Public Act 097-0018
 
HB1698 EnrolledLRB097 07917 AJO 48032 b


  
    AN ACT concerning civil law.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  


 
    Section 5. The Department of Central Management Services 
Law of the
Civil Administrative Code of Illinois is amended  by 
changing Sections 405-105 and 405-411 as follows:
 



    (20 ILCS 405/405-105)  (was 20 ILCS 405/64.1)



    Sec. 405-105. Fidelity, surety, property, and casualty 
insurance. The Department
shall establish and implement a 
program to coordinate
the handling of all fidelity, surety, 
property, and casualty insurance
exposures of the State and the 
departments, divisions, agencies,
branches,
and universities 
of the State.  In performing this responsibility, the
Department 
shall have the power and duty to do the following:

        (1) Develop and maintain loss and exposure data on all 
    State
property.

        (2) Study the feasibility of establishing a 
    self-insurance plan
for
State property and prepare 
    estimates of the costs of reinsurance for
risks beyond the 
    realistic limits of the self-insurance.

        (3) Prepare a plan for centralizing the purchase of 
    property and
casualty insurance on State property under a 
    master policy or policies
and purchase the insurance 
    contracted for as provided in the
Illinois Purchasing Act.

        (4) Evaluate existing provisions for fidelity bonds 
    required of
State employees and recommend changes that are 
    appropriate
commensurate with risk experience and the 
    determinations respecting
self-insurance or reinsurance so 
    as to permit reduction of costs without
loss of coverage.

        (5) Investigate procedures for inclusion of school 
    districts,
public community
college districts, and other 
    units of local government in programs for
the centralized 
    purchase of insurance.

        (6) Implement recommendations of the State Property

    Insurance
Study Commission that the Department finds 
    necessary or desirable in
the
performance of its powers and 
    duties under this Section to achieve
efficient and 
    comprehensive risk management.

        (7) Prepare and, in the discretion of the Director, 
    implement a  plan providing for the purchase of public

    liability insurance or for self-insurance for public 
    liability or for a
combination of purchased  insurance and 
    self-insurance for public
liability (i) covering the State 
    and drivers of motor vehicles
owned,
leased, or controlled 
    by the State of Illinois pursuant to the provisions
and 
    limitations contained in the Illinois Vehicle Code, (ii)

    covering
other public liability exposures of the State and 
    its employees within
the scope of their employment, and 
    (iii) covering drivers of motor
vehicles not owned, leased, 
    or controlled by the State but used by a
State employee on 
    State business, in excess of liability covered by an

    insurance policy obtained by the owner of the motor vehicle 
    or in
excess of the dollar amounts that the Department 
    shall
determine to be
reasonable.  Any contract of insurance 
    let under this Law shall be
by
bid in accordance with the 
    procedure set forth in the Illinois
Purchasing Act.  Any 
    provisions for self-insurance shall conform to
subdivision 
    (11).

        The term "employee" as used in this subdivision (7) and 
    in subdivision
(11)
means a person while in the employ of 
    the State who is a member of the
staff or personnel of a 
    State agency, bureau, board, commission,
committee, 
    department, university, or college or who is a State 
    officer,
elected official, commissioner, member of or ex 
    officio member of a
State agency, bureau, board, 
    commission, committee, department,
university, or college, 
    or a member of the National Guard while on active
duty 
    pursuant to orders of the Governor of the State of 
    Illinois, or any
other person while using a licensed motor 
    vehicle owned, leased, or
controlled by the State of 
    Illinois with the authorization of the State
of Illinois, 
    provided the actual use of the motor vehicle is
within the 
    scope of that
authorization and within the course of State 
    service.

        Subsequent to payment of a claim on behalf of an 
    employee pursuant to this
Section and after reasonable 
    advance written notice to the employee, the
Director may 
    exclude the employee from future coverage or limit the

    coverage under the plan if (i) the Director determines that 
    the
claim
resulted from an incident in which the employee 
    was grossly negligent or
had engaged in willful and wanton 
    misconduct or (ii) the
Director
determines that the 
    employee is no longer an acceptable risk based on a
review 
    of prior accidents in which the employee was at fault and 
    for which
payments were made pursuant to this Section.

        The Director is authorized to
promulgate 
    administrative rules that may be necessary to
establish and

    administer the plan.

        Appropriations from the Road Fund shall be used to pay 
    auto liability claims
and related expenses involving 
    employees of the Department of Transportation,
the 
    Illinois State Police, and the Secretary of State.

        (8) Charge, collect, and receive from all other 
    agencies of
the State
government fees or monies equivalent 
    to the cost of purchasing the insurance.

        (9) Establish, through the Director, charges for risk

    management
services
rendered to State agencies by the 
    Department.
The State agencies so charged shall reimburse 
    the Department by vouchers drawn
against their respective

    appropriations.  The reimbursement shall be determined by 
    the Director as
amounts sufficient to reimburse the 
    Department
for expenditures incurred in rendering the 
    service.

        The Department shall charge the
employing State agency 
    or university for workers' compensation payments for

    temporary total disability paid to any employee after the 
    employee has
received temporary total disability payments 
    for 120 days if the employee's
treating physician has 
    issued a release to return to work with restrictions
and 
    the employee is able to perform modified duty work but the 
    employing
State agency or
university does not return the 
    employee to work at modified duty.  Modified
duty shall be 
    duties assigned that may or may not be delineated
as part 
    of the duties regularly performed by the employee.  Modified 
    duties
shall be assigned within the prescribed 
    restrictions established by the
treating physician and the 
    physician who performed the independent medical

    examination.  The amount of all reimbursements
shall be 
    deposited into the Workers' Compensation Revolving Fund 
    which is
hereby created as a revolving fund in the State 
    treasury.  In addition to any other purpose authorized by 
    law, moneys in the Fund
shall be used, subject to 
    appropriation, to pay these or other temporary
total 
    disability claims of employees of State agencies and 
    universities.

        Beginning with fiscal year 1996, all amounts recovered 
    by the
Department through subrogation in workers' 
    compensation and workers'
occupational disease cases shall 
    be
deposited into the Workers' Compensation Revolving Fund 
    created under
this subdivision (9).

        (10) Establish rules, procedures, and forms to be used 
    by
State agencies
in the administration and payment of 
    workers' compensation claims.
The Department shall 
    initially evaluate and determine the compensability of
any 
    injury that is
the subject of a workers' compensation claim 
    and provide for the
administration and payment of such a 
    claim for all State agencies.  The
Director may delegate to 
    any agency with the agreement of the agency head
the 
    responsibility for evaluation, administration, and payment 
    of that
agency's claims.

        (10a) If the Director determines it would be in the 
    best interests of the State and its employees, prepare and 
    implement a plan providing for: (i) the purchase of 
    workers' compensation insurance for workers' compensation 
    liability; (ii) third-party administration of 
    self-insurance, in whole or in part, for workers' 
    compensation liability; or (iii) a combination of 
    purchased insurance and self-insurance for workers' 
    compensation liability, including reinsurance or stop-loss 
    insurance.  Any contract for insurance or third-party 
    administration shall be on terms consistent with State 
    policy; awarded in compliance with the Illinois 
    Procurement Code; and based on, but not limited to, the 
    following criteria: administrative cost, service 
    capabilities of the carrier or other contractor and 
    premiums, fees, or charges. By April 1 of each year, the 
    Director must report and provide information to the State 
    Workers' Compensation Program Advisory Board concerning 
    the status of the State workers' compensation program for 
    the next fiscal year. Information includes, but is not 
    limited to, documents, reports of negotiations, bid 
    invitations, requests for proposals, specifications, 
    copies of proposed and final contracts or agreements, and 
    any other materials concerning contracts or agreements for 
    the program. By the first of each month thereafter, the 
    Director must provide updated, and any new, information to 
    the State Workers' Compensation Program Advisory Board 
    until the State workers' compensation program for the next 
    fiscal year is determined. 
        (11) Any plan for public liability self-insurance 
    implemented
under this
Section shall provide that (i) the 
    Department
shall attempt to settle and may settle any 
    public liability claim filed
against the State of Illinois 
    or any public liability claim filed
against a State 
    employee on the basis of an occurrence in the course of
the 
    employee's State employment; (ii) any settlement of
such a 
    claim is not subject to fiscal year limitations and must be

    approved by the Director and, in cases of
settlements 
    exceeding $100,000, by the Governor; and (iii) a
settlement 
    of
any public liability claim against the State or a State 
    employee shall
require an unqualified release of any right 
    of action against the State
and the employee for acts 
    within the scope of the employee's employment
giving rise 
    to the claim.

        Whenever and to the extent that a State
employee 
    operates a  motor vehicle or engages in other activity 
    covered
by self-insurance under this Section, the State of 
    Illinois shall
defend, indemnify, and hold harmless the 
    employee against any claim in
tort filed against the 
    employee for acts or omissions within the scope
of the 
    employee's employment in any proper judicial forum and not

    settled pursuant
to this subdivision (11), provided that 
    this obligation of
the State of
Illinois shall not exceed a 
    maximum liability of $2,000,000 for any
single occurrence 
    in connection with the operation of a motor vehicle or

    $100,000 per person per occurrence for any other single 
    occurrence,
or $500,000 for any single occurrence in 
    connection with the provision of
medical care by a licensed 
    physician employee.

        Any
claims against the State of Illinois under a 
    self-insurance plan that
are not settled pursuant to this 
    subdivision (11) shall be
heard and
determined by the Court 
    of  Claims and may not be filed or adjudicated
in any other 
    forum.  The Attorney General of the State of Illinois or
the 
    Attorney General's designee shall be the attorney with 
    respect
to all public liability
self-insurance claims that 
    are not settled pursuant to this
subdivision (11)
and 
    therefore result in litigation.  The payment of any award of 
    the
Court of Claims entered against the State relating to 
    any public
liability self-insurance claim shall act as a 
    release against any State
employee involved in the 
    occurrence.

        (12) Administer a plan the purpose of which is to make 
    payments
on final
settlements or final judgments in 
    accordance with the State Employee
Indemnification Act.  
    The plan shall be funded through appropriations from the

    General Revenue Fund specifically designated for that 
    purpose, except that
indemnification expenses for 
    employees of the Department of Transportation,
the 
    Illinois State Police, and the Secretary of State
shall be 
    paid
from the Road
Fund.  The term "employee" as used in 
    this subdivision (12) has the same
meaning as under 
    subsection (b) of Section 1 of the State Employee

    Indemnification Act.  Subject to sufficient appropriation, 
    the Director shall approve payment of any claim, without 
    regard to fiscal year limitations, presented to
the 
    Director
that is supported by a final settlement or final 
    judgment when the Attorney
General and the chief officer of 
    the public body against whose employee the
claim or cause 
    of action is asserted certify to the Director that
the 
    claim is in
accordance with the State Employee 
    Indemnification Act and that they
approve
of the payment.  
    In no event shall an amount in excess of $150,000 be paid 
    from
this plan to or for the benefit of any claimant.

