Full Text of SB1283 94th General Assembly
SB1283enr 94TH GENERAL ASSEMBLY
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| AN ACT concerning employment.
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| Be it enacted by the People of the State of Illinois, | 3 |
| represented in the General Assembly:
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| Section 5. The Workers' Compensation Act is amended by | 5 |
| changing Sections 7, 8, 8.2, 8.7, and 13.1 as follows:
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| (820 ILCS 305/7) (from Ch. 48, par. 138.7)
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| Sec. 7. The amount of compensation which shall be paid for | 8 |
| an
accidental injury to the employee resulting in death is:
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| (a) If the employee leaves surviving a widow, widower, | 10 |
| child or
children, the applicable weekly compensation rate | 11 |
| computed in accordance
with subparagraph 2 of paragraph (b) of | 12 |
| Section 8, shall be payable
during the life of the widow or | 13 |
| widower and if any surviving child or
children shall not be | 14 |
| physically or mentally incapacitated then until
the death of | 15 |
| the widow or widower or until the youngest child shall
reach | 16 |
| the age of 18, whichever shall come later; provided that if | 17 |
| such
child or children shall be enrolled as a full time student | 18 |
| in any
accredited educational institution, the payments shall | 19 |
| continue until
such child has attained the age of 25. In the | 20 |
| event any surviving child
or children shall be physically or | 21 |
| mentally incapacitated, the payments
shall continue for the | 22 |
| duration of such incapacity.
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| The term "child" means a child whom the deceased employee | 24 |
| left
surviving, including a posthumous child, a child legally | 25 |
| adopted, a
child whom the deceased employee was legally | 26 |
| obligated to support or a
child to whom the deceased employee | 27 |
| stood in loco parentis. The term
"children" means the plural of | 28 |
| "child".
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| The term "physically or mentally incapacitated child or | 30 |
| children"
means a child or children incapable of engaging in | 31 |
| regular and
substantial gainful employment.
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| In the event of the remarriage of a widow or widower, where |
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| the
decedent did not leave surviving any child or children who, | 2 |
| at the time
of such remarriage, are entitled to compensation | 3 |
| benefits under this
Act, the surviving spouse shall be paid a | 4 |
| lump sum equal to 2 years
compensation benefits and all further | 5 |
| rights of such widow or widower
shall be extinguished.
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| If the employee leaves surviving any child or children | 7 |
| under 18 years
of age who at the time of death shall be | 8 |
| entitled to compensation under
this paragraph (a) of this | 9 |
| Section, the weekly compensation payments
herein provided for | 10 |
| such child or children shall in any event continue
for a period | 11 |
| of not less than 6 years.
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| Any beneficiary entitled to compensation under this | 13 |
| paragraph (a) of
this Section shall receive from the special | 14 |
| fund provided in paragraph
(f) of this Section, in addition to | 15 |
| the compensation herein provided,
supplemental benefits in | 16 |
| accordance with paragraph (g) of Section 8.
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| (b) If no compensation is payable under paragraph (a) of | 18 |
| this
Section and the employee leaves surviving a parent or | 19 |
| parents who at the
time of the accident were totally dependent | 20 |
| upon the earnings of the
employee then weekly payments equal to | 21 |
| the compensation rate payable in
the case where the employee | 22 |
| leaves surviving a widow or widower, shall
be paid to such | 23 |
| parent or parents for the duration of their lives, and
in the | 24 |
| event of the death of either, for the life of the survivor.
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| (c) If no compensation is payable under paragraphs (a) or | 26 |
| (b) of
this Section and the employee leaves surviving any child | 27 |
| or children who
are not entitled to compensation under the | 28 |
| foregoing paragraph (a) but
who at the time of the accident | 29 |
| were nevertheless in any manner
dependent upon the earnings of | 30 |
| the employee, or leaves surviving a
parent or parents who at | 31 |
| the time of the accident were partially
dependent upon the | 32 |
| earnings of the employee, then there shall be paid to
such | 33 |
| dependent or dependents for a period of 8 years weekly | 34 |
| compensation
payments at such proportion of the applicable rate | 35 |
| if the employee had
left surviving a widow or widower as such | 36 |
| dependency bears to total
dependency. In the event of the death |
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| of any such beneficiary the share
of such beneficiary shall be | 2 |
| divided equally among the surviving
beneficiaries and in the | 3 |
| event of the death of the last such
beneficiary all the rights | 4 |
| under this paragraph shall be extinguished.
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| (d) If no compensation is payable under paragraphs (a), (b) | 6 |
| or (c)
of this Section and the employee leaves surviving any | 7 |
| grandparent,
grandparents, grandchild or grandchildren or | 8 |
| collateral heirs dependent
upon the employee's earnings to the | 9 |
| extent of 50% or more of total
dependency, then there shall be | 10 |
| paid to such dependent or dependents for
a period of 5 years | 11 |
| weekly compensation payments at such proportion of
the | 12 |
| applicable rate if the employee had left surviving a widow or
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| widower as such dependency bears to total dependency. In the | 14 |
| event of
the death of any such beneficiary the share of such | 15 |
| beneficiary shall be
divided equally among the surviving | 16 |
| beneficiaries and in the event of
the death of the last such | 17 |
| beneficiary all rights hereunder shall be
extinguished.
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| (e) The compensation to be paid for accidental injury which | 19 |
| results
in death, as provided in this Section, shall be paid to | 20 |
| the persons who
form the basis for determining the amount of | 21 |
| compensation to be paid by
the employer, the respective shares | 22 |
| to be in the proportion of their
respective dependency at the | 23 |
| time of the accident on the earnings of the
deceased. The | 24 |
| Commission or an Arbitrator thereof may, in its or his
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| discretion, order or award the payment to the parent or | 26 |
| grandparent of a
child for the latter's support the amount of | 27 |
| compensation which but for
such order or award would have been | 28 |
| paid to such child as its share of
the compensation payable, | 29 |
| which order or award may be modified from time
to time by the | 30 |
| Commission in its discretion with respect to the person
to whom | 31 |
| shall be paid the amount of the order or award remaining unpaid
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| at the time of the modification.
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| The payments of compensation by the employer in accordance | 34 |
| with the
order or award of the Commission discharges such | 35 |
| employer from all
further obligation as to such compensation.
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| (f) The sum of $8,000 for burial expenses shall be paid by |
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| the
employer to the widow or widower, other dependent, next of | 2 |
| kin or to the
person or persons incurring the expense of | 3 |
| burial.
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| In the event the employer failed to provide necessary first | 5 |
| aid,
medical, surgical or hospital service, he shall pay the | 6 |
| cost thereof to
the person or persons entitled to compensation | 7 |
| under paragraphs (a),
(b), (c) or (d) of this Section, or to | 8 |
| the person or persons incurring
the obligation therefore, or | 9 |
| providing the same.
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| On January 15 and July 15, 1981, and on January 15 and July | 11 |
| 15 of each
year thereafter the employer shall within 60 days | 12 |
| pay a sum equal to
1/8 of 1% of all compensation payments made | 13 |
| by him after July 1, 1980, either
under this Act or the | 14 |
| Workers' Occupational Diseases Act, whether by lump
sum | 15 |
| settlement or weekly compensation payments, but not including | 16 |
| hospital,
surgical or rehabilitation payments, made during the | 17 |
| first 6 months and
during the second 6 months respectively of | 18 |
| the fiscal year next preceding
the date of the payments, into a | 19 |
| special fund which shall be designated the
"Second Injury | 20 |
| Fund", of which the State Treasurer is ex-officio custodian,
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| such special fund to be held and disbursed for the purposes | 22 |
| hereinafter
stated in paragraphs (f) and (g) of Section 8, | 23 |
| either upon the order of the
Commission or of a competent | 24 |
| court. Said special fund shall be deposited
the same as are | 25 |
| State funds and any interest accruing thereon shall be
added | 26 |
| thereto every 6 months. It is subject to audit the same as | 27 |
| State
funds and accounts and is protected by the General bond | 28 |
| given by the State
Treasurer. It is considered always | 29 |
| appropriated for the purposes of
disbursements as provided in | 30 |
| Section 8, paragraph (f), of this Act, and
shall be paid out | 31 |
| and disbursed as therein provided and shall not at any
time be | 32 |
| appropriated or diverted to any other use or purpose.
