereafter.
26 (d) Any contract or agreement made by any employer or
27 his agent or attorney with any employee or any other
28 beneficiary of any claim under the provisions of this Act
29 within 7 days after the disablement shall be presumed to be
30 fraudulent.
31 (Source: P.A. 84-981.)
32 (820 ILCS 310/7) (from Ch. 48, par. 172.42)
33 Sec. 7. If any employee sustains any disablement,
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1 impairment, or disfigurement, or dies and his or her
2 disability, impairment, disfigurement or death is caused by a
3 disease aggravated by an exposure of the employment or by an
4 occupational disease arising out of and in the course of his
5 or her employment, such employee or such employee's
6 dependents, as the case may be, shall be entitled to
7 compensation, medical, surgical, hospital and rehabilitation
8 care, prosthesis, burial costs, and all other benefits,
9 rights and remedies, in the same manner, to the same extent
10 and subject to the same terms, conditions and limitations,
11 except as herein otherwise provided, as are now or may
12 hereafter be provided by the "Workers' Compensation Act" for
13 accidental injuries sustained by employees arising out of and
14 in the course of their employment (except that the amount of
15 compensation which shall be paid for loss of hearing of one
16 ear is 100 weeks) and for this purpose the disablement,
17 disfigurement or death of an employee by reason of an
18 occupational disease, arising out of and in the course of his
19 or her employment, shall be treated as the happening of an
20 accidental injury. If the employee has sustained an
21 accidental injury and as a result becomes temporarily and
22 totally disabled from pursuing his or her usual and customary
23 line of work, the employer shall maintain such medical
24 insurance as the employee enjoyed when previously working for
25 the employer.
26 (a) Loss of hearing for compensation purposes shall be
27 confined to the frequencies of 1,000, 2,000 and 3,000 cycles
28 per second. Loss of hearing ability for frequency tones above
29 3,000 cycles per second are not to be considered as
30 constituting disability for hearing.
31 (b) The percent of hearing loss, for purposes of the
32 determination of compensation claims for occupational
33 deafness, shall be calculated as the average in decibels for
34 the thresholds of hearing for the frequencies of 1,000, 2,000
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1 and 3,000 cycles per second. Pure tone air conduction
2 audiometric instruments, approved by nationally recognized
3 authorities in this field, shall be used for measuring
4 hearing loss. If the losses of hearing average 30 decibels or
5 less in the 3 frequencies, such losses of hearing shall not
6 then constitute any compensable hearing disability. If the
7 losses of hearing average 85 decibels or more in the 3
8 frequencies, then the same shall constitute and be total or
9 100 percent compensable hearing loss.
10 (c) In measuring hearing impairment, the lowest measured
11 losses in each of the 3 frequencies shall be added together
12 and divided by 3 to determine the average decibel loss. For
13 every decibel of loss exceeding 30 decibels an allowance of
14 1.82% shall be made up to the maximum of 100 percent which is
15 reached at 85 decibels.
16 (d) If a hearing loss is established to have existed on
17 July 1, 1975, by audiometric testing the employer shall not
18 be liable for the previous loss so established nor shall he
19 be liable for any loss for which compensation has been paid
20 or awarded.
21 (e) No consideration shall be given to the question of
22 whether or not the ability of an employee to understand
23 speech is improved by the use of a hearing aid.
24 (f) No claim for loss of hearing due to industrial noise
25 shall be brought against an employer or allowed unless the
26 employee has been exposed for a period of time sufficient to
27 cause permanent impairment to noise levels in excess of the
28 following:
29 Sound Level DBA
30 Slow Response Hours Per Day
31 90 8
32 92 6
33 95 4
34 97 3
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1 100 2
2 102 1-1/2
3 105 1
4 110 1/2
5 115 1/4
6 This subparagraph (f) shall not be applied in cases of
7 hearing loss resulting from trauma or explosion.
8 Notwithstanding this subsection (f), the Industrial
9 Commission or arbitrator may award disability for hearing
10 loss when an employee is exposed to noise levels which the
11 Commission or arbitrator deems are sufficient to cause
12 permanent impairment.
13 In addition to discharging the foregoing obligations, the
14 employer shall pay into the Special Fund created under
15 paragraph (f) of Section 7 of the "Workers' Compensation
16 Act", the same amounts and in the same manner as is provided
17 in the same Act in cases of accidental injuries arising out
18 of and in the course of the employment.
19 (Source: P.A. 81-1482.)
20 (820 ILCS 310/8) (from Ch. 48, par. 172.43)
21 Sec. 8. Whenever by virtue of the provisions of Section
22 7 of this Act an employee seeks to exercise any right or
23 remedy provided in the Workers' Compensation Act, the period
24 of limitation, except as in this Act otherwise provided,
25 shall be the same as under the Workers' Compensation Act, and
26 where applicable shall begin to run from the date it becomes
27 reasonably discoverable and apparent that a compensable and
28 disabling occupational disease has been sustained of
29 disablement instead of the date of accident.
30 (Source: P.A. 81-992.)
31 (820 ILCS 310/16b new)
32 Sec. 16b. Fees of health care providers. A health care
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1 provider shall not charge a fee for treatment and care which
2 is governed by the provisions of this Act that is greater
3 than the usual and customary fee the provider receives for
4 the same treatment or service when the payor for the
5 treatment or service is a health maintenance organization, a
6 preferred provider organization, or a private health
7 insurance carrier. The charge shall be the lesser of the
8 amounts charged to either the health maintenance
9 organization, the preferred provider organization, or the
10 private health insurance carrier. At the request of either
11 the employee, employer, or insurer, the health care provider
12 shall provide an affidavit of his or her customary and usual
13 charges billed to health maintenance organizations, preferred
14 provider organizations, and private health insurance
15 carriers.