        (13) Administer a plan the purpose of which is to make 
    payments
on final
settlements or final judgments for 
    employee wage claims in situations where
there was an 
    appropriation relevant to the wage claim, the fiscal year

    and lapse period have expired, and sufficient funds were 
    available
to
pay the claim.  The plan shall be funded 
    through
appropriations from the General Revenue Fund 
    specifically designated for
that purpose.

        Subject to sufficient appropriation, the Director is 
    authorized to pay any wage claim presented to the
Director

    that is supported by a final settlement or final judgment 
    when the chief
officer of the State agency employing the 
    claimant certifies to the
Director that
the claim is a 
    valid wage claim and that the fiscal year and lapse period

    have expired.  Payment for claims that are properly 
    submitted and certified
as valid by the Director
shall 
    include interest accrued at the rate of 7% per annum from 
    the
forty-fifth day after the claims are received by the 
    Department or 45 days from the date on which the amount of 
    payment
is agreed upon, whichever is later, until the date 
    the claims are submitted
to the Comptroller for payment. 
    When the Attorney General has filed an
appearance in any 
    proceeding concerning a wage claim settlement or
judgment, 
    the Attorney General shall certify to the Director that the 
    wage claim is valid before any payment is
made.  In no event 
    shall an amount in excess of $150,000 be paid from this

    plan to or for the benefit of any claimant.

        Nothing in Public Act 84-961 shall be construed to 
    affect in any manner the jurisdiction of the
Court of 
    Claims concerning wage claims made against the State of 
    Illinois.

        (14) Prepare and, in the discretion of the Director, 
    implement a program for
self-insurance for official

    fidelity and surety bonds for officers and employees as 
    authorized by the
Official Bond Act.

(Source: P.A. 96-928, eff. 6-15-10.)

 
    (20 ILCS 405/405-411)
    Sec. 405-411. Consolidation of workers' compensation 
functions.
    (a) Notwithstanding any other law to the contrary, the 
Director of Central Management Services, working in 
cooperation with the Director of any other agency, department, 
board, or commission directly responsible to the Governor, may 
direct the consolidation, within the Department of Central 
Management Services, of those workers' compensation functions 
at that agency, department, board, or commission that are 
suitable for centralization.
    Upon receipt of the written direction to transfer workers' 
compensation functions to the Department of Central Management 
Services, the personnel, equipment, and property (both real and 
personal) directly relating to the transferred functions shall 
be transferred to the Department of Central Management 
Services, and the relevant documents, records, and 
correspondence shall be transferred or copied, as the Director 
may prescribe.
    (b) Upon receiving written direction from the Director of 
Central Management Services, the Comptroller and Treasurer are 
authorized to transfer the unexpended balance of any 
appropriations related to the workers' compensation functions 
transferred to the Department of Central Management Services 
and shall make the necessary fund transfers from the General 
Revenue Fund, any special fund in the State treasury, or any 
other federal or State trust fund held by the Treasurer to the 
Workers' Compensation Revolving Fund for use by the Department 
of Central Management Services in support of workers' 
compensation functions or any other related costs or expenses 
of the Department of Central Management Services.
    (c) The rights of employees and the State and its agencies 
under the Personnel Code and applicable collective bargaining 
agreements or under any pension, retirement, or annuity plan 
shall not be affected by any transfer under this Section.
    (d) The functions transferred to the Department of Central 
Management Services by this Section shall be vested in and 
shall be exercised by the Department of Central Management 
Services. Each act done in the exercise of those functions 
shall have the same legal effect as if done by the agencies, 
offices, divisions, departments, bureaus, boards and 
commissions from which they were transferred.
    Every person or other entity shall be subject to the same 
obligations and duties and any penalties, civil or criminal, 
arising therefrom, and shall have the same rights arising from 
the exercise of such rights, powers, and duties as had been 
exercised by the agencies, offices, divisions, departments, 
bureaus, boards, and commissions from which they were 
transferred.
    Whenever reports or notices are now required to be made or 
given or papers or documents furnished or served by any person 
in regards to the functions transferred to or upon the 
agencies, offices, divisions, departments, bureaus, boards, 
and commissions from which the functions were transferred, the 
same shall be made, given, furnished or served in the same 
manner to or upon the Department of Central Management 
Services.
    This Section does not affect any act done, ratified, or 
cancelled or any right occurring or established or any action 
or proceeding had or commenced in an administrative, civil, or 
criminal cause regarding the functions transferred, but those 
proceedings may be continued by the Department of Central 
Management Services.
    This Section does not affect the legality of any rules in 
the Illinois Administrative Code regarding the functions 
transferred in this Section that are in force on the effective 
date of this Section. If necessary, however, the affected 
agencies shall propose, adopt, or repeal rules, rule 
amendments, and rule recodifications as appropriate to 
effectuate this Section.

    (e) There is hereby created within the Department of 
Central Management Services an advisory body to be known as the 
State Workers' Compensation Program Advisory Board to review, 
assess, and provide recommendations to improve the State 
workers' compensation program and to ensure that the State 
manages the program in the interests of injured workers and 
taxpayers. The Governor shall appoint one person to the Board, 
who shall serve as the Chairperson. The Speaker of the House of 
Representatives, the Minority Leader of the House of 
Representatives, the President of the Senate, and the Minority 
Leader of the Senate shall each appoint one person to the 
Board.  Each member initially appointed to the Board shall serve 
a term ending December 31, 2013, and each Board member 
appointed thereafter shall serve a 3-year term.  A Board member 
shall continue to serve on the Board until his or her successor 
is appointed.  In addition, the Director of the Department of 
Central Management Services, the Attorney General, the 
Director of the Department of Insurance, the Secretary of the 
Department of Transportation, the Director of the Department of 
Corrections, the Secretary of the Department of Human Services, 
the Director of the Department of Revenue, and the Chairman of 
the Illinois Workers' Compensation Commission, or their 
designees, shall serve as ex officio, non-voting members of the 
Board. Members of the Board shall not receive compensation but 
shall be reimbursed from the Workers' Compensation Revolving 
Fund for reasonable expenses incurred in the necessary 
performance of their duties, and the Department of Central 
Management Services shall provide administrative support to 
the Board. The Board shall meet at least 3 times per year or 
more often if the Board deems it necessary or proper. By 
September 30, 2011, the Board shall issue a written report, to 
be delivered to the Governor, the Director of the Department of 
Central Management Services, and the General Assembly, with a 
recommended set of best practices for the State workers' 
compensation program. By July 1 of each year thereafter, the 
Board shall issue a written report, to be delivered to those 
same persons or entities, with recommendations on how to 
improve upon such practices. 
(Source: P.A. 93-839, eff. 7-30-04.)
 
    Section 10. The Code of Civil Procedure is amended by 
changing Section 8-802 as follows:
 



    (735 ILCS 5/8-802)  (from Ch. 110, par. 8-802)


    Sec. 8-802. Physician and patient. No physician or surgeon 
shall be
permitted to disclose any information he or she may 
have acquired in
attending any patient in a professional 
character, necessary to enable him
or her professionally to 
serve the patient, except only (1) in trials for
homicide when 
the disclosure relates directly to the fact or immediate

circumstances of the homicide, (2) in actions, civil or 
criminal, against
the physician for malpractice, (3) with the 
expressed consent of the
patient, or in case of his or her 
death or disability, of his or her
personal representative or 
other person authorized to sue for personal
injury or of the 
beneficiary of an insurance policy on his or her life,
health, 
or physical condition, (4) in all actions brought by or against 
the
patient, his or her personal representative, a beneficiary 
under a policy
of insurance, or the executor or administrator 
of his or her estate wherein
the patient's physical or mental 
condition is an issue, (5) upon an issue
as to the validity of 
a document as a will of the patient, (6) in any
criminal action 
where the charge is either first degree murder by abortion,

attempted abortion or abortion, (7) in actions, civil or 
criminal, arising
from the filing of a report in compliance 
with the Abused and Neglected
Child Reporting Act, (8) to any 
department, agency, institution
or facility which has custody 
of the patient pursuant to State statute
or any court order of 
commitment, (9) in prosecutions where written
results of blood 
alcohol tests are admissible pursuant to Section 11-501.4
of 
the Illinois Vehicle Code, (10) in prosecutions where written

results of blood alcohol tests are admissible under Section 
5-11a of the
Boat Registration and Safety Act,
 (11) in criminal 
actions arising from the filing of a report of suspected

terrorist offense in compliance with Section 29D-10(p)(7) of 
the Criminal Code
of 1961, or (12) upon the issuance of a 
subpoena pursuant to Section 38 of the Medical Practice Act of 
1987; the issuance of a subpoena pursuant to Section 25.1 of 
the Illinois Dental Practice Act; or the issuance of a subpoena 
pursuant to Section 22 of the Nursing Home Administrators 
Licensing and Disciplinary Act; or the issuance of a subpoena 
pursuant to Section 25.5 of the Workers' Compensation Act.

    In the event of a conflict between the application of this 
Section
and the Mental Health and Developmental Disabilities 
Confidentiality
Act to a specific situation, the provisions of 
the Mental Health and
Developmental Disabilities 
Confidentiality Act shall control.

(Source: P.A. 95-478, eff. 8-27-07.)

 
    Section 15. The Workers' Compensation Act is amended by 
changing Sections 1, 4, 8, 8.2, 8.7, 11, 13, 13.1, 14, 18, 19, 
and 25.5 and by adding Sections 1.1, 4b, 8.1a, 8.1b, 8.2a, 16b, 
18.1, 29.1, and 29.2 as follows:
 



    (820 ILCS 305/1)  (from Ch. 48, par. 138.1)



    Sec. 1. This Act may be cited as the Workers' Compensation 
Act. 

    (a) The term "employer" as used in this Act means:

    1.  The State and each county, city, town, township, 
incorporated
village, school district, body politic, or 
municipal corporation
therein.

