|
liability insurance;
|
(6) Errors and omissions liability insurance;
|
(7) Officers and directors liability insurance |
reported separately as
follows:
|
(a) non-profit entities;
|
(b) for-profit entities;
|
(8) Products liability insurance;
|
(9) Medical malpractice insurance;
|
(10) Attorney malpractice insurance;
|
(11) Architects and engineers malpractice insurance; |
and
|
(12) Motor vehicle insurance reported separately for |
commercial and
private passenger vehicles as follows:
|
(a) motor vehicle physical damage insurance;
|
(b) motor vehicle liability insurance.
|
(C) Such report may include, but need not be limited to the |
following data,
both
specific to this State and companywide, in |
the aggregate or by type of
insurance for the previous year on |
a calendar year basis:
|
(1) Direct premiums written;
|
(2) Direct premiums earned;
|
(3) Number of policies;
|
(4) Net investment income, using appropriate estimates |
where necessary;
|
(5) Losses paid;
|
(6) Losses incurred;
|
(7) Loss reserves:
|
(a) Losses unpaid on reported claims;
|
(b) Losses unpaid on incurred but not reported |
claims;
|
(8) Number of claims:
|
(a) Paid claims;
|
(b) Arising claims;
|
(9) Loss adjustment expenses:
|
(a) Allocated loss adjustment expenses;
|
(b) Unallocated loss adjustment expenses;
|
|
(10) Net underwriting gain or loss;
|
(11) Net operation gain or loss, including net |
investment income;
|
(12) Any other information requested by the Director.
|
(C-5) Additional information by an advisory organization |
as defined in Section 463 of this Code. |
(1) An advisory organization as defined in Section 463 |
of this Code shall report annually the following |
information in such format as may be prescribed by the |
Secretary: |
(a) paid and incurred losses for each of the past |
10 years; |
(b) medical payments and medical charges, if |
collected, for each of the past 10 years; |
(c) the following indemnity payment information:
|
cumulative payments by accident year by calendar year |
of
development. This array will show payments made and |
frequency of claims in the following categories: |
medical only, permanent partial disability (PPD), |
permanent total
disability (PTD), temporary total |
disability (TTD), and fatalities; |
(d) injuries by frequency and severity; |
(e) by class of employee. |
(2) The report filed with the Secretary of Financial |
and Professional Regulation under paragraph (1) of this
|
subsection (C-5) shall be made available, on an aggregate |
basis, to the General
Assembly and to the general public. |
The identity of the petitioner, the respondent, the |
attorneys, and the insurers shall not be disclosed.
|
(3) Reports required under this
subsection (C-5) shall |
be filed with the Secretary no later than September 1 in |
2006 and no later than September 1 of each year thereafter.
|
(D) In addition to the information which may be requested |
under
subsection (C), the Director may also request on a |
companywide, aggregate
basis, Federal Income Tax recoverable, |
net realized capital gain or loss,
net unrealized capital gain |
|
or loss, and all other expenses not requested
in subsection (C) |
above.
|
(E) Violations - Suspensions - Revocations.
|
(1) Any company or person
subject to this Article, who |
willfully or repeatedly fails to observe or who
otherwise |
violates any of the provisions of this Article or any rule |
or
regulation promulgated by the Director under authority |
of this Article or any
final order of the Director entered |
under the authority of this Article shall
by civil penalty |
forfeit to the State of Illinois a sum not to exceed
|
$2,000. Each day during which a violation occurs |
constitutes a
separate
offense.
|
(2) No forfeiture liability under paragraph (1) of this |
subsection may
attach unless a written notice of apparent |
liability has been issued by the
Director and received by |
the respondent, or the Director sends written
notice of |
apparent liability by registered or certified mail, return
|
receipt requested, to the last known address of the |
respondent. Any
respondent so notified must be granted an |
opportunity to request a hearing
within 10 days from |
receipt of notice, or to show in writing, why he should
not |
be held liable. A notice issued under this Section must set |
forth the
date, facts and nature of the act or omission |
with which the respondent is
charged and must specifically |
identify the particular provision of this
Article, rule, |
regulation or order of which a violation is charged.
|
(3) No forfeiture liability under paragraph (1) of this |
subsection may
attach for any violation occurring more than |
2 years prior to the date of
issuance of the notice of |
apparent liability and in no event may the total
civil |
penalty forfeiture imposed for the acts or omissions set |
forth in any
one notice of apparent liability exceed |
$100,000.
|
(4) All administrative hearings conducted pursuant to |
this Article are
subject to 50 Ill. Adm. Code 2402 and all |
administrative hearings are
subject to the Administrative |
|
Review Law.
|
(5) The civil penalty forfeitures provided for in this |
Section are
payable to the General Revenue Fund of the |
State of Illinois, and may be
recovered in a civil suit in |
the name of the State of Illinois brought in
the Circuit |
Court in Sangamon County or in the Circuit Court of the |
county
where the respondent is domiciled or has its |
principal operating office.
|
(6) In any case where the Director issues a notice of |
apparent liability
looking toward the imposition of a civil |
penalty forfeiture under this
Section that fact may not be |
used in any other proceeding before the
Director to the |
prejudice of the respondent to whom the notice was issued,
|
unless (a) the civil penalty forfeiture has been paid, or |
(b) a court has
ordered payment of the civil penalty |
forfeiture and that order has become
final.
|
(7) When any person or company has a license or |
certificate of authority
under this Code and knowingly |
fails or refuses to comply with a lawful
order of the |
Director requiring compliance with this Article, entered |
after
notice and hearing, within the period of time |
specified in the order, the
Director may, in addition to |
any other penalty or authority
provided, revoke or refuse |
to renew the license or certificate of authority
of such |
person
or company, or may suspend the license or |
certificate of authority
of such
person or company until |
compliance with such order has been obtained.
|
(8) When any person or company has a license or |
certificate of authority
under this Code and knowingly |
fails or refuses to comply with any
provisions of this |
Article, the Director may, after notice and hearing, in
|
addition to any other penalty provided, revoke or refuse to |
renew the
license or certificate of authority of such |
person or company, or may
suspend the license or |
certificate of authority of such person or company,
until |
compliance with such provision of this Article has been |
|
obtained.
|
(9) No suspension or revocation under this Section may |
become effective
until 5 days from the date that the notice |
of suspension or revocation has
been personally delivered |
or delivered by registered or certified mail to
the company |
or person. A suspension or revocation under this Section is
|
stayed upon the filing, by the company or person, of a |
petition for
judicial review under the Administrative |
Review Law.
|
(Source: P.A. 93-32, eff. 7-1-03.)
|
Section 10. The Workers' Compensation Act is amended by |
changing Sections 4, 7, 8, 12, 13, 13.1, 14, 16, and 19 and by |
adding Sections 8.2, 8.3, 8.7, and 25.5 as follows:
|
(820 ILCS 305/4) (from Ch. 48, par. 138.4)
|
Sec. 4. (a) Any employer, including but not limited to |
general contractors
and their subcontractors, who shall come |
within the provisions of
Section 3 of this Act, and any other |
employer who shall elect to provide
and pay the compensation |
provided for in this Act shall:
|
(1) File with the Commission annually an application |
for approval as a
self-insurer which shall include a |
current financial statement, and
annually, thereafter, an |
application for renewal of self-insurance, which
shall |
include a current financial statement. Said
application |
and financial statement shall be signed and sworn to by the
|
president or vice president and secretary or assistant |
secretary of the
employer if it be a corporation, or by all |
of the partners, if it be a
copartnership, or by the owner |
if it be neither a copartnership nor a
corporation. All |
initial applications and all applications for renewal of
|
self-insurance must be submitted at least 60 days prior to |
the requested
effective date of self-insurance. An |
employer may elect to provide and pay
compensation as |
provided
for in this Act as a member of a group workers' |
|
compensation pool under Article
V 3/4 of the Illinois |
Insurance Code. If an employer becomes a member of a
group |
workers' compensation pool, the employer shall not be |
relieved of any
obligations imposed by this Act.
|
If the sworn application and financial statement of any |
such employer
does not satisfy the Commission of the |
financial ability of the employer
who has filed it, the |
Commission shall require such employer to,
|
(2) Furnish security, indemnity or a bond guaranteeing |
the payment
by the employer of the compensation provided |
for in this Act, provided
that any such employer whose |
application and financial statement shall
not have |
satisfied the commission of his or her financial ability |
and
who shall have secured his liability in part by excess |
liability insurance
shall be required to furnish to the |
Commission security, indemnity or bond
guaranteeing his or |
her payment up to the effective limits of the excess
|
coverage, or
|
(3) Insure his entire liability to pay such |
compensation in some
insurance carrier authorized, |
licensed, or permitted to do such
insurance business in |
this State. Every policy of an insurance carrier,
insuring |
the payment of compensation under this Act shall cover all |
the
employees and the entire compensation liability of the |
insured:
Provided, however, that any employer may insure |
his or her compensation
liability with 2 or more insurance |
carriers or may insure a part and
qualify under subsection |
1, 2, or 4 for the remainder of his or her
liability to pay |
such compensation, subject to the following two |
provisions:
|
Firstly, the entire compensation liability of the |
employer to
employees working at or from one location |
shall be insured in one such
insurance carrier or shall |
be self-insured, and
|
Secondly, the employer shall submit evidence |
satisfactorily to the
Commission that his or her entire |
|
liability for the compensation provided
for in this Act |
will be secured. Any provisions in any policy, or in |
any
endorsement attached thereto, attempting to limit |
or modify in any way,
the liability of the insurance |
carriers issuing the same except as
otherwise provided |
herein shall be wholly void.
|
Nothing herein contained shall apply to policies of |
excess liability
carriage secured by employers who have |
been approved by the Commission
as self-insurers, or
|
(4) Make some other provision, satisfactory to the |
Commission, for
the securing of the payment of compensation |
provided for in this Act,
and
|
(5) Upon becoming subject to this Act and thereafter as |
often as the
Commission may in writing demand, file with |
the Commission in form prescribed
by it evidence of his or |
her compliance with the provision of this Section.
|
(a-1) Regardless of its state of domicile or its principal |
place of
business, an employer shall make payments to its |
insurance carrier or group
self-insurance fund, where |
applicable, based upon the premium rates of the
situs where the |
work or project is located in Illinois if:
|
(A) the employer is engaged primarily in the building |
and
construction industry; and
|
(B) subdivision (a)(3) of this Section applies to the |
employer or
the employer is a member of a group |
self-insurance plan as defined in
subsection (1) of Section |
4a.
|
The Illinois Workers' Compensation Commission shall impose |
a penalty upon an employer
for violation of this subsection |
(a-1) if:
|
(i) the employer is given an opportunity at a hearing |
to present
evidence of its compliance with this subsection |
(a-1); and
|
(ii) after the hearing, the Commission finds that the |
employer
failed to make payments upon the premium rates of |
the situs where the work or
project is located in Illinois.
|
|
The penalty shall not exceed $1,000 for each day of work |
for which
the employer failed to make payments upon the premium |
rates of the situs where
the
work or project is located in |
Illinois, but the total penalty shall not exceed
$50,000 for |
each project or each contract under which the work was
|
performed.
|
Any penalty under this subsection (a-1) must be imposed not |
later
than one year after the expiration of the applicable |
limitation period
specified in subsection (d) of Section 6 of |
this Act. Penalties imposed under
this subsection (a-1) shall |
be deposited into the Illinois Workers' Compensation |
Commission
Operations Fund, a special fund that is created in |
the State treasury. Subject
to appropriation, moneys in the |
Fund shall be used solely for the operations
of the Illinois |
Workers' Compensation Commission.
|
(b) The sworn application and financial statement, or |
security,
indemnity or bond, or amount of insurance, or other |
provisions, filed,
furnished, carried, or made by the employer, |
as the case may be, shall
be subject to the approval of the |
Commission.
|
Deposits under escrow agreements shall be cash, negotiable |
United
States government bonds or negotiable general |
obligation bonds of the
State of Illinois. Such cash or bonds |
shall be deposited in
escrow with any State or National Bank or |
Trust Company having trust
authority in the State of Illinois.
|
Upon the approval of the sworn application and financial |
statement,
security, indemnity or bond or amount of insurance, |
filed, furnished or
carried, as the case may be, the Commission |
shall send to the employer
written notice of its approval |
thereof. The certificate of compliance
by the employer with the |
provisions of subparagraphs (2) and (3) of
paragraph (a) of |
this Section shall be delivered by the insurance
carrier to the |
Illinois Workers' Compensation Commission within five days |
after the
effective date of the policy so certified. The |
insurance so certified
shall cover all compensation liability |
occurring during the time that
the insurance is in effect and |
|
no further certificate need be filed in case
such insurance is |
renewed, extended or otherwise continued by such
carrier. The |
insurance so certified shall not be cancelled or in the
event |
that such insurance is not renewed, extended or otherwise
|
continued, such insurance shall not be terminated until at |
least 10
days after receipt by the Illinois Workers' |
Compensation Commission of notice of the
cancellation or |
termination of said insurance; provided, however, that
if the |
employer has secured insurance from another insurance carrier, |
or
has otherwise secured the payment of compensation in |
accordance with
this Section, and such insurance or other |
security becomes effective
prior to the expiration of the 10 |
days, cancellation or termination may, at
the option of the |
insurance carrier indicated in such notice, be effective
as of |
the effective date of such other insurance or security.
|
(c) Whenever the Commission shall find that any |
corporation,
company, association, aggregation of individuals, |
reciprocal or
interinsurers exchange, or other insurer |
effecting workers' compensation
insurance in this State shall |
be insolvent, financially unsound, or
unable to fully meet all |
payments and liabilities assumed or to be
assumed for |
compensation insurance in this State, or shall practice a
|
policy of delay or unfairness toward employees in the |
adjustment,
settlement, or payment of benefits due such |
employees, the Commission
may after reasonable notice and |
hearing order and direct that such
corporation, company, |
association, aggregation of individuals,
reciprocal or |
interinsurers exchange, or insurer, shall from and after a
date |
fixed in such order discontinue the writing of any such |
workers'
compensation insurance in this State. Subject to such |
modification of
the order as the Commission may later make on |
review of the order,
as herein provided, it shall thereupon be |
unlawful for any such
corporation, company, association, |
aggregation of individuals,
reciprocal or interinsurers |
exchange, or insurer to effect any workers'
compensation |
insurance in this State. A copy of the order shall be served
|
|
upon the Director of Insurance by registered mail. Whenever the |
Commission
finds that any service or adjustment company used or |
employed
by a self-insured employer or by an insurance carrier |
to process,
adjust, investigate, compromise or otherwise |
handle claims under this
Act, has practiced or is practicing a |
policy of delay or unfairness
toward employees in the |
adjustment, settlement or payment of benefits
due such |
employees, the Commission may after reasonable notice and
|
hearing order and direct that such service or adjustment |
company shall
from and after a date fixed in such order be |
prohibited from processing,
adjusting, investigating, |
compromising or otherwise handling claims
under this Act.
|
Whenever the Commission finds that any self-insured |
employer has
practiced or is practicing delay or unfairness |
toward employees in the
adjustment, settlement or payment of |
benefits due such employees, the
Commission may, after |
reasonable notice and hearing, order and direct
that after a |
date fixed in the order such self-insured employer shall be
|
disqualified to operate as a self-insurer and shall be required |
to
insure his entire liability to pay compensation in some |
insurance
carrier authorized, licensed and permitted to do such |
insurance business
in this State, as provided in subparagraph 3 |
of paragraph (a) of this
Section.
|
All orders made by the Commission under this Section shall |
be subject
to review by the courts, said review to be taken in |
the same manner and
within the same time as provided by Section |
19 of this Act for review of
awards and decisions of the |
Commission, upon the party seeking the
review filing with the |
clerk of the court to which said review is taken
a bond in an |
amount to be fixed and approved by the court to which the
|
review is taken, conditioned upon the payment of all |
compensation awarded
against the person taking said review |
pending a decision thereof and
further conditioned upon such |
other obligations as the court may impose.
Upon the review the |
Circuit Court shall have power to review all questions
of fact |
as well as of law. The penalty hereinafter provided for in this
|
|
paragraph shall not attach and shall not begin to run until the |
final
determination of the order of the Commission.
|
(d) Whenever a panel of 3 Commissioners comprised of one |
member of the employing class, one member of the employee |
class, and one member not identified with either the employing |
or employee class, with due process and after a hearing, |
determines an employer has knowingly failed to provide coverage |
as required by paragraph (a) of this Section, the failure shall |
be deemed an immediate serious danger to public health, safety, |
and welfare sufficient to justify service by the Commission of |
a work-stop order on such employer, requiring the cessation of |
all business operations of such employer at the place of |
employment or job site. Any law enforcement agency in the State |
shall, at the request of the Commission, render any assistance |
necessary to carry out the provisions of this Section, |
including, but not limited to, preventing any employee of such |
employer from remaining at a place of employment or job site |
after a work-stop order has taken effect. Any work-stop order |
shall be lifted upon proof of insurance as required by this |
Act. Any orders under this Section are appealable under Section |
19(f) to the Circuit Court.
|
Any individual employer, corporate officer or director of a |
corporate employer, partner of an employer partnership, or |
member of an employer limited liability company who knowingly |
fails to provide coverage as required by paragraph (a) of this |
Section is guilty of a Class 4 felony. This provision shall not |
apply to any corporate officer or director of any |
publicly-owned corporation. Each day's violation constitutes a |
separate offense. The State's Attorney of the county in which |
the violation occurred, or the Attorney General, shall bring |
such actions in the name of the People of the State of |
Illinois, or may, in addition to other remedies provided in |
this Section, bring an action for an injunction to restrain the |
violation or to enjoin the operation of any such employer.
|
Any individual employer, corporate officer or director of a |
corporate employer, partner of an employer partnership, or |
|
member of an employer limited liability company who negligently |
fails to provide coverage as required by paragraph (a) of this |
Section is guilty of a Class A misdemeanor. This provision |
shall not apply to any corporate officer or director of any |
publicly-owned corporation. Each day's violation constitutes a |
separate offense. The State's Attorney of the county in which |
the violation occurred, or the Attorney General, shall bring |
such actions in the name of the People of the State of |
Illinois.
|
The criminal penalties in this subsection (d) shall not |
apply where
there exists a good faith dispute as to the |
existence of an
employment relationship. Evidence of good faith |
shall
include, but not be limited to, compliance with the |
definition
of employee as used by the Internal Revenue Service.
|
Employers who are subject to and who knowingly fail to |
comply with this Section shall not be entitled to the benefits |
of this Act during the period of noncompliance, but shall be |
liable in an action under any other applicable law of this |
State. In the action, such employer shall not avail himself or |
herself of the defenses of assumption of risk or negligence or |
that the injury was due to a co-employee. In the action, proof |
of the injury shall constitute prima facie evidence of |
negligence on the part of such employer and the burden shall be |
on such employer to show freedom of negligence resulting in the |
injury. The employer shall not join any other defendant in any |
such civil action. Nothing in this amendatory Act of the 94th |
General Assembly shall affect the employee's rights under |
subdivision (a)3 of Section 1 of this Act. Any employer or |
carrier who makes payments under subdivision (a)3 of Section 1 |
of this Act shall have a right of reimbursement from the |
proceeds of any recovery under this Section.
|
An employee of an uninsured employer, or the employee's |
dependents in case death ensued, may, instead of proceeding |
against the employer in a civil action in court, file an |
application for adjustment of claim with the Commission in |
accordance with the provisions of this Act and the Commission |
|
shall hear and determine the application for adjustment of |
claim in the manner in which other claims are heard and |
determined before the Commission.
|
All proceedings under this subsection (d) shall be reported |
on an annual basis to the Workers' Compensation Advisory Board.
|
Upon a finding by the Commission, after reasonable notice |
and
hearing, of the knowing and wilful failure or refusal of an |
employer to
comply with
any of the provisions of paragraph (a) |
of this Section or the failure or
refusal of an employer, |
service or adjustment company, or an insurance
carrier to |
comply with any order of the Illinois Workers' Compensation |
Commission pursuant to
paragraph (c) of this Section |
disqualifying him or her to operate as a self
insurer and |
requiring him or her to insure his or her liability, the
|
Commission may assess a civil penalty of up to $500 per day for |
each day of
such failure or refusal after the effective date of |
this amendatory Act of
1989. The minimum penalty under this |
Section shall be the sum of $10,000.
Each day of such failure |
or refusal shall constitute a separate offense.
The Commission |
may assess the civil penalty personally and individually
|
against the corporate officers and directors of a corporate |
employer, the
partners of an employer partnership, and the |
members of an employer limited
liability company, after a |
finding of a knowing and willful refusal or failure
of each |
such named corporate officer, director, partner, or member to |
comply
with this Section. The liability for the assessed |
penalty shall be
against the named employer first, and
if the |
named employer fails or refuses to pay the penalty to the
|
Commission within 30 days after the final order of the |
Commission, then the
named
corporate officers, directors, |
partners, or members who have been found to have
knowingly and |
willfully refused or failed to comply with this Section shall |
be
liable for the unpaid penalty or any unpaid portion of the |
penalty. Upon investigation by the insurance non-compliance |
unit of the Commission, the Attorney General shall have the |
authority to prosecute all proceedings to enforce the civil and |
|
administrative provisions of this Section before the |
Commission. The Commission shall promulgate procedural rules |
for enforcing this Section.
All
penalties collected under
this |
Section shall be deposited in the Illinois Workers' |
Compensation Commission Operations Fund.
|
Upon the failure or refusal of any employer, service or |
adjustment
company or insurance carrier to comply with the |
provisions of this Section
and with the orders of the |
Commission under this Section, or the order of
the court on |
review after final adjudication, the Commission may bring a
|
civil action to recover the amount of the penalty in Cook |
County or in
Sangamon County in which litigation the Commission |
shall be represented by
the Attorney General. The Commission |
shall send notice of its finding of
non-compliance and |
assessment of the civil penalty to the Attorney General.
It |
shall be the duty of the Attorney General within 30 days after |
receipt
of the notice, to institute prosecutions and promptly |
prosecute all
reported violations of this Section.
|
Any individual employer, corporate officer or director of a |
corporate employer, partner of an employer partnership, or |
member of an employer limited liability company who, with the |
intent to avoid payment of compensation under this Act to an |
injured employee or the employee's dependents, knowingly |
transfers, sells, encumbers, assigns, or in any manner disposes |
of, conceals, secretes, or destroys any property belonging to |
the employer, officer, director, partner, or member is guilty |
of a Class 4 felony.
|
Penalties and fines collected pursuant to this paragraph |
(d) shall be deposited upon receipt into a special fund which |
shall be designated the Injured Workers' Benefit Fund, of which |
the State Treasurer is ex-officio custodian, such special fund |
to be held and disbursed in accordance with this paragraph (d) |
for the purposes hereinafter stated in this paragraph (d), upon |
the final order of the Commission. The Injured Workers' Benefit |
Fund shall be deposited the same as are State funds and any |
interest accruing thereon shall be added thereto every 6 |
|
months. The Injured Workers' Benefit Fund is subject to audit |
the same as State funds and accounts and is protected by the |
general bond given by the State Treasurer. The Injured Workers' |
Benefit Fund is considered always appropriated for the purposes |
of disbursements as provided in this paragraph, and shall be |
paid out and disbursed as herein provided and shall not at any |
time be appropriated or diverted to any other use or purpose. |
Moneys in the Injured Workers' Benefit Fund shall be used only |
for payment of workers' compensation benefits for injured |
employees when the employer has failed to provide coverage as |
determined under this paragraph (d) and has failed to pay the |
benefits due to the injured employee. The Commission shall have |
the right to obtain reimbursement from the employer for |
compensation obligations paid by the Injured Workers' Benefit |
Fund. Any such amounts obtained shall be deposited by the |
Commission into the Injured Workers' Benefit Fund. If an |
injured employee or his or her personal representative receives |
payment from the Injured Workers' Benefit Fund, the State of |
Illinois has the same rights under paragraph (b) of Section 5 |
that the employer who failed to pay the benefits due to the |
injured employee would have had if the employer had paid those |
benefits, and any moneys recovered by the State as a result of |
the State's exercise of its rights under paragraph (b) of |
Section 5 shall be deposited into the Injured Workers' Benefit |
Fund. The custodian of the Injured Workers' Benefit Fund shall |
be joined with the employer as a party respondent in the |
application for adjustment of claim. After July 1, 2006, the |
Commission shall make disbursements from the Fund once each |
year to each eligible claimant. An eligible claimant is an |
injured worker who has within the previous fiscal year obtained |
a final award for benefits from the Commission against the |
employer and the Injured Workers' Benefit Fund and has notified |
the Commission within 90 days of receipt of such award. Within |
a reasonable time after the end of each fiscal year, the |
Commission shall make a disbursement to each eligible claimant. |
At the time of disbursement, if there are insufficient moneys |
|
in the Fund to pay all claims, each eligible claimant shall |
receive a pro-rata share, as determined by the Commission, of |
the available moneys in the Fund for that year. Payment from |
the Injured Workers' Benefit Fund to an eligible claimant |
pursuant to this provision shall discharge the obligations of |
the Injured Workers' Benefit Fund regarding the award entered |
by the Commission.
|
(e) This Act shall not affect or disturb the continuance of |
any
existing insurance, mutual aid, benefit, or relief |
association or
department, whether maintained in whole or in |
part by the employer or
whether maintained by the employees, |
the payment of benefits of such
association or department being |
guaranteed by the employer or by some
person, firm or |
corporation for him or her: Provided, the employer contributes
|
to such association or department an amount not less than the |
full
compensation herein provided, exclusive of the cost of the |
maintenance
of such association or department and without any |
expense to the
employee. This Act shall not prevent the |
organization and maintaining
under the insurance laws of this |
State of any benefit or insurance
company for the purpose of |
insuring against the compensation provided
for in this Act, the |
expense of which is maintained by the employer.