16 (820 ILCS 310/16c new)
17 Sec. 16c. Resolution of disputes by Commission. The
18 Commission shall, no later than 180 days following the
19 effective date of this amendatory Act of 1995, by rule,
20 establish methods to resolve disputes between employers and
21 health care providers concerning the reasonableness of
22 medical charges (regardless of whether a fee has been paid)
23 or services. The employee shall not be a party to a dispute
24 over medical charges, nor shall the employee's recovery in
25 any way be jeopardized because of a dispute. However,
26 nothing in this Section shall be construed to limit an
27 employee's right to seek reimbursement, payment, or approval
28 of a medical provider's bill, at arbitration or before the
29 Industrial Commission, pursuant to subsection (a) of Section
30 8 of the Workers' Compensation Act.
31 (820 ILCS 310/16d new)
32 Sec. 16d. Disclosure of financial interest. Any
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1 physician or other health care provider who orders, directs
2 or renders treatment, testing, therapy or rehabilitation to a
3 patient at any institution or facility shall, at or prior to
4 the time of the referral, disclose in writing if such health
5 care provider, or any of his partners or his employer has a
6 financial interest in the institution or facility to which
7 the patient is being referred. This disclosure shall be made
8 to the patient, the patient's employer, the workers'
9 compensation insurer of such employer, and the workers'
10 compensation adjusting company for the insurer or
11 self-insured employer. Violation of this Section is a Class
12 A misdemeanor.
13 (820 ILCS 310/16e new)
14 Sec. 16e. Prohibited practices. No hospital, physician
15 or other health care provider shall bill or attempt to
16 collect from the employee, or his or her assignees, any fee
17 for services rendered to an employee due to an alleged work
18 related injury or report to any credit reporting agency any
19 failure of the employee to make any such payment, if the
20 hospital, physician or health care provider has received a
21 notice stating that the injury to the employee was a work
22 related injury covered under this Act. The notice shall be
23 actual notice given by the employee, the employer or the
24 employer's insurer to the hospital, physician or health care
25 provider verbally or in writing signed by the employee, the
26 employer, or the employer's insurer. The notice shall be
27 deemed received by the hospital, physician or health care
28 provider 5 days after mailing by certified mail by the
29 employee, employer, or insurer to the hospital, physician, or
30 health care provider. If a hospital, physician, or health
31 care provider or debt collector on behalf of a hospital,
32 physician, or health care provider pursues any action to
33 collect from an employee after such notice is properly given,
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1 the employee shall have a cause of action against the
2 hospital, physician, or health care provider for actual
3 damages sustained plus $1,000 in additional damages, and
4 costs and reasonable attorney fees.
5 (820 ILCS 310/16f new)
6 Sec. 16f. Medical records; testimony. Any physician,
7 surgeon, hospital, or other health care provider who performs
8 any services in connection with this Act shall provide the
9 patient, his employer, and the insurer with copies of medical
10 records and reports at a reasonable fee. The fee for medical
11 records shall not exceed a cost of $5 per request for
12 administrative cost and 10 cents per copy for the cost of
13 duplication. The fees charged for medical reports and
14 testimony shall not exceed the usual and customary amount for
15 such service. Upon request of the employer, the employee, or
16 the beneficiary affected, the arbitrator or the Commission
17 shall determine the fee to be authorized.
18 Any physician, surgeon, hospital employee, or any other
19 health care provider who is required to testify at the
20 request of the patient, his or her employer, or the insurer
21 shall charge a reasonable fee for the time required to
22 testify. The charge may not exceed $200 per hour. Amounts
23 over the first hour shall be billed in 10 minute increments
24 not to exceed $34.
25 (820 ILCS 310/19) (from Ch. 48, par. 172.54)
26 Sec. 19. Any disputed questions of law or fact shall be
27 determined as herein provided.
28 (a) It shall be the duty of the Commission upon
29 notification that the parties have failed to reach an
30 agreement to designate an Arbitrator.
31 (1) The application for adjustment of claim filed
32 with the Commission shall state:
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1 A. The approximate date of the last day of the
2 last exposure and the approximate date of the
3 disablement.
4 B. The general nature and character of the
5 illness or disease claimed.
6 C. The name and address of the employer by
7 whom employed on the last day of the last exposure
8 and if employed by any other employer after such
9 last exposure and before disablement the name and
10 address of such other employer or employers.
11 D. In case of death, the date and place of
12 death.
13 (2) Amendments to applications for adjustment of
14 claim which relate to the same disablement or disablement
15 resulting in death originally claimed upon may be allowed
16 by the Commissioner or an Arbitrator thereof, in their
17 discretion, and in the exercise of such discretion, they
18 may in proper cases order a trial de novo; such amendment
19 shall relate back to the date of the filing of the
20 original application so amended.
21 (3) Whenever any claimant misconceives his remedy
22 and files an application for adjustment of claim under
23 this Act and it is subsequently discovered, at any time
24 before final disposition of such cause, that the claim
25 for disability or death which was the basis for such
26 application should properly have been made under the
27 Workers' Compensation Act, then the provisions of Section
28 19 paragraph (a-1) of the Workers' Compensation Act
29 having reference to such application shall apply.