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| On January 15, 1991, the employer shall further pay a sum | 34 |
| equal to one
half of 1% of all compensation payments made by | 35 |
| him from January 1, 1990
through June 30, 1990 either under | 36 |
| this Act or under the Workers'
Occupational Diseases Act, |
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| whether by lump sum settlement or weekly
compensation payments, | 2 |
| but not including hospital, surgical or
rehabilitation | 3 |
| payments, into an additional Special Fund which shall be
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| designated as the "Rate Adjustment Fund". On March 15, 1991, | 5 |
| the employer
shall pay into the Rate Adjustment Fund a sum | 6 |
| equal to one half of 1% of
all such compensation payments made | 7 |
| from July 1, 1990 through December 31,
1990. Within 60 days | 8 |
| after July 15, 1991, the employer shall pay into the
Rate | 9 |
| Adjustment Fund a sum equal to one half of 1% of all such | 10 |
| compensation
payments made from January 1, 1991 through June | 11 |
| 30, 1991. Within 60 days
after January 15 of 1992 and each
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| subsequent year through 1996, the employer shall pay
into the | 13 |
| Rate Adjustment Fund a sum equal to one half of 1% of all such
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| compensation payments made in the last 6 months of the | 15 |
| preceding calendar
year. Within 60 days after July 15 of 1992 | 16 |
| and each subsequent year through
1995, the employer shall pay | 17 |
| into the Rate Adjustment Fund a sum equal to one
half of 1% of | 18 |
| all such compensation payments made in the first 6 months of | 19 |
| the
same calendar year. Within 60 days after January 15 of 1997 | 20 |
| and each subsequent
year through 2005, the employer shall pay | 21 |
| into the Rate Adjustment Fund a sum equal to
three-fourths of | 22 |
| 1% of all such compensation payments made in the last 6 months
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| of the preceding calendar year. Within 60 days after July 15 of | 24 |
| 1996 and each
subsequent year through 2004, the employer shall | 25 |
| pay into the Rate Adjustment Fund a sum
equal to three-fourths | 26 |
| of 1% of all such compensation payments made in the
first 6 | 27 |
| months of the same calendar year. Within 60 days after January | 28 |
| 15 of 2006 and each subsequent year, the employer shall pay | 29 |
| into the Rate Adjustment Fund a sum equal to 1% of such | 30 |
| compensation payments made in the last 6 months of the | 31 |
| preceding calendar year. Within 60 days after July 15 of 2005 | 32 |
| and each subsequent year , the employer shall pay into the Rate | 33 |
| Adjustment Fund a sum equal to 1% of such compensation payments | 34 |
| made in the first 6 months of the same calendar year. Within 60 | 35 |
| days after January 15 of 2006 and each subsequent year, the | 36 |
| employer shall pay into the Rate Adjustment Fund a sum equal to |
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| 1.25% of such compensation payments made in the last 6 months | 2 |
| of the preceding calendar year. Within 60 days after July 15 of | 3 |
| 2006 and each subsequent year, the employer shall pay into the | 4 |
| Rate Adjustment Fund a sum equal to 1.25% of such compensation | 5 |
| payments made in the first 6 months of the same calendar year.
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| The administrative costs of
collecting assessments from | 7 |
| employers for the Rate Adjustment Fund shall be
paid from the
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| Rate Adjustment Fund. The cost of an actuarial audit of the | 9 |
| Fund shall be paid
from the Rate Adjustment Fund. The State | 10 |
| Treasurer is ex officio custodian of such Special
Fund and the | 11 |
| same shall be held and disbursed for the purposes hereinafter
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| stated in paragraphs (f) and (g) of Section 8 upon the order of | 13 |
| the
Commission or of a competent court. The Rate Adjustment | 14 |
| Fund shall be
deposited the same as are State funds and any | 15 |
| interest accruing thereon
shall be added thereto every 6 | 16 |
| months. It shall be subject to audit the
same as State funds | 17 |
| and accounts and shall be protected by the general bond
given | 18 |
| by the State Treasurer. It is considered always appropriated | 19 |
| for the
purposes of disbursements as provided in paragraphs (f) | 20 |
| and (g) of Section
8 of this Act and shall be paid out and | 21 |
| disbursed as therein provided and
shall not at any time be | 22 |
| appropriated or diverted to any other use or
purpose. Within 5 | 23 |
| days after the effective date of this amendatory Act of
1990, | 24 |
| the Comptroller and the State Treasurer shall transfer | 25 |
| $1,000,000
from the General Revenue Fund to the Rate Adjustment | 26 |
| Fund. By February 15,
1991, the Comptroller and the State | 27 |
| Treasurer shall transfer $1,000,000
from the Rate Adjustment | 28 |
| Fund to the General Revenue Fund. The Comptroller and Treasurer | 29 |
| are authorized to make
transfers at the
request of the Chairman | 30 |
| up to a total of $19,000,000
from the Second Injury Fund, the | 31 |
| General Revenue Fund, and the Workers'
Compensation Benefit | 32 |
| Trust
Fund to the Rate Adjustment Fund to the extent that there | 33 |
| is insufficient
money in the Rate Adjustment Fund to pay claims | 34 |
| and obligations. Amounts may
be transferred from the General | 35 |
| Revenue Fund only if the funds in the Second
Injury Fund or the | 36 |
| Workers' Compensation Benefit Trust Fund are insufficient to
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| pay claims and obligations of the Rate Adjustment Fund. All
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| amounts transferred from the Second Injury Fund, the General | 3 |
| Revenue Fund,
and the Workers'
Compensation Benefit Trust Fund | 4 |
| shall be repaid from the Rate Adjustment
Fund within 270 days | 5 |
| of a transfer, together with interest at the rate
earned by | 6 |
| moneys on deposit in the Fund or Funds from which the moneys | 7 |
| were
transferred.
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| Upon a finding by the Commission, after reasonable notice | 9 |
| and hearing,
that any employer has willfully and knowingly | 10 |
| failed to pay the proper
amounts into the Second Injury Fund or | 11 |
| the Rate Adjustment Fund required by
this Section or if such | 12 |
| payments are not made within the time periods
prescribed by | 13 |
| this Section, the employer shall, in addition to such
payments, | 14 |
| pay a penalty of 20% of the amount required to be paid or | 15 |
| $2,500,
whichever is greater, for each year or part thereof of | 16 |
| such failure to pay.
This penalty shall only apply to | 17 |
| obligations of an employer to the
Second Injury Fund or the | 18 |
| Rate Adjustment Fund accruing after the effective
date of this | 19 |
| amendatory Act of 1989. All or part of such a penalty may be
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| waived by the Commission for good cause shown.
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| Any obligations of an employer to the Second Injury Fund | 22 |
| and Rate
Adjustment Fund accruing prior to the effective date | 23 |
| of this amendatory Act
of 1989 shall be paid in full by such | 24 |
| employer within 5 years of the
effective date of this | 25 |
| amendatory Act of 1989, with at least one-fifth of
such | 26 |
| obligation to be paid during each year following the effective | 27 |
| date of
this amendatory Act of 1989. If the Commission finds, | 28 |
| following reasonable
notice and hearing, that an employer has | 29 |
| failed to make timely payment of
any obligation accruing under | 30 |
| the preceding sentence, the employer shall,
in addition to all | 31 |
| other payments required by this Section, be liable for a
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| penalty equal to 20% of the overdue obligation or $2,500, | 33 |
| whichever is
greater, for each year or part thereof that | 34 |
| obligation is overdue.
All or part of such a penalty may be | 35 |
| waived by the Commission for
good cause shown.