This Act shall |
not prevent the organization or maintaining under the
insurance |
laws of this State of any voluntary mutual aid, benefit or
|
relief association among employees for the payment of |
additional
accident or sick benefits.
|
(f) No existing insurance, mutual aid, benefit or relief |
association
or department shall, by reason of anything herein |
contained, be
authorized to discontinue its operation without |
first discharging its
obligations to any and all persons |
carrying insurance in the same or
entitled to relief or |
benefits therein.
|
(g) Any contract, oral, written or implied, of employment |
providing
for relief benefit, or insurance or any other device |
whereby the
employee is required to pay any premium or premiums |
for insurance
against the compensation provided for in this Act |
|
shall be null and
void. Any employer withholding from the wages |
of any employee any
amount for the purpose of paying any such |
premium shall be guilty of a
Class B misdemeanor.
|
In the event the employer does not pay the compensation for |
which he or
she is liable, then an insurance company, |
association or insurer which may
have insured such employer |
against such liability shall become primarily
liable to pay to |
the employee, his or her personal representative or
beneficiary |
the compensation required by the provisions of this Act to
be |
paid by such employer. The insurance carrier may be made a |
party to
the proceedings in which the employer is a party and |
an award may be
entered jointly against the employer and the |
insurance carrier.
|
(h) It shall be unlawful for any employer, insurance |
company or
service or adjustment company to interfere with, |
restrain or coerce an
employee in any manner whatsoever in the |
exercise of the rights or
remedies granted to him or her by |
this Act or to discriminate, attempt to
discriminate, or |
threaten to discriminate against an employee in any way
because |
of his or her exercise of the rights or remedies granted to
him |
or her by this Act.
|
It shall be unlawful for any employer, individually or |
through any
insurance company or service or adjustment company, |
to discharge or to
threaten to discharge, or to refuse to |
rehire or recall to active
service in a suitable capacity an |
employee because of the exercise of
his or her rights or |
remedies granted to him or her by this Act.
|
(i) If an employer elects to obtain a life insurance policy |
on his
employees, he may also elect to apply such benefits in |
satisfaction of all
or a portion of the death benefits payable |
under this Act, in which case,
the employer's compensation |
premium shall be reduced accordingly.
|
(j) Within 45 days of receipt of an initial application or |
application
to renew self-insurance privileges the |
Self-Insurers Advisory Board shall
review and submit for |
approval by the Chairman of the Commission
recommendations of |
|
disposition of all initial applications to self-insure
and all |
applications to renew self-insurance privileges filed by |
private
self-insurers pursuant to the provisions of this |
Section and Section 4a-9
of this Act. Each private self-insurer |
shall submit with its initial and
renewal applications the |
application fee required by Section 4a-4 of this Act.
|
The Chairman of the Commission shall promptly act upon all |
initial
applications and applications for renewal in full |
accordance with the
recommendations of the Board or, should the |
Chairman disagree with any
recommendation of disposition of the |
Self-Insurer's Advisory Board, he
shall within 30 days of |
receipt of such recommendation provide to the Board
in writing |
the reasons supporting his decision. The Chairman shall also
|
promptly notify the employer of his decision within 15 days of |
receipt of
the recommendation of the Board.
|
If an employer is denied a renewal of self-insurance |
privileges pursuant
to application it shall retain said |
privilege for 120 days after receipt of
a notice of |
cancellation of the privilege from the Chairman of the |
Commission.
|
All orders made by the Chairman under this Section shall be |
subject to
review by the courts, such review to be taken in the |
same manner and within
the same time as provided by subsection |
(f) of Section 19 of this Act for
review of awards and |
decisions of the Commission, upon the party seeking
the review |
filing with the clerk of the court to which such review is |
taken
a bond in an amount to be fixed and approved by the court |
to which the
review is taken, conditioned upon the payment of |
all compensation awarded
against the person taking such review |
pending a decision thereof and
further conditioned upon such |
other obligations as the court may impose.
Upon the review the |
Circuit Court shall have power to review all questions
of fact |
as well as of law.
|
(Source: P.A. 92-324, eff. 8-9-01; 93-721, eff. 1-1-05.)
|
(820 ILCS 305/7) (from Ch. 48, par. 138.7)
|
|
Sec. 7. The amount of compensation which shall be paid for |
an
accidental injury to the employee resulting in death is:
|
(a) If the employee leaves surviving a widow, widower, |
child or
children, the applicable weekly compensation rate |
computed in accordance
with subparagraph 2 of paragraph (b) of |
Section 8, shall be payable
during the life of the widow or |
widower and if any surviving child or
children shall not be |
physically or mentally incapacitated then until
the death of |
the widow or widower or until the youngest child shall
reach |
the age of 18, whichever shall come later; provided that if |
such
child or children shall be enrolled as a full time student |
in any
accredited educational institution, the payments shall |
continue until
such child has attained the age of 25. In the |
event any surviving child
or children shall be physically or |
mentally incapacitated, the payments
shall continue for the |
duration of such incapacity.
|
The term "child" means a child whom the deceased employee |
left
surviving, including a posthumous child, a child legally |
adopted, a
child whom the deceased employee was legally |
obligated to support or a
child to whom the deceased employee |
stood in loco parentis. The term
"children" means the plural of |
"child".
|
The term "physically or mentally incapacitated child or |
children"
means a child or children incapable of engaging in |
regular and
substantial gainful employment.
|
In the event of the remarriage of a widow or widower, where |
the
decedent did not leave surviving any child or children who, |
at the time
of such remarriage, are entitled to compensation |
benefits under this
Act, the surviving spouse shall be paid a |
lump sum equal to 2 years
compensation benefits and all further |
rights of such widow or widower
shall be extinguished.
|
If the employee leaves surviving any child or children |
under 18 years
of age who at the time of death shall be |
entitled to compensation under
this paragraph (a) of this |
Section, the weekly compensation payments
herein provided for |
such child or children shall in any event continue
for a period |
|
of not less than 6 years.
|
Any beneficiary entitled to compensation under this |
paragraph (a) of
this Section shall receive from the special |
fund provided in paragraph
(f) of this Section, in addition to |
the compensation herein provided,
supplemental benefits in |
accordance with paragraph (g) of Section 8.
|
(b) If no compensation is payable under paragraph (a) of |
this
Section and the employee leaves surviving a parent or |
parents who at the
time of the accident were totally dependent |
upon the earnings of the
employee then weekly payments equal to |
the compensation rate payable in
the case where the employee |
leaves surviving a widow or widower, shall
be paid to such |
parent or parents for the duration of their lives, and
in the |
event of the death of either, for the life of the survivor.
|
(c) If no compensation is payable under paragraphs (a) or |
(b) of
this Section and the employee leaves surviving any child |
or children who
are not entitled to compensation under the |
foregoing paragraph (a) but
who at the time of the accident |
were nevertheless in any manner
dependent upon the earnings of |
the employee, or leaves surviving a
parent or parents who at |
the time of the accident were partially
dependent upon the |
earnings of the employee, then there shall be paid to
such |
dependent or dependents for a period of 8 years weekly |
compensation
payments at such proportion of the applicable rate |
if the employee had
left surviving a widow or widower as such |
dependency bears to total
dependency. In the event of the death |
of any such beneficiary the share
of such beneficiary shall be |
divided equally among the surviving
beneficiaries and in the |
event of the death of the last such
beneficiary all the rights |
under this paragraph shall be extinguished.
|
(d) If no compensation is payable under paragraphs (a), (b) |
or (c)
of this Section and the employee leaves surviving any |
grandparent,
grandparents, grandchild or grandchildren or |
collateral heirs dependent
upon the employee's earnings to the |
extent of 50% or more of total
dependency, then there shall be |
paid to such dependent or dependents for
a period of 5 years |
|
weekly compensation payments at such proportion of
the |
applicable rate if the employee had left surviving a widow or
|
widower as such dependency bears to total dependency. In the |
event of
the death of any such beneficiary the share of such |
beneficiary shall be
divided equally among the surviving |
beneficiaries and in the event of
the death of the last such |
beneficiary all rights hereunder shall be
extinguished.
|
(e) The compensation to be paid for accidental injury which |
results
in death, as provided in this Section, shall be paid to |
the persons who
form the basis for determining the amount of |
compensation to be paid by
the employer, the respective shares |
to be in the proportion of their
respective dependency at the |
time of the accident on the earnings of the
deceased. The |
Commission or an Arbitrator thereof may, in its or his
|
discretion, order or award the payment to the parent or |
grandparent of a
child for the latter's support the amount of |
compensation which but for
such order or award would have been |
paid to such child as its share of
the compensation payable, |
which order or award may be modified from time
to time by the |
Commission in its discretion with respect to the person
to whom |
shall be paid the amount of the order or award remaining unpaid
|
at the time of the modification.
|
The payments of compensation by the employer in accordance |
with the
order or award of the Commission discharges such |
employer from all
further obligation as to such compensation.
|
(f) The sum of $8,000
$4200 for burial expenses shall be |
paid by the
employer to the widow or widower, other dependent, |
next of kin or to the
person or persons incurring the expense |
of burial.
|
In the event the employer failed to provide necessary first |
aid,
medical, surgical or hospital service, he shall pay the |
cost thereof to
the person or persons entitled to compensation |
under paragraphs (a),
(b), (c) or (d) of this Section, or to |
the person or persons incurring
the obligation therefore, or |
providing the same.
|
On January 15 and July 15, 1981, and on January 15 and July |
|
15 of each
year thereafter the employer shall within 60 days |
pay a sum equal to
1/8 of 1% of all compensation payments made |
by him after July 1, 1980, either
under this Act or the |
Workers' Occupational Diseases Act, whether by lump
sum |
settlement or weekly compensation payments, but not including |
hospital,
surgical or rehabilitation payments, made during the |
first 6 months and
during the second 6 months respectively of |
the fiscal year next preceding
the date of the payments, into a |
special fund which shall be designated the
"Second Injury |
Fund", of which the State Treasurer is ex-officio custodian,
|
such special fund to be held and disbursed for the purposes |
hereinafter
stated in paragraphs (f) and (g) of Section 8, |
either upon the order of the
Commission or of a competent |
court. Said special fund shall be deposited
the same as are |
State funds and any interest accruing thereon shall be
added |
thereto every 6 months. It is subject to audit the same as |
State
funds and accounts and is protected by the General bond |
given by the State
Treasurer. It is considered always |
appropriated for the purposes of
disbursements as provided in |
Section 8, paragraph (f), of this Act, and
shall be paid out |
and disbursed as therein provided and shall not at any
time be |
appropriated or diverted to any other use or purpose.
|
On January 15, 1991, the employer shall further pay a sum |
equal to one
half of 1% of all compensation payments made by |
him from January 1, 1990
through June 30, 1990 either under |
this Act or under the Workers'
Occupational Diseases Act, |
whether by lump sum settlement or weekly
compensation payments, |
but not including hospital, surgical or
rehabilitation |
payments, into an additional Special Fund which shall be
|
designated as the "Rate Adjustment Fund". On March 15, 1991, |
the employer
shall pay into the Rate Adjustment Fund a sum |
equal to one half of 1% of
all such compensation payments made |
from July 1, 1990 through December 31,
1990. Within 60 days |
after July 15, 1991, the employer shall pay into the
Rate |
Adjustment Fund a sum equal to one half of 1% of all such |
compensation
payments made from January 1, 1991 through June |
|
30, 1991. Within 60 days
after January 15 of 1992 and each
|
subsequent year through 1996, the employer shall pay
into the |
Rate Adjustment Fund a sum equal to one half of 1% of all such
|
compensation payments made in the last 6 months of the |
preceding calendar
year. Within 60 days after July 15 of 1992 |
and each subsequent year through
1995, the employer shall pay |
into the Rate Adjustment Fund a sum equal to one
half of 1% of |
all such compensation payments made in the first 6 months of |
the
same calendar year. Within 60 days after January 15 of 1997 |
and each subsequent
year through 2005 , the employer shall pay |
into the Rate Adjustment Fund a sum equal to
three-fourths of |
1% of all such compensation payments made in the last 6 months
|
of the preceding calendar year. Within 60 days after July 15 of |
1996 and each
subsequent year through 2004 , the employer shall |
pay into the Rate Adjustment Fund a sum
equal to three-fourths |
of 1% of all such compensation payments made in the
first 6 |
months of the same calendar year. Within 60 days after January |
15 of 2006 and each subsequent year, the employer shall pay |
into the Rate Adjustment Fund a sum equal to 1% of such |
compensation payments made in the last 6 months of the |
preceding calendar year. Within 60 days after July 15 of 2005 |
and each subsequent year, the employer shall pay into the Rate |
Adjustment Fund a sum equal to 1% of such compensation payments |
made in the first 6 months of the same calendar year. The |
administrative costs of
collecting assessments from employers |
for the Rate Adjustment Fund shall be
paid from the
Rate |
Adjustment Fund. The cost of an actuarial audit of the Fund |
shall be paid
from the Rate Adjustment Fund and the audit shall |
be completed no later than
July 1, 1997 . The State Treasurer is |
ex officio custodian of such Special
Fund and the same shall be |
held and disbursed for the purposes hereinafter
stated in |
paragraphs (f) and (g) of Section 8 upon the order of the
|
Commission or of a competent court. The Rate Adjustment Fund |
shall be
deposited the same as are State funds and any interest |
accruing thereon
shall be added thereto every 6 months. It |
shall be subject to audit the
same as State funds and accounts |
|
and shall be protected by the general bond
given by the State |
Treasurer. It is considered always appropriated for the
|
purposes of disbursements as provided in paragraphs (f) and (g) |
of Section
8 of this Act and shall be paid out and disbursed as |
therein provided and
shall not at any time be appropriated or |
diverted to any other use or
purpose. Within 5 days after the |
effective date of this amendatory Act of
1990, the Comptroller |
and the State Treasurer shall transfer $1,000,000
from the |
General Revenue Fund to the Rate Adjustment Fund. By February |
15,
1991, the Comptroller and the State Treasurer shall |
transfer $1,000,000
from the Rate Adjustment Fund to the |
General Revenue Fund. The Comptroller and Treasurer are |
authorized to make
transfers at the
request of the Chairman up |
to a total of $19,000,000
$15,000,000
from the Second Injury |
Fund, the General Revenue Fund, and the Workers'
Compensation |
Benefit Trust
Fund to the Rate Adjustment Fund to the extent |
that there is insufficient
money in the Rate Adjustment Fund to |
pay claims and obligations. Amounts may
be transferred from the |
General Revenue Fund only if the funds in the Second
Injury |
Fund or the Workers' Compensation Benefit Trust Fund are |
insufficient to
pay claims and obligations of the Rate |
Adjustment Fund. All
amounts transferred from the Second Injury |
Fund, the General Revenue Fund,
and the Workers'
Compensation |
Benefit Trust Fund shall be repaid from the Rate Adjustment
|
Fund within 270 days of a transfer, together with interest at |
the rate
earned by moneys on deposit in the Fund or Funds from |
which the moneys were
transferred.
|
Upon a finding by the Commission, after reasonable notice |
and hearing,
that any employer has willfully and knowingly |
failed to pay the proper
amounts into the Second Injury Fund or |
the Rate Adjustment Fund required by
this Section or if such |
payments are not made within the time periods
prescribed by |
this Section, the employer shall, in addition to such
payments, |
pay a penalty of 20% of the amount required to be paid or |
$2,500,
whichever is greater, for each year or part thereof of |
such failure to pay.
This penalty shall only apply to |
|
obligations of an employer to the
Second Injury Fund or the |
Rate Adjustment Fund accruing after the effective
date of this |
amendatory Act of 1989. All or part of such a penalty may be
|
waived by the Commission for good cause shown.
|
Any obligations of an employer to the Second Injury Fund |
and Rate
Adjustment Fund accruing prior to the effective date |
of this amendatory Act
of 1989 shall be paid in full by such |
employer within 5 years of the
effective date of this |
amendatory Act of 1989, with at least one-fifth of
such |
obligation to be paid during each year following the effective |
date of
this amendatory Act of 1989. If the Commission finds, |
following reasonable
notice and hearing, that an employer has |
failed to make timely payment of
any obligation accruing under |
the preceding sentence, the employer shall,
in addition to all |
other payments required by this Section, be liable for a
|
penalty equal to 20% of the overdue obligation or $2,500, |
whichever is
greater, for each year or part thereof that |
obligation is overdue.
All or part of such a penalty may be |
waived by the Commission for
good cause shown.
|
The Chairman of the Illinois Workers' Compensation |
Commission shall, annually, furnish to the
Director of the |
Department of Insurance a list of the amounts paid into the
|
Second Injury Fund and the Rate Adjustment Fund by each |
insurance company
on behalf of their insured employers. The |
Director shall verify to the
Chairman that the amounts paid by |
each insurance company are accurate as
best as the Director can |
determine from the records available to the
Director. The |
Chairman shall verify that the amounts paid by each
|
self-insurer are accurate as best as the Chairman can determine |
from
records available to the Chairman. The Chairman may |
require each
self-insurer to provide information concerning |
the total compensation
payments made upon which contributions |
to the Second Injury Fund and the
Rate Adjustment Fund are |
predicated and any additional information
establishing that |
such payments have been made into these funds. Any
deficiencies |
in payments noted by the Director or Chairman shall be subject
|
|
to the penalty provisions of this Act.
|
The State Treasurer, or his duly authorized |
representative, shall be
named as a party to all proceedings in |
all cases involving claim for the
loss of, or the permanent and |
complete loss of the use of one eye, one
foot, one leg, one arm |
or one hand.
|
The State Treasurer or his duly authorized agent shall have |
the same
rights as any other party to the proceeding, including |
the right to
petition for review of any award. The reasonable |
expenses of
litigation, such as medical examinations, |
testimony, and transcript of
evidence, incurred by the State |
Treasurer or his duly authorized
representative, shall be borne |
by the Second Injury Fund.
|
If the award is not paid within 30 days after the date the |
award has
become final, the Commission shall proceed to take |
judgment thereon in
its own name as is provided for other |
awards by paragraph (g) of Section
19 of this Act and take the |
necessary steps to collect the award.
|
Any person, corporation or organization who has paid or |
become liable
for the payment of burial expenses of the |
deceased employee may in his
or its own name institute |
proceedings before the Commission for the
collection thereof.
|
For the purpose of administration, receipts and |
disbursements, the
Special Fund provided for in paragraph (f) |
of this Section shall be
administered jointly with the Special |
Fund provided for in Section 7,
paragraph (f) of the Workers' |
Occupational Diseases Act.
|
(g) All compensation, except for burial expenses provided |
in this
Section to be paid in case accident results in death, |
shall be paid in
installments equal to the percentage of the |
average earnings as provided
for in Section 8, paragraph (b) of |
this Act, at the same intervals at
which the wages or earnings |
of the employees were paid. If this is not
feasible, then the |
installments shall be paid weekly. Such compensation
may be |
paid in a lump sum upon petition as provided in Section 9 of |
this
Act. However, in addition to the benefits provided by |
|
Section 9 of this
Act where compensation for death is payable |
to the deceased's widow,
widower or to the deceased's widow, |
widower and one or more children,
and where a partial lump sum |
is applied for by such beneficiary or
beneficiaries within 18 |
months after the deceased's death, the
Commission may, in its |
discretion, grant a partial lump sum of not to
exceed 100 weeks |
of the compensation capitalized at their present value
upon the |
basis of interest calculated at 3% per annum with annual rests,
|
upon a showing that such partial lump sum is for the best |
interest of
such beneficiary or beneficiaries.
|
(h) In case the injured employee is under 16 years of age |
at the
time of the accident and is illegally employed, the |
amount of
compensation payable under paragraphs (a), (b), (c), |
(d) and (f) of this
Section shall be increased 50%.
|
Nothing herein contained repeals or amends the provisions |
of the Child
Labor Law relating to the employment of minors |
under the age of 16 years.
|
However, where an employer has on file an employment |
certificate
issued pursuant to the Child Labor Law or work |
permit issued pursuant
to the Federal Fair Labor Standards Act, |
as amended, or a birth
certificate properly and duly issued, |
such certificate, permit or birth
certificate is conclusive |
evidence as to the age of the injured minor
employee for the |
purposes of this Section only.
|
(i) Whenever the dependents of a deceased employee are |
aliens not
residing in the United States, Mexico or Canada, the |
amount of
compensation payable is limited to the beneficiaries |
described in
paragraphs (a), (b) and (c) of this Section and is |
50% of the
compensation provided in paragraphs (a), (b) and (c) |
of this Section,
except as otherwise provided by treaty.
|
In a case where any of the persons who would be entitled to
|
compensation is living at any place outside of the United |
States, then
payment shall be made to the personal |
representative of the deceased
employee. The distribution by |
such personal representative to the
persons entitled shall be |
made to such persons and in such manner as the
Commission |
|
orders.
|
(Source: P.A. 92-714, eff. 1-1-03; 93-721, eff. 1-1-05.)
|
(820 ILCS 305/8) (from Ch. 48, par. 138.8)
|
Sec. 8. The amount of compensation which shall be paid to |
the
employee for an accidental injury not resulting in death |
is:
|
(a) The employer shall provide and pay the negotiated rate, |
if applicable, or the lesser of the health care provider's |
actual charges or according to a fee schedule, subject to |
Section 8.2, in effect at the time the service was rendered for |
all the necessary first
aid, medical and surgical services, and |
all necessary medical, surgical
and hospital services |
thereafter incurred, limited, however, to that
which is |
reasonably required to cure or relieve from the effects of the
|
accidental injury. If the employer does not dispute payment of |
first aid, medical, surgical,
and hospital services, the |
employer shall make such payment to the provider on behalf of |
the employee. The employer shall also pay for treatment,
|
instruction and training necessary for the physical, mental and
|
vocational rehabilitation of the employee, including all |
maintenance
costs and expenses incidental thereto. If as a |
result of the injury the
employee is unable to be |
self-sufficient the employer shall further pay
for such |
maintenance or institutional care as shall be required.
|
The employee may at any time elect to secure his own |
physician,
surgeon and hospital services at the employer's |
expense, or,
|
Upon agreement between the employer and the employees, or |
the employees'
exclusive representative, and subject to the |
approval of the Illinois Workers' Compensation
Commission, the |
employer shall maintain a list of physicians, to be
known as a |
Panel of Physicians, who are accessible to the employees.
The |
employer shall post this list in a place or places easily |
accessible
to his employees. The employee shall have the right |
to make an
alternative choice of physician from such Panel if |
|
he is not satisfied
with the physician first selected. If, due |
to the nature of the injury
or its occurrence away from the |
employer's place of business, the
employee is unable to make a |
selection from the Panel, the selection
process from the Panel |
shall not apply. The physician selected from the
Panel may |
arrange for any consultation, referral or other specialized
|
medical services outside the Panel at the employer's expense. |
Provided
that, in the event the Commission shall find that a |
doctor selected by
the employee is rendering improper or |
inadequate care, the Commission
may order the employee to |
select another doctor certified or qualified
in the medical |
field for which treatment is required. If the employee
refuses |
to make such change the Commission may relieve the employer of
|
his obligation to pay the doctor's charges from the date of |
refusal to
the date of compliance.
|
Any vocational rehabilitation counselors who provide |
service under this Act shall have
appropriate certifications |
which designate the counselor as qualified to render
opinions |
relating to vocational rehabilitation. Vocational |
rehabilitation
may include, but is not limited to, counseling |
for job searches, supervising
a job search program, and |
vocational retraining including education at an
accredited |
learning institution. The employee or employer may petition to |
the Commission to decide disputes relating to vocational |
rehabilitation and the Commission shall resolve any such |
dispute, including payment of the vocational rehabilitation |
program by the employer. |
The maintenance benefit shall not be less than the |
temporary total disability
rate determined for the employee. In |
addition, maintenance shall include costs
and expenses |
incidental to the vocational rehabilitation program. |
When the employee is working light duty on a part-time |
basis or full-time
basis
and earns less than he or she would be |
earning if employed in the full capacity
of the job or jobs, |
then the employee shall be entitled to temporary partial |
disability benefits. Temporary partial disability benefits |
|
shall be
equal to two-thirds of
the difference between the |
average amount that the employee would be able to
earn in the |
full performance of his or her duties in the occupation in |
which he
or she was engaged at the time of accident and the net |
amount which he or she
is
earning in the modified job provided |
to the employee by the employer or in any other job that the |
employee is working. |
Every hospital, physician, surgeon or other person |
rendering
treatment or services in accordance with the |
provisions of this Section
shall upon written request furnish |
full and complete reports thereof to,
and permit their records |
to be copied by, the employer, the employee or
his dependents, |
as the case may be, or any other party to any proceeding
for |
compensation before the Commission, or their attorneys.
|
Notwithstanding the foregoing, the employer's liability to |
pay for such
medical services selected by the employee shall be |
limited to:
|
(1) all first aid and emergency treatment; plus
|
(2) all medical, surgical and hospital services |
provided by the
physician, surgeon or hospital initially |
chosen by the employee or by any
other physician, |
consultant, expert, institution or other provider of
|
services recommended by said initial service provider or |
any subsequent
provider of medical services in the chain of |
referrals from said
initial service provider; plus
|
(3) all medical, surgical and hospital services |
provided by any second
physician, surgeon or hospital |
subsequently chosen by the employee or by
any other |
physician, consultant, expert, institution or other |
provider of
services recommended by said second service |
provider or any subsequent provider
of medical services in |
the chain of referrals
from said second service provider. |
Thereafter the employer shall select
and pay for all |
necessary medical, surgical and hospital treatment and the
|
employee may not select a provider of medical services at |
the employer's
expense unless the employer agrees to such |
|
selection. At any time the employee
may obtain any medical |
treatment he desires at his own expense. This paragraph
|
shall not affect the duty to pay for rehabilitation |
referred to above.
|
When an employer and employee so agree in writing, nothing |
in this
Act prevents an employee whose injury or disability has |
been established
under this Act, from relying in good faith, on |
treatment by prayer or
spiritual means alone, in accordance |
with the tenets and practice of a
recognized church or |
religious denomination, by a duly accredited
practitioner |
thereof, and having nursing services appropriate therewith,
|
without suffering loss or diminution of the compensation |
benefits under
this Act. However, the employee shall submit to |
all physical
examinations required by this Act. The cost of |
such treatment and
nursing care shall be paid by the employee |
unless the employer agrees to
make such payment.