    2.  Every person, firm, public or private corporation, 
including
hospitals, public service, eleemosynary, religious 
or charitable
corporations or associations who has any person 
in service or under any
contract for hire, express or implied, 
oral or written, and who is
engaged in any of the enterprises 
or businesses enumerated in Section 3
of this Act, or who at or 
prior to the time of the accident to the
employee for which 
compensation under this Act may be claimed, has in
the manner 
provided in this Act elected to become subject to the

provisions of this Act, and who has not, prior to such 
accident,
effected a withdrawal of such election in the manner 
provided in this Act.

    3. Any one engaging in any business or enterprise referred 
to in
subsections 1 and 2 of Section 3 of this Act who 
undertakes to do any
work enumerated therein, is liable to pay 
compensation to his own
immediate employees in accordance with 
the provisions of this Act, and
in addition thereto if he 
directly or indirectly engages any contractor
whether 
principal or sub-contractor to do any such work, he is liable 
to
pay compensation to the employees of any such contractor or

sub-contractor unless such contractor or sub-contractor has 
insured, in
any company or association authorized under the 
laws of this State to
insure the liability to pay compensation 
under this Act, or guaranteed
his liability to pay such 
compensation.  With respect to any time
limitation on the filing 
of claims provided by this Act, the timely
filing of a claim 
against a contractor or subcontractor, as the case may
be, 
shall be deemed to be a timely filing with respect to all 
persons
upon whom liability is imposed by this paragraph.

    In the event any such person pays compensation under this 
subsection
he may recover the amount thereof from the 
contractor or sub-contractor,
if any, and in the event the 
contractor pays compensation under this
subsection he may 
recover the amount thereof from the sub-contractor, if any.

    This subsection does not apply in any case where the 
accident occurs
elsewhere than on, in or about the immediate 
premises on which the
principal has contracted that the work be 
done.

    4. Where an employer operating under and subject to the 
provisions
of this Act loans an employee to another such 
employer and such loaned
employee sustains a compensable 
accidental injury in the employment of
such borrowing employer 
and where such borrowing employer does not
provide or pay the 
benefits or payments due such injured employee, such
loaning 
employer is liable to provide or pay all benefits or payments

due such employee under this Act and as to such employee the 
liability
of such loaning and borrowing employers is joint and 
several, provided
that such loaning employer is in the absence 
of agreement to the
contrary entitled to receive from such 
borrowing employer full
reimbursement for all sums paid or 
incurred pursuant to this paragraph
together with reasonable 
attorneys' fees and expenses in any hearings
before the 
Illinois Workers' Compensation Commission or in any action to 
secure such
reimbursement.  Where any benefit is provided or 
paid by such loaning
employer the employee has the duty of 
rendering reasonable cooperation
in any hearings, trials or 
proceedings in the case, including such
proceedings for 
reimbursement.

    Where an employee files an Application for Adjustment of 
Claim with
the Illinois Workers' Compensation

Commission 
alleging that his claim is covered by the
provisions of the 
preceding paragraph, and joining both the alleged
loaning and 
borrowing employers, they and each of them, upon written
demand 
by the employee and within 7 days after receipt of such demand,

shall have the duty of filing with the Illinois Workers' 
Compensation Commission a written
admission or denial of the 
allegation that the claim is covered by the
provisions of the 
preceding paragraph and in default of such filing or
if any 
such denial be ultimately determined not to have been bona fide

then the provisions of Paragraph K of Section 19 of this Act 
shall apply.

    An employer whose business or enterprise or a substantial 
part
thereof consists of hiring, procuring or furnishing 
employees to or for
other employers operating under and subject 
to the provisions of this
Act for the performance of the work 
of such other employers and who pays
such employees their 
salary or wages notwithstanding that they are doing
the work of 
such other employers shall be deemed a loaning employer
within 
the meaning and provisions of this Section.

    (b) The term "employee" as used in this Act means:

    1. Every person in the service of the State, including 
members of
the General Assembly, members of the Commerce 
Commission, members of the
Illinois Workers' Compensation 
Commission, and all persons in the service of the University
of 
Illinois, county, including deputy sheriffs and assistant 
state's
attorneys, city, town, township, incorporated village 
or school
district, body politic, or municipal corporation 
therein, whether by
election, under appointment or contract of 
hire, express or implied,
oral or written, including all 
members of the Illinois National Guard
while on active duty in 
the service of the State, and all probation
personnel of the 
Juvenile Court appointed pursuant to Article VI
of the Juvenile 
Court Act of 1987, and including any official of the
State, any 
county, city, town, township, incorporated village, school

district, body politic or municipal corporation therein except 
any duly
appointed member of a police department  in any city 
whose
population exceeds 200,000 according to the last Federal 
or State
census, and except any member of a fire insurance 
patrol maintained by a
board of underwriters in this State. A 
duly appointed member of a fire
department in any city, the 
population of which exceeds 200,000 according
to the last 
federal or State census, is an employee under this Act only

with respect to claims brought under paragraph (c) of Section 
8.

    One employed by a contractor who has contracted with the 
State, or a
county, city, town, township, incorporated village, 
school district,
body politic or municipal corporation 
therein, through its
representatives, is not considered as an 
employee of the State, county,
city, town, township, 
incorporated village, school district, body
politic or 
municipal corporation which made the contract.

    2. Every person in the service of another under any 
contract of
hire, express or implied, oral or written, 
including persons whose
employment is outside of the State of 
Illinois where the contract of
hire is made within the State of 
Illinois, persons whose employment
results in fatal or 
non-fatal injuries within the State of Illinois
where the 
contract of hire is made outside of the State of Illinois, and

persons whose employment is principally localized within the 
State of
Illinois, regardless of the place of the accident or 
the place where the
contract of hire was made, and including 
aliens, and minors who, for the
purpose of this Act are 
considered the same and have the same power to
contract, 
receive payments and give quittances therefor, as adult 
employees.

    3. Every sole proprietor and every partner of a business 
may elect to
be covered by this Act.

    An employee or his dependents under this Act who shall have 
a cause
of action by reason of any injury, disablement or death 
arising out of
and in the course of his employment may elect to 
pursue his remedy in
the State where injured or disabled, or in 
the State where the contract
of hire is made, or in the State 
where the employment is principally
localized.

    However, any employer may elect to provide and pay 
compensation to
any employee other than those engaged in the 
usual course of the trade,
business, profession or occupation 
of the employer by complying with
Sections 2 and 4 of this Act.  
Employees are not included within the
provisions of this Act 
when excluded by the laws of the United States
relating to 
liability of employers to their employees for personal
injuries 
where such laws are held to be exclusive.

    The term "employee" does not include persons performing 
services as real
estate broker, broker-salesman, or salesman 
when such persons are paid by
commission only.

    (c) "Commission" means the Industrial Commission created 
by Section
5 of "The Civil Administrative Code of Illinois", 
approved March 7,
1917, as amended, or the Illinois Workers' 
Compensation Commission created by Section 13 of
this Act.

    (d)  To obtain compensation under this Act, an employee 
bears the burden of showing, by a preponderance of the 
evidence, that he or she has sustained accidental injuries 
arising out of and in the course of the employment. 
(Source: P.A. 93-721, eff. 1-1-05.)

 
    (820 ILCS 305/1.1 new)
    Sec. 1.1. Standards of conduct.
    (a) Commissioners and arbitrators shall dispose of all 
Workers' Compensation matters promptly, officially and fairly, 
without bias or prejudice. Commissioners and arbitrators shall 
be faithful to the law and maintain professional competence in 
it. They shall be unswayed by partisan interests, public 
clamor, or fear of criticism. Commissioners and arbitrators 
shall take appropriate action or initiate appropriate 
disciplinary measures against a Commissioner, arbitrator, 
lawyer, or others for unprofessional conduct of which the 
Commissioner or arbitrator may become aware.
    (b) Except as otherwise provided in this Act, the Canons of 
the Code of Judicial Conduct as adopted by the Supreme Court of 
Illinois govern the hearing and non-hearing conduct of members 
of the Commission and arbitrators under this Act. The 
Commission may set additional rules and standards, not less 
stringent than those rules and standards established by the 
Code of Judicial Conduct, for the conduct of arbitrators.
    (c) The following provisions of the Code of Judicial 
Conduct do not apply under this Section:
        (1) Canon 3(B), relating to administrative 
    responsibilities of Judges.
        (2) Canon 6(C), relating to annual filings of economic 
    interests. Instead of filing declarations of economic 
    interests with the Clerk of the Illinois Supreme Court 
    under Illinois Supreme Court Rule 68, members of the 
    Commission and arbitrators shall make filings 
    substantially similar to those required by Rule 68 with the 
    Chairman, and such filings shall be made available for 
    examination by the public.
    (d) An arbitrator or a Commissioner may accept an 
uncompensated appointment to a governmental committee, 
commission or other position that is concerned with issues of 
policy on matters which may come before the arbitrator or 
Commissioner if such appointment neither affects his or her 
independent professional judgment nor the conduct of his or her 
duties.
    (e) Decisions of an arbitrator or a Commissioner shall be 
based exclusively on evidence in the record of the proceeding 
and material that has been officially noticed. Any findings of 
fact made by the arbitrator based on inquiries, investigations, 
examinations, or inspections undertaken by the arbitrator 
shall be entered into the record of the proceeding. 
    (f) Nothing in this Section shall prohibit an arbitrator 
from holding a pre-trial conference in accordance with the 
rules of the Commission. 
 



    (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 and by the Department of 
Insurance Financial and Professional Regulation for the 
purposes authorized in subsection (c) of Section 25.5 of this 
Act.

    (a-2) Every Employee Leasing Company (ELC), as defined in 
Section 15 of the Employee Leasing Company Act, shall at a 
minimum provide the following information to the Commission or 
any entity designated by the Commission regarding each workers' 
compensation insurance policy issued to the ELC:
        (1) Any client company of the ELC listed as an 
    additional named insured.
        (2) Any informational schedule attached to the master 
    policy that identifies any individual client company's 
    name, FEIN, and job location.
        (3) Any certificate of insurance coverage document 
    issued to a client company specifying its rights and 
    obligations under the master policy that establishes both 
    the identity and status of the client, as well as the dates 
    of inception and termination of coverage, if applicable. 
    (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.

    An investigator with the Illinois Workers' Compensation 
Commission Insurance Compliance Division may issue a citation 
to any employer that is not in compliance with its obligation 
to have workers' compensation insurance under this Act. The 
amount of the fine shall be based on the period of time the 
employer was in non-compliance, but shall be no less than $500, 
and shall not exceed $2,500. An employer that has been issued a 
citation shall pay the fine to the Commission and provide to 
the Commission proof that it obtained the required workers' 
compensation insurance within 10 days after the citation was 
issued. This Section does not affect any other obligations this 
Act imposes on employers. 
    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, or the 
knowing and willful failure of an employer to comply with a 
citation issued by an investigator with the Illinois Workers' 
Compensation Commission Insurance Compliance Division, 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.