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| The Chairman of the Illinois Workers' Compensation |
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| Commission shall, annually, furnish to the
Director of the | 2 |
| Department of Insurance a list of the amounts paid into the
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| Second Injury Fund and the Rate Adjustment Fund by each | 4 |
| insurance company
on behalf of their insured employers. The | 5 |
| Director shall verify to the
Chairman that the amounts paid by | 6 |
| each insurance company are accurate as
best as the Director can | 7 |
| determine from the records available to the
Director. The | 8 |
| Chairman shall verify that the amounts paid by each
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| self-insurer are accurate as best as the Chairman can determine | 10 |
| from
records available to the Chairman. The Chairman may | 11 |
| require each
self-insurer to provide information concerning | 12 |
| the total compensation
payments made upon which contributions | 13 |
| to the Second Injury Fund and the
Rate Adjustment Fund are | 14 |
| predicated and any additional information
establishing that | 15 |
| such payments have been made into these funds. Any
deficiencies | 16 |
| in payments noted by the Director or Chairman shall be subject
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| to the penalty provisions of this Act.
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| The State Treasurer, or his duly authorized | 19 |
| representative, shall be
named as a party to all proceedings in | 20 |
| all cases involving claim for the
loss of, or the permanent and | 21 |
| complete loss of the use of one eye, one
foot, one leg, one arm | 22 |
| or one hand.
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| The State Treasurer or his duly authorized agent shall have | 24 |
| the same
rights as any other party to the proceeding, including | 25 |
| the right to
petition for review of any award. The reasonable | 26 |
| expenses of
litigation, such as medical examinations, | 27 |
| testimony, and transcript of
evidence, incurred by the State | 28 |
| Treasurer or his duly authorized
representative, shall be borne | 29 |
| by the Second Injury Fund.
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| If the award is not paid within 30 days after the date the | 31 |
| award has
become final, the Commission shall proceed to take | 32 |
| judgment thereon in
its own name as is provided for other | 33 |
| awards by paragraph (g) of Section
19 of this Act and take the | 34 |
| necessary steps to collect the award.
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| Any person, corporation or organization who has paid or | 36 |
| become liable
for the payment of burial expenses of the |
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| deceased employee may in his
or its own name institute | 2 |
| proceedings before the Commission for the
collection thereof.
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| For the purpose of administration, receipts and | 4 |
| disbursements, the
Special Fund provided for in paragraph (f) | 5 |
| of this Section shall be
administered jointly with the Special | 6 |
| Fund provided for in Section 7,
paragraph (f) of the Workers' | 7 |
| Occupational Diseases Act.
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| (g) All compensation, except for burial expenses provided | 9 |
| in this
Section to be paid in case accident results in death, | 10 |
| shall be paid in
installments equal to the percentage of the | 11 |
| average earnings as provided
for in Section 8, paragraph (b) of | 12 |
| this Act, at the same intervals at
which the wages or earnings | 13 |
| of the employees were paid. If this is not
feasible, then the | 14 |
| installments shall be paid weekly. Such compensation
may be | 15 |
| paid in a lump sum upon petition as provided in Section 9 of | 16 |
| this
Act. However, in addition to the benefits provided by | 17 |
| Section 9 of this
Act where compensation for death is payable | 18 |
| to the deceased's widow,
widower or to the deceased's widow, | 19 |
| widower and one or more children,
and where a partial lump sum | 20 |
| is applied for by such beneficiary or
beneficiaries within 18 | 21 |
| months after the deceased's death, the
Commission may, in its | 22 |
| discretion, grant a partial lump sum of not to
exceed 100 weeks | 23 |
| of the compensation capitalized at their present value
upon the | 24 |
| basis of interest calculated at 3% per annum with annual rests,
| 25 |
| upon a showing that such partial lump sum is for the best | 26 |
| interest of
such beneficiary or beneficiaries.
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| (h) In case the injured employee is under 16 years of age | 28 |
| at the
time of the accident and is illegally employed, the | 29 |
| amount of
compensation payable under paragraphs (a), (b), (c), | 30 |
| (d) and (f) of this
Section shall be increased 50%.
| 31 |
| Nothing herein contained repeals or amends the provisions | 32 |
| of the Child
Labor Law relating to the employment of minors | 33 |
| under the age of 16 years.
| 34 |
| However, where an employer has on file an employment | 35 |
| certificate
issued pursuant to the Child Labor Law or work | 36 |
| permit issued pursuant
to the Federal Fair Labor Standards Act, |
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| as amended, or a birth
certificate properly and duly issued, | 2 |
| such certificate, permit or birth
certificate is conclusive | 3 |
| evidence as to the age of the injured minor
employee for the | 4 |
| purposes of this Section only.
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| (i) Whenever the dependents of a deceased employee are | 6 |
| aliens not
residing in the United States, Mexico or Canada, the | 7 |
| amount of
compensation payable is limited to the beneficiaries | 8 |
| described in
paragraphs (a), (b) and (c) of this Section and is | 9 |
| 50% of the
compensation provided in paragraphs (a), (b) and (c) | 10 |
| of this Section,
except as otherwise provided by treaty.
| 11 |
| In a case where any of the persons who would be entitled to
| 12 |
| compensation is living at any place outside of the United | 13 |
| States, then
payment shall be made to the personal | 14 |
| representative of the deceased
employee. The distribution by | 15 |
| such personal representative to the
persons entitled shall be | 16 |
| made to such persons and in such manner as the
Commission | 17 |
| orders.
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| (Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05.)
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| (820 ILCS 305/8) (from Ch. 48, par. 138.8)
| 20 |
| Sec. 8. The amount of compensation which shall be paid to | 21 |
| the
employee for an accidental injury not resulting in death | 22 |
| is:
| 23 |
| (a) The employer shall provide and pay the negotiated rate, | 24 |
| if applicable, or the lesser of the health care provider's | 25 |
| actual charges or according to a fee schedule, subject to | 26 |
| Section 8.2, in effect at the time the service was rendered for | 27 |
| all the necessary first
aid, medical and surgical services, and | 28 |
| all necessary medical, surgical
and hospital services | 29 |
| thereafter incurred, limited, however, to that
which is | 30 |
| reasonably required to cure or relieve from the effects of the
| 31 |
| accidental injury. If the employer does not dispute payment of | 32 |
| first aid, medical, surgical,
and hospital services, the | 33 |
| employer shall make such payment to the provider on behalf of | 34 |
| the employee. The employer shall also pay for treatment,
| 35 |
| instruction and training necessary for the physical, mental and
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| vocational rehabilitation of the employee, including all | 2 |
| maintenance
costs and expenses incidental thereto. If as a | 3 |
| result of the injury the
employee is unable to be | 4 |
| self-sufficient the employer shall further pay
for such | 5 |
| maintenance or institutional care as shall be required.
| 6 |
| The employee may at any time elect to secure his own | 7 |
| physician,
surgeon and hospital services at the employer's | 8 |
| expense, or,
| 9 |
| Upon agreement between the employer and the employees, or | 10 |
| the employees'
exclusive representative, and subject to the | 11 |
| approval of the Illinois Workers' Compensation
Commission, the | 12 |
| employer shall maintain a list of physicians, to be
known as a | 13 |
| Panel of Physicians, who are accessible to the employees.