|
Where the accidental injury results in the amputation of an |
arm,
hand, leg or foot, or the enucleation of an eye, or the |
loss of any of
the natural teeth, the employer shall furnish an |
artificial of any such
members lost or damaged in accidental |
injury arising out of and in the
course of employment, and |
shall also furnish the necessary braces in all
proper and |
necessary cases. In cases of the loss of a member or members
by |
amputation, the employer shall, whenever necessary, maintain |
in good
repair, refit or replace the artificial limbs during |
the lifetime of the
employee. Where the accidental injury |
accompanied by physical injury
results in damage to a denture, |
eye glasses or contact eye lenses, or
where the accidental |
injury results in damage to an artificial member,
the employer |
shall replace or repair such denture, glasses, lenses, or
|
artificial member.
|
The furnishing by the employer of any such services or |
appliances is
not an admission of liability on the part of the |
employer to pay
compensation.
|
The furnishing of any such services or appliances or the |
servicing
thereof by the employer is not the payment of |
|
compensation.
|
(b) If the period of temporary total incapacity for work |
lasts more
than 3 working days, weekly compensation as |
hereinafter provided shall
be paid beginning on the 4th day of |
such temporary total incapacity and
continuing as long as the |
total temporary incapacity lasts. In cases
where the temporary |
total incapacity for work continues for a period of
14 days or |
more from the day of the accident compensation shall commence
|
on the day after the accident.
|
1. The compensation rate for temporary total |
incapacity under this
paragraph (b) of this Section shall |
be equal to 66 2/3% of the
employee's average weekly wage |
computed in accordance with Section 10,
provided that it |
shall be not less than 66 2/3% of the sum of the Federal |
minimum wage under the Fair Labor
Standards Act, or the |
Illinois minimum wage under the Minimum Wage Law,
whichever |
is more, multiplied by 40 hours. This percentage rate shall |
be
increased by 10% for each spouse and child, not to |
exceed 100% of the total
minimum wage calculation,
the |
following amounts in the
following cases:
|
$100.90 in case of a single person;
|
$105.50 in case of a married person with no |
children;
|
$108.30 in case of one child;
|
$113.40 in case of 2 children;
|
$117.40 in case of 3 children;
|
$124.30 in case of 4 or more children;
|
nor exceed the employee's average weekly wage computed in |
accordance
with the provisions of Section 10, whichever is |
less.
|
2. The compensation rate in all cases other than for |
temporary total
disability under this paragraph (b), and |
other than for serious and
permanent disfigurement under |
paragraph (c) and other than for permanent
partial |
disability under subparagraph (2) of paragraph (d) or under
|
paragraph (e), of this Section shall be equal to 66
2/3% of |
|
the employee's average weekly wage computed in accordance |
with
the provisions of Section 10, provided that it shall |
be not less than
66 2/3% of the sum of the Federal minimum |
wage under the Fair Labor Standards Act, or the Illinois |
minimum wage under the Minimum Wage Law, whichever is more, |
multiplied by 40 hours. This percentage rate shall be |
increased by 10% for each spouse and child, not to exceed |
100% of the total minimum wage calculation,
the following |
amounts in the following cases:
|
$80.90 in case of a single person;
|
$83.20 in case of a married person with no |
children;
|
$86.10 in case of one child;
|
$88.90 in case of 2 children;
|
$91.80 in case of 3 children;
|
$96.90 in case of 4 or more children;
|
nor exceed the employee's average weekly wage computed in |
accordance
with the provisions of Section 10, whichever is |
less.
|
2.1. The compensation rate in all cases of serious and |
permanent
disfigurement under paragraph (c) and of |
permanent partial disability
under subparagraph (2) of |
paragraph (d) or under paragraph (e) of this
Section shall |
be equal to
60% of the employee's average
weekly wage |
computed in accordance with
the provisions of Section 10, |
provided that it shall be not less than
66 2/3% of the sum |
of the Federal minimum wage under the Fair Labor Standards |
Act, or the Illinois minimum wage under the Minimum Wage |
Law, whichever is more, multiplied by 40 hours. This |
percentage rate shall be increased by 10% for each spouse |
and child, not to exceed 100% of the total minimum wage |
calculation,
the following amounts in the following cases:
|
$80.90 in case of a single person;
|
$83.20 in case of a married person with no |
children;
|
$86.10 in case of one child;
|
|
$88.90 in case of 2 children;
|
$91.80 in case of 3 children;
|
$96.90 in case of 4 or more children;
|
nor exceed the employee's average weekly wage computed in |
accordance
with the provisions of Section 10, whichever is |
less.
|
3. As used in this Section the term "child" means a |
child of the
employee including any child legally adopted |
before the accident or whom
at the time of the accident the |
employee was under legal obligation to
support or to whom |
the employee stood in loco parentis, and who at the
time of |
the accident was under 18 years of age and not emancipated. |
The
term "children" means the plural of "child".
|
4. All weekly compensation rates provided under |
subparagraphs 1,
2 and 2.1 of this paragraph (b) of this |
Section shall be subject to the
following limitations:
|
The maximum weekly compensation rate from July 1, 1975, |
except as
hereinafter provided, shall be 100% of the |
State's average weekly wage in
covered industries under the |
Unemployment Insurance Act, that being the
wage that most |
closely approximates the State's average weekly wage.
|
The maximum weekly compensation rate, for the period |
July 1, 1984,
through June 30, 1987, except as hereinafter |
provided, shall be $293.61.
Effective July 1, 1987 and on |
July 1 of each year thereafter the maximum
weekly |
compensation rate, except as hereinafter provided, shall |
be
determined as follows: if during the preceding 12 month |
period there shall
have been an increase in the State's |
average weekly wage in covered
industries under the |
Unemployment Insurance Act, the weekly compensation
rate |
shall be proportionately increased by the same percentage |
as the
percentage of increase in the State's average weekly |
wage in covered
industries under the Unemployment |
Insurance Act during such period.
|
The maximum weekly compensation rate, for the period |
January 1, 1981
through December 31, 1983, except as |
|
hereinafter provided, shall be 100% of
the State's average |
weekly wage in covered industries under the
Unemployment |
Insurance Act in effect on January 1, 1981. Effective |
January
1, 1984 and on January 1, of each year thereafter |
the maximum weekly
compensation rate, except as |
hereinafter provided, shall be determined as
follows: if |
during the preceding 12 month period there shall have been |
an
increase in the State's average weekly wage in covered |
industries under the
Unemployment Insurance Act, the |
weekly compensation rate shall be
proportionately |
increased by the same percentage as the percentage of
|
increase in the State's average weekly wage in covered |
industries under the
Unemployment Insurance Act during |
such period.
|
From July 1, 1977 and thereafter such maximum weekly |
compensation
rate in death cases under Section 7, and |
permanent total disability
cases under paragraph (f) or |
subparagraph 18 of paragraph (3) of this
Section and for |
temporary total disability under paragraph (b) of this
|
Section and for amputation of a member or enucleation of an |
eye under
paragraph (e) of this Section shall be increased |
to 133-1/3% of the
State's average weekly wage in covered |
industries under the
Unemployment Insurance Act.
|
For injuries occurring on or after February 1, 2006, |
the maximum weekly benefit under paragraph (d)1 of this |
Section shall be 100% of the State's average weekly wage in |
covered industries under the Unemployment Insurance Act.
|
4.1. Any provision herein to the contrary |
notwithstanding, the
weekly compensation rate for |
compensation payments under subparagraph 18
of paragraph |
(e) of this Section and under paragraph (f) of this
Section |
and under paragraph (a) of Section 7 and for amputation of |
a member or enucleation of an eye under paragraph (e) of |
this Section , shall in no event be less
than 50% of the |
State's average weekly wage in covered industries under
the |
Unemployment Insurance Act.
|
|
4.2. Any provision to the contrary notwithstanding, |
the total
compensation payable under Section 7 shall not |
exceed the greater of $500,000
$250,000 or 25
20 years.
|
5. For the purpose of this Section this State's average |
weekly wage
in covered industries under the Unemployment |
Insurance Act on
July 1, 1975 is hereby fixed at $228.16 |
per
week and the computation of compensation rates shall be |
based on the
aforesaid average weekly wage until modified |
as hereinafter provided.
|
6. The Department of Employment Security of the State |
shall
on or before the first day of December, 1977, and on |
or before the first
day of June, 1978, and on the first day |
of each December and June of each
year thereafter, publish |
the State's average weekly wage in covered
industries under |
the Unemployment Insurance Act and the Illinois Workers' |
Compensation
Commission shall on the 15th day of January, |
1978 and on the 15th day of
July, 1978 and on the 15th day |
of each January and July of each year
thereafter, post and |
publish the State's average weekly wage in covered
|
industries under the Unemployment Insurance Act as last |
determined and
published by the Department of Employment |
Security. The amount when so
posted and published shall be |
conclusive and shall be applicable as the
basis of |
computation of compensation rates until the next posting |
and
publication as aforesaid.
|
7. The payment of compensation by an employer or his |
insurance
carrier to an injured employee shall not |
constitute an admission of the
employer's liability to pay |
compensation.
|
(c) For any serious and permanent disfigurement to the |
hand, head,
face, neck, arm, leg below the knee or the chest |
above the axillary
line, the employee is entitled to |
compensation for such disfigurement,
the amount determined by |
agreement at any time or by arbitration under
this Act, at a |
hearing not less than 6 months after the date of the
accidental |
injury, which amount shall not exceed 162
150 weeks at the
|
|
applicable rate provided in subparagraph 2.1 of paragraph (b) |
of this Section.
|
No compensation is payable under this paragraph where |
compensation is
payable under paragraphs (d), (e) or (f) of |
this Section.
|
A duly appointed member of a fire department in a city, the |
population of
which exceeds 200,000 according to the last |
federal or State census, is
eligible for compensation under |
this paragraph only where such serious and
permanent |
disfigurement results from burns.
|
(d) 1. If, after the accidental injury has been sustained, |
the
employee as a result thereof becomes partially |
incapacitated from
pursuing his usual and customary line of |
employment, he shall, except in
cases compensated under the |
specific schedule set forth in paragraph (e)
of this Section, |
receive compensation for the duration of his
disability, |
subject to the limitations as to maximum amounts fixed in
|
paragraph (b) of this Section, equal to 66-2/3% of the |
difference
between the average amount which he would be able to |
earn in the full
performance of his duties in the occupation in |
which he was engaged at
the time of the accident and the |
average amount which he is earning or
is able to earn in some |
suitable employment or business after the accident.
|
2. If, as a result of the accident, the employee sustains |
serious
and permanent injuries not covered by paragraphs (c) |
and (e) of this
Section or having sustained injuries covered by |
the aforesaid
paragraphs (c) and (e), he shall have sustained |
in addition thereto
other injuries which injuries do not |
incapacitate him from pursuing the
duties of his employment but |
which would disable him from pursuing other
suitable |
occupations, or which have otherwise resulted in physical
|
impairment; or if such injuries partially incapacitate him from |
pursuing
the duties of his usual and customary line of |
employment but do not
result in an impairment of earning |
capacity, or having resulted in an
impairment of earning |
capacity, the employee elects to waive his right
to recover |
|
under the foregoing subparagraph 1 of paragraph (d) of this
|
Section then in any of the foregoing events, he shall receive |
in
addition to compensation for temporary total disability |
under paragraph
(b) of this Section, compensation at the rate |
provided in subparagraph 2.1
of paragraph (b) of this Section |
for that percentage of 500 weeks that
the partial disability |
resulting from the injuries covered by this
paragraph bears to |
total disability. If the employee shall have
sustained a |
fracture of one or more vertebra or fracture of the skull,
the |
amount of compensation allowed under this Section shall be not |
less
than 6 weeks for a fractured skull and 6 weeks for each |
fractured
vertebra, and in the event the employee shall have |
sustained a fracture
of any of the following facial bones: |
nasal, lachrymal, vomer, zygoma,
maxilla, palatine or |
mandible, the amount of compensation allowed under
this Section |
shall be not less than 2 weeks for each such fractured
bone, |
and for a fracture of each transverse process not less than 3
|
weeks. In the event such injuries shall result in the loss of a |
kidney,
spleen or lung, the amount of compensation allowed |
under this Section
shall be not less than 10 weeks for each |
such organ. Compensation
awarded under this subparagraph 2 |
shall not take into consideration
injuries covered under |
paragraphs (c) and (e) of this Section and the
compensation |
provided in this paragraph shall not affect the employee's
|
right to compensation payable under paragraphs (b), (c) and (e) |
of this
Section for the disabilities therein covered.
|
(e) For accidental injuries in the following schedule, the |
employee
shall receive compensation for the period of temporary |
total incapacity
for work resulting from such accidental |
injury, under subparagraph 1 of
paragraph (b) of this Section, |
and shall receive in addition thereto
compensation for a |
further period for the specific loss herein
mentioned, but |
shall not receive any compensation under any other
provisions |
of this Act. The following listed amounts apply to either
the |
loss of or the permanent and complete loss of use of the member
|
specified, such compensation for the length of time as follows:
|
|
1. Thumb- 76
70 weeks.
|
2. First, or index finger- 43
40 weeks.
|
3. Second, or middle finger- 38
35 weeks.
|
4. Third, or ring finger- 27
25 weeks.
|
5. Fourth, or little finger- 22
20 weeks.
|
6. Great toe- 38
35 weeks.
|
7. Each toe other than great toe- 13
12 weeks.
|
8. The loss of the first or distal phalanx of the thumb |
or of any
finger or toe shall be considered to be equal to |
the loss of one-half of
such thumb, finger or toe and the |
compensation payable shall be one-half
of the amount above |
specified. The loss of more than one phalanx shall
be |
considered as the loss of the entire thumb, finger or toe. |
In no
case shall the amount received for more than one |
finger exceed the
amount provided in this schedule for the |
loss of a hand.
|
9. Hand- 205
190 weeks. The loss of 2 or more digits, or |
one or more
phalanges of 2 or more digits, of a hand may be |
compensated on the basis
of partial loss of use of a hand, |
provided, further, that the loss of 4
digits, or the loss |
of use of 4 digits, in the same hand shall
constitute the |
complete loss of a hand.
|
10. Arm- 253
235 weeks. Where an accidental injury |
results in the
amputation of an arm below the elbow, such |
injury shall be compensated
as a loss of an arm. Where an |
accidental injury results in the
amputation of an arm above |
the elbow, compensation for an additional 17
15
weeks shall |
be paid, except where the accidental injury results in the
|
amputation of an arm at the shoulder joint, or so close to |
shoulder
joint that an artificial arm cannot be used, or |
results in the
disarticulation of an arm at the shoulder |
joint, in which case
compensation for an additional 70
65 |
weeks shall be paid.
|
11. Foot- 167
155 weeks.
|
12. Leg- 215
200 weeks. Where an accidental injury |
results in the
amputation of a leg below the knee, such |
|
injury shall be compensated as
loss of a leg. Where an |
accidental injury results in the amputation of a
leg above |
the knee, compensation for an additional 27
25 weeks shall |
be
paid, except where the accidental injury results in the |
amputation of a
leg at the hip joint, or so close to the |
hip joint that an artificial
leg cannot be used, or results |
in the disarticulation of a leg at the
hip joint, in which |
case compensation for an additional 81
75 weeks shall
be |
paid.
|
13. Eye- 162
150 weeks. Where an accidental injury |
results in the
enucleation of an eye, compensation for an |
additional 11
10 weeks shall be
paid.
|
14. Loss of hearing of one ear- 54
50 weeks; total and |
permanent loss of
hearing of both ears- 215
200 weeks.
|
15. Testicle- 54
50 weeks; both testicles- 162
150 |
weeks.
|
16. For the permanent partial loss of use of a member |
or sight of an
eye, or hearing of an ear, compensation |
during that proportion of the
number of weeks in the |
foregoing schedule provided for the loss of such
member or |
sight of an eye, or hearing of an ear, which the partial |
loss
of use thereof bears to the total loss of use of such |
member, or sight
of eye, or hearing of an ear.
|
(a) Loss of hearing for compensation purposes |
shall be
confined to the frequencies of 1,000, 2,000 |
and 3,000 cycles per second.
Loss of hearing ability |
for frequency tones above 3,000 cycles per second
are |
not to be considered as constituting disability for |
hearing.
|
(b) The percent of hearing loss, for purposes of |
the
determination of compensation claims for |
occupational deafness,
shall be calculated as the |
average in decibels for the thresholds
of hearing for |
the frequencies of 1,000, 2,000 and 3,000 cycles per |
second.
Pure tone air conduction audiometric |
instruments, approved by
nationally recognized |
|
authorities in this field, shall be used for measuring
|
hearing loss. If the losses of hearing average 30 |
decibels or less in the
3 frequencies, such losses of |
hearing shall not then constitute any
compensable |
hearing disability. If the losses of hearing average 85
|
decibels or more in the 3 frequencies, then the same |
shall constitute and
be total or 100% compensable |
hearing loss.
|
(c) In measuring hearing impairment, the lowest |
measured
losses in each of the 3 frequencies shall be |
added together and
divided by 3 to determine the |
average decibel loss. For every decibel
of loss |
exceeding 30 decibels an allowance of 1.82% shall be |
made up to
the maximum of 100% which is reached at 85 |
decibels.
|
(d) If a hearing loss is established to have |
existed on July 1, 1975 by
audiometric testing the |
employer shall not be liable for the previous loss
so |
established nor shall he be liable for any loss for |
which compensation
has been paid or awarded.
|
(e) No consideration shall be given to the question |
of
whether or not the ability of an employee to |
understand speech
is improved by the use of a hearing |
aid.
|
(f) No claim for loss of hearing due to industrial |
noise
shall be brought against an employer or allowed |
unless the employee has
been exposed for a period of |
time sufficient to cause permanent impairment
to noise |
levels in excess of the following:
|
|
Sound Level DBA |
|
|
Slow Response |
Hours Per Day |
|
90 |
8 |
|
92 |
6 |
|
95 |
4 |
|
97 |
3 |
|
100 |
2 |
|
|
|
102 |
1-1/2 |
|
105 |
1 |
|
110 |
1/2 |
|
115 |
1/4 |
|
This subparagraph (f) shall not be applied in cases of |
hearing loss
resulting from trauma or explosion.
|
17. In computing the compensation to be paid to any |
employee who,
before the accident for which he claims |
compensation, had before that
time sustained an injury |
resulting in the loss by amputation or partial
loss by |
amputation of any member, including hand, arm, thumb or |
fingers,
leg, foot or any toes, such loss or partial loss |
of any such member
shall be deducted from any award made |
for the subsequent injury. For
the permanent loss of use or |
the permanent partial loss of use of any
such member or the |
partial loss of sight of an eye, for which
compensation has |
been paid, then such loss shall be taken into
consideration |
and deducted from any award for the subsequent injury.
|
18. The specific case of loss of both hands, both arms, |
or both
feet, or both legs, or both eyes, or of any two |
thereof, or the
permanent and complete loss of the use |
thereof, constitutes total and
permanent disability, to be |
compensated according to the compensation
fixed by |
paragraph (f) of this Section. These specific cases of |
total
and permanent disability do not exclude other cases.
|
Any employee who has previously suffered the loss or |
permanent and
complete loss of the use of any of such |
members, and in a subsequent
independent accident loses |
another or suffers the permanent and complete
loss of the |
use of any one of such members the employer for whom the
|
injured employee is working at the time of the last |
independent accident
is liable to pay compensation only for |
the loss or permanent and
complete loss of the use of the |
member occasioned by the last
independent accident.
|
19. In a case of specific loss and the subsequent death |
of such
injured employee from other causes than such injury |
|
leaving a widow,
widower, or dependents surviving before |
payment or payment in full for
such injury, then the amount |
due for such injury is payable to the widow
or widower and, |
if there be no widow or widower, then to such
dependents, |
in the proportion which such dependency bears to total
|
dependency.
|
Beginning July 1, 1980, and every 6 months thereafter, the |
Commission
shall examine the Second Injury Fund and when, after |
deducting all
advances or loans made to such Fund, the amount |
therein is $500,000
then the amount required to be paid by |
employers pursuant to paragraph
(f) of Section 7 shall be |
reduced by one-half. When the Second Injury Fund
reaches the |
sum of $600,000 then the payments shall cease entirely.
|
However, when the Second Injury Fund has been reduced to |
$400,000, payment
of one-half of the amounts required by |
paragraph (f) of Section 7
shall be resumed, in the manner |
herein provided, and when the Second Injury
Fund has been |
reduced to $300,000, payment of the full amounts required by
|
paragraph (f) of Section 7 shall be resumed, in the manner |
herein provided.
The Commission shall make the changes in |
payment effective by
general order, and the changes in payment |
become immediately effective
for all cases coming before the |
Commission thereafter either by
settlement agreement or final |
order, irrespective of the date of the
accidental injury.
|
On August 1, 1996 and on February 1 and August 1 of each |
subsequent year, the Commission
shall examine the special fund |
designated as the "Rate
Adjustment Fund" and when, after |
deducting all advances or loans made to
said fund, the amount |
therein is $4,000,000, the amount required to be
paid by |
employers pursuant to paragraph (f) of Section 7 shall be
|
reduced by one-half. When the Rate Adjustment Fund reaches the |
sum of
$5,000,000 the payment therein shall cease entirely. |
However, when said
Rate Adjustment Fund has been reduced to |
$3,000,000 the amounts required by
paragraph (f) of Section 7 |
shall be resumed in the manner herein provided.
|
(f) In case of complete disability, which renders the |
|
employee
wholly and permanently incapable of work, or in the |
specific case of
total and permanent disability as provided in |
subparagraph 18 of
paragraph (e) of this Section, compensation |
shall be payable at the rate
provided in subparagraph 2 of |
paragraph (b) of this Section for life.
|
An employee entitled to benefits under paragraph (f) of |
this Section
shall also be entitled to receive from the Rate |
Adjustment
Fund provided in paragraph (f) of Section 7 of the |
supplementary benefits
provided in paragraph (g) of this |
Section 8.
|
If any employee who receives an award under this paragraph |
afterwards
returns to work or is able to do so, and earns or is |
able to earn as
much as before the accident, payments under |
such award shall cease. If
such employee returns to work, or is |
able to do so, and earns or is able
to earn part but not as much |
as before the accident, such award shall be
modified so as to |
conform to an award under paragraph (d) of this
Section. If |
such award is terminated or reduced under the provisions of
|
this paragraph, such employees have the right at any time |
within 30
months after the date of such termination or |
reduction to file petition
with the Commission for the purpose |
of determining whether any
disability exists as a result of the |
original accidental injury and the
extent thereof.
|
Disability as enumerated in subdivision 18, paragraph (e) |
of this
Section is considered complete disability.
|
If an employee who had previously incurred loss or the |
permanent and
complete loss of use of one member, through the |
loss or the permanent
and complete loss of the use of one hand, |
one arm, one foot, one leg, or
one eye, incurs permanent and |
complete disability through the loss or
the permanent and |
complete loss of the use of another member, he shall
receive, |
in addition to the compensation payable by the employer and
|
after such payments have ceased, an amount from the Second |
Injury Fund
provided for in paragraph (f) of Section 7, which, |
together with the
compensation payable from the employer in |
whose employ he was when the
last accidental injury was |
|
incurred, will equal the amount payable for
permanent and |
complete disability as provided in this paragraph of this
|
Section.
|
The custodian of the Second Injury Fund provided for in |
paragraph (f)
of Section 7 shall be joined with the employer as |
a party respondent in
the application for adjustment of claim. |
The application for adjustment
of claim shall state briefly and |
in general terms the approximate time
and place and manner of |
the loss of the first member.
|
In its award the Commission or the Arbitrator shall |
specifically find
the amount the injured employee shall be |
weekly paid, the number of
weeks compensation which shall be |
paid by the employer, the date upon
which payments begin out of |
the Second Injury Fund provided for in
paragraph (f) of Section |
7 of this Act, the length of time the weekly
payments continue, |
the date upon which the pension payments commence and
the |
monthly amount of the payments. The Commission shall 30 days |
after
the date upon which payments out of the Second Injury |
Fund have begun as
provided in the award, and every month |
thereafter, prepare and submit to
the State Comptroller a |
voucher for payment for all compensation accrued
to that date |
at the rate fixed by the Commission. The State Comptroller
|
shall draw a warrant to the injured employee along with a |
receipt to be
executed by the injured employee and returned to |
the Commission. The
endorsed warrant and receipt is a full and |
complete acquittance to the
Commission for the payment out of |
the Second Injury Fund. No other
appropriation or warrant is |
necessary for payment out of the Second
Injury Fund. The Second |
Injury Fund is appropriated for the purpose of
making payments |
according to the terms of the awards.
|
As of July 1, 1980 to July 1, 1982, all claims against and |
obligations
of the Second Injury Fund shall become claims |
against and obligations of
the Rate Adjustment Fund to the |
extent there is insufficient money in the
Second Injury Fund to |
pay such claims and obligations. In that case, all
references |
to "Second Injury Fund" in this Section shall also include the
|
|
Rate Adjustment Fund.
|
(g) Every award for permanent total disability entered by |
the
Commission on and after July 1, 1965 under which |
compensation payments
shall become due and payable after the |
effective date of this amendatory
Act, and every award for |
death benefits or permanent total disability
entered by the |
Commission on and after the effective date of this
amendatory |
Act shall be subject to annual adjustments as to the amount
of |
the compensation rate therein provided. Such adjustments shall |
first
be made on July 15, 1977, and all awards made and entered |
prior to July
1, 1975 and on July 15 of each year
thereafter. |
In all other cases such adjustment shall be made on July 15
of |
the second year next following the date of the entry of the |
award and
shall further be made on July 15 annually thereafter. |
If during the
intervening period from the date of the entry of |
the award, or the last
periodic adjustment, there shall have |
been an increase in the State's
average weekly wage in covered |
industries under the Unemployment
Insurance Act, the weekly |
compensation rate shall be proportionately
increased by the |
same percentage as the percentage of increase in the
State's |
average weekly wage in covered industries under the
|
Unemployment Insurance Act. The increase in the compensation |
rate
under this paragraph shall in no event bring the total |
compensation rate
to an amount greater than the prevailing |
maximum rate at the time that the annual adjustment is made . |
Such increase
shall be paid in the same manner as herein |
provided for payments under
the Second Injury Fund to the |
injured employee, or his dependents, as
the case may be, out of |
the Rate Adjustment Fund provided
in paragraph (f) of Section 7 |
of this Act. Payments shall be made at
the same intervals as |
provided in the award or, at the option of the
Commission, may |
be made in quarterly payment on the 15th day of January,
April, |
July and October of each year. In the event of a decrease in
|
such average weekly wage there shall be no change in the then |
existing
compensation rate. The within paragraph shall not |
apply to cases where
there is disputed liability and in which a |
|
compromise lump sum settlement
between the employer and the |
injured employee, or his dependents, as the
case may be, has |
been duly approved by the Illinois Workers' Compensation
|
Commission.