30 Whenever any claimant misconceives his remedy and
31 files an application for adjustment of claim under the
32 Workers' Compensation Act and it is subsequently
33 discovered, at any time before final disposition of such
34 cause that the claim for injury or death which was the
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1 basis for such application should properly have been made
2 under this Act, then the application so filed under the
3 Workers' Compensation Act may be amended in form,
4 substance or both to assert claim for such disability or
5 death under this Act and it shall be deemed to have been
6 so filed as amended on the date of the original filing
7 thereof, and such compensation may be awarded as is
8 warranted by the whole evidence pursuant to the
9 provisions of this Act. When such amendment is submitted,
10 further or additional evidence may be heard by the
11 Arbitrator or Commission when deemed necessary; provided,
12 that nothing in this Section contained shall be construed
13 to be or permit a waiver of any provisions of this Act
14 with reference to notice, but notice if given shall be
15 deemed to be a notice under the provisions of this Act if
16 given within the time required herein.
17 (b) The Arbitrator shall make such inquiries and
18 investigations as he shall deem necessary and may examine and
19 inspect all books, papers, records, places, or premises
20 relating to the questions in dispute and hear such proper
21 evidence as the parties may submit.
22 The hearings before the Arbitrator shall be held in the
23 vicinity where the last exposure occurred, after 10 days'
24 notice of the time and place of such hearing shall have been
25 given to each of the parties or their attorneys of record.
26 The Arbitrator may find that the disabling condition is
27 temporary and has not yet reached a permanent condition and
28 may order the payment of compensation up to the date of the
29 hearing, which award shall be reviewable and enforceable in
30 the same manner as other awards, and in no instance be a bar
31 to a further hearing and determination of a further amount of
32 temporary total compensation or of compensation for permanent
33 disability, but shall be conclusive as to all other questions
34 except the nature and extent of such disability.
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1 The decision of the Arbitrator shall be filed with the
2 Commission which Commission shall immediately send to each
3 party or his attorney a copy of such decision, together with
4 a notification of the time when it was filed. Beginning
5 January 1, 1981, all decisions of the Arbitrator shall set
6 forth in writing findings of fact and conclusions of law,
7 separately stated. Unless a petition for review is filed by
8 either party within 30 days after the receipt by such party
9 of the copy of the decision and notification of time when
10 filed, and unless such party petitioning for a review shall
11 within 35 days after the receipt by him of the copy of the
12 decision, file with the Commission either an agreed statement
13 of the facts appearing upon the hearing before the
14 Arbitrator, or if such party shall so elect a correct
15 transcript of evidence of the proceedings at such hearings,
16 then the decision shall become the decision of the Commission
17 and in the absence of fraud shall be conclusive. The Petition
18 for Review shall contain a statement of the petitioning
19 party's specific exceptions to the decision of the
20 arbitrator. The jurisdiction of the Commission to review the
21 decision of the arbitrator shall not be limited to the
22 exceptions stated in the Petition for Review. The Commission,
23 or any member thereof, may grant further time not exceeding
24 30 days, in which to file such agreed statement or transcript
25 of evidence. Such agreed statement of facts or correct
26 transcript of evidence, as the case may be, shall be
27 authenticated by the signatures of the parties or their
28 attorneys, or the official court reporter, and in the event
29 they do not agree as to the correctness of the transcript of
30 evidence it shall be authenticated by the signature of the
31 Arbitrator designated by the Commission.
32 (b-1) If the employee is not receiving, pursuant to
33 Section 7, medical, surgical or hospital services of the type
34 provided for in paragraph (a) of Section 8 of the Workers'
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1 Compensation Act or compensation of the type provided for in
2 paragraph (b) of Section 8 of the Workers' Compensation Act,
3 the employee, in accordance with Commission Rules, may file a
4 petition for an emergency hearing by an Arbitrator on the
5 issue of whether or not he is entitled to receive payment of
6 such compensation or services as provided therein. Such
7 petition shall have priority over all other petitions and
8 shall be heard by the Arbitrator and Commission with all
9 convenient speed.
10 Such petition shall contain the following information and
11 shall be served on the employer at least 15 days before it is
12 filed:
13 (i) the date and approximate time of the last
14 exposure;
15 (ii) the approximate location of the last exposure;
16 (iii) a description of the last exposure;
17 (iv) the nature of the disability incurred by the
18 employee;
19 (v) the identity of the person, if known, to whom
20 the disability was reported and the date on which it was
21 reported;
22 (vi) the name and title of the person, if known,
23 representing the employer with whom the employee
24 conferred in any effort to obtain pursuant to Section 7
25 compensation of the type provided for in paragraph (b) of
26 Section 8 of the Workers' Compensation Act or medical,
27 surgical or hospital services of the type provided for in
28 paragraph (a) of Section 8 of the Workers' Compensation
29 Act and the date of such conference;
30 (vii) a statement that the employer has refused to
31 pay compensation pursuant to Section 7 of the type
32 provided for in paragraph (b) of Section 8 of the
33 Workers' Compensation Act or for medical, surgical or
34 hospital services pursuant to Section 7 of the type
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1 provided for in paragraph (a) of Section 8 of the
2 Workers' Compensation Act;
3 (viii) the name and address, if known, of each
4 witness to the last exposure and of each other person
5 upon whom the employee will rely to support his
6 allegations;
7 (ix) the dates of treatment related to the
8 disability by medical practitioners, and the names and
9 addresses of such practitioners, including the dates of
10 treatment related to the disability at any hospitals and
11 the names and addresses of such hospitals, and a signed
12 authorization permitting the employer to examine all
13 medical records of all practitioners and hospitals named
14 pursuant to this paragraph;
15 (x) a copy of a signed report by a medical
16 practitioner, relating to the employee's current
17 inability to return to work because of the disability
18 incurred as a result of the exposure or such other
19 documents or affidavits which show that the employee is
20 entitled to receive pursuant to Section 7 compensation of
21 the type provided for in paragraph (b) of Section 8 of
22 the Workers' Compensation Act or medical, surgical or
23 hospital services of the type provided for in paragraph
24 (a) of Section 8 of the Workers' Compensation Act. Such
25 reports, documents or affidavits shall state, if
26 possible, the history of the exposure given by the
27 employee, and describe the disability and medical
28 diagnosis, the medical services for such disability which
29 the employee has received and is receiving, the physical
30 activities which the employee cannot currently perform as
31 a result of such disability, and the prognosis for
32 recovery;
33 (xi) complete copies of any reports, records,
34 documents and affidavits in the possession of the
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1 employee on which the employee will rely to support his
2 allegations, provided that the employer shall pay the
3 reasonable cost of reproduction thereof;
4 (xii) a list of any reports, records, documents and
5 affidavits which the employee has demanded by subpoena
6 and on which he intends to rely to support his
7 allegations;
8 (xiii) a certification signed by the employee or
9 his representative that the employer has received the
10 petition with the required information 15 days before
11 filing.