The | 14 |
| employer shall post this list in a place or places easily | 15 |
| accessible
to his employees. The employee shall have the right | 16 |
| to make an
alternative choice of physician from such Panel if | 17 |
| he is not satisfied
with the physician first selected. If, due | 18 |
| to the nature of the injury
or its occurrence away from the | 19 |
| employer's place of business, the
employee is unable to make a | 20 |
| selection from the Panel, the selection
process from the Panel | 21 |
| shall not apply. The physician selected from the
Panel may | 22 |
| arrange for any consultation, referral or other specialized
| 23 |
| medical services outside the Panel at the employer's expense. | 24 |
| Provided
that, in the event the Commission shall find that a | 25 |
| doctor selected by
the employee is rendering improper or | 26 |
| inadequate care, the Commission
may order the employee to | 27 |
| select another doctor certified or qualified
in the medical | 28 |
| field for which treatment is required. If the employee
refuses | 29 |
| to make such change the Commission may relieve the employer of
| 30 |
| his obligation to pay the doctor's charges from the date of | 31 |
| refusal to
the date of compliance.
| 32 |
| Any vocational rehabilitation counselors who provide | 33 |
| service under this Act shall have
appropriate certifications | 34 |
| which designate the counselor as qualified to render
opinions | 35 |
| relating to vocational rehabilitation. Vocational | 36 |
| rehabilitation
may include, but is not limited to, counseling |
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| for job searches, supervising
a job search program, and | 2 |
| vocational retraining including education at an
accredited | 3 |
| learning institution. The employee or employer may petition to | 4 |
| the Commission to decide disputes relating to vocational | 5 |
| rehabilitation and the Commission shall resolve any such | 6 |
| dispute, including payment of the vocational rehabilitation | 7 |
| program by the employer. | 8 |
| The maintenance benefit shall not be less than the | 9 |
| temporary total disability
rate determined for the employee. In | 10 |
| addition, maintenance shall include costs
and expenses | 11 |
| incidental to the vocational rehabilitation program. | 12 |
| When the employee is working light duty on a part-time | 13 |
| basis or full-time
basis
and earns less than he or she would be | 14 |
| earning if employed in the full capacity
of the job or jobs, | 15 |
| then the employee shall be entitled to temporary partial | 16 |
| disability benefits. Temporary partial disability benefits | 17 |
| shall be
equal to two-thirds of
the difference between the | 18 |
| average amount that the employee would be able to
earn in the | 19 |
| full performance of his or her duties in the occupation in | 20 |
| which he
or she was engaged at the time of accident and the net | 21 |
| amount which he or she
is
earning in the modified job provided | 22 |
| to the employee by the employer or in any other job that the | 23 |
| employee is working. | 24 |
| Every hospital, physician, surgeon or other person | 25 |
| rendering
treatment or services in accordance with the | 26 |
| provisions of this Section
shall upon written request furnish | 27 |
| full and complete reports thereof to,
and permit their records | 28 |
| to be copied by, the employer, the employee or
his dependents, | 29 |
| as the case may be, or any other party to any proceeding
for | 30 |
| compensation before the Commission, or their attorneys.
| 31 |
| Notwithstanding the foregoing, the employer's liability to | 32 |
| pay for such
medical services selected by the employee shall be | 33 |
| limited to:
| 34 |
| (1) all first aid and emergency treatment; plus
| 35 |
| (2) all medical, surgical and hospital services | 36 |
| provided by the
physician, surgeon or hospital initially |
|
|
|
SB1283 Enrolled |
- 13 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| chosen by the employee or by any
other physician, | 2 |
| consultant, expert, institution or other provider of
| 3 |
| services recommended by said initial service provider or | 4 |
| any subsequent
provider of medical services in the chain of | 5 |
| referrals from said
initial service provider; plus
| 6 |
| (3) all medical, surgical and hospital services | 7 |
| provided by any second
physician, surgeon or hospital | 8 |
| subsequently chosen by the employee or by
any other | 9 |
| physician, consultant, expert, institution or other | 10 |
| provider of
services recommended by said second service | 11 |
| provider or any subsequent provider
of medical services in | 12 |
| the chain of referrals
from said second service provider. | 13 |
| Thereafter the employer shall select
and pay for all | 14 |
| necessary medical, surgical and hospital treatment and the
| 15 |
| employee may not select a provider of medical services at | 16 |
| the employer's
expense unless the employer agrees to such | 17 |
| selection. At any time the employee
may obtain any medical | 18 |
| treatment he desires at his own expense. This paragraph
| 19 |
| shall not affect the duty to pay for rehabilitation | 20 |
| referred to above.
| 21 |
| When an employer and employee so agree in writing, nothing | 22 |
| in this
Act prevents an employee whose injury or disability has | 23 |
| been established
under this Act, from relying in good faith, on | 24 |
| treatment by prayer or
spiritual means alone, in accordance | 25 |
| with the tenets and practice of a
recognized church or | 26 |
| religious denomination, by a duly accredited
practitioner | 27 |
| thereof, and having nursing services appropriate therewith,
| 28 |
| without suffering loss or diminution of the compensation | 29 |
| benefits under
this Act. However, the employee shall submit to | 30 |
| all physical
examinations required by this Act. The cost of | 31 |
| such treatment and
nursing care shall be paid by the employee | 32 |
| unless the employer agrees to
make such payment.
| 33 |
| Where the accidental injury results in the amputation of an | 34 |
| arm,
hand, leg or foot, or the enucleation of an eye, or the | 35 |
| loss of any of
the natural teeth, the employer shall furnish an | 36 |
| artificial of any such
members lost or damaged in accidental |
|
|
|
SB1283 Enrolled |
- 14 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| injury arising out of and in the
course of employment, and | 2 |
| shall also furnish the necessary braces in all
proper and | 3 |
| necessary cases. In cases of the loss of a member or members
by | 4 |
| amputation, the employer shall, whenever necessary, maintain | 5 |
| in good
repair, refit or replace the artificial limbs during | 6 |
| the lifetime of the
employee. Where the accidental injury | 7 |
| accompanied by physical injury
results in damage to a denture, | 8 |
| eye glasses or contact eye lenses, or
where the accidental | 9 |
| injury results in damage to an artificial member,
the employer | 10 |
| shall replace or repair such denture, glasses, lenses, or
| 11 |
| artificial member.
| 12 |
| The furnishing by the employer of any such services or | 13 |
| appliances is
not an admission of liability on the part of the | 14 |
| employer to pay
compensation.
| 15 |
| The furnishing of any such services or appliances or the | 16 |
| servicing
thereof by the employer is not the payment of | 17 |
| compensation.
| 18 |
| (b) If the period of temporary total incapacity for work | 19 |
| lasts more
than 3 working days, weekly compensation as | 20 |
| hereinafter provided shall
be paid beginning on the 4th day of | 21 |
| such temporary total incapacity and
continuing as long as the | 22 |
| total temporary incapacity lasts. In cases
where the temporary | 23 |
| total incapacity for work continues for a period of
14 days or | 24 |
| more from the day of the accident compensation shall commence
| 25 |
| on the day after the accident.
| 26 |
| 1. The compensation rate for temporary total | 27 |
| incapacity under this
paragraph (b) of this Section shall | 28 |
| be equal to 66 2/3% of the
employee's average weekly wage | 29 |
| computed in accordance with Section 10,
provided that it | 30 |
| shall be not less than 66 2/3% of the sum of the Federal | 31 |
| minimum wage under the Fair Labor
Standards Act, or the | 32 |
| Illinois minimum wage under the Minimum Wage Law,
whichever | 33 |
| is more, multiplied by 40 hours. This percentage rate shall | 34 |
| be
increased by 10% for each spouse and child, not to | 35 |
| exceed 100% of the total
minimum wage calculation,
| 36 |
| nor exceed the employee's average weekly wage computed in |
|
|
|
SB1283 Enrolled |
- 15 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| accordance
with the provisions of Section 10, whichever is | 2 |
| less.
| 3 |
| 2. The compensation rate in all cases other than for | 4 |
| temporary total
disability under this paragraph (b), and | 5 |
| other than for serious and
permanent disfigurement under | 6 |
| paragraph (c) and other than for permanent
partial | 7 |
| disability under subparagraph (2) of paragraph (d) or under
| 8 |
| paragraph (e), of this Section shall be equal to 66
2/3% of | 9 |
| the employee's average weekly wage computed in accordance | 10 |
| with
the provisions of Section 10, provided that it shall | 11 |
| be not less than
66 2/3% of the sum of the Federal minimum | 12 |
| wage under the Fair Labor Standards Act, or the Illinois | 13 |
| minimum wage under the Minimum Wage Law, whichever is more, | 14 |
| multiplied by 40 hours. This percentage rate shall be | 15 |
| increased by 10% for each spouse and child, not to exceed | 16 |
| 100% of the total minimum wage calculation,
| 17 |
| nor exceed the employee's average weekly wage computed in | 18 |
| accordance
with the provisions of Section 10, whichever is | 19 |
| less.