|
Provided, that in cases of awards entered by the Commission |
for
injuries occurring before July 1, 1975, the increases in |
the
compensation rate adjusted under the foregoing provision of |
this
paragraph (g) shall be limited to increases in the State's |
average
weekly wage in covered industries under the |
Unemployment Insurance Act
occurring after July 1, 1975.
|
For every accident occurring after the effective date of |
this amendatory Act of the 94th General Assembly, the annual |
adjustments to the compensation rate in awards for death |
benefits or permanent total disability, as provided in this |
Act, shall be paid by the employer. The adjustment shall be |
made by the employer on July 15 of the second year next |
following the date of the entry of the award and shall further |
be made on July 15 annually thereafter. If during the |
intervening period from the date of the entry of the award, or |
the last periodic adjustment, there shall have been an increase |
in the State's average weekly wage in covered industries under |
the Unemployment Insurance Act, the employer shall increase the |
weekly compensation rate proportionately by the same |
percentage as the percentage of increase in the State's average |
weekly wage in covered industries under the Unemployment |
Insurance Act. The increase in the compensation rate under this |
paragraph shall in no event bring the total compensation rate |
to an amount greater than the prevailing maximum rate at the |
time that the annual adjustment is made. In the event of a |
decrease in such average weekly wage there shall be no change |
in the then existing compensation rate. Such increase shall be |
paid by the employer in the same manner and at the same |
intervals as the payment of compensation in the award. This |
paragraph shall not apply to cases where there is disputed |
liability and in which a compromise lump sum settlement between |
the employer and the injured employee, or his or her |
|
dependents, as the case may be, has been duly approved by the |
Illinois Workers' Compensation Commission. |
The annual adjustments for every award of death benefits or |
permanent total disability involving accidents occurring |
before the effective date of this amendatory Act of the 94th |
General Assembly shall continue to be paid from the Rate |
Adjustment Fund pursuant to this paragraph and Section 7(f) of |
this Act.
|
(h) In case death occurs from any cause before the total
|
compensation to which the employee would have been entitled has |
been
paid, then in case the employee leaves any widow, widower, |
child, parent
(or any grandchild, grandparent or other lineal |
heir or any collateral
heir dependent at the time of the |
accident upon the earnings of the
employee to the extent of 50% |
or more of total dependency) such
compensation shall be paid to |
the beneficiaries of the deceased employee
and distributed as |
provided in paragraph (g) of Section 7.
|
(h-1) In case an injured employee is under legal disability
|
at the time when any right or privilege accrues to him or her |
under this
Act, a guardian may be appointed pursuant to law, |
and may, on behalf
of such person under legal disability, claim |
and exercise any
such right or privilege with the same effect |
as if the employee himself
or herself had claimed or exercised |
the right or privilege. No limitations
of time provided by this |
Act run so long as the employee who is under legal
disability |
is without a conservator or guardian.
|
(i) In case the injured employee is under 16 years of age |
at the
time of the accident and is illegally employed, the |
amount of
compensation payable under paragraphs (b), (c), (d), |
(e) and (f) of this
Section is increased 50%.
|
However, where an employer has on file an employment |
certificate
issued pursuant to the Child Labor Law or work |
permit issued pursuant
to the Federal Fair Labor Standards Act, |
as amended, or a birth
certificate properly and duly issued, |
such certificate, permit or birth
certificate is conclusive |
evidence as to the age of the injured minor
employee for the |
|
purposes of this Section.
|
Nothing herein contained repeals or amends the provisions |
of the
Child Labor Law relating to the employment of minors |
under the age of 16 years.
|
(j) 1. In the event the injured employee receives benefits,
|
including medical, surgical or hospital benefits under any |
group plan
covering non-occupational disabilities contributed |
to wholly or
partially by the employer, which benefits should |
not have been payable
if any rights of recovery existed under |
this Act, then such amounts so
paid to the employee from any |
such group plan as shall be consistent
with, and limited to, |
the provisions of paragraph 2 hereof, shall be
credited to or |
against any compensation payment for temporary total
|
incapacity for work or any medical, surgical or hospital |
benefits made
or to be made under this Act. In such event, the |
period of time for
giving notice of accidental injury and |
filing application for adjustment
of claim does not commence to |
run until the termination of such
payments. This paragraph does |
not apply to payments made under any
group plan which would |
have been payable irrespective of an accidental
injury under |
this Act. Any employer receiving such credit shall keep
such |
employee safe and harmless from any and all claims or |
liabilities
that may be made against him by reason of having |
received such payments
only to the extent of such credit.
|
Any excess benefits paid to or on behalf of a State |
employee by the
State Employees' Retirement System under |
Article 14 of the Illinois Pension
Code on a death claim or |
disputed disability claim shall be credited
against any |
payments made or to be made by the State of Illinois to or on
|
behalf of such employee under this Act, except for payments for |
medical
expenses which have already been incurred at the time |
of the award. The
State of Illinois shall directly reimburse |
the State Employees' Retirement
System to the extent of such |
credit.
|
2. Nothing contained in this Act shall be construed to give |
the
employer or the insurance carrier the right to credit for |
|
any benefits
or payments received by the employee other than |
compensation payments
provided by this Act, and where the |
employee receives payments other
than compensation payments, |
whether as full or partial salary, group
insurance benefits, |
bonuses, annuities or any other payments, the
employer or |
insurance carrier shall receive credit for each such payment
|
only to the extent of the compensation that would have been |
payable
during the period covered by such payment.
|
3. The extension of time for the filing of an Application |
for
Adjustment of Claim as provided in paragraph 1 above shall |
not apply to
those cases where the time for such filing had |
expired prior to the date
on which payments or benefits |
enumerated herein have been initiated or
resumed. Provided |
however that this paragraph 3 shall apply only to
cases wherein |
the payments or benefits hereinabove enumerated shall be
|
received after July 1, 1969.
|
(Source: P.A. 93-721, eff. 1-1-05.)
|
(820 ILCS 305/8.2 new)
|
Sec. 8.2. Fee schedule.
|
(a) Except as provided for in subsection (c), on and after |
February 1, 2006, the maximum allowable payment for procedures, |
treatments, or services covered under this Act shall be 90% of |
the 80th percentile of charges and fees as determined by the |
Commission utilizing information provided by employers' and |
insurers' national databases, with a minimum of 12,000,000 |
Illinois line item charges and fees comprised of health care |
provider and hospital charges and fees as of August 1, 2004 but |
not earlier than August 1, 2002. These charges and fees are |
provider billed amounts and shall not include discounted |
charges. The 80th percentile is the point on an ordered data |
set from low to high such that 80% of the cases are below or |
equal to that point and at most 20% are above or equal to that |
point. The Commission shall adjust these historical charges and |
fees as of August 1, 2004 by the Consumer Price Index-U for the |
period August 1, 2004 through September 30, 2005. The |
|
Commission shall establish fee schedules for procedures, |
treatments, or services for hospital inpatient, hospital |
outpatient, emergency room and trauma, ambulatory surgical |
treatment centers, and professional services. These charges |
and fees shall be designated by geozip or any smaller |
geographic unit. The data shall in no way identify or tend to |
identify any patient, employer, or health care provider. As |
used in this Section, "geozip" means a three-digit zip code |
based on data similarities, geographical similarities, and |
frequencies. A geozip does not cross state boundaries. As used |
in this Section, "three-digit zip code" means a geographic area |
in which all zip codes have the same first 3 digits. If a |
geozip does not have the necessary number of charges and fees |
to calculate a valid percentile for a specific procedure, |
treatment, or service, the Commission may combine data from the |
geozip with up to 4 other geozips that are demographically and |
economically similar and exhibit similarities in data and |
frequencies until the Commission reaches 9 charges or fees for |
that specific procedure, treatment, or service. In cases where |
the compiled data contains less than 9 charges or fees for a |
procedure, treatment, or service, reimbursement shall occur at |
76% of charges and fees as determined by the Commission in a |
manner consistent with the provisions of this paragraph. The |
Commission has the authority to set the maximum allowable |
payment to providers of out-of-state procedures, treatments, |
or services covered under this Act in a manner consistent with |
this Section. Not later than September 30 in 2006 and each year |
thereafter, the Commission shall automatically increase or |
decrease the maximum allowable payment for a procedure, |
treatment, or service established and in effect on January 1 of |
that year by the percentage change in the Consumer Price |
Index-U for the 12 month period ending August 31 of that year. |
The increase or decrease shall become effective on January 1 of |
the following year. As used in this Section, "Consumer Price |
Index-U" means the index published by the Bureau of Labor |
Statistics of the U.S. Department of Labor, that measures the |
|
average change in prices of all goods and services purchased by |
all urban consumers, U.S. city average, all items, 1982-84=100. |
(b) Notwithstanding the provisions of subsection (a), if
|
the Commission finds that there is a significant limitation on
|
access to quality health care in either a specific field of
|
health care services or a specific geographic limitation on
|
access to health care, it may change the Consumer Price Index-U
|
increase or decrease for that specific field or specific
|
geographic limitation on access to health care to address that
|
limitation. |
(c) The Commission shall establish by rule a process to |
review those medical cases or outliers that involve |
extra-ordinary treatment to determine whether to make an |
additional adjustment to the maximum payment within a fee |
schedule for a procedure, treatment, or service. |
(d) When a patient notifies a provider that the treatment, |
procedure, or service being sought is for a work-related |
illness or injury and furnishes the provider the name and |
address of the responsible employer, the provider shall bill |
the employer directly. The employer shall make payment and |
providers shall submit bills and records in accordance with the |
provisions of this Section. All payments to providers for |
treatment provided pursuant to this Act shall be made within 60 |
days of receipt of the bills as long as the claim contains |
substantially all the required data elements necessary to |
adjudicate the bills. In the case of nonpayment to a provider |
within 60 days of receipt of the bill which contained |
substantially all of the required data elements necessary to |
adjudicate the bill or nonpayment to a provider of a portion of |
such a bill up to the lesser of the actual charge or the |
payment level set by the Commission in the fee schedule |
established in this Section, the bill, or portion of the bill, |
shall incur interest at a rate of 1% per month payable to the |
provider. |
(e) Except as provided in subsections (e-5), (e-10), and |
(e-15), a provider shall not hold an employee liable for costs |
|
related to a non-disputed procedure, treatment, or service |
rendered in connection with a compensable injury. The |
provisions of subsections (e-5), (e-10), (e-15), and (e-20) |
shall not apply if an employee provides information to the |
provider regarding participation in a group health plan. If the |
employee participates in a group health plan, the provider may |
submit a claim for services to the group health plan. If the |
claim for service is covered by the group health plan, the |
employee's responsibility shall be limited to applicable |
deductibles, co-payments, or co-insurance. Except as provided |
under subsections (e-5), (e-10), (e-15), and (e-20), a provider |
shall not bill or otherwise attempt to recover from the |
employee the difference between the provider's charge and the |
amount paid by the employer or the insurer on a compensable |
injury. |
(e-5) If an employer notifies a provider that the employer |
does not consider the illness or injury to be compensable under |
this Act, the provider may seek payment of the provider's |
actual charges from the employee for any procedure, treatment, |
or service rendered. Once an employee informs the provider that |
there is an application filed with the Commission to resolve a |
dispute over payment of such charges, the provider shall cease |
any and all efforts to collect payment for the services that |
are the subject of the dispute. Any statute of limitations or |
statute of repose applicable to the provider's efforts to |
collect payment from the employee shall be tolled from the date |
that the employee files the application with the Commission |
until the date that the provider is permitted to resume |
collection efforts under the provisions of this Section. |
(e-10) If an employer notifies a provider that the employer |
will pay only a portion of a bill for any procedure, treatment, |
or service rendered in connection with a compensable illness or |
disease, the provider may seek payment from the employee for |
the remainder of the amount of the bill up to the lesser of the |
actual charge, negotiated rate, if applicable, or the payment |
level set by the Commission in the fee schedule established in |
|
this Section. Once an employee informs the provider that there |
is an application filed with the Commission to resolve a |
dispute over payment of such charges, the provider shall cease |
any and all efforts to collect payment for the services that |
are the subject of the dispute. Any statute of limitations or |
statute of repose applicable to the provider's efforts to |
collect payment from the employee shall be tolled from the date |
that the employee files the application with the Commission |
until the date that the provider is permitted to resume |
collection efforts under the provisions of this Section. |
(e-15) When there is a dispute over the compensability of |
or amount of payment for a procedure, treatment, or service, |
and a case is pending or proceeding before an Arbitrator or the |
Commission, the provider may mail the employee reminders that |
the employee will be responsible for payment of any procedure, |
treatment or service rendered by the provider. The reminders |
must state that they are not bills, to the extent practicable |
include itemized information, and state that the employee need |
not pay until such time as the provider is permitted to resume |
collection efforts under this Section. The reminders shall not |
be provided to any credit rating agency. The reminders may |
request that the employee furnish the provider with information |
about the proceeding under this Act, such as the file number, |
names of parties, and status of the case. If an employee fails |
to respond to such request for information or fails to furnish |
the information requested within 90 days of the date of the |
reminder, the provider is entitled to resume any and all |
efforts to collect payment from the employee for the services |
rendered to the employee and the employee shall be responsible |
for payment of any outstanding bills for a procedure, |
treatment, or service rendered by a provider. |
(e-20) Upon a final award or judgment by an Arbitrator or |
the Commission, or a settlement agreed to by the employer and |
the employee, a provider may resume any and all efforts to |
collect payment from the employee for the services rendered to |
the employee and the employee shall be responsible for payment |
|
of any outstanding bills for a procedure, treatment, or service |
rendered by a provider as well as the interest awarded under |
subsection (d) of this Section. In the case of a procedure, |
treatment, or service deemed compensable, the provider shall |
not require a payment rate, excluding the interest provisions |
under subsection (d), greater than the lesser of the actual |
charge or the payment level set by the Commission in the fee |
schedule established in this Section. Payment for services |
deemed not covered or not compensable under this Act is the |
responsibility of the employee unless a provider and employee |
have agreed otherwise in writing. Services not covered or not |
compensable under this Act are not subject to the fee schedule |
in this Section. |
(f) Nothing in this Act shall prohibit an employer or
|
insurer from contracting with a health care provider or group
|
of health care providers for reimbursement levels for benefits |
under this Act different
from those provided in this Section. |
(g) On or before January 1, 2010 the Commission shall |
provide to the Governor and General Assembly a report regarding |
the implementation of the medical fee schedule and the index |
used for annual adjustment to that schedule as described in |
this Section. |
(820 ILCS 305/8.3 new)
|
Sec. 8.3. Workers' Compensation Medical Fee Advisory |
Board. There is created a Workers' Compensation Medical Fee |
Advisory Board consisting of 9 members appointed by the |
Governor with the advice and consent of the Senate. Three |
members of the Advisory Board shall be representative citizens |
chosen from the employee class, 3 members shall be |
representative citizens chosen from the employing class, and 3 |
members shall be representative citizens chosen from the |
medical provider class. Each member shall serve a 4-year term |
and shall continue to serve until a successor is appointed. A |
vacancy on the Advisory Board shall be filled by the Governor |
for the unexpired term. |
|
Members of the Advisory Board shall receive no compensation |
for their services but shall be reimbursed for expenses |
incurred in the performance of their duties by the Commission |
from appropriations made to the Commission for that purpose. |
The Advisory Board shall advise the Commission on |
establishment of fees for medical services and accessibility of |
medical treatment. |
(820 ILCS 305/8.7 new) |
Sec. 8.7. Utilization review programs. |
(a) As used in this Section: |
"Utilization review" means the evaluation of proposed or |
provided health care services to determine the appropriateness |
of both the level of health care services medically necessary |
and the quality of health care services provided to a patient, |
including evaluation of their efficiency, efficacy, and |
appropriateness of treatment, hospitalization, or office |
visits based on medically accepted standards. The evaluation |
must be accomplished by means of a system that identifies the |
utilization of health care services based on standards of care |
or nationally recognized peer review guidelines as well as |
nationally recognized evidence based upon standards as |
provided in this Act. Utilization techniques may include |
prospective review, second opinions, concurrent review, |
discharge planning, peer review, independent medical |
examinations, and retrospective review. Nothing in this |
Section applies to prospective review of necessary first aid or |
emergency treatment. |
(b) No person may conduct a utilization review program for |
workers' compensation services in this State unless once every |
2 years the person registers the utilization review program |
with the Department of Financial and Professional Regulation |
and certifies compliance with the Workers' Compensation |
Utilization Management standards or Health Utilization |
Management Standards of URAC sufficient to achieve URAC |
accreditation or submits evidence of accreditation by URAC for |
|
its Workers' Compensation Utilization Management Standards or |
Health Utilization Management Standards. Nothing in this Act |
shall be construed to require an employer or insurer or its |
subcontractors to become URAC accredited. |
(c) In addition, the Secretary of Financial and |
Professional Regulation may certify alternative utilization |
review standards of national accreditation organizations or |
entities in order for plans to comply with this Section. Any |
alternative utilization review standards shall meet or exceed |
those standards required under subsection (b). |
(d) This registration shall include submission of all of |
the following information regarding utilization review program |
activities: |
(1) The name, address, and telephone number of the |
utilization review programs. |
(2) The organization and governing structure of the |
utilization review programs. |
(3) The number of lives for which utilization review is |
conducted by each utilization review program. |
(4) Hours of operation of each utilization review |
program. |
(5) Description of the grievance process for each |
utilization review program. |
(6) Number of covered lives for which utilization |
review was conducted for the previous calendar year for |
each utilization review program. |
(7) Written policies and procedures for protecting |
confidential information according to applicable State and |
federal laws for each utilization review program. |
(e) A utilization review program shall have written |
procedures to ensure that patient-specific information |
obtained during the process of utilization review will be: |
(1) kept confidential in accordance with applicable |
State and federal laws; and |
(2) shared only with the employee, the employee's |
designee, and the employee's health care provider, and |
|
those who are authorized by law to receive the information. |
Summary data shall not be considered confidential if it |
does not provide information to allow identification of |
individual patients or health care providers. |
Only a health care professional may make determinations |
regarding the medical necessity of health care services during |
the course of utilization review. |
When making retrospective reviews, utilization review |
programs shall base reviews solely on the medical information |
available to the attending physician or ordering provider at |
the time the health care services were provided. |
(f) If the Department of Financial and Professional |
Regulation finds that a utilization review program is not in |
compliance with this Section, the Department shall issue a |
corrective action plan and allow a reasonable amount of time |
for compliance with the plan. If the utilization review program |
does not come into compliance, the Department may issue a cease |
and desist order. Before issuing a cease and desist order under |
this Section, the Department shall provide the utilization |
review program with a written notice of the reasons for the |
order and allow a reasonable amount of time to supply |
additional information demonstrating compliance with the |
requirements of this Section and to request a hearing. The |
hearing notice shall be sent by certified mail, return receipt |
requested, and the hearing shall be conducted in accordance |
with the Illinois Administrative Procedure Act. |
(g) A utilization review program subject to a corrective |
action may continue to conduct business until a final decision |
has been issued by the Department. |
(h) The Secretary of Financial and Professional Regulation |
may by rule establish a registration fee for each person |
conducting a utilization review program. |
(i) A utilization review will be considered by the |
Commission, along with all other evidence and in the same |
manner as all other evidence, in the determination of the |
reasonableness and necessity of the medical bills or treatment. |
|
Nothing in this Section shall be construed to diminish the |
rights of employees to reasonable and necessary medical |
treatment or employee choice of health care provider under |
Section 8(a) or the rights of employers to medical examinations |
under Section 12. |
(j) When an employer denies payment of or refuses to |
authorize payment of first aid, medical, surgical, or hospital |
services under Section 8(a) of this Act, if that denial or |
refusal to authorize complies with a utilization review program |
registered under this Section and complies with all other |
requirements of this Section, then there shall be a rebuttable |
presumption that the employer shall not be responsible for |
payment of additional compensation pursuant to Section 19(k) of |
this Act and if that denial or refusal to authorize does not |
comply with a utilization review program registered under this |
Section and does not comply with all other requirements of this |
Section, then that will be considered by the Commission, along |
with all other evidence and in the same manner as all other |
evidence, in the determination of whether the employer may be |
responsible for the payment of additional compensation |
pursuant to Section 19(k) of this Act.
|
(820 ILCS 305/12) (from Ch. 48, par. 138.12)
|
Sec. 12. An employee entitled to receive disability |
payments shall be
required, if requested by the employer, to |
submit himself, at the
expense of the employer, for examination |
to a duly qualified medical
practitioner or surgeon selected by |
the employer, at any time and place
reasonably convenient for |
the employee, either within or without the
State of Illinois, |
for the purpose of determining the nature, extent and
probable |
duration of the injury received by the employee, and for the
|
purpose of ascertaining the amount of compensation which may be |
due the
employee from time to time for disability according to |
the provisions of
this Act. An employee may also be required to |
submit himself for examination
by medical experts under |
subsection (c) of Section 19.
|
|
An employer requesting such an examination, of an employee |
residing
within the State of Illinois, shall deliver to the |
employee with the notice of the time and place of examination
|
pay in advance of the time fixed for
the examination sufficient |
money to defray the necessary expense of
travel by the most |
convenient means to and from the place of
examination, and the |
cost of meals necessary during the trip, and if the
examination |
or travel to and from the place of examination causes any
loss |
of working time on the part of the employee, the employer shall
|
reimburse him for such loss of wages upon the basis of his |
average daily
wage. Such examination shall be made in the |
presence of a duly qualified
medical practitioner or surgeon |
provided and paid for by the employee,
if such employee so |
desires.
|
In all cases where the examination is made by a surgeon |
engaged by
the employer, and the injured employee has no |
surgeon present at such
examination, it shall be the duty of |
the surgeon making the examination
at the instance of the |
employer to deliver to the injured employee, or
his |
representative, a statement in writing of the condition and |
extent
of the injury to the same extent that said surgeon |
reports to the
employer and the same shall be an exact copy of |
that furnished to the
employer, said copy to be furnished the |
employee, or his representative
as soon as practicable but not |
later than 48 hours before the time the
case is set for |
hearing. Such delivery shall be made in person either to
the |
employee or his representative, or by registered mail to |
either, and
the receipt of either shall be proof of such |
delivery. If such surgeon
refuses to furnish the employee with |
such statement to the same extent
as that furnished the |
employer said surgeon shall not be permitted to
testify at the |
hearing next following said examination.
|
If the employee refuses so to submit himself to examination |
or
unnecessarily obstructs the same, his right to compensation |
payments
shall be temporarily suspended until such examination |
shall have taken
place, and no compensation shall be payable |
|
under this Act for such
period.
|
It shall be the duty of surgeons treating an injured |
employee who is
likely to die, and treating him at the instance |
of the employer, to have
called in another surgeon to be |
designated and paid for by either the
injured employee or by |
the person or persons who would become his
beneficiary or |
beneficiaries, to make an examination before the death of
such |
injured employee.
|
In all cases where the examination is made by a surgeon |
engaged by
the injured employee, and the employer has no |
surgeon present at such
examination, it shall be the duty of |
the surgeon making the examination
at the instance of the |
employee, to deliver to the employer, or his
representative, a |
statement in writing of the condition and extent of
the injury |
to the same extent that said surgeon reports to the employee
|
and the same shall be an exact copy of that furnished to the |
employee,
said copy to be furnished the employer, or his |
representative, as soon
as practicable but not later than 48 |
hours before the time the case is
set for hearing. Such |
delivery shall be made in person either to the
employer, or his |
representative, or by registered mail to either, and
the |
receipt of either shall be proof of such delivery. If such |
surgeon
refuses to furnish the employer with such statement to |
the same extent
as that furnished the employee, said surgeon |
shall not be permitted to
testify at the hearing next following |
said examination.
|
(Source: P.A. 81-1482.)
|
(820 ILCS 305/13) (from Ch. 48, par. 138.13)
|
Sec. 13. There is created an Illinois Workers' Compensation |
Commission consisting of 10
7
members to be appointed by the |
Governor, by and with the consent of the
Senate, 3
2 of whom |
shall be representative citizens of the
employing class |
operating under this Act and 3
2 of whom shall
be |
representative citizens of the class of employees covered under |
this
Act, and 4
3 of whom shall be representative citizens not |
|
identified
with either the employing or employee classes. Not |
more than 6
4 members
of the Commission shall be of the same |
political party.
|
One of the 3
members not identified with either the |
employing or employee classes shall
be designated by the |
Governor as Chairman. The Chairman shall be the chief
|
administrative and executive officer of the Commission; and he |
or she shall
have general supervisory authority over all |
personnel of the Commission,
including arbitrators and |
Commissioners, and the final authority in all
administrative |
matters relating to the Commissioners, including but not
|
limited to the assignment and distribution of cases and |
assignment of
Commissioners to the panels, except in the |
promulgation of procedural rules
and orders under Section 16 |
and in the determination of cases under this Act.
|
Notwithstanding the general supervisory authority of the |
Chairman, each
Commissioner, except those assigned to the |
temporary panel, shall have the
authority to hire and supervise |
2 staff attorneys each. Such staff attorneys
shall report |
directly to the individual Commissioner.