12 Fifteen days after receipt by the employer of the
13 petition with the required information the employee may file
14 said petition and required information and shall serve notice
15 of the filing upon the employer. The employer may file a
16 motion addressed to the sufficiency of the petition. If an
17 objection has been filed to the sufficiency of the petition,
18 the arbitrator shall rule on the objection within 2 working
19 days. If such an objection is filed, the time for filing the
20 final decision of the Commission as provided in this
21 paragraph shall be tolled until the arbitrator has determined
22 that the petition is sufficient.
23 The employer shall, within 15 days after receipt of the
24 notice that such petition is filed, file with the Commission
25 and serve on the employee or his representative a written
26 response to each claim set forth in the petition, including
27 the legal and factual basis for each disputed allegation and
28 the following information: (i) complete copies of any
29 reports, records, documents and affidavits in the possession
30 of the employer on which the employer intends to rely in
31 support of his response, (ii) a list of any reports, records,
32 documents and affidavits which the employer has demanded by
33 subpoena and on which the employer intends to rely in support
34 of his response, (iii) the name and address of each witness
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1 on whom the employer will rely to support his response, and
2 (iv) the names and addresses of any medical practitioners
3 selected by the employer pursuant to Section 12 of this Act
4 and the time and place of any examination scheduled to be
5 made pursuant to such Section.
6 Any employer who does not timely file and serve a written
7 response without good cause may not introduce any evidence to
8 dispute any claim of the employee but may cross examine the
9 employee or any witness brought by the employee and otherwise
10 be heard.
11 No document or other evidence not previously identified
12 by either party with the petition or written response, or by
13 any other means before the hearing, may be introduced into
14 evidence without good cause. If, at the hearing, material
15 information is discovered which was not previously disclosed,
16 the Arbitrator may extend the time for closing proof on the
17 motion of a party for a reasonable period of time which may
18 be more than 30 days. No evidence may be introduced pursuant
19 to this paragraph as to permanent disability. No award may
20 be entered for permanent disability pursuant to this
21 paragraph. Either party may introduce into evidence the
22 testimony taken by deposition of any medical practitioner.
23 The Commission shall adopt rules, regulations and
24 procedures whereby the final decision of the Commission is
25 filed not later than 90 days from the date the petition for
26 review is filed but in no event later than 180 days from the
27 date the petition for an emergency hearing is filed with the
28 Industrial Commission.
29 All service required pursuant to this paragraph (b-1)
30 must be by personal service or by certified mail and with
31 evidence of receipt. In addition, for the purposes of this
32 paragraph, all service on the employer must be at the
33 premises where the accident occurred if the premises are
34 owned or operated by the employer. Otherwise service must be
-137- LRB9002213DJcd
1 at the employee's principal place of employment by the
2 employer. If service on the employer is not possible at
3 either of the above, then service shall be at the employer's
4 principal place of business. After initial service in each
5 case, service shall be made on the employer's attorney or
6 designated representative.
7 (c) (1) At a reasonable time in advance of and in
8 connection with the hearing under Section 19(e) or 19(h), the
9 Commission may on its own motion order an impartial physical
10 or mental examination of a petitioner whose mental or
11 physical condition is in issue, when in the Commission's
12 discretion it appears that such an examination will
13 materially aid in the just determination of the case. The
14 examination shall be made by a member or members of a panel
15 of physicians chosen for their special qualifications by the
16 Illinois State Medical Society. The Commission shall
17 establish procedures by which a physician shall be selected
18 from such list.
19 (2) Should the Commission at any time during the hearing
20 find that compelling considerations make it advisable to have
21 an examination and report at that time, the Commission may in
22 its discretion so order.
23 (3) A copy of the report of examination shall be given
24 to the Commission and to the attorneys for the parties.
25 (4) Either party or the Commission may call the
26 examining physician or physicians to testify. Any physician
27 so called shall be subject to cross-examination.
28 (5) The examination shall be made, and the physician or
29 physicians, if called, shall testify, without cost to the
30 parties. The Commission shall determine the compensation and
31 the pay of the physician or physicians. The compensation for
32 this service shall not exceed the usual and customary amount
33 for such service.
34 The fees and payment thereof of all attorneys and
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1 physicians for services authorized by the Commission under
2 this Act shall, upon request of either the employer or the
3 employee or the beneficiary affected, be subject to the
4 review and decision of the Commission.