| 20 |
| 2.1. The compensation rate in all cases of serious and | 21 |
| permanent
disfigurement under paragraph (c) and of | 22 |
| permanent partial disability
under subparagraph (2) of | 23 |
| paragraph (d) or under paragraph (e) of this
Section shall | 24 |
| be equal to
60% of the employee's average
weekly wage | 25 |
| computed in accordance with
the provisions of Section 10, | 26 |
| provided that it shall be not less than
66 2/3% of the sum | 27 |
| of the Federal minimum wage under the Fair Labor Standards | 28 |
| Act, or the Illinois minimum wage under the Minimum Wage | 29 |
| Law, whichever is more, multiplied by 40 hours. This | 30 |
| percentage rate shall be increased by 10% for each spouse | 31 |
| and child, not to exceed 100% of the total minimum wage | 32 |
| calculation,
| 33 |
| nor exceed the employee's average weekly wage computed in | 34 |
| accordance
with the provisions of Section 10, whichever is | 35 |
| less.
| 36 |
| 3. As used in this Section the term "child" means a |
|
|
|
SB1283 Enrolled |
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LRB094 04940 WGH 34969 b |
|
| 1 |
| child of the
employee including any child legally adopted | 2 |
| before the accident or whom
at the time of the accident the | 3 |
| employee was under legal obligation to
support or to whom | 4 |
| the employee stood in loco parentis, and who at the
time of | 5 |
| the accident was under 18 years of age and not emancipated. | 6 |
| The
term "children" means the plural of "child".
| 7 |
| 4. All weekly compensation rates provided under | 8 |
| subparagraphs 1,
2 and 2.1 of this paragraph (b) of this | 9 |
| Section shall be subject to the
following limitations:
| 10 |
| The maximum weekly compensation rate from July 1, 1975, | 11 |
| except as
hereinafter provided, shall be 100% of the | 12 |
| State's average weekly wage in
covered industries under the | 13 |
| Unemployment Insurance Act, that being the
wage that most | 14 |
| closely approximates the State's average weekly wage.
| 15 |
| The maximum weekly compensation rate, for the period | 16 |
| July 1, 1984,
through June 30, 1987, except as hereinafter | 17 |
| provided, shall be $293.61.
Effective July 1, 1987 and on | 18 |
| July 1 of each year thereafter the maximum
weekly | 19 |
| compensation rate, except as hereinafter provided, shall | 20 |
| be
determined as follows: if during the preceding 12 month | 21 |
| period there shall
have been an increase in the State's | 22 |
| average weekly wage in covered
industries under the | 23 |
| Unemployment Insurance Act, the weekly compensation
rate | 24 |
| shall be proportionately increased by the same percentage | 25 |
| as the
percentage of increase in the State's average weekly | 26 |
| wage in covered
industries under the Unemployment | 27 |
| Insurance Act during such period.
| 28 |
| The maximum weekly compensation rate, for the period | 29 |
| January 1, 1981
through December 31, 1983, except as | 30 |
| hereinafter provided, shall be 100% of
the State's average | 31 |
| weekly wage in covered industries under the
Unemployment | 32 |
| Insurance Act in effect on January 1, 1981. Effective | 33 |
| January
1, 1984 and on January 1, of each year thereafter | 34 |
| the maximum weekly
compensation rate, except as | 35 |
| hereinafter provided, shall be determined as
follows: if | 36 |
| during the preceding 12 month period there shall have been |
|
|
|
SB1283 Enrolled |
- 17 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| an
increase in the State's average weekly wage in covered | 2 |
| industries under the
Unemployment Insurance Act, the | 3 |
| weekly compensation rate shall be
proportionately | 4 |
| increased by the same percentage as the percentage of
| 5 |
| increase in the State's average weekly wage in covered | 6 |
| industries under the
Unemployment Insurance Act during | 7 |
| such period.
| 8 |
| From July 1, 1977 and thereafter such maximum weekly | 9 |
| compensation
rate in death cases under Section 7, and | 10 |
| permanent total disability
cases under paragraph (f) or | 11 |
| subparagraph 18 of paragraph (3) of this
Section and for | 12 |
| temporary total disability under paragraph (b) of this
| 13 |
| Section and for amputation of a member or enucleation of an | 14 |
| eye under
paragraph (e) of this Section shall be increased | 15 |
| to 133-1/3% of the
State's average weekly wage in covered | 16 |
| industries under the
Unemployment Insurance Act.
| 17 |
| For injuries occurring on or after February 1, 2006, | 18 |
| the maximum weekly benefit under paragraph (d)1 of this | 19 |
| Section shall be 100% of the State's average weekly wage in | 20 |
| covered industries under the Unemployment Insurance Act.
| 21 |
| 4.1. Any provision herein to the contrary | 22 |
| notwithstanding, the
weekly compensation rate for | 23 |
| compensation payments under subparagraph 18
of paragraph | 24 |
| (e) of this Section and under paragraph (f) of this
Section | 25 |
| and under paragraph (a) of Section 7 and for amputation of | 26 |
| a member or enucleation of an eye under paragraph (e) of | 27 |
| this Section, shall in no event be less
than 50% of the | 28 |
| State's average weekly wage in covered industries under
the | 29 |
| Unemployment Insurance Act.
| 30 |
| 4.2. Any provision to the contrary notwithstanding, | 31 |
| the total
compensation payable under Section 7 shall not | 32 |
| exceed the greater of $500,000
or 25
years.
| 33 |
| 5. For the purpose of this Section this State's average | 34 |
| weekly wage
in covered industries under the Unemployment | 35 |
| Insurance Act on
July 1, 1975 is hereby fixed at $228.16 | 36 |
| per
week and the computation of compensation rates shall be |
|
|
|
SB1283 Enrolled |
- 18 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| based on the
aforesaid average weekly wage until modified | 2 |
| as hereinafter provided.
| 3 |
| 6. The Department of Employment Security of the State | 4 |
| shall
on or before the first day of December, 1977, and on | 5 |
| or before the first
day of June, 1978, and on the first day | 6 |
| of each December and June of each
year thereafter, publish | 7 |
| the State's average weekly wage in covered
industries under | 8 |
| the Unemployment Insurance Act and the Illinois Workers' | 9 |
| Compensation
Commission shall on the 15th day of January, | 10 |
| 1978 and on the 15th day of
July, 1978 and on the 15th day | 11 |
| of each January and July of each year
thereafter, post and | 12 |
| publish the State's average weekly wage in covered
| 13 |
| industries under the Unemployment Insurance Act as last | 14 |
| determined and
published by the Department of Employment | 15 |
| Security. The amount when so
posted and published shall be | 16 |
| conclusive and shall be applicable as the
basis of | 17 |
| computation of compensation rates until the next posting | 18 |
| and
publication as aforesaid.
| 19 |
| 7. The payment of compensation by an employer or his | 20 |
| insurance
carrier to an injured employee shall not | 21 |
| constitute an admission of the
employer's liability to pay | 22 |
| compensation.
| 23 |
| (c) For any serious and permanent disfigurement to the | 24 |
| hand, head,
face, neck, arm, leg below the knee or the chest | 25 |
| above the axillary
line, the employee is entitled to | 26 |
| compensation for such disfigurement,
the amount determined by | 27 |
| agreement at any time or by arbitration under
this Act, at a | 28 |
| hearing not less than 6 months after the date of the
accidental | 29 |
| injury, which amount shall not exceed 150 weeks (if the | 30 |
| accidental injury occurs on or after the effective date of this | 31 |
| amendatory Act of the 94th General Assembly
but before February
| 32 |
| 1, 2006) or 162
weeks (if the accidental injury occurs on or | 33 |
| after February
1, 2006) at the
applicable rate provided in | 34 |
| subparagraph 2.1 of paragraph (b) of this Section.
| 35 |
| No compensation is payable under this paragraph where | 36 |
| compensation is
payable under paragraphs (d), (e) or (f) of |
|
|
|
SB1283 Enrolled |
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LRB094 04940 WGH 34969 b |
|
| 1 |
| this Section.