    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. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05; 
94-839, eff. 6-6-06.)

 
    (820 ILCS 305/4b new)
    Sec. 4b. Collective bargaining pilot program.
    (a) The Director of the Department of Labor shall adopt a 
selection process to designate 2 international, national, or 
statewide organizations made up of affiliates who are the 
exclusive representatives of construction employer employees 
recognized or certified pursuant to the National Labor 
Relations Act

to
participate in the collective bargaining pilot 
program provided for in this Section. 
    (a-5)  For purposes of this Section, the term "construction 
employer" means any person or legal entity or group of persons 
or legal entities engaging in or planning to engage in any 
constructing, altering, reconstructing, repairing, 
rehabilitating, refinishing, refurbishing, remodeling, 
remediating, renovating, custom fabricating, maintaining, 
landscaping, improving, wrecking, painting, decorating, 
demolishing, and adding to or subtracting from any building, 
structure, airport facility, highway, roadway, street, alley, 
bridge, sewer, drain, ditch, sewage disposal plant, water 
works, parking facility, railroad, excavation or other 
project, structure, development, real property or improvement, 
or to do any part thereof, whether or not the performance of 
the work herein described involves the addition to, or 
fabrication into, any project, structure, development, real 
property or improvement herein described, and shall also 
include any moving of construction-related materials on the job 
site or to or from the job site.
    For purposes of this Section, "labor organization" means an 
affiliate of an international, national, or statewide 
organization that has been selected by the Department of Labor 
to participate in the collective bargaining pilot program as 
provided for in this Section.
    (b) Upon appropriate filing, the Commission and the courts 
of this State shall recognize as valid and binding any 
provision in a collective bargaining agreement between any 
construction employer or group of construction employers and a 
labor organization, which contains certain obligations and 
procedures relating to workers' compensation.  This agreement 
must be limited to, but need not include, all of the following:
        (1) An alternative dispute resolution ("ADR") system 
    to supplement, modify or replace the procedural or dispute 
    resolution provisions of this Act.  The system may include 
    mediation, arbitration, or other dispute resolution 
    proceedings, the results of which shall be final and 
    binding upon the parties;
        (2) An agreed list of medical treatment providers that 
    may be the exclusive source of all medical and related 
    treatment provided under this Act;
        (3) The use of a limited list of impartial physicians 
    to conduct independent medical examinations;
        (4) The creation of a light duty, modified job, or 
    return to work program;
        (5) The use of a limited list of individuals and 
    companies for the establishment of vocational 
    rehabilitation or retraining programs that may be the 
    exclusive source of rehabilitation and retraining services 
    provided under this Act; or
        (6) The establishment of joint labor management safety 
    committees and safety procedures.
    (c)  Void agreements.  Nothing in this Section shall be 
construed to authorize any provision in a collective bargaining 
agreement that diminishes or increases a construction 
employer's entitlements under this Act or an employee's 
entitlement to benefits as otherwise set forth in this Act.  For 
the purposes of this Section, the procedural rights and dispute 
resolution agreements under subparagraphs (1) through (6) of 
subsection (b) of this Section are not agreements which 
diminish or increase a construction employer's entitlements 
under this Act or an employee's entitlement to benefits under 
this Act.  Any agreement that diminishes or increases a 
construction employer's entitlements under this Act or an 
employee's entitlement to benefits as set forth in this Act is 
null and void. Nothing in this Section shall be construed as 
creating a mandatory subject of bargaining.
    (d) Form of agreement.  The agreement reached herein shall 
demonstrate that:
        (1) The construction employer or group of construction 
    employers and the recognized or certified exclusive 
    bargaining representative have entered into a binding 
    collective bargaining agreement adopting the ADR plan for a 
    period of no less than 2 years;
        (2) Contractual agreements have been reached with the 
    construction employer's workers' compensation carrier, 
    group self-insurance fund, and any excess carriers 
    relating to the ADR plan;
        (3) Procedures have been established by which claims 
    for benefits by employees will be lodged, administered, and 
    decided while affording procedural due process;
        (4) The plan has designated forms upon which claims for 
    benefits shall be made;
        (5) The system and means by which the construction 
    employer's obligation to furnish medical services and 
    vocational rehabilitation and retraining benefits shall be 
    fulfilled and provider selected;
        (6) The method by which mediators or arbitrators are to 
    be selected.
    (e) Filing.  A copy of the agreement and a statement 
identifying the parties to the agreement shall be filed with 
the Commission.  Within 21 days of receipt of an agreement, the 
Chairman shall review the agreement for compliance with this 
Section and notify the parties of its acceptance or notify the 
parties of any additional information required or any 
recommended modification that would bring the agreement into 
compliance.   If no additional information or modification is 
required, the agreement shall be valid and binding from the 
time the parties receive acceptance of the agreement from the 
Chairman.  Upon receipt of any requested information or 
modification, the Chairman shall notify the parties within 21 
days whether the agreement is in compliance with this Section.  
All rejections made by the Chairman under this subsection shall 
be subject to review by the courts of this State, 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 review, the Circuit Court 
shall have power to review all questions of fact as well as of 
law.
    (f) Notice to insurance carrier.  If the construction 
employer is insured under this Act, it shall provide notice to 
and obtain consent from its insurance carrier, in the manner 
provided in the insurance contract, of its intent to enter into 
an agreement as provided in this Section with its employees.
    (g) Employees' claims for workers' compensation benefits.
        (1) Claims for benefits shall be filed with the ADR 
    plan administrator within those periods of limitation 
    prescribed by this Act.  Within 10 days of the filing of a 
    claim, the ADR plan administrator shall serve a copy of the 
    claim application upon the Commission, which shall 
    maintain records of all ADR claims and resolutions.
        (2) Settlements of claims presented to the ADR plan 
    administrator shall be evidenced by a settlement 
    agreement.  All such settlements shall be filed with the ADR 
    plan administrator, who within 10 days shall forward a copy 
    to the Commission for recording.
        (3) Upon assignment of claims, unless settled, 
    mediators and arbitrators shall render final orders 
    containing essential findings of fact, rulings of law and 
    referring to other matters as pertinent to the questions at 
    issue.  The ADR plan administrator shall maintain a record 
    of the proceedings.
    (h) Reporting requirements. Annually, each ADR plan 
administrator shall submit a report to the Commission 
containing the following information:
        (1) The number of employees within the ADR program;
        (2) The number of occurrences of work-related injuries 
    or diseases;
        (3) The breakdown within the ADR program of injuries 
    and diseases treated;
        (4) The total amount of disability benefits paid within 
    the ADR program;
        (5) The total medical treatment cost paid within the 
    ADR program;
        (6) The number of claims filed within the ADR program; 
    and
        (7) The disposition of all claims.
 



    (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, even if a health care provider sells, 
transfers, or otherwise assigns an account receivable for 
procedures, treatments, or services covered under this Act. 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 
gross 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.

        (4) The following shall apply for injuries occurring on 
    or after the effective date of this amendatory Act of the 
    97th General Assembly and only when an employer has an 
    approved preferred provider program pursuant to Section 
    8.1a on the date the employee sustained his or her 
    accidental injuries:
            (A) The employer shall, in writing, on a form 
        promulgated by the Commission, inform the employee of 
        the preferred provider program;
            (B) Subsequent to the report of an injury by an 
        employee, the employee may choose in writing at any 
        time to decline the preferred provider program, in 
        which case that would constitute one of the two choices 
        of medical providers to which the employee is entitled 
        under subsection (a)(2) or (a)(3); and
            (C) Prior to the report of an injury by an 
        employee, when an employee chooses non-emergency 
        treatment from a provider not within the preferred 
        provider program, that would constitute the employee's 
        one choice of medical providers to which the employee 
        is entitled under subsection (a)(2) or (a)(3). 
    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,


    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,



    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,



    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
 or 25
 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 150 weeks (if the 
accidental injury occurs on or after the effective date of this 
amendatory Act of the 94th General Assembly
but before February

1, 2006) or 162
 weeks (if the accidental injury occurs on or  
after February
1, 2006) 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. For 
accidental injuries that occur on or after September 1, 2011, 
an award for wage differential under this subsection shall be 
effective only until the employee reaches the age of 67 or 5 
years from the date the award becomes final, whichever is 
later. 

    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-
            70 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            76
 weeks if the accidental injury occurs on or 
        after  February
1, 2006.


        2. First, or index finger-
            40 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            43
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        3. Second, or middle finger-
            35 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            38
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        4. Third, or ring finger-
            25 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            27
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        5. Fourth, or little finger-
            20 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            22
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        6. Great toe-
            35 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            38
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        7. Each toe other than great toe-
            12 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            13
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        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-
            190 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            205
 weeks if the accidental injury occurs on or 
        after February
1, 2006.  
            190 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        97th General Assembly and if the accidental injury 
        involves carpal tunnel syndrome due to repetitive or 
        cumulative trauma, in which case the permanent partial 
        disability shall not exceed 15% loss of use of the 
        hand, except for cause shown by clear and convincing 
        evidence and in which case the award shall not exceed 
        30% loss of use of the hand. 
        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-
            235 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            253
 weeks if the accidental injury occurs on or 
        after February
1, 2006.  
        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 15 weeks (if the accidental injury occurs on or 
    after the effective date of this amendatory Act of the 94th 
    General Assembly
but before February
1, 2006) or an 
    additional 17

weeks (if the accidental injury occurs on or 
    after February
1, 2006) 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 65 weeks (if the 
    accidental injury occurs on or after the effective date of 
    this amendatory Act of the 94th General Assembly
but before 
    February
1, 2006) or an additional 70
 weeks (if the 
    accidental injury occurs on or after February
1, 2006)

    shall be paid.


        11. Foot-
            155 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            167
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        12. Leg-
            200 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            215
 weeks if the accidental injury occurs on or 
        after February
1, 2006.  
        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 25 weeks (if the accidental injury occurs on or 
    after the effective date of this amendatory Act of the 94th 
    General Assembly
but before February
1, 2006) or an 
    additional 27
 weeks (if the accidental injury occurs on or 
    after February
1, 2006) 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 75 weeks (if the accidental injury occurs on or 
    after the effective date of this amendatory Act of the 94th 
    General Assembly
but before February
1, 2006) or an 
    additional 81
 weeks (if the accidental injury occurs on or 
    after February
1, 2006) shall
be paid.