5 (d) If any employee shall persist in insanitary or
6 injurious practices which tend to either imperil or retard
7 his recovery or shall refuse to submit to such medical,
8 surgical, or hospital treatment as is reasonably essential to
9 promote his recovery, the Commission may, in its discretion,
10 reduce or suspend the compensation of any such employee;
11 provided, that when an employer and employee so agree in
12 writing, the foregoing provision shall not be construed to
13 authorize the reduction or suspension of compensation of an
14 employee who is relying in good faith, on treatment by prayer
15 or spiritual means alone, in accordance with the tenets and
16 practice of a recognized church or religious denomination, by
17 a duly accredited practitioner thereof.
18 (e) This paragraph shall apply to all hearings before
19 the Commission. Such hearings may be held in its office or
20 elsewhere as the Commission may deem advisable. The taking
21 of testimony on such hearings may be had before any member of
22 the Commission. If a petition for review and agreed statement
23 of facts or transcript of evidence is filed, as provided
24 herein, the Commission shall promptly review the decision of
25 the Arbitrator and all questions of law or fact which appear
26 from the statement of facts or transcripts of evidence. In
27 all cases in which the hearing before the arbitrator is held
28 after the effective date of this amendatory Act of 1989, no
29 additional evidence shall be introduced by the parties before
30 the Commission on review of the decision of the Arbitrator.
31 The Commission shall file in its office its decision thereon,
32 and shall immediately send to each party or his attorney a
33 copy of such decision and a notification of the time when it
34 was filed. Decisions shall be filed within 60 days after the
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1 Statement of Exceptions and Supporting Brief and Response
2 thereto are required to be filed or oral argument whichever
3 is later.
4 In the event either party requests oral argument, such
5 argument shall be had before a panel of 3 members of the
6 Commission (or before all available members pursuant to the
7 determination of 5 members of the Commission that such
8 argument be held before all available members of the
9 Commission) pursuant to the rules and regulations of the
10 Commission. A panel of 3 members, which shall be comprised
11 of not more than one representative citizen of the employing
12 class and not more than one representative citizen of the
13 employee class, shall hear the argument; provided that if all
14 the issues in dispute are solely the nature and extent of the
15 permanent partial disability, if any, a majority of the panel
16 may deny the request for such argument and such argument
17 shall not be held; and provided further that 5 members of the
18 Commission may determine that the argument be held before all
19 available members of the Commission. A decision of the
20 Commission shall be approved by a majority of Commissioners
21 present at such hearing if any; provided, if no such hearing
22 is held, a decision of the Commission shall be approved by a
23 majority of a panel of 3 members of the Commission as
24 described in this Section. The Commission shall give 10 days'
25 notice to the parties or their attorneys of the time and
26 place of such taking of testimony and of such argument.
27 In any case the Commission in its decision may in its
28 discretion find specially upon any question or questions of
29 law or facts which shall be submitted in writing by either
30 party whether ultimate or otherwise; provided that on issues
31 other than nature and extent of the disablement, if any, the
32 Commission in its decision shall find specially upon any
33 question or questions of law or fact, whether ultimate or
34 otherwise, which are submitted in writing by either party;
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1 provided further that not more than 5 such questions may be
2 submitted by either party. Any party may, within 20 days
3 after receipt of notice of the Commission's decision, or
4 within such further time, not exceeding 30 days, as the
5 Commission may grant, file with the Commission either an
6 agreed statement of the facts appearing upon the hearing, or,
7 if such party shall so elect, a correct transcript of
8 evidence of the additional proceedings presented before the
9 Commission in which report the party may embody a correct
10 statement of such other proceedings in the case as such party
11 may desire to have reviewed, such statement of facts or
12 transcript of evidence to be authenticated by the signature
13 of the parties or their attorneys, and in the event that they
14 do not agree, then the authentication of such transcript of
15 evidence shall be by the signature of any member of the
16 Commission.
17 If a reporter does not for any reason furnish a
18 transcript of the proceedings before the Arbitrator in any
19 case for use on a hearing for review before the Commission,
20 within the limitations of time as fixed in this Section, the
21 Commission may, in its discretion, order a trial de novo
22 before the Commission in such case upon application of either
23 party. The applications for adjustment of claim and other
24 documents in the nature of pleadings filed by either party,
25 together with the decisions of the Arbitrator and of the
26 Commission and the statement of facts or transcript of
27 evidence hereinbefore provided for in paragraphs (b) and (c)
28 shall be the record of the proceedings of the Commission, and
29 shall be subject to review as hereinafter provided.
30 At the request of either party or on its own motion, the
31 Commission shall set forth in writing the reasons for the
32 decision, including findings of fact and conclusions of law,
33 separately stated. The Commission shall by rule adopt a
34 format for written decisions for the Commission and
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1 arbitrators. The written decisions shall be concise and shall
2 succinctly state the facts and reasons for the decision. The
3 Commission may adopt in whole or in part, the decision of the
4 arbitrator as the decision of the Commission. When the
5 Commission does so adopt the decision of the arbitrator, it
6 shall do so by order. Whenever the Commission adopts part of
7 the arbitrator's decision, but not all, it shall include in
8 the order the reasons for not adopting all of the
9 arbitrator's decision. When a majority of a panel, after
10 deliberation, has arrived at its decision, the decision shall
11 be filed as provided in this Section without unnecessary
12 delay, and without regard to the fact that a member of the
13 panel has expressed an intention to dissent. Any member of
14 the panel may file a dissent. Any dissent shall be filed no
15 later than 10 days after the decision of the majority has
16 been filed.