| 2 |
| A duly appointed member of a fire department in a city, the | 3 |
| population of
which exceeds 200,000 according to the last | 4 |
| federal or State census, is
eligible for compensation under | 5 |
| this paragraph only where such serious and
permanent | 6 |
| disfigurement results from burns.
| 7 |
| (d) 1. If, after the accidental injury has been sustained, | 8 |
| the
employee as a result thereof becomes partially | 9 |
| incapacitated from
pursuing his usual and customary line of | 10 |
| employment, he shall, except in
cases compensated under the | 11 |
| specific schedule set forth in paragraph (e)
of this Section, | 12 |
| receive compensation for the duration of his
disability, | 13 |
| subject to the limitations as to maximum amounts fixed in
| 14 |
| paragraph (b) of this Section, equal to 66-2/3% of the | 15 |
| difference
between the average amount which he would be able to | 16 |
| earn in the full
performance of his duties in the occupation in | 17 |
| which he was engaged at
the time of the accident and the | 18 |
| average amount which he is earning or
is able to earn in some | 19 |
| suitable employment or business after the accident.
| 20 |
| 2. If, as a result of the accident, the employee sustains | 21 |
| serious
and permanent injuries not covered by paragraphs (c) | 22 |
| and (e) of this
Section or having sustained injuries covered by | 23 |
| the aforesaid
paragraphs (c) and (e), he shall have sustained | 24 |
| in addition thereto
other injuries which injuries do not | 25 |
| incapacitate him from pursuing the
duties of his employment but | 26 |
| which would disable him from pursuing other
suitable | 27 |
| occupations, or which have otherwise resulted in physical
| 28 |
| impairment; or if such injuries partially incapacitate him from | 29 |
| pursuing
the duties of his usual and customary line of | 30 |
| employment but do not
result in an impairment of earning | 31 |
| capacity, or having resulted in an
impairment of earning | 32 |
| capacity, the employee elects to waive his right
to recover | 33 |
| under the foregoing subparagraph 1 of paragraph (d) of this
| 34 |
| Section then in any of the foregoing events, he shall receive | 35 |
| in
addition to compensation for temporary total disability | 36 |
| under paragraph
(b) of this Section, compensation at the rate |
|
|
|
SB1283 Enrolled |
- 20 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| provided in subparagraph 2.1
of paragraph (b) of this Section | 2 |
| for that percentage of 500 weeks that
the partial disability | 3 |
| resulting from the injuries covered by this
paragraph bears to | 4 |
| total disability. If the employee shall have
sustained a | 5 |
| fracture of one or more vertebra or fracture of the skull,
the | 6 |
| amount of compensation allowed under this Section shall be not | 7 |
| less
than 6 weeks for a fractured skull and 6 weeks for each | 8 |
| fractured
vertebra, and in the event the employee shall have | 9 |
| sustained a fracture
of any of the following facial bones: | 10 |
| nasal, lachrymal, vomer, zygoma,
maxilla, palatine or | 11 |
| mandible, the amount of compensation allowed under
this Section | 12 |
| shall be not less than 2 weeks for each such fractured
bone, | 13 |
| and for a fracture of each transverse process not less than 3
| 14 |
| weeks. In the event such injuries shall result in the loss of a | 15 |
| kidney,
spleen or lung, the amount of compensation allowed | 16 |
| under this Section
shall be not less than 10 weeks for each | 17 |
| such organ. Compensation
awarded under this subparagraph 2 | 18 |
| shall not take into consideration
injuries covered under | 19 |
| paragraphs (c) and (e) of this Section and the
compensation | 20 |
| provided in this paragraph shall not affect the employee's
| 21 |
| right to compensation payable under paragraphs (b), (c) and (e) | 22 |
| of this
Section for the disabilities therein covered.
| 23 |
| (e) For accidental injuries in the following schedule, the | 24 |
| employee
shall receive compensation for the period of temporary | 25 |
| total incapacity
for work resulting from such accidental | 26 |
| injury, under subparagraph 1 of
paragraph (b) of this Section, | 27 |
| and shall receive in addition thereto
compensation for a | 28 |
| further period for the specific loss herein
mentioned, but | 29 |
| shall not receive any compensation under any other
provisions | 30 |
| of this Act. The following listed amounts apply to either
the | 31 |
| loss of or the permanent and complete loss of use of the member
| 32 |
| specified, such compensation for the length of time as follows:
| 33 |
| 1. Thumb- | 34 |
| 70 weeks if the accidental injury occurs on or | 35 |
| after the effective date of this amendatory Act of the | 36 |
| 94th General Assembly
but before February
1, 2006.
|
|
|
|
SB1283 Enrolled |
- 21 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| 76
weeks if the accidental injury occurs on or | 2 |
| after February
1, 2006 .
| 3 |
| 2. First, or index finger- | 4 |
| 40 weeks if the accidental injury occurs on or | 5 |
| after the effective date of this amendatory Act of the | 6 |
| 94th General Assembly
but before February
1, 2006.
| 7 |
| 43
weeks if the accidental injury occurs on or | 8 |
| after February
1, 2006 .
| 9 |
| 3. Second, or middle finger- | 10 |
| 35 weeks if the accidental injury occurs on or | 11 |
| after the effective date of this amendatory Act of the | 12 |
| 94th General Assembly
but before February
1, 2006.
| 13 |
| 38
weeks if the accidental injury occurs on or | 14 |
| after February
1, 2006 .
| 15 |
| 4. Third, or ring finger- | 16 |
| 25 weeks if the accidental injury occurs on or | 17 |
| after the effective date of this amendatory Act of the | 18 |
| 94th General Assembly
but before February
1, 2006.
| 19 |
| 27
weeks if the accidental injury occurs on or | 20 |
| after February
1, 2006 .
| 21 |
| 5. Fourth, or little finger- | 22 |
| 20 weeks if the accidental injury occurs on or | 23 |
| after the effective date of this amendatory Act of the | 24 |
| 94th General Assembly
but before February
1, 2006.
| 25 |
| 22
weeks if the accidental injury occurs on or | 26 |
| after February
1, 2006 .
| 27 |
| 6. Great toe- | 28 |
| 35 weeks if the accidental injury occurs on or | 29 |
| after the effective date of this amendatory Act of the | 30 |
| 94th General Assembly
but before February
1, 2006.
| 31 |
| 38
weeks if the accidental injury occurs on or | 32 |
| after February
1, 2006 .
| 33 |
| 7. Each toe other than great toe- | 34 |
| 12 weeks if the accidental injury occurs on or | 35 |
| after the effective date of this amendatory Act of the | 36 |
| 94th General Assembly
but before February
1, 2006.
|
|
|
|
SB1283 Enrolled |
- 22 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| 13
weeks if the accidental injury occurs on or | 2 |
| after February
1, 2006 .
| 3 |
| 8. The loss of the first or distal phalanx of the thumb | 4 |
| or of any
finger or toe shall be considered to be equal to | 5 |
| the loss of one-half of
such thumb, finger or toe and the | 6 |
| compensation payable shall be one-half
of the amount above | 7 |
| specified. The loss of more than one phalanx shall
be | 8 |
| considered as the loss of the entire thumb, finger or toe. | 9 |
| In no
case shall the amount received for more than one | 10 |
| finger exceed the
amount provided in this schedule for the | 11 |
| loss of a hand.
| 12 |
| 9. Hand- | 13 |
| 190 weeks if the accidental injury occurs on or | 14 |
| after the effective date of this amendatory Act of the | 15 |
| 94th General Assembly
but before February
1, 2006.
| 16 |
| 205
weeks if the accidental injury occurs on or | 17 |
| after February
1, 2006 . | 18 |
| The loss of 2 or more digits, or one or more
phalanges | 19 |
| of 2 or more digits, of a hand may be compensated on the | 20 |
| basis
of partial loss of use of a hand, provided, further, | 21 |
| that the loss of 4
digits, or the loss of use of 4 digits, | 22 |
| in the same hand shall
constitute the complete loss of a | 23 |
| hand.