        13. Eye-
            150 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            162
 weeks if the accidental injury occurs on or 
        after February
1, 2006.  
        Where an accidental injury results in the
enucleation 
    of an eye, compensation for an additional 10 weeks (if the 
    accidental injury occurs on or after the effective date of 
    this amendatory Act of the 94th General Assembly
but before 
    February
1, 2006) or an additional 11
 weeks (if the 
    accidental injury occurs on or after February
1, 2006)

    shall be
paid.


        14. Loss of hearing of one ear-
            50 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            54
 weeks if the accidental injury occurs on or 
        after February
1, 2006.

        Total and permanent loss of
hearing of both ears-
            200 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.
            215
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        15. Testicle-
            50 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            54
 weeks if the accidental injury occurs on or 
        after February
1, 2006.

        Both testicles-
            150 weeks if the accidental injury occurs on or 
        after the effective date of this amendatory Act of the 
        94th General Assembly
but before February
1, 2006.

            162
 weeks if the accidental injury occurs on or 
        after February
1, 2006.


        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 ResponseHours Per Day
908
926
954
973
1002
1021-1/2
1051
1101/2
1151/4
        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 on or after July 20, 2005 but 
before the effective date of this amendatory Act of the 94th 
General Assembly (Senate Bill 1283 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 July 20, 2005 and accidents occurring on or after the 
effective date of this amendatory Act of the 94th General 
Assembly (Senate Bill 1283 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; 94-277, eff. 7-20-05; 
94-695, eff. 11-16-05.)

 
    (820 ILCS 305/8.1a new)
    Sec. 8.1a. Preferred provider programs.  Starting on the 
effective date of this amendatory Act of the 97th General 
Assembly, to satisfy its liabilities under this Act for the 
provision of medical treatment to injured employees, an 
employer may utilize a preferred provider program approved by 
the Illinois Department of Insurance as in compliance with 
Sections 370k, 370l, 370m, and 370p of Article XX-1/2 of the 
Illinois Insurance Code. For the purposes of compliance with 
these Sections, the employee shall be considered the 
"beneficiary" and the employer shall be considered the 
"insured". Employers and insurers contracting directly with 
providers or utilizing multiple preferred provider programs to 
implement a preferred provider program providing workers' 
compensation benefits shall be subject to the above 
requirements of Article XX-1/2 applicable to administrators 
with regard to such program, with the exception of Section 370l 
of the Illinois Insurance Code.
    (a) In addition to the above requirements of Article XX-1/2 
of the Illinois Insurance Code, all preferred provider programs 
under this Section shall meet the following requirements:
        (1) The provider network shall include an adequate 
    number of occupational and non-occupational providers.
        (2) The provider network shall include an adequate 
    number and type of physicians or other providers to treat 
    common injuries experienced by injured workers in the 
    geographic area where the employees reside.
        (3) Medical treatment for injuries shall be readily 
    available at reasonable times to all employees. To the 
    extent feasible, all medical treatment for injuries shall 
    be readily accessible to all employees.
        (4) Physician compensation shall not be structured in 
    order to achieve the goal of inappropriately reducing, 
    delaying, or denying medical treatment or restricting 
    access to medical treatment.
        (5) Before entering into any agreement under this 
    Section, a program shall establish terms and conditions 
    that must be met by noninstitutional providers wishing to 
    enter into an agreement with the program. These terms and 
    conditions may not discriminate unreasonably against or 
    among noninstitutional providers. Neither difference in 
    prices among noninstitutional providers produced by a 
    process of individual negotiation nor price differences 
    among other noninstitutional providers in different 
    geographical areas or different specialties constitutes 
    unreasonable discrimination. 
    (b) The administrator of any preferred provider program 
under this Act that uses economic evaluation shall file with 
the Director of Insurance a description of any policies and 
procedures related to economic evaluation utilized by the 
program. The filing shall describe how these policies and 
procedures are used in utilization review, peer review, 
incentive and penalty programs, and in provider retention and 
termination decisions. The Director of Insurance may deny 
approval of any preferred provider program that uses any policy 
or procedure of economic evaluation to inappropriately reduce, 
delay or deny medical treatment, or to restrict access to 
medical treatment. Evaluation of providers based upon 
objective medical quality and patient outcome measurements, 
appropriate use of best clinical practices and evidence based 
medicine, and use of health information technology shall be 
permitted. If approved, the employer shall provide a copy of 
the filing to all participating providers.
        (1) The Director of the Department of Insurance shall 
    make each administrator's filing available to the public 
    upon request. The Director of the Department of Insurance 
    may not publicly disclose any information submitted 
    pursuant to this Section that is determined by the Director 
    of the Department of Insurance to be confidential, 
    proprietary, or trade secret information pursuant to State 
    or federal law.
        (2) For the purposes of this subsection (b), "economic 
    evaluation" shall mean any evaluation of a particular 
    physician, provider, medical group, or individual practice 
    association based in whole or in part on the economic costs 
    or utilization of services associated with medical care 
    provided or authorized by the physician, provider, medical 
    group, or individual practice association. Economic 
    evaluation shall not include negotiated rates with a 
    provider.
    (c) Except for the provisions of subsection (a)(4) of 
Section 8 and for injuries occurring on or after the effective 
date of this amendatory Act of the 97th General Assembly, an 
employee of an employer utilizing a preferred provider program 
shall only be allowed to select a participating network 
provider from the network. An employer shall be responsible 
for: (i) all first aid and emergency treatment; (ii) all 
medical, surgical, and hospital services provided by the 
participating network provider initially selected by the 
employee or by any other participating network provider 
recommended by the initial participating network provider or 
any subsequent participating network provider in the chain of 
referrals from the initial participating network provider; and 
(iii) all medical, surgical, and hospital services provided by 
the participating network provider subsequently chosen by the 
employee or by any other participating network provider 
recommended by the subsequent participating network provider 
or any subsequent participating network provider in the chain 
of referrals from the second participating network provider. An 
employer shall not be liable for services determined by the 
Commission not to be compensable. An employer shall not be 
liable for medical services provided by a non-authorized 
provider when proper notice is provided to the injured worker.
        (1) When the injured employee notifies the employer of 
    the injury or files a claim for workers' compensation with 
    the employer, the employer shall notify the employee of his 
    or her right to be treated by a physician of his or her 
    choice from the preferred provider network established 
    pursuant to this Section, and the method by which the list 
    of participating network providers may be accessed by the 
    employee, except as provided in subsection (a)(4) of 
    Section 8.
        (2) Consistent with Article XX-1/2 of the Illinois 
    Insurance Code, treatment by a specialist who is not a 
    member of the preferred provider network shall be permitted 
    on a case-by-case basis if the medical provider network 
    does not contain a physician who can provide the approved 
    treatment, and if the employee has complied with any 
    pre-authorization requirements of the preferred provider 
    network.  Consent for the employee to visit an 
    out-of-network provider may not be unreasonably withheld. 
    When a non-network provider is authorized pursuant to this 
    subparagraph (2), the non-network provider shall not hold 
    an employee liable for costs except as provided in 
    subsection (e) of Section 8.2.
        (3) The Director shall not approve, and may withdraw 
    prior approval of, a preferred provider program that fails 
    to provide an injured employee with sufficient access to 
    necessary treating physicians, surgeons, and specialists. 
    (d) Except as provided in subsection (a)(4) of Section 8, 
upon a finding by the Commission that the care being rendered 
by the employee's second choice of provider within the 
employer's network is improper or inadequate, the employee may 
then choose a provider outside of the network at the employer's 
expense. The Commission shall issue a decision on any petition 
filed pursuant to this Section within 5 working days. 
    (e) The Director of the Department of Insurance may 
promulgate such rules as are necessary to carry out the 
provisions of this Section relating to approval and regulation 
of preferred provider programs. 
 
    (820 ILCS 305/8.1b new)
    Sec. 8.1b. Determination of permanent partial disability.  
For accidental injuries that occur on or after September 1, 
2011, permanent partial disability shall be established using 
the following criteria: 
    (a) A physician licensed to practice medicine in all of its 
branches preparing a permanent partial disability impairment 
report shall report the level of impairment in writing.  The 
report shall include an evaluation of medically defined and 
professionally appropriate measurements of impairment that 
include, but are not limited to:  loss of range of motion; loss 
of strength; measured atrophy of tissue mass consistent with 
the injury; and any other measurements that establish the 
nature and extent of the impairment.  The most current edition 
of the American Medical Association's "Guides to the Evaluation 
of Permanent Impairment" shall be used by the physician in 
determining the level of impairment. 
    (b) In determining the level of permanent partial 
disability, the Commission shall base its determination on the 
following factors:  (i) the reported level of impairment 
pursuant to subsection (a); (ii) the occupation of the injured 
employee; (iii) the age of the employee at the time of the 
injury; (iv) the employee's future earning capacity; and (v) 
evidence of disability corroborated by the treating medical 
records.  No single enumerated factor shall be the sole 
determinant of disability.  In determining the level of 
disability, the relevance and weight of any factors used in 
addition to the level of impairment as reported by the 
physician must be explained in a written order. 
 
    (820 ILCS 305/8.2)

    Sec. 8.2. Fee schedule.