|
A formal training program for newly-appointed |
Commissioners shall be
implemented. The training program shall |
include the following:
|
(a) substantive and procedural aspects of the office of |
Commissioner;
|
(b) current issues in workers' compensation law and |
practice;
|
(c) medical lectures by specialists in areas such as |
orthopedics,
ophthalmology, psychiatry, rehabilitation |
counseling;
|
(d) orientation to each operational unit of the |
Illinois Workers' Compensation Commission;
|
(e) observation of experienced arbitrators and |
Commissioners conducting
hearings of cases, combined with |
the opportunity to discuss evidence
presented and rulings |
made;
|
|
(f) the use of hypothetical cases requiring the |
newly-appointed
Commissioner to issue judgments as a means |
to evaluating knowledge and
writing ability;
|
(g) writing skills.
|
A formal and ongoing professional development program |
including, but not
limited to, the above-noted areas shall be |
implemented to keep
Commissioners informed of recent |
developments and issues and to assist them
in maintaining and |
enhancing their professional competence.
|
The Commissioner candidates, other than the Chairman, must |
meet one of
the following qualifications: (a) licensed to |
practice law in the State of
Illinois; or (b) served as an |
arbitrator at the Illinois Workers' Compensation
Commission |
for at least 3 years; or (c) has at least 4 years of
|
professional labor relations experience. The Chairman |
candidate must have
public or private sector management and |
budget experience, as determined
by the Governor.
|
Each Commissioner shall devote full time to his duties and |
any
Commissioner who is an attorney-at-law shall not engage in |
the practice
of law, nor shall any Commissioner hold any other |
office or position of
profit under the United States or this |
State or any municipal
corporation or political subdivision of |
this State, nor engage in any other
business, employment, or |
vocation.
|
The term of office of each member of the Commission holding |
office on
the effective date of this amendatory Act of 1989 is |
abolished, but
the incumbents shall continue to exercise all of |
the powers and be subject
to all of the duties of Commissioners |
until their respective successors are
appointed and qualified.
|
The Illinois Workers' Compensation Commission shall |
administer this Act.
|
In the promulgation of procedural rules, the determination |
of cases heard en banc, and other matters determined by the |
full Commission, the Chairman's vote shall break a tie in the |
event of a tie vote.
|
The members shall be appointed by the Governor, with the |
|
advice and
consent of the Senate, as follows:
|
(a) After the effective date of this amendatory Act of |
1989, 3
members, at least one of
each political party, and |
one of whom shall be a representative citizen
of the |
employing class operating under this Act, one of whom shall |
be
a representative citizen of the class of employees |
covered under this
Act, and one of whom shall be a |
representative citizen not identified
with either the |
employing or employee classes, shall be appointed
to hold |
office until the third Monday in January of 1993, and until |
their
successors are appointed and qualified, and 4 |
members, one of whom shall be
a representative citizen of |
the employing class operating under this Act,
one of whom |
shall be a representative citizen of the class of employees
|
covered in this Act, and two of whom shall be |
representative citizens not
identified with either the |
employing or employee classes, one of whom shall
be |
designated by the Governor as Chairman (at least one of |
each of the two
major political parties) shall be appointed |
to hold office until the third
Monday of January in 1991, |
and until their successors are appointed and
qualified.
|
(a-5) Notwithstanding any other provision of this |
Section,
the term of each member of the Commission
who was |
appointed by the Governor and is in office on June 30, 2003 |
shall
terminate at the close of business on that date or |
when all of the successor
members to be appointed pursuant |
to this amendatory Act of the 93rd General
Assembly have |
been appointed by the Governor, whichever occurs later. As |
soon
as possible, the Governor shall appoint persons to |
fill the vacancies created
by this amendatory Act. Of the |
initial commissioners appointed pursuant to
this |
amendatory Act of the 93rd General Assembly, 3 shall be |
appointed for
terms ending on the third Monday in January, |
2005, and 4 shall be appointed
for terms ending on the |
third Monday in January, 2007.
|
(a-10) After the effective date of this amendatory Act |
|
of the 94th General Assembly, the Commission shall be |
increased to 10 members. As soon as possible after the |
effective date of this amendatory Act of the 94th General |
Assembly, the Governor shall appoint, by and with the |
consent of the
Senate, the 3 members added to the |
Commission under this amendatory Act of the 94th General |
Assembly, one of whom shall be a representative citizen of |
the employing class operating under this Act, one of whom |
shall be a representative of the class of employees covered |
under this Act, and one of whom shall be a representative |
citizen not identified with either the employing or |
employee classes. Of the members appointed under this |
amendatory Act of the 94th General Assembly, one shall be |
appointed for a term ending on the third Monday in January, |
2007, and 2 shall be appointed for terms ending on the |
third Monday in January, 2009, and until their successors |
are appointed and qualified.
|
(b) Members shall thereafter be appointed to hold |
office for terms of 4
years from the third Monday in |
January of the year of their appointment,
and until their |
successors are appointed and qualified. All such
|
appointments shall be made so that the composition of the |
Commission is in
accordance with the provisions of the |
first paragraph of this Section.
|
The Chairman shall receive an annual salary of $42,500, or
|
a salary set by the Compensation Review Board, whichever is |
greater,
and each other member shall receive an annual salary |
of $38,000, or a
salary set by the Compensation Review Board, |
whichever is greater.
|
In case of a vacancy in the office of a Commissioner during |
the
recess of the Senate, the Governor shall make a temporary |
appointment
until the next meeting of the Senate, when he shall |
nominate some person
to fill such office. Any person so |
nominated who is confirmed by the
Senate shall hold office |
during the remainder of the term and until his
successor is |
appointed and qualified.
|
|
The Illinois Workers' Compensation Commission created by |
this amendatory Act of 1989
shall succeed to all the rights, |
powers, duties, obligations, records
and other property and |
employees of the Industrial Commission which it
replaces as |
modified by this amendatory Act of 1989 and all applications
|
and reports to actions and proceedings of such prior Industrial |
Commission
shall be considered as applications and reports to |
actions and proceedings
of the Illinois Workers' Compensation |
Commission created by this amendatory Act of 1989.
|
Notwithstanding any other provision of this Act, in the |
event the
Chairman shall make a finding that a member is or |
will be unavailable to
fulfill the responsibilities of his or |
her office, the Chairman shall
advise the Governor and the |
member in writing and shall designate a
certified arbitrator to |
serve as acting Commissioner. The certified
arbitrator shall |
act as a Commissioner until the member resumes the duties
of |
his or her office or until a new member is appointed by the |
Governor, by
and with the consent of the Senate, if a vacancy |
occurs in the office of
the Commissioner, but in no event shall |
a certified arbitrator serve in the
capacity of Commissioner |
for more than 6 months from the date of
appointment by the |
Chairman. A finding by the Chairman that a member is or
will be |
unavailable to fulfill the responsibilities of his or her |
office
shall be based upon notice to the Chairman by a member |
that he or she will
be unavailable or facts and circumstances |
made known to the Chairman which
lead him to reasonably find |
that a member is unavailable to fulfill the
responsibilities of |
his or her office. The designation of a certified
arbitrator to |
act as a Commissioner shall be considered representative of
|
citizens not identified with either the employing or employee |
classes and
the arbitrator shall serve regardless of his or her |
political affiliation.
A certified arbitrator who serves as an |
acting Commissioner shall have all
the rights and powers of a |
Commissioner, including salary.
|
Notwithstanding any other provision of this Act, the |
Governor shall appoint
a special panel of Commissioners |
|
comprised of 3 members who shall be chosen
by the Governor, by |
and with the consent of the Senate, from among the
current |
ranks of certified arbitrators. Three members shall hold office
|
until the Commission in consultation with the Governor |
determines that the
caseload on review has been reduced |
sufficiently to allow cases to proceed
in a timely manner or |
for a term of 18 months from the effective date of
their |
appointment by the Governor, whichever shall be earlier. The 3
|
members shall be considered representative of citizens not |
identified with
either the employing or employee classes and |
shall serve regardless of
political affiliation. Each of the 3 |
members shall have only such rights
and powers of a |
Commissioner necessary to dispose of those cases assigned
to |
the special panel. Each of the 3 members appointed to the |
special panel
shall receive the same salary as other |
Commissioners for the duration of
the panel.
|
The Commission may have an Executive Director; if so, the |
Executive
Director shall be appointed by the Governor with the |
advice and consent of the
Senate. The salary and duties of the |
Executive Director shall be fixed by the
Commission.
|
On the effective date of this amendatory Act of
the 93rd |
General Assembly, the name of the Industrial Commission is |
changed to the Illinois Workers' Compensation Commission. |
References in any law, appropriation, rule, form, or other
|
document: (i) to the Industrial Commission
are deemed, in |
appropriate contexts, to be references to the Illinois Workers' |
Compensation Commission for all purposes; (ii) to the |
Industrial Commission Operations Fund
are deemed, in |
appropriate contexts, to be references to the Illinois Workers' |
Compensation Commission Operations Fund for all purposes; |
(iii) to the Industrial Commission Operations Fund Fee are |
deemed, in appropriate contexts, to be
references to the |
Illinois Workers' Compensation Commission Operations Fund Fee |
for all
purposes; and (iv) to the Industrial Commission |
Operations Fund Surcharge are deemed, in appropriate contexts, |
to be
references to the Illinois Workers' Compensation |
|
Commission Operations Fund Surcharge for all
purposes. |
(Source: P.A. 93-509, eff. 8-11-03; 93-721, eff. 1-1-05.)
|
(820 ILCS 305/13.1) (from Ch. 48, par. 138.13-1)
|
Sec. 13.1. (a) There is created a Workers' Compensation |
Advisory Board
hereinafter referred to as the Advisory Board . |
After the effective date of this amendatory Act of the 94th |
General Assembly, the Advisory Board shall consist , consisting |
of 12
9 members
appointed by the Governor with the advice and |
consent of the Senate. Six
Three
members of the Advisory Board |
shall be
representative citizens chosen from the employee |
class, and 6
3 members shall be
representative citizens chosen |
from the employing class and 3 members shall
be representative |
citizens not identified with either the employing or
employee |
class . The Chairman of the Commission shall serve as the ex |
officio Chairman of the Advisory Board. After the effective |
date of this amendatory Act of the 94th General Assembly, each |
member of the Advisory Board shall serve a 4 year
term ending |
on the third Monday in January 2007 and shall continue to serve |
until his or her successor is appointed and qualified. Members |
of the Advisory Board shall thereafter be appointed for 4 year |
terms from the third Monday in January of the year of their |
appointment, and until their successors are appointed and |
qualified . The Governor shall select one of the members not |
identified with
either the employing or employee class to serve |
as Chairman.
Seven
Five members
of the Advisory Board shall |
constitute a quorum to do business, but in no
case shall there |
be less than one representative from each class , employee,
|
employing and representative citizen not identified with |
either the
employing or employee class . A vacancy on the |
Advisory Board shall be
filled by the Governor for the |
unexpired term.
|
(b) Members of the Advisory Board shall receive no |
compensation for
their services but shall be reimbursed for |
expenses incurred in the
performance of their duties by the |
Commission from appropriations made to
the Commission for such |
|
purpose.
|
(c) The Advisory Board shall aid the Commission in |
formulating policies,
discussing problems, setting priorities |
of expenditures and establishing
short and long range |
administrative goals. Prior to making appointments to the |
Commission, the Governor shall request that the Advisory Board |
make recommendations as to candidates to consider for |
appointment and the Advisory Board may then make such |
recommendations.
|
(Source: P.A. 86-998.)
|
(820 ILCS 305/14) (from Ch. 48, par. 138.14)
|
Sec. 14. The Commission shall appoint a secretary, an |
assistant
secretary, and arbitrators and shall employ such
|
assistants and clerical help as may be necessary.
|
Each arbitrator appointed after November 22, 1977 shall be |
required
to demonstrate in writing and in accordance with
the |
rules and regulations of the Illinois Department of Central |
Management
Services his or
her knowledge of and expertise in |
the law of and judicial processes of
the Workers' Compensation |
Act and the Occupational Diseases Act.
|
A formal training program for newly-hired arbitrators |
shall be
implemented. The training program shall include the |
following:
|
(a) substantive and procedural aspects of the |
arbitrator position;
|
(b) current issues in workers' compensation law and |
practice;
|
(c) medical lectures by specialists in areas such as |
orthopedics,
ophthalmology, psychiatry, rehabilitation |
counseling;
|
(d) orientation to each operational unit of the |
Illinois Workers' Compensation Commission;
|
(e) observation of experienced arbitrators conducting |
hearings of cases,
combined with the opportunity to discuss |
evidence presented and rulings made;
|
|
(f) the use of hypothetical cases requiring the trainee |
to issue
judgments as a means to evaluating knowledge and |
writing ability;
|
(g) writing skills.
|
A formal and ongoing professional development program |
including, but not
limited to, the above-noted areas shall be |
implemented to keep arbitrators
informed of recent |
developments and issues and to assist them in
maintaining and |
enhancing their professional competence.
|
Each
arbitrator shall devote full time to his or her duties |
and shall serve when
assigned as
an acting Commissioner when a |
Commissioner is unavailable in accordance
with the provisions |
of Section 13 of this Act. Any
arbitrator who is an |
attorney-at-law shall not engage in the practice of
law, nor |
shall any arbitrator hold any other office or position of
|
profit under the United States or this State or any municipal
|
corporation or political subdivision of this State.
|
Notwithstanding any other provision of this Act to the |
contrary, an arbitrator
who serves as an acting Commissioner in |
accordance with the provisions of
Section 13 of this Act shall |
continue to serve in the capacity of Commissioner
until a |
decision is reached in every case heard by that arbitrator |
while
serving as an acting Commissioner.
|
Each arbitrator appointed after the effective date of this |
amendatory
Act of 1989 shall be appointed for a term of 6 |
years. Each arbitrator
shall be appointed for a subsequent term |
unless the Chairman makes a
recommendation to the Commission, |
no later than 60 days prior to the
expiration of the term, not |
to reappoint the arbitrator. Notice of such a
recommendation |
shall also be given to the arbitrator no later than 60 days
|
prior to the expiration of the term. Upon
such recommendation |
by the Chairman, the arbitrator shall be appointed for
a |
subsequent term unless 8
5 of 10
7 members of the Commission, |
including the
Chairman, vote not to reappoint the arbitrator.
|
All arbitrators shall be subject to the provisions of the |
Personnel Code,
and the performance of all arbitrators shall be |
|
reviewed by the Chairman on
an annual basis. The Chairman shall |
allow input from the Commissioners in
all such reviews.
|
The Secretary and each arbitrator shall receive a per annum |
salary of
$4,000 less than the per annum salary of members of |
The
Illinois Workers' Compensation Commission as
provided in |
Section 13 of this Act, payable in equal monthly installments.
|
The members of the Commission, Arbitrators and other |
employees whose
duties require them to travel, shall have |
reimbursed to them their
actual traveling expenses and |
disbursements made or incurred by them in
the discharge of |
their official duties while away from their place of
residence |
in the performance of their duties.
|
The Commission shall provide itself with a seal for the
|
authentication of its orders, awards and proceedings upon which |
shall be
inscribed the name of the Commission and the words |
"Illinois--Seal".
|
The Secretary or Assistant Secretary, under the direction |
of the
Commission, shall have charge and custody of the seal of |
the Commission
and also have charge and custody of all records, |
files, orders,
proceedings, decisions, awards and other |
documents on file with the
Commission. He shall furnish |
certified copies, under the seal of the
Commission, of any such |
records, files, orders, proceedings, decisions,
awards and |
other documents on file with the Commission as may be
required. |
Certified copies so furnished by the Secretary or Assistant
|
Secretary shall be received in evidence before the Commission |
or any
Arbitrator thereof, and in all courts, provided that the |
original of
such certified copy is otherwise competent and |
admissible in evidence.
The Secretary or Assistant Secretary |
shall perform such other duties as
may be prescribed from time |
to time by the Commission.
|
(Source: P.A. 93-721, eff. 1-1-05.)
|
(820 ILCS 305/16) (from Ch. 48, par. 138.16)
|
Sec. 16. The Commission shall make and publish procedural |
rules and
orders for carrying out the duties imposed upon it by |
|
law and for
determining the extent of disability sustained, |
which rules and orders
shall be deemed prima facie reasonable |
and valid.
|
The process and procedure before the Commission shall be as |
simple
and summary as reasonably may be.
|
The Commission upon application of either party may issue |
dedimus
potestatem directed to a commissioner, notary public, |
justice of the
peace or any other officer authorized by law to |
administer oaths, to
take the depositions of such witness or |
witnesses as may be necessary in
the judgment of such |
applicant. Such dedimus potestatem may issue to
any of the |
officers aforesaid in any state or territory of the United
|
States. When the deposition of any witness resident of a |
foreign
country is desired to be taken, the dedimus shall be |
directed to and the
deposition taken before a consul, vice |
consul or other authorized
representative of the government of |
the United States of America, whose
station is in the country |
where the witness whose deposition is to be
taken resides. In |
countries where the government of the United States
has no |
consul or other diplomatic representative, then depositions in
|
such case shall be taken through the appropriate judicial |
authority of
that country; or where treaties provide for other |
methods of taking
depositions, then the same may be taken as in |
such treaties provided.
The Commission shall have the power to |
adopt necessary rules to govern
the issue of such dedimus |
potestatem.
|
The Commission, or any member thereof, or any Arbitrator |
designated
by the Commission shall have the power to administer |
oaths, subpoena
and examine witnesses; to issue subpoenas duces |
tecum, requiring the
production of such books, papers, records |
and documents as may be
evidence of any matter under inquiry |
and to examine and inspect the same
and such places or premises |
as may relate to the question in dispute.
The Commission, or |
any member thereof, or any Arbitrator designated by
the |
Commission, shall on written request of either party to the
|
dispute, issue subpoenas for the attendance of such witnesses |
|
and
production of such books, papers, records and documents as |
shall be
designated in the applications, and the parties
|
applying for such subpoena shall advance the officer and |
witness fees
provided for in civil actions pending in circuit |
courts of this State, except
as otherwise
provided by Section |
20 of this Act. Service of such subpoena shall be
made by any |
sheriff or other person. In case any person
refuses to comply |
with an order of the Commission or subpoenas issued by
it or by |
any member thereof, or any Arbitrator designated by the
|
Commission or to permit an inspection of places or premises, or |
to
produce any books, papers, records or documents, or any |
witness refuses
to testify to any matters regarding which he or |
she may be lawfully
interrogated, the Circuit Court of the |
county in which the hearing or
matter is pending, on |
application of any member of the Commission or any
Arbitrator |
designated by the Commission, shall compel obedience by
|
attachment proceedings, as for contempt, as in a case of |
disobedience of
the requirements of a subpoena from such court |
on a refusal to testify
therein.
|
The records , reports, and bills kept by a treating |
hospital , treating physician, or other treating healthcare |
provider that renders treatment to the employee as a result of |
accidental injuries in question , certified to as true and |
correct by
the hospital, physician, or other healthcare |
provider or by designated agents of the hospital, physician, or |
other healthcare provider,
superintendent or other officer in |
charge, showing the medical and
surgical treatment given an |
injured employee by
in such hospital, physician, or other |
healthcare provider, shall be
admissible without any further |
proof as evidence of the medical and
surgical matters stated |
therein, but shall not be conclusive proof of
such matters. |
There shall be a rebuttable presumption that any such records, |
reports, and bills received in response to Commission subpoena |
are certified to be true and correct. This paragraph does not |
restrict, limit, or prevent the admissibility of records, |
reports, or bills that are otherwise admissible. This provision |
|
does not apply to reports prepared by treating providers for |
use in litigation.
|
The Commission at its expense shall provide an official |
court
reporter to take the testimony and record of proceedings |
at the hearings
before an Arbitrator or the Commission, who
|
shall furnish a transcript of such testimony or proceedings to |
either
party requesting it, upon payment therefor at the rate |
of $1.00
per page for the original and 35 cents per page for |
each copy of such
transcript. Payment for photostatic copies of |
exhibits shall be extra.
If the Commission has determined, as |
provided in Section 20
of this Act, that the employee is a poor |
person, a transcript of such
testimony and proceedings, |
including photostatic copies of exhibits,
shall be furnished to |
such employee at the
Commission's expense.
|
The Commission shall have the power to determine the |
reasonableness
and fix the amount of any fee of compensation |
charged by any person,
including attorneys, physicians, |
surgeons and hospitals, for any service
performed in connection |
with this Act, or for which payment is to be
made under this |
Act or rendered in securing any right under this Act.
|
Whenever the Commission shall find that the employer, his |
or her agent,
service company or insurance carrier has been |
guilty of delay or
unfairness towards an employee in the |
adjustment, settlement or payment
of benefits due such employee |
within the purview of the provisions of
paragraph (c) of |
Section 4 of this Act; or has been guilty of
unreasonable or |
vexatious delay, intentional under-payment of
compensation |
benefits, or has engaged in frivolous defenses which do not
|
present a real controversy, within the purview of the |
provisions of
paragraph (k) of Section 19 of this Act, the |
Commission may assess all
or any part of the attorney's fees |
and costs against such employer and
his or her insurance |
carrier.
|
(Source: P.A. 86-998.)
|
(820 ILCS 305/19) (from Ch. 48, par. 138.19)
|
|
Sec. 19. Any disputed questions of law or fact shall be |
determined
as herein provided.
|
(a) It shall be the duty of the Commission upon |
notification that
the parties have failed to reach an |
agreement, to designate an Arbitrator.
|
1. Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under this Act |
and it is
subsequently discovered, at any time before final |
disposition of such
cause, that the claim for disability or |
death which was the basis for
such application should |
properly have been made under the Workers'
Occupational |
Diseases Act, then the provisions of Section 19, paragraph
|
(a-1) of the Workers' Occupational Diseases Act having |
reference to such
application shall apply.
|
2. Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under the |
Workers' Occupational
Diseases Act and it is subsequently |
discovered, at any time before final
disposition of such |
cause that the claim for injury or death which was
the |
basis for such application should properly have been made |
under this
Act, then the application so filed under the |
Workers' Occupational
Diseases Act may be amended in form, |
substance or both to assert claim
for such disability or |
death under this Act and it shall be deemed to
have been so |
filed as amended on the date of the original filing
|
thereof, and such compensation may be awarded as is |
warranted by the
whole evidence pursuant to this Act. When |
such amendment is submitted,
further or additional |
evidence may be heard by the Arbitrator or
Commission when |
deemed necessary. Nothing in this Section contained
shall |
be construed to be or permit a waiver of any provisions of |
this
Act with reference to notice but notice if given shall |
be deemed to be a
notice under the provisions of this Act |
if given within the time
required herein.
|
(b) The Arbitrator shall make such inquiries and |
investigations as he or
they shall deem necessary and may |
|
examine and inspect all books, papers,
records, places, or |
premises relating to the questions in dispute and hear
such |
proper evidence as the parties may submit.
|
The hearings before the Arbitrator shall be held in the |
vicinity where
the injury occurred after 10 days' notice of the |
time and place of such
hearing shall have been given to each of |
the parties or their attorneys
of record.
|
The Arbitrator may find that the disabling condition is |
temporary and has
not yet reached a permanent condition and may |
order the payment of
compensation up to the date of the |
hearing, which award shall be reviewable
and enforceable in the |
same manner as other awards, and in no instance be a
bar to a |
further hearing and determination of a further amount of |
temporary
total compensation or of compensation for permanent |
disability, but shall
be conclusive as to all other questions |
except the nature and extent of said
disability.
|
The decision of the Arbitrator shall be filed with the |
Commission which
Commission shall immediately send to each |
party or his attorney a copy of
such decision, together with a |
notification of the time when it was filed.
As of the effective |
date of this amendatory Act of the 94th General Assembly
|
Beginning January 1, 1981 , all decisions of the Arbitrator |
shall set forth
in writing findings of fact and conclusions of |
law, separately stated , if requested by either party .
Unless a |
petition for review is filed by either party within 30 days |
after
the receipt by such party of the copy of the decision and |
notification of
time when filed, and unless such party |
petitioning for a review shall
within 35 days after the receipt |
by him of the copy of the decision, file
with the Commission |
either an agreed statement of the facts appearing upon
the |
hearing before the Arbitrator, or if such
party shall so elect |
a correct transcript of evidence of the proceedings
at such |
hearings, then the decision shall become the decision of the
|
Commission and in the absence of fraud shall be conclusive.
The |
Petition for Review shall contain a statement of the |
petitioning party's
specific exceptions to the decision of the |
|
arbitrator. The jurisdiction
of the Commission to review the |
decision of the arbitrator shall not be
limited to the |
exceptions stated in the Petition for Review.