17 Decisions rendered by the Commission after the effective
18 date of this amendatory Act of 1980 and dissents, if any,
19 shall be published together by the Commission. The
20 conclusions of law set out in such decisions shall be
21 regarded as precedents by arbitrators, for the purpose of
22 achieving a more uniform administration of this Act.
23 (f) The decision of the Commission acting within its
24 powers, according to the provisions of paragraph (e) of this
25 Section shall, in the absence of fraud, be conclusive unless
26 reviewed as in this paragraph hereinafter provided. However,
27 the Arbitrator or the Commission may on his or its own
28 motion, or on the motion of either party, correct any
29 clerical error or errors in computation within 15 days after
30 the date of receipt of any award by such Arbitrator or any
31 decision on review of the Commission, and shall have the
32 power to recall the original award on arbitration or decision
33 on review, and issue in lieu thereof such corrected award or
34 decision. Where such correction is made the time for review
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1 herein specified shall begin to run from the date of the
2 receipt of the corrected award or decision.
3 (1) Except in cases of claims against the State of
4 Illinois, in which case the decision of the Commission
5 shall not be subject to judicial review, the Circuit
6 Court of the county where any of the parties defendant
7 may be found, or if none of the parties defendant be
8 found in this State then the Circuit Court of the county
9 where any of the exposure occurred, shall by summons to
10 the Commission have power to review all questions of law
11 and fact presented by such record.
12 A proceeding for review shall be commenced within 20
13 days of the receipt of notice of the decision of the
14 Commission. The summons shall be issued by the clerk of
15 such court upon written request returnable on a
16 designated return day, not less than 10 or more than 60
17 days from the date of issuance thereof, and the written
18 request shall contain the last known address of other
19 parties in interest and their attorneys of record who are
20 to be served by summons. Service upon any member of the
21 Commission or the Secretary or the Assistant Secretary
22 thereof shall be service upon the Commission, and service
23 upon other parties in interest and their attorneys of
24 record shall be by summons, and such service shall be
25 made upon the Commission and other parties in interest by
26 mailing notices of the commencement of the proceedings
27 and the return day of the summons to the office of the
28 Commission and to the last known place of residence of
29 other parties in interest or their attorney or attorneys
30 of record. The clerk of the court issuing the summons
31 shall on the day of issue mail notice of the commencement
32 of the proceedings which shall be done by mailing a copy
33 of the summons to the office of the Commission, and a
34 copy of the summons to the other parties in interest or
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1 their attorney or attorneys of record and the clerk of
2 the court shall make certificate that he has so sent such
3 notices in pursuance of this Section, which shall be
4 evidence of service on the Commission and other parties
5 in interest.
6 The Commission shall not be required to certify the
7 record of their proceedings in the Circuit Court unless
8 the party commencing the proceedings for review in the
9 Circuit Court as above provided, shall pay to the
10 Commission the sum of 80 cents per page of testimony
11 taken before the Commission, and 35 cents per page of all
12 other matters contained in such record, except as
13 otherwise provided by Section 20 of this Act. Payment for
14 photostatic copies of exhibit shall be extra. It shall be
15 the duty of the Commission upon such payment, or failure
16 to pay as permitted under Section 20 of this Act, to
17 prepare a true and correct typewritten copy of such
18 testimony and a true and correct copy of all other
19 matters contained in such record and certified to by the
20 Secretary or Assistant Secretary thereof.
21 In its decision on review the Commission shall
22 determine in each particular case the amount of the
23 probable cost of the record to be filed as a return to
24 the summons in that case and no request for a summons may
25 be filed and no summons shall issue unless the party
26 seeking to review the decision of the Commission shall
27 exhibit to the clerk of the Circuit Court proof of
28 payment by filing a receipt showing payment or an
29 affidavit of the attorney setting forth that payment has
30 been made of the sums so determined to the Secretary or
31 Assistant Secretary of the Commission.
32 (2) No such summons shall issue unless the one
33 against whom the Commission shall have rendered an award
34 for the payment of money shall upon the filing of his
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1 written request for such summons file with the clerk of
2 the court a bond conditioned that if he shall not
3 successfully prosecute the review, he will pay the award
4 and the costs of the proceedings in the court. The amount
5 of the bond shall be fixed by any member of the
6 Commission and the surety or sureties of the bond shall
7 be approved by the clerk of the court. The acceptance of
8 the bond by the clerk of the court shall constitute
9 evidence of his approval of the bond.
10 Every county, city, town, township, incorporated
11 village, school district, body politic or municipal
12 corporation having a population of 500,000 or more
13 against whom the Commission shall have rendered an award
14 for the payment of money shall not be required to file a
15 bond to secure the payment of the award and the costs of
16 the proceedings in the court to authorize the court to
17 issue such summons.
18 The court may confirm or set aside the decision of
19 the Commission. If the decision is set aside and the
20 facts found in the proceedings before the Commission are
21 sufficient, the court may enter such decision as is
22 justified by law, or may remand the cause to the
23 Commission for further proceedings and may state the
24 questions requiring further hearing, and give such other
25 instructions as may be proper. Appeals shall be taken to
26 the Industrial Commission Division of the Appellate Court
27 in accordance with Supreme Court Rules 22(g) and 303.
28 Appeals shall be taken from the Industrial Commission
29 Division of the Appellate Court to the Supreme Court in
30 accordance with Supreme Court Rule 315.
31 It shall be the duty of the clerk of any court
32 rendering a decision affecting or affirming an award of
33 the Commission to promptly furnish the Commission with a
34 copy of such decision, without charge.
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1 The decision of a majority of the members of the
2 panel of the Commission, shall be considered the decision
3 of the Commission.