    (a) Except as provided for in subsection (c), for 
procedures, treatments, or services covered under this Act and 
rendered or to be rendered on  and after February  1, 2006, the 
maximum allowable payment 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. 
Providers of out-of-state procedures, treatments, services, 
products, or supplies shall be reimbursed at the lesser of that 
state's fee schedule amount or the fee schedule amount for the 
region in which the employee resides. If no fee schedule exists 
in that state, the provider shall be reimbursed at the lesser 
of the actual charge or the fee schedule amount for the region 
in which the employee resides. 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.
    (a-1) Notwithstanding the provisions of subsection (a) and 
unless otherwise indicated, the following provisions shall 
apply to the medical fee schedule starting on September 1, 
2011:
        (1) The Commission shall establish and maintain fee 
    schedules for procedures, treatments, products, services, 
    or supplies for hospital inpatient, hospital outpatient, 
    emergency room, ambulatory surgical treatment centers, 
    accredited ambulatory surgical treatment facilities, 
    prescriptions filled and dispensed outside of a licensed 
    pharmacy, dental services, and professional services. This 
    fee schedule shall be based on the fee schedule amounts 
    already established by the Commission pursuant to 
    subsection (a) of this Section. However, starting on 
    January 1, 2012, these fee schedule amounts shall be 
    grouped into geographic regions in the following manner:
            (A) Four regions for non-hospital fee schedule 
        amounts shall be utilized:
                (i) Cook County;
                (ii) DuPage, Kane, Lake, and Will Counties;
                (iii) Bond, Calhoun, Clinton, Jersey, 
            Macoupin, Madison, Monroe, Montgomery, Randolph, 
            St. Clair, and Washington Counties; and
                (iv) All other counties of the State.
            (B) Fourteen regions for hospital fee schedule 
        amounts shall be utilized:
                (i) Cook, DuPage, Will, Kane, McHenry, DeKalb, 
            Kendall, and Grundy Counties;
                (ii) Kankakee County;
                (iii) Madison, St. Clair, Macoupin, Clinton, 
            Monroe, Jersey, Bond, and Calhoun Counties;
                (iv) Winnebago and Boone Counties;
                (v) Peoria, Tazewell, Woodford, Marshall, and 
            Stark Counties;
                (vi) Champaign, Piatt, and Ford Counties;
                (vii) Rock Island, Henry, and Mercer Counties;
                (viii) Sangamon and Menard Counties;
                (ix) McLean County;
                (x) Lake County;
                (xi) Macon County;
                (xii) Vermilion County;
                (xiii) Alexander County; and
                (xiv) All other counties of the State.
        (2) If a geozip, as defined in subsection (a) of this 
    Section, overlaps into one or more of the regions set forth 
    in this Section, then the Commission shall average or 
    repeat the charges and fees in a geozip in order to 
    designate charges and fees for each region.
        (3) In cases where the compiled data contains less than 
    9 charges or fees for a procedure, treatment, product, 
    supply, or service or where the fee schedule amount cannot 
    be determined by the non-discounted charge data, 
    non-Medicare relative values and conversion factors 
    derived from established fee schedule amounts, coding 
    crosswalks, or other data as determined by the Commission, 
    reimbursement shall occur at 76% of charges and fees until 
    September 1, 2011 and 53.2% of charges and fees thereafter 
    as determined by the Commission in a manner consistent with 
    the provisions of this paragraph.
        (4) To establish additional fee schedule amounts, the 
    Commission shall utilize provider non-discounted charge 
    data, non-Medicare relative values and conversion factors 
    derived from established fee schedule amounts, and coding 
    crosswalks. The Commission may establish additional fee 
    schedule amounts based on either the charge or cost of the 
    procedure, treatment, product, supply, or service.
        (5) Implants shall be reimbursed at 25% above the net 
    manufacturer's invoice price less rebates, plus actual 
    reasonable and customary shipping charges whether or not 
    the implant charge is submitted by a provider in 
    conjunction with a bill for all other services associated 
    with the implant, submitted by a provider on a separate 
    claim form, submitted by a distributor, or submitted by the 
    manufacturer of the implant. "Implants" include the 
    following codes or any substantially similar updated code 
    as determined by the Commission: 0274 
    (prosthetics/orthotics); 0275 (pacemaker); 0276 (lens 
    implant); 0278 (implants); 0540 and 0545 (ambulance); 0624 
    (investigational devices); and 0636 (drugs requiring 
    detailed coding). Non-implantable devices or supplies 
    within these codes shall be reimbursed at 65% of actual 
    charge, which is the provider's normal rates under its 
    standard chargemaster. A standard chargemaster is the 
    provider's list of charges for procedures, treatments, 
    products, supplies, or services used to bill payers in a 
    consistent manner.
        (6) The Commission shall automatically update all 
    codes and associated rules with the version of the codes 
    and rules valid on January 1 of that year.
    (a-2) For procedures, treatments, services, or supplies 
covered under this Act and rendered or to be rendered on or 
after September 1, 2011, the maximum allowable payment shall be 
70% of the fee schedule amounts, which shall be adjusted yearly 
by the Consumer Price Index-U, as described in subsection (a) 
of this Section.
    (a-3) Prescriptions filled and dispensed outside of a 
licensed pharmacy shall be subject to a fee schedule that shall 
not exceed the Average Wholesale Price (AWP) plus a dispensing 
fee of $4.18. AWP or its equivalent as registered by the 
National Drug Code shall be set forth for that drug on that 
date as published in Medispan. 
    (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.  
        (1) All payments to providers for treatment provided 
    pursuant to this Act shall be made within 30 60 days of 
    receipt of the bills as long as the claim contains 
    substantially all the required data elements necessary to 
    adjudicate the bills.  
        (2) If the claim does not contain substantially all the 
    required data elements necessary to adjudicate the bill, or 
    the claim is denied for any other reason, in whole or in 
    part, the employer or insurer shall provide written 
    notification, explaining the basis for the denial and 
    describing any additional necessary data elements, to the 
    provider within 30 days of receipt of the bill. 
        (3) In the case of nonpayment to a provider within 30 
    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. Any required interest 
    payments shall be made within 30 days after payment. 
    (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, or for medical services or treatment determined by the 
Commission to be excessive or unnecessary.
    (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.

(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)
 
    (820 ILCS 305/8.2a new)
    Sec. 8.2a. Electronic claims.
    (a) The Director of Insurance shall adopt rules to do all 
of the following:
        (1) Ensure that all health care providers and 
    facilities submit medical bills for payment on 
    standardized forms.
        (2) Require acceptance by employers and insurers of 
    electronic claims for payment of medical services.
        (3) Ensure confidentiality of medical information 
    submitted on electronic claims for payment of medical 
    services.
    (b) To the extent feasible, standards adopted pursuant to 
subdivision (a) shall be consistent with existing standards 
under the federal Health Insurance Portability and 
Accountability Act of 1996 and standards adopted under the 
Illinois Health Information Exchange and Technology Act.
    (c) The rules requiring employers and insurers to accept 
electronic claims for payment of medical services shall be 
proposed on or before January 1, 2012, and shall require all 
employers and insurers to accept electronic claims for payment 
of medical services on or before June 30, 2012.
    (d) The Director of Insurance shall by rule establish 
criteria for granting exceptions to employers, insurance 
carriers, and health care providers who are unable to submit or 
accept medical bills electronically. 
 
    (820 ILCS 305/8.7)
    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 
of or nationally recognized peer review guidelines as well as 
nationally recognized treatment guidelines and evidence-based 
medicine 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 
(for purposes of this sentence, retrospective review shall be 
applicable to services rendered on or after July 20, 2005).  
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 Insurance 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 Director Secretary of Insurance 
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 Insurance 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 Department of Insurance Secretary of Financial and 
Professional Regulation may by rule establish a registration 
fee for each person conducting a utilization review program.
    (i) Upon receipt of written notice that the employer or the 
employer's agent or insurer wishes to invoke the utilization 
review process, the provider of medical, surgical, or hospital 
services shall submit to the utilization review, following 
accredited procedural guidelines.
        (1) The provider shall make reasonable efforts to 
    provide timely and complete reports of clinical 
    information needed to support a request for treatment. If 
    the provider fails to make such reasonable efforts, the 
    charges for the treatment or service may not be compensable 
    nor collectible by the provider or claimant from the 
    employer, the employer's agent, or the employee. The 
    reporting obligations of providers shall not be 
    unreasonable or unduly burdensome.
        (2) Written notice of utilization review decisions, 
    including the clinical rationale for certification or 
    non-certification and references to applicable standards 
    of care or evidence-based medical guidelines, shall be 
    furnished to the provider and employee.
        (3) An employer may only deny payment of or refuse to 
    authorize payment of medical services rendered or proposed 
    to be rendered on the grounds that the extent and scope of 
    medical treatment is excessive and unnecessary in 
    compliance with an accredited utilization review program 
    under this Section.
        (4) When a payment for medical services has been denied 
    or not authorized by an employer or when authorization for 
    medical services is denied pursuant to utilization review, 
    the employee has the burden of proof to show by a 
    preponderance of the evidence that a variance from the 
    standards of care used by the person or entity performing 
    the utilization review pursuant to subsection (a) is 
    reasonably required to cure or relieve the effects of his 
    or her injury.
        (5) The medical professional responsible for review in 
    the final stage of utilization review or appeal must be 
    available in this State for interview or deposition; or 
    must be available for deposition by telephone, video 
    conference, or other remote electronic means. A medical 
    professional who works or resides in this State or outside 
    of this State may comply with this requirement by making 
    himself or herself available for an interview or deposition 
    in person or by making himself or herself available by 
    telephone, video conference, or other remote electronic 
    means. The remote interview or deposition shall be 
    conducted in a fair, open, and cost-effective manner. The 
    expense of interview and the deposition method shall be 
    paid by the employer. The deponent shall be in the presence 
    of the officer administering the oath and recording the 
    deposition, unless otherwise agreed by the parties.  Any 
    exhibits or other demonstrative evidence to be presented to 
    the deponent by any party at the deposition shall be 
    provided to the officer administering the oath and all 
    other parties within a reasonable period of time prior to 
    the deposition.  Nothing shall prohibit any party from being 
    with the deponent during the deposition, at that party's 
    expense; provided, however, that a party attending a 
    deposition shall give written notice of that party's 
    intention to appear at the deposition to all other parties 
    within a reasonable time prior to the deposition.
    An admissible A utilization review shall will be considered 
by the Commission, along with all other evidence and in the 
same manner as all other evidence, and must be addressed along 
with 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.

    The changes to this Section made by this amendatory Act of 
the 97th General Assembly apply only to health care services 
provided or proposed to be provided on or after September 1, 
2011. 
(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)
 



    (820 ILCS 305/11)  (from Ch. 48, par. 138.11)



    Sec. 11. The compensation herein provided, together with 
the
provisions of this Act, shall be the measure of the 
responsibility of
any employer engaged in any of the 
enterprises or businesses enumerated
in Section 3 of this Act, 
or of any employer who is not engaged in any
such enterprises 
or businesses, but who has elected to provide and pay

compensation for accidental injuries sustained by any employee 
arising
out of and in the course of the employment according to 
the provisions
of this Act, and whose election to continue 
under this Act, has not been
nullified by any action of his 
employees as provided for in this Act.

    Accidental injuries incurred while participating in 
voluntary recreational
programs including but not limited to 
athletic events, parties and picnics
do not arise out of and in 
the course of the employment even though the
employer pays some 
or all of the cost thereof.  This exclusion shall not apply
in 
the event that the injured employee was ordered or assigned by 
his employer
to participate in the program.