The Commission, |
or any member thereof, may grant further time not exceeding
30 |
days, in which to file such agreed statement or transcript of
|
evidence. Such agreed statement of facts or correct transcript |
of
evidence, as the case may be, shall be authenticated by the |
signatures
of the parties or their attorneys, and in the event |
they do not agree as
to the correctness of the transcript of |
evidence it shall be authenticated
by the signature of the |
Arbitrator designated by the Commission.
|
Whether the employee is working or not, if the employee is |
not receiving or has not received medical, surgical, or |
hospital services or other services or compensation as provided |
in paragraph (a) of Section 8, or compensation as provided in |
paragraph (b) of Section 8, the employee may at any time |
petition for an expedited hearing by an Arbitrator on the issue |
of whether or not he or she is entitled to receive payment of |
the services or compensation. Provided the employer continues |
to pay compensation pursuant to paragraph (b) of Section 8, the |
employer may at any time petition for an expedited hearing on |
the issue of whether or not the employee is entitled to receive |
medical, surgical, or hospital services or other services or |
compensation as provided in paragraph (a) of Section 8, or |
compensation as provided in paragraph (b) of Section 8. When an |
employer has petitioned for an expedited hearing, the employer |
shall continue to pay compensation as provided in paragraph (b) |
of Section 8 unless the arbitrator renders a decision that the |
employee is not entitled to the benefits that are the subject |
of the expedited hearing or unless the employee's treating |
physician has released the employee to return to work at his or |
her regular job with the employer or the employee actually |
returns to work at any other job. If the arbitrator renders a |
decision that the employee is not entitled to the benefits that |
are the subject of the expedited hearing, a petition for review |
filed by the employee shall receive the same priority as if the |
|
employee had filed a petition for an expedited hearing by an |
Arbitrator. Neither party shall be entitled to an expedited |
hearing when the employee has returned to work and the sole |
issue in dispute amounts to less than 12 weeks of unpaid |
compensation pursuant to paragraph (b) of Section 8. |
Expedited hearings shall have priority over all other |
petitions and shall be heard by the Arbitrator and Commission |
with all convenient speed. Any party requesting an expedited |
hearing shall give notice of a request for an expedited hearing |
under this paragraph. A copy of the Application for Adjustment |
of Claim shall be attached to the notice. The Commission shall |
adopt rules and procedures under which the final decision of |
the Commission under this paragraph is filed not later than 180 |
days from the date that the Petition for Review is filed with |
the Commission. |
Where 2 or more insurance carriers, private self-insureds, |
or a group workers' compensation pool under Article V 3/4 of |
the Illinois Insurance Code dispute coverage for the same |
injury, any such insurance carrier, private self-insured, or |
group workers' compensation pool may request an expedited |
hearing pursuant to this paragraph to determine the issue of |
coverage, provided coverage is the only issue in dispute and |
all other issues are stipulated and agreed to and further |
provided that all compensation benefits including medical |
benefits pursuant to Section 8(a) continue to be paid to or on |
behalf of petitioner. Any insurance carrier, private |
self-insured, or group workers' compensation pool that is |
determined to be liable for coverage for the injury in issue |
shall reimburse any insurance carrier, private self-insured, |
or group workers' compensation pool that has paid benefits to |
or on behalf of petitioner for the injury.
|
(b-1) If the employee is not receiving medical, surgical or |
hospital
services as provided in paragraph (a) of Section 8 or |
compensation as
provided in paragraph (b) of Section 8, the |
employee, in accordance with
Commission Rules, may file a |
petition for an emergency hearing by an
Arbitrator on the issue |
|
of whether or not he is entitled to receive payment
of such |
compensation or services as provided therein. Such petition |
shall
have priority over all other petitions and shall be heard |
by the Arbitrator
and Commission with all convenient speed.
|
Such petition shall contain the following information and |
shall be served
on the employer at least 15 days before it is |
filed:
|
(i) the date and approximate time of accident;
|
(ii) the approximate location of the accident;
|
(iii) a description of the accident;
|
(iv) the nature of the injury incurred by the employee;
|
(v) the identity of the person, if known, to whom the |
accident was
reported and the date on which it was |
reported;
|
(vi) the name and title of the person, if known, |
representing the
employer with whom the employee conferred |
in any effort to obtain
compensation pursuant to paragraph |
(b) of Section 8 of this Act or medical,
surgical or |
hospital services pursuant to paragraph (a) of Section 8 of
|
this Act and the date of such conference;
|
(vii) a statement that the employer has refused to pay |
compensation
pursuant to paragraph (b) of Section 8 of this |
Act or for medical, surgical
or hospital services pursuant |
to paragraph (a) of Section 8 of this Act;
|
(viii) the name and address, if known, of each witness |
to the accident
and of each other person upon whom the |
employee will rely to support his
allegations;
|
(ix) the dates of treatment related to the accident by |
medical
practitioners, and the names and addresses of such |
practitioners, including
the dates of treatment related to |
the accident at any hospitals and the
names and addresses |
of such hospitals, and a signed authorization
permitting |
the employer to examine all medical records of all |
practitioners
and hospitals named pursuant to this |
paragraph;
|
(x) a copy of a signed report by a medical |
|
practitioner, relating to the
employee's current inability |
to return to work because of the injuries
incurred as a |
result of the accident or such other documents or |
affidavits
which show that the employee is entitled to |
receive compensation pursuant
to paragraph (b) of Section 8 |
of this Act or medical, surgical or hospital
services |
pursuant to paragraph (a) of Section 8 of this Act. Such |
reports,
documents or affidavits shall state, if possible, |
the history of the
accident given by the employee, and |
describe the injury and medical
diagnosis, the medical |
services for such injury which the employee has
received |
and is receiving, the physical activities which the |
employee
cannot currently perform as a result of any |
impairment or disability due to
such injury, and the |
prognosis for recovery;
|
(xi) complete copies of any reports, records, |
documents and affidavits
in the possession of the employee |
on which the employee will rely to
support his allegations, |
provided that the employer shall pay the
reasonable cost of |
reproduction thereof;
|
(xii) a list of any reports, records, documents and |
affidavits which
the employee has demanded by subpoena and |
on which he intends to
rely to support his allegations;
|
(xiii) a certification signed by the employee or his |
representative that
the employer has received the petition |
with the required information 15
days before filing.
|
Fifteen days after receipt by the employer of the petition |
with the
required information the employee may file said |
petition and required
information and shall serve notice of the |
filing upon the employer. The
employer may file a motion |
addressed to the sufficiency of the petition.
If an objection |
has been filed to the sufficiency of the petition, the
|
arbitrator shall rule on the objection within 2 working days. |
If such an
objection is filed, the time for filing the final |
decision of the
Commission as provided in this paragraph shall |
be tolled until the
arbitrator has determined that the petition |
|
is sufficient.
|
The employer shall, within 15 days after receipt of the |
notice that such
petition is filed, file with the Commission |
and serve on the employee or
his representative a written |
response to each claim set forth in the
petition, including the |
legal and factual basis for each disputed
allegation and the |
following information: (i) complete copies of any
reports, |
records, documents and affidavits in the possession of the
|
employer on which the employer intends to rely in support of |
his response,
(ii) a list of any reports, records, documents |
and affidavits which the
employer has demanded by subpoena and |
on which the employer intends to rely
in support of his |
response, (iii) the name and address of each witness on
whom |
the employer will rely to support his response, and (iv) the |
names and
addresses of any medical practitioners selected by |
the employer pursuant to
Section 12 of this Act and the time |
and place of any examination scheduled
to be made pursuant to |
such Section.
|
Any employer who does not timely file and serve a written |
response
without good cause may not introduce any evidence to |
dispute any claim of
the employee but may cross examine the |
employee or any witness brought by
the employee and otherwise |
be heard.
|
No document or other evidence not previously identified by |
either party
with the petition or written response, or by any |
other means before the
hearing, may be introduced into evidence |
without good cause.
If, at the hearing, material information is |
discovered which was
not previously disclosed, the Arbitrator |
may extend the time for closing
proof on the motion of a party |
for a reasonable period of time which may
be more than 30 days. |
No evidence may be introduced pursuant
to this paragraph as to |
permanent disability. No award may be entered for
permanent |
disability pursuant to this paragraph. Either party may |
introduce
into evidence the testimony taken by deposition of |
any medical practitioner.
|
The Commission shall adopt rules, regulations and |
|
procedures whereby the
final decision of the Commission is |
filed not later than 90 days from the
date the petition for |
review is filed but in no event later than 180 days from
the |
date the petition for an emergency hearing is filed with the |
Illinois Workers' Compensation
Commission.
|
All service required pursuant to this paragraph (b-1) must |
be by personal
service or by certified mail and with evidence |
of receipt. In addition for
the purposes of this paragraph, all |
service on the employer must be at the
premises where the |
accident occurred if the premises are owned or operated
by the |
employer. Otherwise service must be at the employee's principal
|
place of employment by the employer. If service on the employer |
is not
possible at either of the above, then service shall be |
at the employer's
principal place of business. After initial |
service in each case, service
shall be made on the employer's |
attorney or designated representative.
|
(c) (1) At a reasonable time in advance of and in |
connection with the
hearing under Section 19(e) or 19(h), the |
Commission may on its own motion
order an impartial physical or |
mental examination of a petitioner whose
mental or physical |
condition is in issue, when in the Commission's
discretion it |
appears that such an examination will materially aid in the
|
just determination of the case. The examination shall be made |
by a member
or members of a panel of physicians chosen for |
their special qualifications
by the Illinois State Medical |
Society. The Commission shall establish
procedures by which a |
physician shall be selected from such list.
|
(2) Should the Commission at any time during the hearing |
find that
compelling considerations make it advisable to have |
an examination and
report at that time, the commission may in |
its discretion so order.
|
(3) A copy of the report of examination shall be given to |
the Commission
and to the attorneys for the parties.
|
(4) Either party or the Commission may call the examining |
physician or
physicians to testify. Any physician so called |
shall be subject to
cross-examination.
|
|
(5) The examination shall be made, and the physician or |
physicians, if
called, shall testify, without cost to the |
parties. The Commission shall
determine the compensation and |
the pay of the physician or physicians. The
compensation for |
this service shall not exceed the usual and customary amount
|
for such service.
|
(6) The fees and payment thereof of all attorneys and |
physicians for
services authorized by the Commission under this |
Act shall, upon request
of either the employer or the employee |
or the beneficiary affected, be
subject to the review and |
decision of the Commission.
|
(d) If any employee shall persist in insanitary or |
injurious
practices which tend to either imperil or retard his |
recovery or shall
refuse to submit to such medical, surgical, |
or hospital treatment as is
reasonably essential to promote his |
recovery, the Commission may, in its
discretion, reduce or |
suspend the compensation of any such injured
employee. However, |
when an employer and employee so agree in writing,
the |
foregoing provision shall not be construed to authorize the
|
reduction or suspension of compensation of an employee who is |
relying in
good faith, on treatment by prayer or spiritual |
means alone, in
accordance with the tenets and practice of a |
recognized church or
religious denomination, by a duly |
accredited practitioner thereof.
|
(e) This paragraph shall apply to all hearings before the |
Commission.
Such hearings may be held in its office or |
elsewhere as the Commission
may deem advisable. The taking of |
testimony on such hearings may be had
before any member of the |
Commission. If a petition for review and agreed
statement of |
facts or transcript of evidence is filed, as provided herein,
|
the Commission shall promptly review the decision of the |
Arbitrator and all
questions of law or fact which appear from |
the statement of facts or
transcript of evidence.
|
In all cases in which the hearing before the arbitrator is |
held after
December 18, 1989, no additional evidence shall be |
introduced by the
parties before the Commission on review of |
|
the decision of the Arbitrator.
In reviewing decisions of an |
arbitrator the Commission shall award such
temporary |
compensation, permanent compensation and other payments as are
|
due under this Act. The Commission shall file in its office its |
decision
thereon, and shall immediately send to each party or |
his attorney a copy of
such decision and a notification of the |
time when it was filed. Decisions
shall be filed within 60 days |
after the Statement of Exceptions and
Supporting Brief and |
Response thereto are required to be filed or oral
argument |
whichever is later.
|
In the event either party requests oral argument, such |
argument shall be
had before a panel of 3 members of the |
Commission (or before all available
members pursuant to the |
determination of 7
5 members of the Commission that
such |
argument be held before all available members of the |
Commission)
pursuant to the rules and regulations of the |
Commission. A panel of 3
members, which shall be comprised of |
not more than one representative
citizen of the employing class |
and not more than one representative citizen
of the employee |
class, shall hear the argument; provided that if all the
issues |
in dispute are solely the nature and extent of the permanent |
partial
disability, if any, a majority of the panel may deny |
the request for such
argument and such argument shall not be |
held; and provided further that 7
5
members of the Commission |
may determine that the argument be held before
all available |
members of the Commission. A decision of the Commission
shall |
be approved by a majority of Commissioners present at such |
hearing if
any; provided, if no such hearing is held, a |
decision of the Commission
shall be approved by a majority of a |
panel of 3 members of the Commission
as described in this |
Section. The Commission shall give 10 days' notice to
the |
parties or their attorneys of the time and place of such taking |
of
testimony and of such argument.
|
In any case the Commission in its decision may find |
specially
upon any question or questions of law or fact which |
shall be submitted
in writing by either party whether ultimate |
|
or otherwise;
provided that on issues other than nature and |
extent of the disability,
if any, the Commission in its |
decision shall find specially upon any
question or questions of |
law or fact, whether ultimate or otherwise,
which are submitted |
in writing by either party; provided further that
not more than |
5 such questions may be submitted by either party. Any
party |
may, within 20 days after receipt of notice of the Commission's
|
decision, or within such further time, not exceeding 30 days, |
as the
Commission may grant, file with the Commission either an |
agreed
statement of the facts appearing upon the hearing, or, |
if such party
shall so elect, a correct transcript of evidence |
of the additional
proceedings presented before the Commission, |
in which report the party
may embody a correct statement of |
such other proceedings in the case as
such party may desire to |
have reviewed, such statement of facts or
transcript of |
evidence to be authenticated by the signature of the
parties or |
their attorneys, and in the event that they do not agree,
then |
the authentication of such transcript of evidence shall be by |
the
signature of any member of the Commission.
|
If a reporter does not for any reason furnish a transcript |
of the
proceedings before the Arbitrator in any case for use on |
a hearing for
review before the Commission, within the |
limitations of time as fixed in
this Section, the Commission |
may, in its discretion, order a trial de
novo before the |
Commission in such case upon application of either
party. The |
applications for adjustment of claim and other documents in
the |
nature of pleadings filed by either party, together with the
|
decisions of the Arbitrator and of the Commission and the |
statement of
facts or transcript of evidence hereinbefore |
provided for in paragraphs
(b) and (c) shall be the record of |
the proceedings of the Commission,
and shall be subject to |
review as hereinafter provided.
|
At the request of either party or on its own motion, the |
Commission shall
set forth in writing the reasons for the |
decision, including findings of
fact and conclusions of law |
separately stated. The Commission shall by rule
adopt a format |
|
for written decisions for the Commission and arbitrators.
The |
written decisions shall be concise and shall succinctly state |
the facts
and reasons for the decision. The Commission may |
adopt in whole or in part,
the decision of the arbitrator as |
the decision of the Commission. When the
Commission does so |
adopt the decision of the arbitrator, it shall do so by
order. |
Whenever the Commission adopts part of the arbitrator's |
decision,
but not all, it shall include in the order the |
reasons for not adopting all
of the arbitrator's decision. When |
a majority of a panel, after
deliberation, has arrived at its |
decision, the decision shall be filed as
provided in this |
Section without unnecessary delay, and without regard to
the |
fact that a member of the panel has expressed an intention to |
dissent.
Any member of the panel may file a dissent. Any |
dissent shall be filed no
later than 10 days after the decision |
of the majority has been filed.
|
Decisions rendered by the Commission and dissents, if any, |
shall be
published together by the Commission. The conclusions |
of law set out in
such decisions shall be regarded as |
precedents by arbitrators for the purpose
of achieving a more |
uniform administration of this Act.
|
(f) The decision of the Commission acting within its |
powers,
according to the provisions of paragraph (e) of this |
Section shall, in
the absence of fraud, be conclusive unless |
reviewed as in this paragraph
hereinafter provided. However, |
the Arbitrator or the Commission may on
his or its own motion, |
or on the motion of either party, correct any
clerical error or |
errors in computation within 15 days after the date of
receipt |
of any award by such Arbitrator or any decision on review of |
the
Commission and shall have the power to recall the original |
award on
arbitration or decision on review, and issue in lieu |
thereof such
corrected award or decision. Where such correction |
is made the time for
review herein specified shall begin to run |
from the date of
the receipt of the corrected award or |
decision.
|
(1) Except in cases of claims against the State of |
|
Illinois, in
which case the decision of the Commission |
shall not be subject to
judicial review, the Circuit Court |
of the county where any of the
parties defendant may be |
found, or if none of the parties defendant can
be found in |
this State then the Circuit Court of the county where the
|
accident occurred, shall by summons to the Commission have
|
power to review all questions of law and fact presented by |
such record.
|
A proceeding for review shall be commenced within 20 |
days of
the receipt of notice of the decision of the |
Commission. The summons shall
be issued by the clerk of |
such court upon written request returnable on a
designated |
return day, not less than 10 or more than 60 days from the |
date
of issuance thereof, and the written request shall |
contain the last known
address of other parties in interest |
and their attorneys of record who are
to be served by |
summons. Service upon any member of the Commission or the
|
Secretary or the Assistant Secretary thereof shall be |
service upon the
Commission, and service upon other parties |
in interest and their attorneys
of record shall be by |
summons, and such service shall be made upon the
Commission |
and other parties in interest by mailing notices of the
|
commencement of the proceedings and the return day of the |
summons to the
office of the Commission and to the last |
known place of residence of other
parties in interest or |
their attorney or attorneys of record. The clerk of
the |
court issuing the summons shall on the day of issue mail |
notice of the
commencement of the proceedings which shall |
be done by mailing a copy of
the summons to the office of |
the Commission, and a copy of the summons to
the other |
parties in interest or their attorney or attorneys of |
record and
the clerk of the court shall make certificate |
that he has so sent said
notices in pursuance of this |
Section, which shall be evidence of service on
the |
Commission and other parties in interest.
|
The Commission shall not be required to certify the |
|
record of their
proceedings to the Circuit Court, unless |
the party commencing the
proceedings for review in the |
Circuit Court as above provided, shall pay
to the |
Commission the sum of 80¢ per page of testimony taken |
before the
Commission, and 35¢ per page of all other |
matters contained in such
record, except as otherwise |
provided by Section 20 of this Act. Payment
for photostatic |
copies of exhibit shall be extra. It shall be the duty
of |
the Commission upon such payment, or failure to pay as |
permitted
under Section 20 of this Act, to prepare a true |
and correct typewritten
copy of such testimony and a true |
and correct copy of all other matters
contained in such |
record and certified to by the Secretary or Assistant
|
Secretary thereof.
|
In its decision on review the Commission shall |
determine in each
particular case the amount of the |
probable cost of the record to be
filed as a part of the |
summons in that case and no request for a summons
may be |
filed and no summons shall issue unless the party seeking |
to review
the decision of the Commission shall exhibit to |
the clerk of the Circuit
Court proof of payment by filing a |
receipt showing payment or an affidavit
of the attorney |
setting forth that payment has been made of the sums so
|
determined to the Secretary or Assistant Secretary of the |
Commission,
except as otherwise provided by Section 20 of |
this Act.
|
(2) No such summons shall issue unless the one against |
whom the
Commission shall have rendered an award for the |
payment of money shall upon
the filing of his written |
request for such summons file with the clerk of
the court a |
bond conditioned that if he shall not successfully
|
prosecute the review, he will pay the award and the costs |
of the
proceedings in the courts. The amount of the bond |
shall be fixed by any
member of the Commission and the |
surety or sureties of the bond shall be
approved by the |
clerk of the court. The acceptance of the bond by the
clerk |
|
of the court shall constitute evidence of his approval of |
the bond.
|
Every county, city, town, township, incorporated |
village, school
district, body politic or municipal |
corporation against whom the
Commission shall have |
rendered an award for the payment of money shall
not be |
required to file a bond to secure the payment of the award |
and
the costs of the proceedings in the court to authorize |
the court to
issue such summons.
|
The court may confirm or set aside the decision of the |
Commission. If
the decision is set aside and the facts |
found in the proceedings before
the Commission are |
sufficient, the court may enter such decision as is
|
justified by law, or may remand the cause to the Commission |
for further
proceedings and may state the questions |
requiring further hearing, and
give such other |
instructions as may be proper. Appeals shall be taken
to |
the Appellate Court in accordance
with Supreme Court Rules |
22(g) and 303. Appeals
shall be taken from the Appellate
|
Court to the Supreme Court in accordance with Supreme Court |
Rule 315.
|
It shall be the duty of the clerk of any court |
rendering a decision
affecting or affirming an award of the |
Commission to promptly furnish
the Commission with a copy |
of such decision, without charge.
|
The decision of a majority of the members of the panel |
of the Commission,
shall be considered the decision of the |
Commission.
|
(g) Except in the case of a claim against the State of |
Illinois,
either party may present a certified copy of the |
award of the
Arbitrator, or a certified copy of the decision of |
the Commission when
the same has become final, when no |
proceedings for review are pending,
providing for the payment |
of compensation according to this Act, to the
Circuit Court of |
the county in which such accident occurred or either of
the |
parties are residents, whereupon the court shall enter a |
|
judgment
in accordance therewith. In a case where the employer |
refuses to pay
compensation according to such final award or |
such final decision upon
which such judgment is entered the |
court shall in entering judgment
thereon, tax as costs against |
him the reasonable costs and attorney fees
in the arbitration |
proceedings and in the court entering the judgment
for the |
person in whose favor the judgment is entered, which judgment
|
and costs taxed as therein provided shall, until and unless set |
aside,
have the same effect as though duly entered in an action |
duly tried and
determined by the court, and shall with like |
effect, be entered and
docketed. The Circuit Court shall have |
power at any time upon
application to make any such judgment |
conform to any modification
required by any subsequent decision |
of the Supreme Court upon appeal, or
as the result of any |
subsequent proceedings for review, as provided in
this Act.
|
Judgment shall not be entered until 15 days' notice of the |
time and
place of the application for the entry of judgment |
shall be served upon
the employer by filing such notice with |
the Commission, which Commission
shall, in case it has on file |
the address of the employer or the name
and address of its |
agent upon whom notices may be served, immediately
send a copy |
of the notice to the employer or such designated agent.
|
(h) An agreement or award under this Act providing for |
compensation
in installments, may at any time within 18 months |
after such agreement
or award be reviewed by the Commission at |
the request of either the
employer or the employee, on the |
ground that the disability of the
employee has subsequently |
recurred, increased, diminished or ended.
|
However, as to accidents occurring subsequent to July 1, |
1955, which
are covered by any agreement or award under this |
Act providing for
compensation in installments made as a result |
of such accident, such
agreement or award may at any time |
within 30 months , or 60 months in the case of an award under |
Section 8(d)1, after such agreement
or award be reviewed by the |
Commission at the request of either the
employer or the |
employee on the ground that the disability of the
employee has |
|
subsequently recurred, increased, diminished or ended.
|
On such review, compensation payments may be |
re-established,
increased, diminished or ended. The Commission |
shall give 15 days'
notice to the parties of the hearing for |
review. Any employee, upon any
petition for such review being |
filed by the employer, shall be entitled
to one day's notice |
for each 100 miles necessary to be traveled by him in
attending |
the hearing of the Commission upon the petition, and 3 days in
|
addition thereto. Such employee shall, at the discretion of the
|
Commission, also be entitled to 5 cents per mile necessarily |
traveled by
him within the State of Illinois in attending such |
hearing, not to
exceed a distance of 300 miles, to be taxed by |
the Commission as costs
and deposited with the petition of the |
employer.
|
When compensation which is payable in accordance with an |
award or
settlement contract approved by the Commission, is |
ordered paid in a
lump sum by the Commission, no review shall |
be had as in this paragraph
mentioned.
|
(i) Each party, upon taking any proceedings or steps |
whatsoever
before any Arbitrator, Commission or court, shall |
file with the Commission
his address, or the name and address |
of any agent upon whom all notices to
be given to such party |
shall be served, either personally or by registered
mail, |
addressed to such party or agent at the last address so filed |
with
the Commission. In the event such party has not filed his |
address, or the
name and address of an agent as above provided, |
service of any notice may
be had by filing such notice with the |
Commission.
|
(j) Whenever in any proceeding testimony has been taken or |
a final
decision has been rendered and after the taking of such |
testimony or
after such decision has become final, the injured |
employee dies, then in
any subsequent proceedings brought by |
the personal representative or
beneficiaries of the deceased |
employee, such testimony in the former
proceeding may be |
introduced with the same force and effect as though
the witness |
having so testified were present in person in such
subsequent |
|
proceedings and such final decision, if any, shall be taken
as |
final adjudication of any of the issues which are the same in |
both
proceedings.
|
(k) In case where there has been any unreasonable or |
vexatious delay
of payment or intentional underpayment of |
compensation, or proceedings
have been instituted or carried on |
by the one liable to pay the
compensation, which do not present |
a real controversy, but are merely
frivolous or for delay, then |
the Commission may award compensation
additional to that |
otherwise payable under this Act equal to 50% of the
amount |
payable at the time of such award. Failure to pay compensation
|
in accordance with the provisions of Section 8, paragraph (b) |
of this
Act, shall be considered unreasonable delay.
|
When determining whether this subsection (k) shall apply, |
the
Commission shall consider whether an Arbitrator has |
determined
that the claim is not compensable or whether the |
employer has
made payments under Section 8(j). |
(l) If the employee has made written demand for payment of
|
benefits under Section 8(a) or Section 8(b), the employer shall
|
have 14 days after receipt of the demand to set forth in
|
writing the reason for the delay. In the case of demand for
|
payment of medical benefits under Section 8(a), the time for
|
the employer to respond shall not commence until the expiration
|
of the allotted 60 days specified under Section 8.2(d). In case
|
the employer or his or her insurance carrier shall without good |
and
just cause fail, neglect, refuse, or unreasonably delay the
|
payment of benefits under Section 8(a) or Section 8(b), the
|
Arbitrator or the Commission shall allow to the employee
|
additional compensation in the sum of $30 per day for each day
|
that the benefits under Section 8(a) or Section 8(b) have been
|
so withheld or refused, not to exceed $10,000.
A delay in |
payment of 14 days or more
shall create a rebuttable |
presumption of unreasonable delay.