| 24 |
| 10. Arm- | 25 |
| 235 weeks if the accidental injury occurs on or | 26 |
| after the effective date of this amendatory Act of the | 27 |
| 94th General Assembly
but before February
1, 2006.
| 28 |
| 253
weeks if the accidental injury occurs on or | 29 |
| after February
1, 2006 . | 30 |
| Where an accidental injury results in the
amputation of | 31 |
| an arm below the elbow, such injury shall be compensated
as | 32 |
| a loss of an arm. Where an accidental injury results in the
| 33 |
| amputation of an arm above the elbow, compensation for an | 34 |
| additional 15 weeks (if the accidental injury occurs on or | 35 |
| after the effective date of this amendatory Act of the 94th | 36 |
| General Assembly
but before February
1, 2006) or an |
|
|
|
SB1283 Enrolled |
- 23 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| additional 17
weeks (if the accidental injury occurs on or | 2 |
| after February
1, 2006) shall be paid, except where the | 3 |
| accidental injury results in the
amputation of an arm at | 4 |
| the shoulder joint, or so close to shoulder
joint that an | 5 |
| artificial arm cannot be used, or results in the
| 6 |
| disarticulation of an arm at the shoulder joint, in which | 7 |
| case
compensation for an additional 65 weeks (if the | 8 |
| accidental injury occurs on or after the effective date of | 9 |
| this amendatory Act of the 94th General Assembly
but before | 10 |
| February
1, 2006) or an additional 70
weeks (if the | 11 |
| accidental injury occurs on or after February
1, 2006)
| 12 |
| shall be paid.
| 13 |
| 11. Foot- | 14 |
| 155 weeks if the accidental injury occurs on or | 15 |
| after the effective date of this amendatory Act of the | 16 |
| 94th General Assembly
but before February
1, 2006.
| 17 |
| 167
weeks if the accidental injury occurs on or | 18 |
| after February
1, 2006 .
| 19 |
| 12. Leg- | 20 |
| 200 weeks if the accidental injury occurs on or | 21 |
| after the effective date of this amendatory Act of the | 22 |
| 94th General Assembly
but before February
1, 2006.
| 23 |
| 215
weeks if the accidental injury occurs on or | 24 |
| after February
1, 2006 . | 25 |
| Where an accidental injury results in the
amputation of | 26 |
| a leg below the knee, such injury shall be compensated as
| 27 |
| loss of a leg. Where an accidental injury results in the | 28 |
| amputation of a
leg above the knee, compensation for an | 29 |
| additional 25 weeks (if the accidental injury occurs on or | 30 |
| after the effective date of this amendatory Act of the 94th | 31 |
| General Assembly
but before February
1, 2006) or an | 32 |
| additional 27
weeks (if the accidental injury occurs on or | 33 |
| after February
1, 2006) shall be
paid, except where the | 34 |
| accidental injury results in the amputation of a
leg at the | 35 |
| hip joint, or so close to the hip joint that an artificial
| 36 |
| leg cannot be used, or results in the disarticulation of a |
|
|
|
SB1283 Enrolled |
- 24 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| leg at the
hip joint, in which case compensation for an | 2 |
| additional 75 weeks (if the accidental injury occurs on or | 3 |
| after the effective date of this amendatory Act of the 94th | 4 |
| General Assembly
but before February
1, 2006) or an | 5 |
| additional 81
weeks (if the accidental injury occurs on or | 6 |
| after February
1, 2006) shall
be paid.
| 7 |
| 13. Eye- | 8 |
| 150 weeks if the accidental injury occurs on or | 9 |
| after the effective date of this amendatory Act of the | 10 |
| 94th General Assembly
but before February
1, 2006.
| 11 |
| 162
weeks if the accidental injury occurs on or | 12 |
| after February
1, 2006 . | 13 |
| Where an accidental injury results in the
enucleation | 14 |
| of an eye, compensation for an additional 10 weeks (if the | 15 |
| accidental injury occurs on or after the effective date of | 16 |
| this amendatory Act of the 94th General Assembly
but before | 17 |
| February
1, 2006) or an additional 11
weeks (if the | 18 |
| accidental injury occurs on or after February
1, 2006)
| 19 |
| shall be
paid.
| 20 |
| 14. Loss of hearing of one ear- | 21 |
| 50 weeks if the accidental injury occurs on or | 22 |
| after the effective date of this amendatory Act of the | 23 |
| 94th General Assembly
but before February
1, 2006.
| 24 |
| 54
weeks if the accidental injury occurs on or | 25 |
| after February
1, 2006. ;
| 26 |
| Total
total and permanent loss of
hearing of both ears- | 27 |
| 200 weeks if the accidental injury occurs on or | 28 |
| after the effective date of this amendatory Act of the | 29 |
| 94th General Assembly
but before February
1, 2006. | 30 |
| 215
weeks if the accidental injury occurs on or | 31 |
| after February
1, 2006 .
| 32 |
| 15. Testicle- | 33 |
| 50 weeks if the accidental injury occurs on or | 34 |
| after the effective date of this amendatory Act of the | 35 |
| 94th General Assembly
but before February
1, 2006.
| 36 |
| 54
weeks if the accidental injury occurs on or |
|
|
|
SB1283 Enrolled |
- 25 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| after February
1, 2006. ;
| 2 |
| Both
both testicles- | 3 |
| 150 weeks if the accidental injury occurs on or | 4 |
| after the effective date of this amendatory Act of the | 5 |
| 94th General Assembly
but before February
1, 2006.
| 6 |
| 162
weeks if the accidental injury occurs on or | 7 |
| after February
1, 2006 .
| 8 |
| 16. For the permanent partial loss of use of a member | 9 |
| or sight of an
eye, or hearing of an ear, compensation | 10 |
| during that proportion of the
number of weeks in the | 11 |
| foregoing schedule provided for the loss of such
member or | 12 |
| sight of an eye, or hearing of an ear, which the partial | 13 |
| loss
of use thereof bears to the total loss of use of such | 14 |
| member, or sight
of eye, or hearing of an ear.
| 15 |
| (a) Loss of hearing for compensation purposes | 16 |
| shall be
confined to the frequencies of 1,000, 2,000 | 17 |
| and 3,000 cycles per second.
Loss of hearing ability | 18 |
| for frequency tones above 3,000 cycles per second
are | 19 |
| not to be considered as constituting disability for | 20 |
| hearing.
| 21 |
| (b) The percent of hearing loss, for purposes of | 22 |
| the
determination of compensation claims for | 23 |
| occupational deafness,
shall be calculated as the | 24 |
| average in decibels for the thresholds
of hearing for | 25 |
| the frequencies of 1,000, 2,000 and 3,000 cycles per | 26 |
| second.
Pure tone air conduction audiometric | 27 |
| instruments, approved by
nationally recognized | 28 |
| authorities in this field, shall be used for measuring
| 29 |
| hearing loss. If the losses of hearing average 30 | 30 |
| decibels or less in the
3 frequencies, such losses of | 31 |
| hearing shall not then constitute any
compensable | 32 |
| hearing disability. If the losses of hearing average 85
| 33 |
| decibels or more in the 3 frequencies, then the same | 34 |
| shall constitute and
be total or 100% compensable | 35 |
| hearing loss.
| 36 |
| (c) In measuring hearing impairment, the lowest |
|
|
|
SB1283 Enrolled |
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LRB094 04940 WGH 34969 b |
|
| 1 |
| measured
losses in each of the 3 frequencies shall be | 2 |
| added together and
divided by 3 to determine the | 3 |
| average decibel loss. For every decibel
of loss | 4 |
| exceeding 30 decibels an allowance of 1.82% shall be | 5 |
| made up to
the maximum of 100% which is reached at 85 | 6 |
| decibels.
| 7 |
| (d) If a hearing loss is established to have | 8 |
| existed on July 1, 1975 by
audiometric testing the | 9 |
| employer shall not be liable for the previous loss
so | 10 |
| established nor shall he be liable for any loss for | 11 |
| which compensation
has been paid or awarded.