    Accidental injuries incurred while participating as a 
patient in a drug
or alcohol rehabilitation program do not 
arise out of and in the course
of employment even though the 
employer pays some or all of the costs thereof.
    Any injury to or disease or death of an employee arising 
from the administration of a vaccine, including without 
limitation smallpox vaccine, to prepare for, or as a response 
to, a threatened or potential bioterrorist incident to the 
employee as part of a voluntary inoculation program in 
connection with the person's employment or in connection with 
any governmental program or recommendation for the inoculation 
of workers in the employee's occupation, geographical area, or 
other category that includes the employee is deemed to arise 
out of and in the course of the employment for all purposes 
under this Act.  This paragraph added by this amendatory Act of 
the 93rd General Assembly is declarative of existing law and is 
not a new enactment.


    No compensation shall be payable if (i) the employee's 
intoxication is the proximate cause of the employee's 
accidental injury or (ii) at the time the employee incurred the 
accidental injury, the employee was so intoxicated that the 
intoxication constituted a departure from the employment. 
Admissible evidence of the concentration of (1) alcohol, (2) 
cannabis as defined in the Cannabis Control Act, (3) a 
controlled substance listed in the Illinois Controlled 
Substances Act, or (4) an intoxicating compound listed in the 
Use of Intoxicating Compounds Act in the employee's blood, 
breath, or urine at the time the employee incurred the 
accidental injury shall be considered in any hearing under this 
Act to determine whether the employee was intoxicated at the 
time the employee incurred the accidental injuries. If at the 
time of the accidental injuries, there was 0.08% or more by 
weight of alcohol in the employee's blood, breath, or urine or 
if there is any evidence of impairment due to the unlawful or 
unauthorized use of (1) cannabis as defined in the Cannabis 
Control Act, (2) a controlled substance listed in the Illinois 
Controlled Substances Act, or (3) an intoxicating compound 
listed in the Use of Intoxicating Compounds Act or if the 
employee refuses to submit to testing of blood, breath, or 
urine, then there shall be a rebuttable presumption that the 
employee was intoxicated and that the intoxication was the 
proximate cause of the employee's injury. The employee may 
overcome the rebuttable presumption by the preponderance of the 
admissible evidence that the intoxication was not the sole 
proximate cause or proximate cause of the accidental injuries. 
Percentage by weight of alcohol in the blood shall be based on 
grams of alcohol per 100 milliliters of blood. Percentage by 
weight of alcohol in the breath shall be based upon grams of 
alcohol per 210 liters of breath. Any testing that has not been 
performed by an accredited or certified testing laboratory 
shall not be admissible in any hearing under this Act to 
determine whether the employee was intoxicated at the time the 
employee incurred the accidental injury. 
    All sample collection and testing for alcohol and drugs 
under this Section shall be performed in accordance with rules 
to be adopted by the Commission. These rules shall ensure: 
        (1) compliance with the National Labor Relations Act 
    regarding collective bargaining agreements or regulations 
    promulgated by the United States Department of 
    Transportation;
        (2) that samples are collected and tested in 
    conformance with national and State legal and regulatory 
    standards for the privacy of the individual being tested, 
    and in a manner reasonably calculated to prevent 
    substitutions or interference with the collection or 
    testing of reliable sample;
        (3) that split testing procedures are utilized;
        (4) that sample collection is documented, and the 
    documentation procedures include: 
            (A) the labeling of samples in a manner so as to 
        reasonably preclude the probability of erroneous 
        identification of test result; and
            (B) an opportunity for the employee to provide 
        notification of any information which he or she 
        considers relevant to the test, including 
        identification of currently or recently used 
        prescription or nonprescription drugs and other 
        relevant medical information; 
        (5) that sample collection, storage, and 
    transportation to the place of testing is performed in a 
    manner so as to reasonably preclude the probability of 
    sample contamination or adulteration; and
        (6) that chemical analyses of blood, urine, breath, or 
    other bodily substance are performed according to 
    nationally scientifically accepted analytical methods and 
    procedures. 
    The changes to this Section made by this amendatory Act of 
the 97th General Assembly apply only to accidental injuries 
that occur on or after September 1, 2011. 
(Source: P.A. 93-829, eff. 7-28-04.)

 



    (820 ILCS 305/13)  (from Ch. 48, par. 138.13)



    Sec. 13. There is created an Illinois Workers' Compensation 
Commission consisting of 10

members to be appointed by the 
Governor, by and with the consent of the
Senate, 3 of whom 
shall be representative citizens of the
employing class 
operating under this Act and 3 of whom shall
be representative 
citizens of the class of employees covered under this
Act, and 
4 of whom shall be representative citizens not identified
with 
either the employing or employee classes.  Not more than 6 
members
of the Commission shall be of the same political party.

    One of the
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; .

        (h) professional and ethical standards pursuant to 
    Section 1.1 of this Act;
        (i) detection of workers' compensation fraud and 
    reporting obligations of Commission employees and 
    appointees;
        (j) standards of evidence-based medical treatment and 
    best practices for measuring and improving quality and 
    health care outcomes in the workers' compensation system, 
    including but not limited to the use of the American 
    Medical Association's "Guides to the Evaluation of 
    Permanent Impairment" and the practice of utilization 
    review; and 
        (k) substantive and procedural aspects of coal 
    workers' pneumoconiosis (black lung) cases. 
    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. Each Commissioner 
shall complete 20 hours of training in the above-noted areas 
during every 2 years such Commissioner shall remain in office.

    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; 
94-277, eff. 7-20-05.)

 



    (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 of 12 
members
appointed by the Governor with the advice and consent 
of the Senate.  Six

members of the Advisory Board shall be

representative citizens chosen from the employee class, and 6 
members shall be
representative citizens chosen from the 
employing 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
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.
Seven 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.  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, reviewing advisory rates filed by an advisory 
organization as defined in Section 463 of the  Illinois 
Insurance Code, and establishing
short and long range 
administrative goals. Prior to making the (1) initial set of 
arbitrator appointments pursuant to this amendatory Act of the 
97th General Assembly and (2) appointment of Commissioners, 
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.


    (d) The terms of all Advisory Board members serving on the 
effective date of this amendatory Act of the 97th General 
Assembly are terminated.  The Governor shall appoint new members 
to the Advisory Board within 30 days after the effective date 
of the amendatory Act of the 97th General Assembly, subject to 
the advice and consent of the Senate. 
(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)

 



    (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. Arbitrators 
shall be appointed pursuant to this Section, notwithstanding 
any provision of the Personnel Code. 

    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; .

        (h) professional and ethical standards pursuant to 
    Section 1.1 of this Act;
        (i) detection of workers' compensation fraud and 
    reporting obligations of Commission employees and 
    appointees;
        (j) standards of evidence-based medical treatment and 
    best practices for measuring and improving quality and 
    health care outcomes in the workers' compensation system, 
    including but not limited to the use of the American 
    Medical Association's "Guides to the Evaluation of 
    Permanent Impairment" and the practice of utilization 
    review; and 
        (k) substantive and procedural aspects of coal 
    workers' pneumoconiosis (black lung) cases. 
    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 
complete 20 hours of training in the above-noted areas during 
every 2 years such arbitrator shall remain in office. 

    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.

    Notwithstanding any other provision of this Section, the 
term of all arbitrators serving on the effective date of this 
amendatory Act of the 97th General Assembly, including any 
arbitrators on administrative leave, shall terminate at the 
close of business on July 1, 2011, but the incumbents shall 
continue to exercise all of their duties until they are 
reappointed or their successors are appointed. 
    On and after the effective date of this amendatory Act of 
the 97th General Assembly, arbitrators shall be appointed to 
3-year terms by the full Commission, except that initial 
appointments made on and after the effective date of this 
amendatory Act of the 97th General Assembly shall be made as 
follows:
        (1) All appointments shall be made by the Governor with 
    the advice and consent of the Senate.
        (2) 12 arbitrators shall be appointed to terms expiring 
    July 1, 2012; 12 arbitrators shall be appointed to terms 
    expiring July 1, 2013; and all additional arbitrators shall 
    be appointed to terms expiring July 1, 2014. 
    Upon the expiration of a term, the Chairman shall evaluate 
the performance of the arbitrator and may recommend that he or 
she be reappointed to a second or subsequent term by the full 
Commission. 
    Each arbitrator appointed on or after the effective date of 
this amendatory Act of the 97th General Assembly and who has 
not previously served as an arbitrator for the Commission shall 
be required to be authorized to practice law in this State by 
the Supreme Court, and to maintain this authorization 
throughout his or her term of employment. 
    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 of 10 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 changes made 
to this Section by this amendatory Act of the 97th General 
Assembly shall prevail over any conflict with the Personnel 
Code. The Chairman shall allow input from the Commissioners in

all such reviews.

    The Commission shall assign no fewer than 3 arbitrators to 
each hearing site. The Commission shall establish a procedure 
to ensure that the arbitrators assigned to each hearing site 
are assigned cases on a random basis. No arbitrator shall hear 
cases in any county, other than Cook County, for more than 2 
years in each 3-year term. 
    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; 94-277, eff. 7-20-05.)

 
    (820 ILCS 305/16b new)
    Sec. 16b. Gift ban.
    (a) An attorney appearing before the Commission shall not 
provide compensation or any gift to any person in exchange for 
the referral of a client involving a matter to be heard before 
the Commission except for a division of a fee between lawyers 
who are not in the same firm in accordance with Rule 1.5 of the 
Code of Professional Responsibility. For purposes of this 
Section, "gift" means any gratuity, discount, entertainment, 
hospitality, loan, forbearance, or any other tangible or 
intangible item having monetary value including, but not 
limited to, cash, food and drink, and honoraria except for food 
or refreshments not exceeding $75 per person in value on a 
single calendar day, provided that the food or refreshments are 
(1) consumed on the premises from which they were purchased or 
prepared or (2) catered. "Catered" means food or refreshments 
that are purchased ready to eat and delivered by any means.
    (b) Violation of this Section is a Class A misdemeanor. 
 



    (820 ILCS 305/18)  (from Ch. 48, par. 138.18)



    Sec. 18. 
All questions arising under this Act, if not 
settled by
agreement of the parties interested therein, shall, 
except as otherwise
provided, be determined by the Commission. 
Claims from current and former employees of the Commission 
shall be determined in accordance with Section 18.1 of this 
Act. 

(Source: Laws 1951, p. 1060.)