4 (g) Except in the case of a claim against the State of
5 Illinois, either party may present a certified copy of the
6 award of the Arbitrator, or a certified copy of the decision
7 of the Commission when the same has become final, when no
8 proceedings for review are pending, providing for the payment
9 of compensation according to this Act, to the Circuit Court
10 of the county in which such exposure occurred or either of
11 the parties are residents, whereupon the court shall enter a
12 judgment in accordance therewith. In case where the employer
13 refuses to pay compensation according to such final award or
14 such final decision upon which such judgment is entered, the
15 court shall in entering judgment thereon, tax as costs
16 against him the reasonable costs and attorney fees in the
17 arbitration proceedings and in the court entering the
18 judgment for the person in whose favor the judgment is
19 entered, which judgment and costs taxed as herein provided
20 shall, until and unless set aside, have the same effect as
21 though duly entered in an action duly tried and determined by
22 the court, and shall with like effect, be entered and
23 docketed. The Circuit Court shall have power at any time upon
24 application to make any such judgment conform to any
25 modification required by any subsequent decision of the
26 Supreme Court upon appeal, or as the result of any subsequent
27 proceedings for review, as provided in this Act.
28 Judgment shall not be entered until 15 days' notice of
29 the time and place of the application for the entry of
30 judgment shall be served upon the employer by filing such
31 notice with the Commission, which Commission shall, in case
32 it has on file the address of the employer or the name and
33 address of its agent upon whom notices may be served,
34 immediately send a copy of the notice to the employer or such
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1 designated agent.
2 (h) An agreement or award under this Act providing for
3 compensation in installments, may at any time within 18
4 months after such agreement or award be reviewed by the
5 Commission at the request of either the employer or the
6 employee on the ground that the disability of the employee
7 has subsequently recurred, increased, diminished or ended.
8 However, as to disablements occurring subsequently to
9 July 1, 1955, which are covered by any agreement or award
10 under this Act providing for compensation in installments
11 made as a result of such disablement, such agreement or award
12 may at any time within 30 months after such agreement or
13 award be reviewed by the Commission at the request of either
14 the employer or the employee on the ground that the
15 disability of the employee has subsequently recurred,
16 increased, diminished or ended. Compensation for the purposes
17 of this subsection shall include temporary total disability
18 benefits payable under subsection (b) of Section 8. An
19 employee whose disability recurs, increases, or is
20 re-established after the issuance of an award or decision of
21 an Arbitrator or the Commission for permanent disability
22 benefits under Section 8 of this Act shall not under any
23 circumstances be barred from receiving temporary, total
24 disability compensation benefits for any periods of temporary
25 total incapacity for work under subsection (b) of Section 8
26 even if those periods occur after the award or decision and
27 even if the recurrence of the disability does not increase
28 the permanent disability already awarded.
29 On such review compensation payments may be
30 re-established, increased, diminished or ended. The
31 Commission shall give 15 days' notice to the parties of the
32 hearing for review. Any employee, upon any petition for such
33 review being filed by the employer, shall be entitled to one
34 day's notice for each 100 miles necessary to be traveled by
-147- LRB9002213DJcd
1 him in attending the hearing of the Commission upon the
2 petition, and 3 days in addition thereto. Such employee
3 shall, at the discretion of the Commission, also be entitled
4 to 5 cents per mile necessarily traveled by him within the
5 State of Illinois in attending such hearing, not to exceed a
6 distance of 300 miles, to be taxed by the Commission as costs
7 and deposited with the petition of the employer.
8 When compensation which is payable in accordance with an
9 award or settlement contract approved by the Commission, is
10 ordered paid in a lump sum by the Commission, no review shall
11 be had as in this paragraph mentioned.
12 (i) Each party, upon taking any proceedings or steps
13 whatsoever before any Arbitrator, Commission or court, shall
14 file with the Commission his address, or the name and address
15 of any agent upon whom all notices to be given to such party
16 shall be served, either personally or by registered mail,
17 addressed to such party or agent at the last address so filed
18 with the Commission. In the event such party has not filed
19 his address, or the name and address of an agent as above
20 provided, service of any notice may be had by filing such
21 notice with the Commission.
22 (j) Whenever in any proceeding testimony has been taken
23 or a final decision has been rendered, and after the taking
24 of such testimony or after such decision has become final,
25 the employee dies, then in any subsequent proceeding brought
26 by the personal representative or beneficiaries of the
27 deceased employee, such testimony in the former proceeding
28 may be introduced with the same force and effect as though
29 the witness having so testified were present in person in
30 such subsequent proceedings and such final decision, if any,
31 shall be taken as final adjudication of any of the issues
32 which are the same in both proceedings.
33 (k) In any case where there has been any unreasonable or
34 vexatious delay of payment or intentional underpayment of
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1 compensation, or proceedings have been instituted or carried
2 on by one liable to pay the compensation, which do not
3 present a real controversy, but are merely frivolous or for
4 delay, then the Commission may award compensation additional
5 to that otherwise payable under this Act equal to 50% of the
6 amount payable at the time of such award. Failure to pay
7 compensation in accordance with the provisions of Section 8,
8 paragraph (b) of this Act, shall be considered unreasonable
9 delay.
10 (k-1) In any case where the employer or his insurance
11 carrier shall without good and just cause fail, neglect,
12 refuse or delay the payment of any benefits due under this
13 Act to an employee the arbitrator or the Commission shall
14 allow to the employee additional benefits in the sum of $50
15 per day for each day that the benefits were withheld or
16 refused, provided that such additional compensation shall not
17 exceed the sum of $10,000 or 50% of the benefits, whichever
18 is greater. In addition, the arbitrator or commissioner
19 shall assess attorney's fees and costs against the employer
20 and his insurance carrier. A delay in payment of 14 days or
21 more shall create a rebuttable presumption of unreasonable
22 delay.