In case the employer or his |
insurance carrier shall without good
and just cause fail, |
neglect, refuse or unreasonably delay the payment
of weekly |
compensation benefits due to an injured employee during the
|
|
period of temporary total disability the arbitrator or the |
Commission
shall allow to the employee additional compensation |
in the sum of $10
per day for each day that a weekly |
compensation payment has been so
withheld or refused, provided |
that such additional compensation shall
not exceed the sum of |
$2,500. A delay in payment of 14 days or more
shall create a |
rebuttable presumption of unreasonable delay.
|
(m) If the commission finds that an accidental injury was |
directly
and proximately caused by the employer's wilful |
violation of a health
and safety standard under the Health and |
Safety Act in force at the time of the
accident, the arbitrator |
or the Commission shall allow to the injured
employee or his |
dependents, as the case may be, additional compensation
equal |
to 25% of the amount which otherwise would be payable under the
|
provisions of this Act exclusive of this paragraph. The |
additional
compensation herein provided shall be allowed by an |
appropriate increase
in the applicable weekly compensation |
rate.
|
(n) After June 30, 1984, decisions of the Illinois Workers' |
Compensation Commission
reviewing an award of an arbitrator of |
the Commission shall draw interest
at a rate equal to the yield |
on indebtedness issued by the United States
Government with a |
26-week maturity next previously auctioned on the day on
which |
the decision is filed. Said rate of interest shall be set forth |
in
the Arbitrator's Decision. Interest shall be drawn from the |
date of the
arbitrator's award on all accrued compensation due |
the employee through the
day prior to the date of payments. |
However, when an employee appeals an
award of an Arbitrator or |
the Commission, and the appeal results in no
change or a |
decrease in the award, interest shall not further accrue from
|
the date of such appeal.
|
The employer or his insurance carrier may tender the |
payments due under
the award to stop the further accrual of |
interest on such award
notwithstanding the prosecution by |
either party of review, certiorari,
appeal to the Supreme Court |
or other steps to reverse, vacate or modify
the award.
|
|
(o) By the 15th day of each month each insurer providing |
coverage for
losses under this Act shall notify each insured |
employer of any compensable
claim incurred during the preceding |
month and the amounts paid or reserved
on the claim including a |
summary of the claim and a brief statement of the
reasons for |
compensability. A cumulative report of all claims incurred
|
during a calendar year or continued from the previous year |
shall be
furnished to the insured employer by the insurer |
within 30 days after the
end of that calendar year.
|
The insured employer may challenge, in proceeding before |
the Commission,
payments made by the insurer without |
arbitration and payments
made after a case is determined to be |
noncompensable. If the Commission
finds that the case was not |
compensable, the insurer shall purge its records
as to that |
employer of any loss or expense associated with the claim, |
reimburse
the employer for attorneys' fees arising from the |
challenge and for any
payment required of the employer to the |
Rate Adjustment Fund or the
Second Injury Fund, and may not |
reflect the loss or expense for rate making
purposes. The |
employee shall not be required to refund the challenged
|
payment. The decision of the Commission may be reviewed in the |
same manner
as in arbitrated cases. No challenge may be |
initiated under this paragraph
more than 3 years after the |
payment is made. An employer may waive the
right of challenge |
under this paragraph on a case by case basis.
|
(p) After filing an application for adjustment of claim but |
prior to
the hearing on arbitration the parties may voluntarily |
agree to submit such
application for adjustment of claim for |
decision by an arbitrator under
this subsection (p) where such |
application for adjustment of claim raises
only a dispute over |
temporary total disability, permanent partial
disability or |
medical expenses. Such agreement shall be in writing in such
|
form as provided by the Commission. Applications for adjustment |
of claim
submitted for decision by an arbitrator under this |
subsection (p) shall
proceed according to rule as established |
by the Commission. The Commission
shall promulgate rules |
|
including, but not limited to, rules to ensure that
the parties |
are adequately informed of their rights under this subsection
|
(p) and of the voluntary nature of proceedings under this |
subsection (p).
The findings of fact made by an arbitrator |
acting within his or her powers
under this subsection (p) in |
the absence of fraud shall be conclusive.
However, the |
arbitrator may on his own motion, or the motion of either
|
party, correct any clerical errors or errors in computation |
within 15 days
after the date of receipt of such award of the |
arbitrator
and shall have the power to recall the original |
award on arbitration, and
issue in lieu thereof such corrected |
award.
The decision of the arbitrator under this subsection (p) |
shall be
considered the decision of the Commission and |
proceedings for review of
questions of law arising from the |
decision may be commenced by either party
pursuant to |
subsection (f) of Section 19. The Advisory Board established
|
under Section 13.1 shall compile a list of certified Commission
|
arbitrators, each of whom shall be approved by at least 7 |
members of the
Advisory Board. The chairman shall select 5 |
persons from such list to
serve as arbitrators under this |
subsection (p). By agreement, the parties
shall select one |
arbitrator from among the 5 persons selected by the
chairman |
except that if the parties do not agree on an arbitrator from
|
among the 5 persons, the parties may, by agreement, select an |
arbitrator of
the American Arbitration Association, whose fee |
shall be paid by the State
in accordance with rules promulgated |
by the Commission. Arbitration under
this subsection (p) shall |
be voluntary.
|
(Source: P.A. 93-721, eff. 1-1-05.)
|
(820 ILCS 305/25.5 new)
|
Sec. 25.5. Unlawful acts; penalties. |
(a) It is unlawful for any person, company, corporation, |
insurance carrier, healthcare provider, or other entity to: |
(1) Intentionally present or cause to be presented any |
false or
fraudulent claim for the payment of any workers' |
|
compensation
benefit.
|
(2) Intentionally make or cause to be made any false or
|
fraudulent material statement or material representation |
for the
purpose of obtaining or denying any workers' |
compensation
benefit.
|
(3) Intentionally make or cause to be made any false or
|
fraudulent statements with regard to entitlement to |
workers'
compensation benefits with the intent to prevent |
an injured
worker from making a legitimate claim for any |
workers'
compensation benefits.
|
(4) Intentionally prepare or provide an invalid, |
false, or
counterfeit certificate of insurance as proof of |
workers'
compensation insurance.
|
(5) Intentionally make or cause to be made any false or
|
fraudulent material statement or material representation |
for the
purpose of obtaining workers' compensation |
insurance at less
than the proper rate for that insurance.
|
(6) Intentionally make or cause to be made any false or
|
fraudulent material statement or material representation |
on an
initial or renewal self-insurance application or |
accompanying
financial statement for the purpose of |
obtaining self-insurance
status or reducing the amount of |
security that may be required
to be furnished pursuant to |
Section 4 of this Act.
|
(7) Intentionally make or cause to be made any false or
|
fraudulent material statement to the Division of |
Insurance's
fraud and insurance non-compliance unit in the |
course of an
investigation of fraud or insurance |
non-compliance.
|
(8) Intentionally assist, abet, solicit, or conspire |
with any
person, company, or other entity to commit any of |
the acts in
paragraph (1), (2), (3), (4), (5), (6), or (7) |
of this subsection (a).
|
For the purposes of paragraphs (2), (3), (5), (6), and (7), |
the term "statement" includes any writing, notice, proof of |
injury, bill for services, hospital or doctor records and |
|
reports, or X-ray and test results.
|
(b) Any person violating subsection (a) is guilty of a |
Class 4 felony. Any person or entity convicted of any violation |
of this Section shall be ordered to pay complete restitution to |
any person or entity so defrauded in addition to any fine or |
sentence imposed as a result of the conviction.
|
(c) The Division of Insurance of the Department of |
Financial and Professional Regulation shall establish a fraud |
and insurance non-compliance unit responsible for |
investigating incidences of fraud and insurance non-compliance |
pursuant to this Section. The size of the staff of the unit |
shall be subject to appropriation by the General Assembly. It |
shall be the duty of the fraud and insurance non-compliance |
unit to determine the identity of insurance carriers, |
employers, employees, or other persons or entities who have |
violated the fraud and insurance non-compliance provisions of |
this Section. The fraud and insurance non-compliance unit shall |
report violations of the fraud and insurance non-compliance |
provisions of this Section to the Attorney General or to the |
State's Attorney of the county in which the offense allegedly |
occurred, either of whom has the authority to prosecute |
violations under this Section.
|
With respect to the subject of any investigation being |
conducted, the fraud and insurance non-compliance unit shall |
have the general power of subpoena of the Division of |
Insurance.
|
(d) Any person may report allegations of insurance |
non-compliance and fraud pursuant to this Section to the |
Division of Insurance's fraud and insurance non-compliance |
unit whose duty it shall be to investigate the report. The unit |
shall notify the Commission of reports of insurance |
non-compliance. Any person reporting an allegation of |
insurance non-compliance or fraud against either an employee or |
employer under this Section must identify himself. Except as |
provided in this subsection and in subsection (e), all reports |
shall remain confidential except to refer an investigation to |
|
the Attorney General or State's Attorney for prosecution or if |
the fraud and insurance non-compliance unit's investigation |
reveals that the conduct reported may be in violation of other |
laws or regulations of the State of Illinois, the unit may |
report such conduct to the appropriate governmental agency |
charged with administering such laws and regulations. Any |
person who intentionally makes a false report under this |
Section to the fraud and insurance non-compliance unit is |
guilty of a Class A misdemeanor.
|
(e) In order for the fraud and insurance non-compliance |
unit to investigate a report of fraud by an employee, (i) the |
employee must have filed with the Commission an Application for |
Adjustment of Claim and the employee must have either received |
or attempted to receive benefits under this Act that are |
related to the reported fraud or (ii) the employee must have |
made a written demand for the payment of benefits that are |
related to the reported fraud. Upon receipt of a report of |
fraud, the employee or employer shall receive immediate notice |
of the reported conduct, including the verified name and |
address of the complainant if that complainant is connected to |
the case and the nature of the reported conduct. The fraud and |
insurance non-compliance unit shall resolve all reports of |
fraud against employees or employers within 120 days of receipt |
of the report. There shall be no immunity, under this Act or |
otherwise, for any person who files a false report or who files |
a report without good and just cause. Confidentiality of |
medical information shall be strictly maintained. |
Investigations that are not referred for prosecution shall be |
immediately expunged and shall not be disclosed except that the |
employee or employer who was the subject of the report and the |
person making the report shall be notified that the |
investigation is being closed, at which time the name of any |
complainant not connected to the case shall be disclosed to the |
employee or the employer. It is unlawful for any employer, |
insurance carrier, or service adjustment company to file or |
threaten to file a report of fraud against an employee because |
|
of the exercise by the employee of the rights and remedies |
granted to the employee by this Act.
|
For purposes of this subsection (e), "employer" means any |
employer, insurance carrier, third party administrator, |
self-insured, or similar entity.
|
For purposes of this subsection (e), "complainant" refers |
to the person contacting the fraud and insurance non-compliance |
unit to initiate the complaint.
|
(f) Any person convicted of fraud related to workers' |
compensation pursuant to this Section shall be subject to the |
penalties prescribed in the Criminal Code of 1961 and shall be |
ineligible to receive or retain any compensation, disability, |
or medical benefits as defined in this Act if the compensation, |
disability, or medical benefits were owed or received as a |
result of fraud for which the recipient of the compensation, |
disability, or medical benefit was convicted. This subsection |
applies to accidental injuries or diseases that occur on or |
after the effective date of this amendatory Act of the 94th |
General Assembly.
|
(g) Civil liability. Any person convicted of fraud who |
knowingly obtains, attempts to obtain, or causes to be obtained |
any benefits under this Act by the making of a false claim or |
who knowingly misrepresents any material fact shall be civilly |
liable to the payor of benefits or the insurer or the payor's |
or insurer's subrogee or assignee in an amount equal to 3 times |
the value of the benefits or insurance coverage wrongfully |
obtained or twice the value of the benefits or insurance |
coverage attempted to be obtained, plus reasonable attorney's |
fees and expenses incurred by the payor or the payor's subrogee |
or assignee who successfully brings a claim under this |
subsection. This subsection applies to accidental injuries or |
diseases that occur on or after the effective date of this |
amendatory Act of the 94th General Assembly.
|
(h) All proceedings under this Section shall be reported by |
the fraud and insurance non-compliance unit on an annual basis |
to the Workers' Compensation Advisory Board.
|
|
Section 15. The Workers' Occupational Diseases Act is |
amended by changing Sections 12 and 19 as follows:
|
(820 ILCS 310/12) (from Ch. 48, par. 172.47)
|
Sec. 12. (a) An employee entitled to receive disability |
payments
shall be required, if requested by the employer, to |
submit himself, at
the expense of the employer, for examination |
to a duly qualified medical
practitioner or surgeon selected by |
the employer, at any time and place
reasonably convenient for |
the employee, either within or without the
State of Illinois, |
for the purpose of determining the nature, extent and
probable |
duration of the occupational disease and the disability
|
therefrom suffered by the employee, and for the purpose of |
ascertaining
the amount of compensation which may be due the |
employee from time to
time for disability according to the |
provisions of this Act. An employee
may also be required to |
submit himself for examination by medical experts
under |
subsection (c) of Section 19.
|
An employer requesting such an examination, of an employee |
residing
within the State of Illinois, shall deliver to the |
employee with the notice of the time and place of examination
|
pay in advance of the time fixed for
the examination sufficient |
money to defray the necessary expense of
travel by the most |
convenient means to and from the place of
examination, and the |
cost of meals necessary during the trip, and if the
examination |
or travel to and from the place of examination causes any
loss |
of working time on the part of the employee, the employer shall
|
reimburse him for such loss of wages upon the basis of his |
average daily
wage. Such examination shall be made in the |
presence of a duly qualified
medical practitioner or surgeon |
provided and paid for by the employee,
if such employee so |
desires.
|
In all cases where the examination is made by a physician |
or surgeon
engaged by the employer, and the employee has no |
physician or surgeon
present at such examination, it shall be |
|
the duty of the physician or
surgeon making the examination at |
the instance of the employer to
deliver to the employee, or his |
representative, a statement in writing
of the examination and |
findings to the same extent that said physician
or surgeon |
reports to the employer and the same shall be an exact copy
of |
that furnished to the employer, said copy to be furnished the
|
employee, or his representative as soon as practicable but not |
later
than the time the case is set for hearing. Such delivery |
shall be made
in person either to the employee or his |
representative, or by registered
mail to either, and the |
receipt of either shall be proof of such
delivery. If such |
physician or surgeon refuses to furnish the employee
with such |
statement to the same extent as that furnished the employer
|
said physician or surgeon shall not be permitted to testify at |
the
hearing next following said examination.
|
If the employee refuses so to submit himself to examination |
or
unnecessarily obstructs the same, his right to compensation |
payment
shall be temporarily suspended until such examination |
shall have taken
place, and no compensation shall be payable |
under this Act for such
period.
|
It shall be the duty of physicians or surgeons treating an |
employee
who is likely to die, and treating him at the instance |
of the employer,
to have called in another physician or surgeon |
to be designated and paid
for by either the employee or by the |
person or persons who would become
his beneficiary or |
beneficiaries, to make an examination before the
death of such |
employee.
|
In all cases where the examination is made by a physician |
or surgeon
engaged by the employee, and the employer has no |
physician or surgeon
present at such examination, it shall be |
the duty of the physician or
surgeon making the examination at |
the instance of the employee, to
deliver to the employer, or |
his representative, a statement in writing
of the condition and |
extent of the examination and findings to the same
extent that |
said physician or surgeon reports to the employee and the
same |
shall be an exact copy of that furnished to the employee, said |
|
copy
to be furnished the employer, or his representative, as |
soon as
practicable but not later than the time the case is set |
for hearing.
Such delivery shall be made in person either to |
the employer, or his
representative, or by registered mail to |
either, and the receipt of
either shall be proof of such |
delivery. If such physician or surgeon
refuses to furnish the |
employer with such statement to the same extent
as that |
furnished the employee, said physician or surgeon shall not be
|
permitted to testify at the hearing next following said |
examination.
|
(b) Whenever, after the death of an employee, any party in |
interest
files an application for adjustment of claim under |
this Act, and it
appears that an autopsy may disclose material |
evidence as to whether or
not such death was due to the |
inhalation of silica or asbestos dust, the
commission, upon |
petition of either party, may order an autopsy at the
expense |
of the party requesting same, and if such autopsy is so |
ordered,
the commission shall designate a competent |
pathologist to perform the
same, and shall give the parties in |
interest such reasonable notice of
the time and place thereof |
as will afford a reasonable opportunity to
witness such autopsy |
in person or by a representative.
|
It shall be the duty of such pathologist to perform such |
autopsy as,
in his best judgment, is required to ascertain the |
cause of death. Such
pathologist shall make a complete written |
report of all his findings to
the commission (including |
laboratory results described as such, if any).
The said report |
of the pathologist shall contain his findings on
post-mortem |
examination and said report shall not contain any conclusion
of |
the said pathologist based upon the findings so reported.
|
Said report shall be placed on file with the commission, |
and shall be
a public record. Said report, or a certified copy |
thereof, may be
introduced by either party on any hearing as |
evidence of the findings
therein stated, but shall not be |
conclusive evidence of such findings,
and either party may |
rebut any part thereof.
|
|
Where an autopsy has been performed at any time with the |
express or
implied consent of any interested party, and without |
some opposing
party, if known or reasonably ascertainable, |
having reasonable notice of
and reasonable opportunity of |
witnessing the same, all evidence obtained
by such autopsy |
shall be barred upon objection at any hearing. This
paragraph |
shall not apply to autopsies by a coroner's physician in the
|
discharge of his official duties.
|
(Source: P.A. 81-1482.)
|
(820 ILCS 310/19) (from Ch. 48, par. 172.54)
|
Sec. 19. Any disputed questions of law or fact shall be |
determined as
herein provided.
|
(a) It shall be the duty of the Commission upon |
notification that
the parties have failed to reach an agreement |
to designate an
Arbitrator.
|
(1) The application for adjustment of claim filed with |
the
Commission shall state:
|
A. The approximate date of the last day of the last |
exposure and the
approximate date of the disablement.
|
B. The general nature and character of the illness |
or disease
claimed.
|
C. The name and address of the employer by whom |
employed on the last
day of the last exposure and if |
employed by any other employer after
such last exposure |
and before disablement the name and address of such
|
other employer or employers.
|
D. In case of death, the date and place of death.
|
(2) Amendments to applications for adjustment of claim |
which relate
to the same disablement or disablement |
resulting in death originally
claimed upon may be allowed |
by the Commissioner or an Arbitrator
thereof, in their |
discretion, and in the exercise of such discretion,
they |
may in proper cases order a trial de novo; such amendment |
shall
relate back to the date of the filing of the original |
application so
amended.
|
|
(3) Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under this Act |
and it is
subsequently discovered, at any time before final |
disposition of such
cause, that the claim for disability or |
death which was the basis for
such application should |
properly have been made under the Workers'
Compensation |
Act, then the provisions of Section 19 paragraph (a-1) of
|
the Workers' Compensation Act having reference to such |
application shall
apply.
|
Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under the |
Workers' Compensation Act
and it is subsequently |
discovered, at any time before final disposition
of such |
cause that the claim for injury or death which was the |
basis for
such application should properly have been made |
under this Act, then the
application so filed under the |
Workers' Compensation Act may be amended
in form, substance |
or both to assert claim for such disability or death
under |
this Act and it shall be deemed to have been so filed as |
amended
on the date of the original filing thereof, and |
such compensation may be
awarded as is warranted by the |
whole evidence pursuant to the provisions
of this Act. When |
such amendment is submitted, further or additional
|
evidence may be heard by the Arbitrator or Commission when |
deemed
necessary; provided, that nothing in this Section |
contained shall be
construed to be or permit a waiver of |
any provisions of this Act with
reference to notice, but |
notice if given shall be deemed to be a notice
under the |
provisions of this Act if given within the time required
|
herein.
|
(b) The Arbitrator shall make such inquiries and |
investigations as he
shall deem necessary and may examine and |
inspect all books, papers,
records, places, or premises |
relating to the questions in dispute and hear
such proper |
evidence as the parties may submit.
|
The hearings before the Arbitrator shall be held in the |
|
vicinity where
the last exposure occurred, after 10 days' |
notice of the time and place of
such hearing shall have been |
given to each of the parties or their attorneys of record.
|
The Arbitrator may find that the disabling condition is |
temporary and has
not yet reached a permanent condition and may |
order the payment of
compensation up to the date of the |
hearing, which award shall be reviewable
and enforceable in the |
same manner as other awards, and in no instance be a
bar to a |
further hearing and determination of a further amount of |
temporary
total compensation or of compensation for permanent |
disability, but shall
be conclusive as to all other questions |
except the nature and extent of such
disability.
|
The decision of the Arbitrator shall be filed with the |
Commission which
Commission shall immediately send to each |
party or his attorney a copy of
such decision, together with a |
notification of the time when it was filed.
As of the effective |
date of this amendatory Act of the 94th General Assembly
|
Beginning January 1, 1981 , all decisions of the Arbitrator |
shall set forth
in writing findings of fact and conclusions of |
law, separately stated , if requested by either party .
Unless a |
petition for review is filed by either party within 30 days |
after
the receipt by such party of the copy of the decision and |
notification of
time when filed, and unless such party |
petitioning for a review shall
within 35 days after the receipt |
by him of the copy of the decision, file
with the Commission |
either an agreed statement of the facts appearing upon
the |
hearing before the Arbitrator, or if such party shall so elect |
a
correct transcript of evidence of the proceedings at such |
hearings, then
the decision shall become the decision of the |
Commission and in the absence
of fraud shall be conclusive. The |
Petition for Review shall contain a
statement of the |
petitioning party's specific exceptions to the decision of
the |
arbitrator. The jurisdiction of the Commission to review the |
decision
of the arbitrator shall not be limited to the |
exceptions stated in the
Petition for Review. The Commission, |
or any member thereof, may grant
further time not exceeding 30 |
|
days, in which to file such agreed statement
or transcript of |
evidence. Such agreed statement of facts or correct
transcript |
of evidence, as the case may be, shall be authenticated by the
|
signatures of the parties or their attorneys, and in the event |
they do not
agree as to the correctness of the transcript of |
evidence it shall be
authenticated by the signature of the |
Arbitrator designated by the Commission.
|
Whether the employee is working or not, if the employee is |
not receiving or has not received medical, surgical, or |
hospital services or other services or compensation as provided |
in paragraph (a) of Section 8 of the Workers' Compensation
Act, |
or compensation as provided in paragraph (b) of Section 8 of |
the Workers' Compensation
Act, the employee may at any time |
petition for an expedited hearing by an Arbitrator on the issue |
of whether or not he or she is entitled to receive payment of |
the services or compensation. Provided the employer continues |
to pay compensation pursuant to paragraph (b) of Section 8 of |
the Workers' Compensation
Act, the employer may at any time |
petition for an expedited hearing on the issue of whether or |
not the employee is entitled to receive medical, surgical, or |
hospital services or other services or compensation as provided |
in paragraph (a) of Section 8 of the Workers' Compensation
Act, |
or compensation as provided in paragraph (b) of Section 8 of |
the Workers' Compensation
Act. When an employer has petitioned |
for an expedited hearing, the employer shall continue to pay |
compensation as provided in paragraph (b) of Section 8 of the |
Workers' Compensation
Act unless the arbitrator renders a |
decision that the employee is not entitled to the benefits that |
are the subject of the expedited hearing or unless the |
employee's treating physician has released the employee to |
return to work at his or her regular job with the employer or |
the employee actually returns to work at any other job. If the |
arbitrator renders a decision that the employee is not entitled |
to the benefits that are the subject of the expedited hearing, |
a petition for review filed by the employee shall receive the |
same priority as if the employee had filed a petition for an |
|
expedited hearing by an arbitrator. Neither party shall be |
entitled to an expedited hearing when the employee has returned |
to work and the sole issue in dispute amounts to less than 12 |
weeks of unpaid compensation pursuant to paragraph (b) of |
Section 8 of the Workers' Compensation
Act. |
Expedited hearings shall have priority over all other |
petitions and shall be heard by the Arbitrator and Commission |
with all convenient speed. Any party requesting an expedited |
hearing shall give notice of a request for an expedited hearing |
under this paragraph. A copy of the Application for Adjustment |
of Claim shall be attached to the notice. The Commission shall |
adopt rules and procedures under which the final decision of |
the Commission under this paragraph is filed not later than 180 |
days from the date that the Petition for Review is filed with |
the Commission. |
Where 2 or more insurance carriers, private self-insureds, |
or a group workers' compensation pool under Article V 3/4 of |
the Illinois Insurance Code dispute coverage for the same |
disease, any such insurance carrier, private self-insured, or |
group workers' compensation pool may request an expedited |
hearing pursuant to this paragraph to determine the issue of |
coverage, provided coverage is the only issue in dispute and |
all other issues are stipulated and agreed to and further |
provided that all compensation benefits including medical |
benefits pursuant to Section 8(a) of the Workers' Compensation
|
Act continue to be paid to or on behalf of petitioner. Any |
insurance carrier, private self-insured, or group workers' |
compensation pool that is determined to be liable for coverage |
for the disease in issue shall reimburse any insurance carrier, |
private self-insured, or group workers' compensation pool that |
has paid benefits to or on behalf of petitioner for the |
disease.
|
(b-1) If the employee is not receiving, pursuant to Section |
7, medical,
surgical or hospital services of the type provided |
for in paragraph (a) of
Section 8 of the Workers' Compensation |
Act or compensation of the type
provided for in paragraph (b) |
|
of Section 8 of the Workers' Compensation
Act, the employee, in |
accordance with Commission Rules, may file a petition
for an |
emergency hearing by an Arbitrator on the issue of whether or |
not he
is entitled to receive payment of such compensation or |
services as provided
therein. Such petition shall have priority |
over all other petitions and
shall be heard by the Arbitrator |
and Commission with all convenient speed.
|
Such petition shall contain the following information and |
shall be served
on the employer at least 15 days before it is |
filed:
|
(i) the date and approximate time of the last exposure;
|
(ii) the approximate location of the last exposure;
|
(iii) a description of the last exposure;
|
(iv) the nature of the disability incurred by the |
employee;
|
(v) the identity of the person, if known, to whom the |
disability was
reported and the date on which it was |
reported;
|
(vi) the name and title of the person, if known, |
representing the
employer with whom the employee conferred |
in any effort to obtain pursuant
to Section 7 compensation |
of the type provided for in paragraph (b) of
Section 8 of |
the Workers' Compensation Act or medical, surgical or |
hospital
services of the type provided for in paragraph (a) |
of Section 8 of the
Workers' Compensation Act and the date |
of such conference;
|
(vii) a statement that the employer has refused to pay |
compensation
pursuant to Section 7 of the type provided for |
in paragraph (b) of Section
8 of the Workers' Compensation |
Act or for medical, surgical
or hospital services pursuant |
to Section 7 of the type provided for in
paragraph (a) of |
Section 8 of the Workers' Compensation Act;
|
(viii) the name and address, if known, of each witness |
to the last
exposure and of each other person upon whom the |
employee will rely to
support his allegations;
|
(ix) the dates of treatment related to the disability |
|
by medical
practitioners, and the names and addresses of |
such practitioners, including
the dates of treatment |
related to the disability at any hospitals and the
names |
and addresses of such hospitals, and a signed authorization
|
permitting the employer to examine all medical records of |
all practitioners
and hospitals named pursuant to this |
paragraph;
|
(x) a copy of a signed report by a medical |
practitioner, relating to the
employee's current inability |
to return to work because of the disability
incurred as a |
result of the exposure or such other documents or |
affidavits
which show that the employee is entitled to |
receive pursuant to Section 7
compensation of the type |
provided for in paragraph (b) of Section 8 of the
Workers' |
Compensation Act or medical, surgical or hospital services |
of the
type provided for in paragraph (a) of Section 8 of |
the Workers'
Compensation Act. Such reports, documents or |
affidavits shall state, if
possible, the history of the |
exposure given by the employee, and describe
the disability |
and medical diagnosis, the medical services for such
|
disability which the employee has received and is |
receiving, the physical
activities which the employee |
cannot currently perform as a result of such
disability, |
and the prognosis for recovery;
|
(xi) complete copies of any reports, records, |
documents and affidavits
in the possession of the employee |
on which the employee will rely to
support his allegations, |
provided that the employer shall pay the
reasonable cost of |
reproduction thereof;
|
(xii) a list of any reports, records, documents and |
affidavits which
the employee has demanded by subpoena and |
on which he intends to
rely to support his allegations;
|
(xiii) a certification signed by the employee or his |
representative that
the employer has received the petition |
with the required information 15
days before filing.
|
Fifteen days after receipt by the employer of the petition |
|
with the
required information the employee may file said |
petition and required
information and shall serve notice of the |
filing upon the employer. The
employer may file a motion |
addressed to the sufficiency of the petition.