 
    (820 ILCS 305/18.1 new)
    Sec. 18.1. Claims by former and current employees of the 
Commission. All claims by current and former employees and 
appointees of the Commission shall be assigned to a certified 
independent arbitrator not employed by the Commission 
designated by the Chairman.  The Chairman shall designate an 
arbitrator from a list of approved certified arbitrators 
provided by the Commission Review Board.  If the Chairman is the 
claimant, then the independent arbitrator from the approved 
list shall be designated by the longest serving Commissioner.  
The designated independent arbitrator shall have the authority 
of arbitrators of the Commission regarding settlement and 
adjudication of the claim of the current and former employees 
and appointees of the Commission.  The decision of the 
independent arbitrator shall become the decision of the 
Commission.  An appeal of the independent arbitrator's decision 
shall be subject to judicial review in accordance with 
subsection (f) of Section 19.
 



    (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, 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 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

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 other than those claims under Section 18.1, 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 30 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. 

    (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; 94-277, eff. 7-20-05.)

 
    (820 ILCS 305/25.5)

    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 Department 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).

        (9) Intentionally present a bill or statement for the 
    payment for medical services that were not provided. 
    For the purposes of paragraphs (2), (3), (5), (6), and (7), 
and (9), 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) Sentences for violations of subsection (a) are as 
follows: 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.

        (1) A violation in which the value of the property 
    obtained or attempted to be obtained is $300 or less is a 
    Class A misdemeanor.
        (2) A violation in which the value of the property 
    obtained or attempted to be obtained is more than $300 but 
    not more than $10,000 is a Class 3 felony.
        (3) A violation in which the value of the property 
    obtained or attempted to be obtained is more than $10,000 
    but not more than $100,000 is a Class 2 felony.
        (4) A violation in which the value of the property 
    obtained or attempted to be obtained is more than $100,000 
    is a Class 1 felony.
        (5) A person convicted under this Section shall be 
    ordered to pay monetary restitution to the insurance 
    company or self-insured entity or any other person for any 
    financial loss sustained as a result of a violation of this 
    Section, including any court costs and attorney fees. An 
    order of restitution also includes expenses incurred and 
    paid by the State of Illinois or an insurance company or 
    self-insured entity in connection with any medical 
    evaluation or treatment services.
    For the purposes of this Section, where the exact value of 
property obtained or attempted to be obtained is either not 
alleged or is not specifically set by the terms of a policy of 
insurance, the value of the property shall be the fair market 
replacement value of the property claimed to be lost, the 
reasonable costs of reimbursing a vendor or other claimant for 
services to be rendered, or both. Notwithstanding the 
foregoing, an insurance company, self-insured entity, or any 
other person suffering financial loss sustained as a result of 
violation of this Section may seek restitution, including court 
costs and attorney's fees in a civil action in a court of 
competent jurisdiction. 
    (c) The Department 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 Special Prosecutions Bureau 
of the Criminal Division of the Office of 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 Department Division 
of Insurance, including the authority to issue a subpoena to a 
medical provider, pursuant to Section 8-802 of the Code of 
Civil Procedure.

    (d) Any person may report allegations of insurance 
non-compliance and fraud pursuant to this Section to the 
Department 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 related to an employee's 
claim 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 destroyed upon the expiration of the 
statute of limitations for the acts under investigation 
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, third party 
administrator, self-insured, or similar entity 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.

    (e-5) The fraud and insurance non-compliance unit shall 
procure and implement a system utilizing advanced analytics 
inclusive of predictive modeling, data mining, social network 
analysis, and scoring algorithms for the detection and 
prevention of fraud, waste, and abuse on or before January 1, 
2012. The fraud and insurance non-compliance unit shall procure 
this system using a request for proposals process governed by 
the Illinois Procurement Code and rules adopted under that 
Code. The fraud and insurance non-compliance unit shall provide 
a report to the President of the Senate, Speaker of the House 
of Representatives, Minority Leader of the House of 
Representatives, Minority Leader of the Senate, Governor, 
Chairman of the Commission, and Director of Insurance on or 
before July 1, 2012 and annually thereafter detailing its 
activities and providing recommendations regarding 
opportunities for additional fraud waste and abuse detection 
and prevention. 
    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) The All proceedings under this Section shall be 
reported by the fraud and insurance non-compliance unit shall 
submit a written report on an annual basis to the Chairman of 
the Commission, the Workers' Compensation Advisory Board, the 
General Assembly, the Governor, and the Attorney General by 
January 1 and July 1 of each year. This report shall include, 
at the minimum, the following information:
        (1) The number of allegations of insurance 
    non-compliance and fraud reported to the fraud and 
    insurance non-compliance unit.
        (2) The source of the reported allegations 
    (individual, employer, or other).
        (3) The number of allegations investigated by the fraud 
    and insurance non-compliance unit.
        (4) The number of criminal referrals made in accordance 
    with this Section and the entity to which the referral was 
    made.
        (5) All proceedings under this Section.


(Source: P.A. 94-277, eff. 7-20-05.)
 
    (820 ILCS 305/29.1 new)
    Sec. 29.1. Recalculation of premiums. On the effective date 
of this amendatory Act of the 97th General Assembly, the 
Director of Insurance shall immediately direct in writing any 
workers' compensation rate setting advisory organization to 
recalculate workers' compensation advisory premium rates and 
assigned risk pool premium rates so that those premiums 
incorporate the provisions of this amendatory Act of the 97th 
General Assembly, and to publish such rates on or before 
September 1, 2011.
 
    (820 ILCS 305/29.2 new)
    Sec. 29.2. Insurance oversight.
    (a) The Department of Insurance shall annually submit to 
the Governor, the Chairman of the Commission, the President of 
the Senate, the Speaker of the House of Representatives, the 
Minority Leader of the Senate, and the Minority Leader of the 
House of Representatives a written report that details the 
state of the workers' compensation insurance market in 
Illinois. The report shall be completed by April 1 of each 
year, beginning in 2012, or later if necessary data or analyses 
are only available to the Department at a later date. The 
report shall be posted on the Department of Insurance's 
Internet website. Information to be included in the report 
shall be for the preceding calendar year. The report shall 
include, at a minimum, the following:
        (1) Gross premiums collected by workers' compensation 
    carriers in Illinois and the national rank of Illinois 
    based on premium volume.
        (2) The number of insurance companies actively engaged 
    in Illinois in the workers' compensation insurance market, 
    including both holding companies and subsidiaries or 
    affiliates, and the national rank of Illinois based on 
    number of competing insurers.
        (3) The total number of insured participants in the 
    Illinois workers' compensation assigned risk insurance 
    pool, and the size of the assigned risk pool as a 
    proportion of the total Illinois workers' compensation 
    insurance market.
        (4) The advisory organization premium rate for 
    workers' compensation insurance in Illinois for the 
    previous year.
        (5) The advisory organization prescribed assigned risk 
    pool premium rate.
        (6) The total amount of indemnity payments made by 
    workers' compensation insurers in Illinois.
        (7) The total amount of medical payments made by 
    workers' compensation insurers in Illinois, and the 
    national rank of Illinois based on average cost of medical 
    claims per injured worker.
        (8) The gross profitability of workers' compensation 
    insurers in Illinois, and the national rank of Illinois 
    based on profitability of workers' compensation insurers.
        (9) The loss ratio of workers' compensation insurers in 
    Illinois and the national rank of Illinois based on the  
    loss ratio of workers' compensation insurers. For purposes 
    of this loss ratio calculation, the denominator shall 
    include all premiums and other fees collected by workers' 
    compensation insurers and the numerator shall include the 
    total amount paid by the insurer for care or compensation 
    to injured workers.
        (10) The growth of total paid indemnity benefits by 
    temporary total disability, scheduled and non-scheduled 
    permanent partial disability, and total disability.
        (11) The number of injured workers receiving wage loss 
    differential awards and the average wage loss differential 
    award payout.
        (12) Illinois' rank, relative to other states, for: 
            (i) the maximum and minimum temporary total 
        disability benefit level;
            (ii) the maximum and minimum scheduled and 
        non-scheduled permanent partial disability benefit 
        level;
            (iii) the maximum and minimum total disability 
        benefit level; and
            (iv) the maximum and minimum death benefit level. 
        (13) The aggregate growth of medical benefit payout by 
    non-hospital providers and hospitals.
        (14) The aggregate growth of medical utilization for 
    the top 10 most common injuries to specific body parts by 
    non-hospital providers and hospitals.
        (15) The percentage of injured workers filing claims at 
    the Commission that are represented by an attorney.
        (16) The total amount paid by injured workers for 
    attorney representation. 
    (b)  The Director of Insurance shall promulgate rules 
requiring each insurer licensed to write workers' compensation 
coverage in the State to record and report the following 
information on an aggregate basis to the Department of 
Insurance before March 1 of each year, relating to claims in 
the State opened within the prior calendar year:
        (1) The number of claims opened.
        (2) The number of reported medical only claims.
        (3) The number of contested claims.
        (4) The number of claims for which the employee has 
    attorney representation.
        (5) The number of claims with lost time and the number 
    of claims for which temporary total disability was paid.
        (6) The number of claim adjusters employed to adjust 
    workers' compensation claims.
        (7) The number of claims for which temporary total 
    disability was not paid within 14 days from the first full 
    day off, regardless of reason.
        (8) The number of medical bills paid 60 days or later 
    from date of service and the average days paid on those 
    paid after 60 days for the previous calendar year.
        (9) The number of claims in which in-house defense 
    counsel participated, and the total amount spent on 
    in-house legal services.
        (10) The number of claims in which outside defense 
    counsel participated, and the total amount paid to outside 
    defense counsel.
        (11) The total amount billed to employers for bill 
    review.
        (12) The total amount billed to employers for fee 
    schedule savings.
        (13) The total amount charged to employers for any and 
    all managed care fees.
        (14) The number of claims involving in-house medical 
    nurse case management, and the total amount spent on 
    in-house medical nurse case management.
        (15) The number of claims involving outside medical 
    nurse case management, and the total amount paid for 
    outside medical nurse case management.
        (16) The total amount paid for Independent Medical 
    exams.
        (17) The total amount spent on in-house Utilization 
    Review for the previous calendar year.
        (18) The total amount paid for outside Utilization 
    Review for the previous calendar year.
    The Department shall make the submitted information 
publicly available on the Department's Internet website or such 
other media as appropriate in a form useful for consumers. 
 
    Section 97. Severability. The provisions of this Act are 
severable under Section 1.31 of the Statute on Statutes.
 

    Section 99. Effective date. This Act takes effect upon 
becoming law.