23 (l) By the 15th day of each month each insurer providing
24 coverage for losses under this Act shall notify each insured
25 employer of any compensable claim incurred during the
26 preceding month and the amounts paid or reserved on the claim
27 including a summary of the claim and a brief statement of the
28 reasons for compensability. A cumulative report of all
29 claims incurred during a calendar year or continued from the
30 previous year shall be furnished to the insured employer by
31 the insurer within 30 days after the end of that calendar
32 year.
33 The insured employer may challenge, in proceeding before
34 the Commission, payments made by the insurer without
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1 arbitration and payments made after a case is determined to
2 be noncompensable. If the Commission finds that the case was
3 not compensable, the insurer shall purge its records as to
4 that employer of any loss or expense associated with the
5 claim, reimburse the employer for attorneys fee arising from
6 the challenge and for any payment required of the employer to
7 the Rate Adjustment Fund or the Second Injury Fund, and may
8 not effect the loss or expense for rate making purposes. The
9 employee shall not be required to refund the challenged
10 payment. The decision of the Commission may be reviewed in
11 the same manner as in arbitrated cases. No challenge may be
12 initiated under this paragraph more than 3 years after the
13 payment is made. An employer may waive the right of
14 challenge under this paragraph on a case by case basis.
15 (m) After filing an application for adjustment of claim
16 but prior to the hearing on arbitration the parties may
17 voluntarily agree to submit such application for adjustment
18 of claim for decision by an arbitrator under this subsection
19 (m) where such application for adjustment of claim raises
20 only a dispute over temporary total disability, permanent
21 partial disability or medical expenses. Such agreement shall
22 be in writing in such form as provided by the Commission.
23 Applications for adjustment of claim submitted for decision
24 by an arbitrator under this subsection (m) shall proceed
25 according to rule as established by the Commission. The
26 Commission shall promulgate rules including, but not limited
27 to, rules to ensure that the parties are adequately informed
28 of their rights under this subsection (m) and of the
29 voluntary nature of proceedings under this subsection (m).
30 The findings of fact made by an arbitrator acting within his
31 or her powers under this subsection (m) in the absence of
32 fraud shall be conclusive. However, the arbitrator may on
33 his own motion, or the motion of either party, correct any
34 clerical errors or errors in computation within 15 days after
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1 the date of receipt of such award of the arbitrator and shall
2 have the power to recall the original award on arbitration,
3 and issue in lieu thereof such corrected award. The decision
4 of the arbitrator under this subsection (m) shall be
5 considered the decision of the Commission and proceedings for
6 review of questions of law arising from the decision may be
7 commenced by either party pursuant to subsection (f) of
8 Section 19. The Advisory Board established under Section
9 13.1 of the Workers' Compensation Act shall compile a list of
10 certified Commission arbitrators, each of whom shall be
11 approved by at least 7 members of the Advisory Board. The
12 chairman shall select 5 persons from such list to serve as
13 arbitrators under this subsection (m). By agreement, the
14 parties shall select one arbitrator from among the 5 persons
15 selected by the chairman except, that if the parties do not
16 agree on an arbitrator from among the 5 persons, the parties
17 may, by agreement, select an arbitrator of the American
18 Arbitration Association, whose fee shall be paid by the State
19 in accordance with rules promulgated by the Commission.
20 Arbitration under this subsection (m) shall be voluntary.
21 (Source: P.A. 86-998; 87-435.)
-151- LRB9002213DJcd
1 INDEX
2 Statutes amended in order of appearance
3 805 ILCS 5/2.10 from Ch. 32, par. 2.10
4 805 ILCS 5/2.15 from Ch. 32, par. 2.15
5 820 ILCS 305/1 from Ch. 48, par. 138.1
6 820 ILCS 305/3a new
7 820 ILCS 305/4 from Ch. 48, par. 138.4
8 820 ILCS 305/4a-10 new
9 820 ILCS 305/5 from Ch. 48, par. 138.5
10 820 ILCS 305/6 from Ch. 48, par. 138.6
11 820 ILCS 305/7 from Ch. 48, par. 138.7
12 820 ILCS 305/8 from Ch. 48, par. 138.8
13 820 ILCS 305/8a new
14 820 ILCS 320/8b new
15 820 ILCS 305/8c new
16 820 ILCS 305/8d new
17 820 ILCS 305/10 from Ch. 48, par. 138.10
18 820 ILCS 305/16 from Ch. 48, par. 138.16
19 820 ILCS 305/16b new
20 820 ILCS 305/16c new
21 820 ILCS 305/16d new
22 820 ILCS 305/16e new
23 820 ILCS 305/16f new
24 820 ILCS 305/19 from Ch. 48, par. 138.19
25 820 ILCS 310/1 from Ch. 48, par. 172.36
26 820 ILCS 310/4 from Ch. 48, par. 172.39
27 820 ILCS 310/4c new
28 820 ILCS 310/6 from Ch. 48, par. 172.41
29 820 ILCS 310/7 from Ch. 48, par. 172.42
30 820 ILCS 310/8 from Ch. 48, par. 172.43
31 820 ILCS 310/16b new
32 820 ILCS 310/16c new
33 820 ILCS 310/16d new
34 820 ILCS 310/16e new
-152- LRB9002213DJcd
1 820 ILCS 310/16f new
2 820 ILCS 310/19 from Ch. 48, par. 172.54