If an objection |
has been filed to the sufficiency of the petition, the
|
arbitrator shall rule on the objection within 2 working days. |
If such an
objection is filed, the time for filing the final |
decision of the Commission
as provided in this paragraph shall |
be tolled until the arbitrator has
determined that the petition |
is sufficient.
|
The employer shall, within 15 days after receipt of the |
notice that such
petition is filed, file with the Commission |
and serve on the employee or
his representative a written |
response to each claim set
forth in the petition, including the |
legal and factual basis for each
disputed allegation and the |
following information: (i)
complete copies of any reports, |
records, documents and affidavits
in the possession of the |
employer on which the employer intends to rely in
support of |
his response, (ii) a list of any reports, records, documents |
and
affidavits which the employer has demanded by subpoena and |
on which the
employer intends to rely in support of his |
response, (iii) the name and address
of each witness on whom |
the employer will rely to support his response,
and (iv) the |
names and addresses of any medical practitioners
selected by |
the employer pursuant to Section 12 of this Act and the time
|
and place of any examination scheduled to be made pursuant to |
such Section.
|
Any employer who does not timely file and serve a written |
response
without good cause may not introduce any evidence to |
dispute any claim of
the employee but may cross examine the |
employee or any witness brought by
the employee and otherwise |
be heard.
|
No document or other evidence not previously identified by |
either party
with the petition or written response, or by any |
other means before the
hearing, may be introduced into evidence |
without good cause. If, at the
hearing, material information is |
|
discovered which was not previously
disclosed, the Arbitrator |
may extend the time for closing proof on the
motion of a party |
for a reasonable period of time which may be more than 30
days. |
No evidence may be introduced pursuant to this paragraph as to
|
permanent disability. No award may be entered for permanent |
disability
pursuant to this paragraph. Either party may |
introduce into evidence the
testimony taken by deposition of |
any medical practitioner.
|
The Commission shall adopt rules, regulations and |
procedures whereby
the final decision of the Commission is |
filed not later than 90 days from
the date the petition for |
review is filed but in no event later than 180
days from the |
date the petition for an emergency hearing is filed with the
|
Illinois Workers' Compensation Commission.
|
All service required pursuant to this paragraph (b-1) must |
be by personal
service or by certified mail and with evidence |
of receipt. In addition,
for the purposes of this paragraph, |
all service on the employer must be at
the premises where the |
accident occurred if the premises are owned or
operated by the |
employer. Otherwise service must be at the employee's
principal |
place of employment by the employer. If service on the employer
|
is not possible at either of the above, then service shall be |
at the
employer's principal place of business. After initial |
service in each case,
service shall be made on the employer's |
attorney or designated representative.
|
(c) (1) At a reasonable time in advance of and in |
connection with the
hearing under Section 19(e) or 19(h), the |
Commission may on its own motion
order an impartial physical or |
mental examination of a petitioner whose
mental or physical |
condition is in issue, when in the Commission's
discretion it |
appears that such an examination will materially aid in the
|
just determination of the case. The examination shall be made |
by a member
or members of a panel of physicians chosen for |
their special qualifications
by the Illinois State Medical |
Society. The Commission shall establish
procedures by which a |
physician shall be selected from such list.
|
|
(2) Should the Commission at any time during the hearing |
find that
compelling considerations make it advisable to have |
an examination and
report at that time, the Commission may in |
its discretion so order.
|
(3) A copy of the report of examination shall be given to |
the Commission
and to the attorneys for the parties.
|
(4) Either party or the Commission may call the examining |
physician
or physicians to testify. Any physician so called |
shall be subject to
cross-examination.
|
(5) The examination shall be made, and the physician or |
physicians,
if called, shall testify, without cost to the |
parties. The Commission shall
determine the compensation and |
the pay of the physician or physicians. The
compensation for |
this service shall not exceed the usual and customary amount
|
for such service.
|
The fees and payment thereof of all attorneys and |
physicians for
services authorized by the Commission under this |
Act shall, upon request
of either the employer or the employee |
or the beneficiary affected, be
subject to the review and |
decision of the Commission.
|
(d) If any employee shall persist in insanitary or |
injurious
practices which tend to either imperil or retard his |
recovery or shall
refuse to submit to such medical, surgical, |
or hospital treatment as is
reasonably essential to promote his |
recovery, the Commission may, in its
discretion, reduce or |
suspend the compensation of any such employee;
provided, that |
when an employer and employee so agree in writing, the
|
foregoing provision shall not be construed to authorize the |
reduction or
suspension of compensation of an employee who is |
relying in good faith,
on treatment by prayer or spiritual |
means alone, in accordance with the
tenets and practice of a |
recognized church or religious denomination, by
a duly |
accredited practitioner thereof.
|
(e) This paragraph shall apply to all hearings before the |
Commission.
Such hearings may be held in its office or |
elsewhere as the Commission may
deem advisable. The taking of |
|
testimony on such hearings may be had before
any member of the |
Commission. If a petition for review and agreed statement
of |
facts or transcript of evidence is filed, as provided herein, |
the
Commission shall promptly review the decision of the |
Arbitrator and all
questions of law or fact which appear from |
the statement of facts or
transcripts of evidence. In all cases |
in which the hearing before the
arbitrator is held after the |
effective date of this amendatory Act of 1989,
no additional |
evidence shall be introduced by the parties before the
|
Commission on review of the decision of the Arbitrator. The |
Commission
shall file in its office its decision thereon, and |
shall immediately send
to each party or his attorney a copy of |
such decision and a notification of
the time when it was filed. |
Decisions shall be filed within 60 days after
the Statement of |
Exceptions and Supporting Brief and Response thereto are
|
required to be filed or oral argument whichever is later.
|
In the event either party requests oral argument, such |
argument shall be
had before a panel of 3 members of the |
Commission (or before all available
members pursuant to the |
determination of 7
5 members of the Commission that
such |
argument be held before all available members of the |
Commission)
pursuant to the rules and regulations of the |
Commission. A panel of 3
members, which shall be comprised of |
not more than one representative
citizen of the employing class |
and not more than one representative citizen
of the employee |
class, shall hear the argument; provided that if all the
issues |
in dispute are solely the nature and extent of the permanent |
partial
disability, if any, a majority of the panel may deny |
the request for such
argument and such argument shall not be |
held; and provided further that 7
5
members of the Commission |
may determine that the argument be held before
all available |
members of the Commission. A decision of the Commission shall
|
be approved by a majority of Commissioners present at such |
hearing if any;
provided, if no such hearing is held, a |
decision of the Commission shall be
approved by a majority of a |
panel of 3 members of the Commission as
described in this |
|
Section. The Commission shall give 10 days' notice to the
|
parties or their attorneys of the time and place of such taking |
of
testimony and of such argument.
|
In any case the Commission in its decision may in its |
discretion find
specially upon any question or questions of law |
or facts which shall be
submitted in writing by either party |
whether ultimate or otherwise;
provided that on issues other |
than nature and extent of the disablement,
if any, the |
Commission in its decision shall find specially upon any
|
question or questions of law or fact, whether ultimate or |
otherwise,
which are submitted in writing by either party; |
provided further that
not more than 5 such questions may be |
submitted by either party. Any
party may, within 20 days after |
receipt of notice of the Commission's
decision, or within such |
further time, not exceeding 30 days, as the
Commission may |
grant, file with the Commission either an agreed
statement of |
the facts appearing upon the hearing, or, if such party
shall |
so elect, a correct transcript of evidence of the additional
|
proceedings presented before the Commission in which report the |
party
may embody a correct statement of such other proceedings |
in the case as
such party may desire to have reviewed, such |
statement of facts or
transcript of evidence to be |
authenticated by the signature of the
parties or their |
attorneys, and in the event that they do not agree,
then the |
authentication of such transcript of evidence shall be by the
|
signature of any member of the Commission.
|
If a reporter does not for any reason furnish a transcript |
of the
proceedings before the Arbitrator in any case for use on |
a hearing for
review before the Commission, within the |
limitations of time as fixed in
this Section, the Commission |
may, in its discretion, order a trial de
novo before the |
Commission in such case upon application of either
party. The |
applications for adjustment of claim and other documents in
the |
nature of pleadings filed by either party, together with the
|
decisions of the Arbitrator and of the Commission and the |
statement of
facts or transcript of evidence hereinbefore |
|
provided for in paragraphs
(b) and (c) shall be the record of |
the proceedings of the Commission,
and shall be subject to |
review as hereinafter provided.
|
At the request of either party or on its own motion, the |
Commission shall
set forth in writing the reasons for the |
decision, including findings of
fact and conclusions of law, |
separately stated. The Commission shall by
rule adopt a format |
for written decisions for the Commission and
arbitrators. The |
written decisions shall be concise and shall succinctly
state |
the facts and reasons for the decision. The Commission may |
adopt in
whole or in part, the decision of the arbitrator as |
the decision of the
Commission. When the Commission does so |
adopt the decision of the
arbitrator, it shall do so by order. |
Whenever the Commission adopts part of
the arbitrator's |
decision, but not all, it shall include in the order the
|
reasons for not adopting all of the arbitrator's decision. When |
a majority
of a panel, after deliberation, has arrived at its |
decision, the decision
shall be filed as provided in this |
Section without unnecessary delay, and
without regard to the |
fact that a member of the panel has expressed an
intention to |
dissent. Any member of the panel may file a dissent. Any
|
dissent shall be filed no later than 10 days after the decision |
of the
majority has been filed.
|
Decisions rendered by the Commission after the effective |
date of this
amendatory Act of 1980 and dissents, if any, shall |
be published
together by the Commission. The conclusions
of law |
set out in such decisions shall be regarded as precedents
by |
arbitrators, for the purpose of achieving
a more uniform |
administration of this Act.
|
(f) The decision of the Commission acting within its |
powers,
according to the provisions of paragraph (e) of this |
Section shall, in
the absence of fraud, be conclusive unless |
reviewed as in this paragraph
hereinafter provided. However, |
the Arbitrator or the Commission may on
his or its own motion, |
or on the motion of either party, correct any
clerical error or |
errors in computation within 15 days after the date of
receipt |
|
of any award by such Arbitrator or any decision on review of |
the
Commission, and shall have the power to recall the original |
award on
arbitration or decision on review, and issue in lieu |
thereof such
corrected award or decision. Where such correction |
is made the time for
review herein specified shall begin to run |
from the date of
the receipt of the corrected award or |
decision.
|
(1) Except in cases of claims against the State of |
Illinois, in
which case the decision of the Commission |
shall not be subject to
judicial review, the Circuit Court |
of the county where any of the
parties defendant may be |
found, or if none of the parties defendant be
found in this |
State then the Circuit Court of the county where any of
the |
exposure occurred, shall by summons to the Commission
have |
power to review all questions of law and fact presented by |
such
record.
|
A proceeding for review shall be commenced within 20 |
days of the
receipt of notice of the decision of the |
Commission. The summons shall be
issued by the clerk of |
such court upon written request returnable on a
designated |
return day, not less than 10 or more than 60 days from the |
date
of issuance thereof, and the written request shall |
contain the last known
address of other parties in interest |
and their attorneys of record who are
to be served by |
summons. Service upon any member of the Commission or the
|
Secretary or the Assistant Secretary thereof shall be |
service upon the
Commission, and service upon other parties |
in interest and their attorneys
of record shall be by |
summons, and such service shall be made upon the
Commission |
and other parties in interest by mailing notices of the
|
commencement of the proceedings and the return day of the |
summons to the
office of the Commission and to the last |
known place of residence of
other parties in interest or |
their attorney or attorneys of record. The
clerk of the |
court issuing the summons shall on the day of issue mail |
notice
of the commencement of the proceedings which shall |
|
be done by mailing a
copy of the summons to the office of |
the Commission, and a copy of the
summons to the other |
parties in interest or their attorney or
attorneys of |
record and the clerk of the court shall make certificate
|
that he has so sent such notices in pursuance of this |
Section, which
shall be evidence of service on the |
Commission and other parties in
interest.
|
The Commission shall not be required to certify the |
record of their
proceedings in the Circuit Court unless the |
party commencing the
proceedings for review in the Circuit |
Court as above provided, shall pay
to the Commission the |
sum of 80 cents per page of testimony taken before
the |
Commission, and 35 cents per page of all other matters |
contained in
such record, except as otherwise provided by |
Section 20 of this Act.
Payment for photostatic copies of |
exhibit shall be extra. It shall be
the duty of the |
Commission upon such payment, or failure to pay as
|
permitted under Section 20 of this Act, to prepare a true |
and correct
typewritten copy of such testimony and a true |
and correct copy of all
other matters contained in such |
record and certified to by the Secretary
or Assistant |
Secretary thereof.
|
In its decision on review the Commission shall |
determine in each
particular case the amount of the |
probable cost of the record to be
filed as a return to the |
summons in that case and no request
for a summons may be |
filed and no summons shall
issue unless the party seeking |
to review the decision of the Commission
shall exhibit to |
the clerk of the Circuit Court proof of payment by
filing a |
receipt showing payment or an affidavit of the attorney |
setting
forth that payment has been made of the sums so |
determined to the Secretary
or Assistant Secretary of the |
Commission.
|
(2) No such summons shall issue unless the one against
|
whom the Commission shall have rendered an award for the |
payment of money
shall upon the filing of his written |
|
request for such summons file with the
clerk of the court a |
bond conditioned that if he shall not successfully
|
prosecute the review, he will pay the award and the costs |
of the
proceedings in the court. The amount of the bond |
shall be fixed by any
member of the Commission and the |
surety or sureties of the bond shall be
approved by the |
clerk of the court. The acceptance of the bond by the
clerk |
of the court shall constitute evidence of his approval of |
the
bond.
|
Every county, city, town, township, incorporated |
village, school
district, body politic or municipal |
corporation having a population of
500,000 or more against |
whom the Commission shall have rendered an award
for the |
payment of money shall not be required to file a bond to |
secure
the payment of the award and the costs of the |
proceedings in the court
to authorize the court to issue |
such summons.
|
The court may confirm or set aside the decision of the |
Commission. If
the decision is set aside and the facts |
found in the proceedings before
the Commission are |
sufficient, the court may enter such decision as is
|
justified by law, or may remand the cause to the Commission |
for further
proceedings and may state the questions |
requiring further hearing, and
give such other |
instructions as may be proper. Appeals shall be taken
to |
the Appellate Court in accordance
with Supreme Court Rules |
22(g) and 303. Appeals shall be taken from the
Appellate |
Court to the Supreme Court
in accordance with Supreme Court |
Rule 315.
|
It shall be the duty of the clerk of any court |
rendering a decision
affecting or affirming an award of the |
Commission to promptly furnish
the Commission with a copy |
of such decision, without charge.
|
The decision of a majority of the members of the panel |
of the Commission,
shall be considered the decision of the |
Commission.
|
|
(g) Except in the case of a claim against the State of |
Illinois,
either party may present a certified copy of the |
award of the
Arbitrator, or a certified copy of the decision of |
the Commission when
the same has become final, when no |
proceedings for review are pending,
providing for the payment |
of compensation according to this Act, to the
Circuit Court of |
the county in which such exposure occurred or either of
the |
parties are residents, whereupon the court shall enter a |
judgment
in accordance therewith. In case where the employer |
refuses to pay
compensation according to such final award or |
such final decision upon
which such judgment is entered, the |
court shall in entering judgment
thereon, tax as costs against |
him the reasonable costs and attorney fees
in the arbitration |
proceedings and in the court entering the judgment
for the |
person in whose favor the judgment is entered, which judgment
|
and costs taxed as herein provided shall, until and unless set |
aside,
have the same effect as though duly entered in an action |
duly tried and
determined by the court, and shall with like |
effect, be entered and
docketed. The Circuit Court shall have |
power at any time upon
application to make any such judgment |
conform to any modification
required by any subsequent decision |
of the Supreme Court upon appeal, or
as the result of any |
subsequent proceedings for review, as provided in
this Act.
|
Judgment shall not be entered until 15 days' notice of the |
time and
place of the application for the entry of judgment |
shall be served upon
the employer by filing such notice with |
the Commission, which Commission
shall, in case it has on file |
the address of the employer or the name
and address of its |
agent upon whom notices may be served, immediately
send a copy |
of the notice to the employer or such designated agent.
|
(h) An agreement or award under this Act providing for |
compensation
in installments, may at any time within 18 months |
after such agreement
or award be reviewed by the Commission at |
the request of either the
employer or the employee on the |
ground that the disability of the
employee has subsequently |
recurred, increased, diminished or ended.
|
|
However, as to disablements occurring subsequently to July |
1, 1955,
which are covered by any agreement or award under this |
Act providing for
compensation in installments made as a result |
of such disablement, such
agreement or award may at any time |
within 30 months after such agreement
or award be reviewed by |
the Commission at the request of either the
employer or the |
employee on the ground that the disability of the
employee has |
subsequently recurred, increased, diminished or ended.
|
On such review compensation payments may be |
re-established,
increased, diminished or ended. The Commission |
shall give 15 days'
notice to the parties of the hearing for |
review. Any employee, upon any
petition for such review being |
filed by the employer, shall be entitled
to one day's notice |
for each 100 miles necessary to be traveled by him in
attending |
the hearing of the Commission upon the petition, and 3 days in
|
addition thereto. Such employee shall, at the discretion of the
|
Commission, also be entitled to 5 cents per mile necessarily |
traveled by
him within the State of Illinois in attending such |
hearing, not to
exceed a distance of 300 miles, to be taxed by |
the Commission as costs
and deposited with the petition of the |
employer.
|
When compensation which is payable in accordance with an |
award or
settlement contract approved by the Commission, is |
ordered paid in a
lump sum by the Commission, no review shall |
be had as in this paragraph
mentioned.
|
(i) Each party, upon taking any proceedings or steps |
whatsoever
before any Arbitrator, Commission or court,
shall |
file with the Commission his address, or the name and address |
of
any agent upon whom all notices to be given to such party |
shall be
served, either personally or by registered mail, |
addressed to such party
or agent at the last address so filed |
with the Commission. In the event
such party has not filed his |
address, or the name and address of an
agent as above provided, |
service of any notice may be had by filing such
notice with the |
Commission.
|
(j) Whenever in any proceeding testimony has been taken or |
|
a final
decision has been rendered, and after the taking of |
such testimony or
after such decision has become final, the |
employee dies, then in any
subsequent proceeding brought by the |
personal representative or
beneficiaries of the deceased |
employee, such testimony in the former
proceeding may be |
introduced with the same force and effect as though
the witness |
having so testified were present in person in such
subsequent |
proceedings and such final decision, if any, shall be taken
as |
final adjudication of any of the issues which are the same in |
both
proceedings.
|
(k) In any case where there has been any unreasonable or |
vexatious
delay of payment or intentional underpayment of |
compensation, or
proceedings have been instituted or carried on |
by one liable to pay the
compensation, which do not present a |
real controversy, but are merely
frivolous or for delay, then |
the Commission may award compensation
additional to that |
otherwise payable under this Act equal to 50% of the
amount |
payable at the time of such award. Failure to pay compensation |
in
accordance with the provisions of Section 8, paragraph (b) |
of this Act,
shall be considered unreasonable delay.
|
When determining whether this subsection (k) shall apply, |
the
Commission shall consider whether an arbitrator has |
determined
that the claim is not compensable or whether the |
employer has
made payments under Section 8(j) of the Workers' |
Compensation Act. |
(k-1) If the employee has made written demand for payment |
of
benefits under Section 8(a) or Section 8(b) of the Workers' |
Compensation Act, the employer shall
have 14 days after receipt |
of the demand to set forth in
writing the reason for the delay. |
In the case of demand for
payment of medical benefits under |
Section 8(a) of the Workers' Compensation Act, the time for
the |
employer to respond shall not commence until the expiration
of |
the allotted 60 days specified under Section 8.2(d) of the |
Workers' Compensation Act. In case
the employer or his or her |
insurance carrier shall without good and
just cause fail, |
neglect, refuse, or unreasonably delay the
payment of benefits |
|
under Section 8(a) or Section 8(b) of the Workers' Compensation |
Act, the
Arbitrator or the Commission shall allow to the |
employee
additional compensation in the sum of $30 per day for |
each day
that the benefits under Section 8(a) or Section 8(b) |
of the Workers' Compensation Act have been
so withheld or |
refused, not to exceed $10,000.
A delay in payment of 14 days |
or more
shall create a rebuttable presumption of unreasonable |
delay.
|
(l) By the 15th day of each month each insurer providing |
coverage for
losses under this Act shall notify each insured |
employer of any compensable
claim incurred during the preceding |
month and the amounts paid or reserved
on the claim including a |
summary of the claim and a brief statement of the
reasons for |
compensability. A cumulative report of all claims incurred
|
during a calendar year or continued
from the previous year |
shall be furnished to the insured employer by the
insurer |
within 30 days after the end of that calendar year.
|
The insured employer may challenge, in proceeding before |
the Commission,
payments made by the insurer without |
arbitration and payments made after
a case is determined to be |
noncompensable. If the Commission finds that
the case was not |
compensable, the insurer shall purge its records as to
that |
employer of any loss or expense associated with the claim, |
reimburse
the employer for attorneys fee arising from the |
challenge and for any payment
required of the employer to the |
Rate Adjustment Fund or the Second Injury
Fund, and may not |
effect the loss or expense for rate making purposes. The
|
employee shall not be required to refund the challenged |
payment. The
decision of the Commission may be reviewed in the |
same
manner as in arbitrated cases. No challenge may be |
initiated under this
paragraph more than 3 years after the |
payment is made. An employer may
waive the right of challenge |
under this paragraph on a case by case basis.
|
(m) After filing an application for adjustment of claim but |
prior to
the hearing on arbitration the parties may voluntarily |
agree to submit such
application for adjustment of claim for |
|
decision by an arbitrator under
this subsection (m) where such |
application for adjustment
of claim raises only a dispute over |
temporary total disability, permanent
partial disability or |
medical expenses. Such agreement shall be in writing
in such |
form as provided by the Commission. Applications for adjustment |
of
claim submitted for decision by an arbitrator under
this |
subsection (m) shall proceed according
to rule as established |
by the Commission. The Commission shall promulgate
rules |
including, but not limited to, rules to ensure that the parties |
are
adequately informed of their rights under this subsection |
(m) and of the
voluntary nature of proceedings under this |
subsection
(m). The findings of fact made by an arbitrator |
acting within his or her
powers under this subsection (m) in |
the absence of fraud shall be
conclusive. However, the |
arbitrator may on his own motion, or the motion
of either |
party, correct any clerical errors or errors in computation
|
within 15 days after the date of receipt of such award of the |
arbitrator
and shall have the power to recall the original |
award on arbitration, and
issue in lieu thereof such corrected |
award.
The decision of the arbitrator under this subsection (m) |
shall be
considered the decision of the Commission and |
proceedings for review of
questions of law arising from the |
decision may be commenced by either party
pursuant to |
subsection (f) of Section 19. The Advisory Board established
|
under Section 13.1 of the Workers' Compensation Act shall |
compile a list of
certified Commission arbitrators, each of |
whom shall be approved by at least
7 members of the Advisory |
Board. The chairman shall select 5 persons
from such list to |
serve as arbitrators under this subsection (m). By
agreement, |
the parties shall select one arbitrator from among the 5 |
persons
selected by the chairman except, that if the parties do |
not agree on an
arbitrator from among the 5 persons, the |
parties may, by agreement,
select an arbitrator of the American |
Arbitration Association, whose fee
shall be paid by the State |
in accordance with rules promulgated by the
Commission. |
Arbitration under this subsection (m) shall be voluntary.
|
|
(Source: P.A. 93-721, eff. 1-1-05.)
|
Section 95. Applicability. The amendatory changes to the |
first paragraph of subsection (f) of Section 7 relating to |
payment for burial expenses, subsections (a) and (b) of Section |
8, and subsections (h), (k), and (l) of Section 19 of the |
Workers' Compensation Act and subsections (k) and (k-1) of |
Section 19 of the Workers' Occupational Diseases Act apply to |
accidental injuries or diseases that occur on or after February |
1, 2006. |
Section 98. Inseverability. The provisions of this Act are |
mutually
dependent and inseverable. If any provision or its |
application to any person
or circumstance is held invalid, then |
this entire Act is invalid. |
Section 99. Effective date. This Act takes effect upon |
becoming law. |