| 12 |
| (e) No consideration shall be given to the question | 13 |
| of
whether or not the ability of an employee to | 14 |
| understand speech
is improved by the use of a hearing | 15 |
| aid.
| 16 |
| (f) No claim for loss of hearing due to industrial | 17 |
| noise
shall be brought against an employer or allowed | 18 |
| unless the employee has
been exposed for a period of | 19 |
| time sufficient to cause permanent impairment
to noise | 20 |
| levels in excess of the following:
|
|
21 | | Sound Level DBA |
|
|
22 | | Slow Response |
Hours Per Day |
|
23 | | 90 |
8 |
|
24 | | 92 |
6 |
|
25 | | 95 |
4 |
|
26 | | 97 |
3 |
|
27 | | 100 |
2 |
|
28 | | 102 |
1-1/2 |
|
29 | | 105 |
1 |
|
30 | | 110 |
1/2 |
|
31 | | 115 |
1/4 |
|
32 |
| This subparagraph (f) shall not be applied in cases of | 33 |
| hearing loss
resulting from trauma or explosion.
| 34 |
| 17. In computing the compensation to be paid to any | 35 |
| employee who,
before the accident for which he claims | 36 |
| compensation, had before that
time sustained an injury |
|
|
|
SB1283 Enrolled |
- 27 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| resulting in the loss by amputation or partial
loss by | 2 |
| amputation of any member, including hand, arm, thumb or | 3 |
| fingers,
leg, foot or any toes, such loss or partial loss | 4 |
| of any such member
shall be deducted from any award made | 5 |
| for the subsequent injury. For
the permanent loss of use or | 6 |
| the permanent partial loss of use of any
such member or the | 7 |
| partial loss of sight of an eye, for which
compensation has | 8 |
| been paid, then such loss shall be taken into
consideration | 9 |
| and deducted from any award for the subsequent injury.
| 10 |
| 18. The specific case of loss of both hands, both arms, | 11 |
| or both
feet, or both legs, or both eyes, or of any two | 12 |
| thereof, or the
permanent and complete loss of the use | 13 |
| thereof, constitutes total and
permanent disability, to be | 14 |
| compensated according to the compensation
fixed by | 15 |
| paragraph (f) of this Section. These specific cases of | 16 |
| total
and permanent disability do not exclude other cases.
| 17 |
| Any employee who has previously suffered the loss or | 18 |
| permanent and
complete loss of the use of any of such | 19 |
| members, and in a subsequent
independent accident loses | 20 |
| another or suffers the permanent and complete
loss of the | 21 |
| use of any one of such members the employer for whom the
| 22 |
| injured employee is working at the time of the last | 23 |
| independent accident
is liable to pay compensation only for | 24 |
| the loss or permanent and
complete loss of the use of the | 25 |
| member occasioned by the last
independent accident.
| 26 |
| 19. In a case of specific loss and the subsequent death | 27 |
| of such
injured employee from other causes than such injury | 28 |
| leaving a widow,
widower, or dependents surviving before | 29 |
| payment or payment in full for
such injury, then the amount | 30 |
| due for such injury is payable to the widow
or widower and, | 31 |
| if there be no widow or widower, then to such
dependents, | 32 |
| in the proportion which such dependency bears to total
| 33 |
| dependency.
| 34 |
| Beginning July 1, 1980, and every 6 months thereafter, the | 35 |
| Commission
shall examine the Second Injury Fund and when, after | 36 |
| deducting all
advances or loans made to such Fund, the amount |
|
|
|
SB1283 Enrolled |
- 28 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| therein is $500,000
then the amount required to be paid by | 2 |
| employers pursuant to paragraph
(f) of Section 7 shall be | 3 |
| reduced by one-half. When the Second Injury Fund
reaches the | 4 |
| sum of $600,000 then the payments shall cease entirely.
| 5 |
| However, when the Second Injury Fund has been reduced to | 6 |
| $400,000, payment
of one-half of the amounts required by | 7 |
| paragraph (f) of Section 7
shall be resumed, in the manner | 8 |
| herein provided, and when the Second Injury
Fund has been | 9 |
| reduced to $300,000, payment of the full amounts required by
| 10 |
| paragraph (f) of Section 7 shall be resumed, in the manner | 11 |
| herein provided.
The Commission shall make the changes in | 12 |
| payment effective by
general order, and the changes in payment | 13 |
| become immediately effective
for all cases coming before the | 14 |
| Commission thereafter either by
settlement agreement or final | 15 |
| order, irrespective of the date of the
accidental injury.
| 16 |
| On August 1, 1996 and on February 1 and August 1 of each | 17 |
| subsequent year, the Commission
shall examine the special fund | 18 |
| designated as the "Rate
Adjustment Fund" and when, after | 19 |
| deducting all advances or loans made to
said fund, the amount | 20 |
| therein is $4,000,000, the amount required to be
paid by | 21 |
| employers pursuant to paragraph (f) of Section 7 shall be
| 22 |
| reduced by one-half. When the Rate Adjustment Fund reaches the | 23 |
| sum of
$5,000,000 the payment therein shall cease entirely. | 24 |
| However, when said
Rate Adjustment Fund has been reduced to | 25 |
| $3,000,000 the amounts required by
paragraph (f) of Section 7 | 26 |
| shall be resumed in the manner herein provided.
| 27 |
| (f) In case of complete disability, which renders the | 28 |
| employee
wholly and permanently incapable of work, or in the | 29 |
| specific case of
total and permanent disability as provided in | 30 |
| subparagraph 18 of
paragraph (e) of this Section, compensation | 31 |
| shall be payable at the rate
provided in subparagraph 2 of | 32 |
| paragraph (b) of this Section for life.
| 33 |
| An employee entitled to benefits under paragraph (f) of | 34 |
| this Section
shall also be entitled to receive from the Rate | 35 |
| Adjustment
Fund provided in paragraph (f) of Section 7 of the | 36 |
| supplementary benefits
provided in paragraph (g) of this |
|
|
|
SB1283 Enrolled |
- 29 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| Section 8.
| 2 |
| If any employee who receives an award under this paragraph | 3 |
| afterwards
returns to work or is able to do so, and earns or is | 4 |
| able to earn as
much as before the accident, payments under | 5 |
| such award shall cease. If
such employee returns to work, or is | 6 |
| able to do so, and earns or is able
to earn part but not as much | 7 |
| as before the accident, such award shall be
modified so as to | 8 |
| conform to an award under paragraph (d) of this
Section. If | 9 |
| such award is terminated or reduced under the provisions of
| 10 |
| this paragraph, such employees have the right at any time | 11 |
| within 30
months after the date of such termination or | 12 |
| reduction to file petition
with the Commission for the purpose | 13 |
| of determining whether any
disability exists as a result of the | 14 |
| original accidental injury and the
extent thereof.
| 15 |
| Disability as enumerated in subdivision 18, paragraph (e) | 16 |
| of this
Section is considered complete disability.
| 17 |
| If an employee who had previously incurred loss or the | 18 |
| permanent and
complete loss of use of one member, through the | 19 |
| loss or the permanent
and complete loss of the use of one hand, | 20 |
| one arm, one foot, one leg, or
one eye, incurs permanent and | 21 |
| complete disability through the loss or
the permanent and | 22 |
| complete loss of the use of another member, he shall
receive, | 23 |
| in addition to the compensation payable by the employer and
| 24 |
| after such payments have ceased, an amount from the Second | 25 |
| Injury Fund
provided for in paragraph (f) of Section 7, which, | 26 |
| together with the
compensation payable from the employer in | 27 |
| whose employ he was when the
last accidental injury was | 28 |
| incurred, will equal the amount payable for
permanent and | 29 |
| complete disability as provided in this paragraph of this
| 30 |
| Section.
| 31 |
| The custodian of the Second Injury Fund provided for in | 32 |
| paragraph (f)
of Section 7 shall be joined with the employer as | 33 |
| a party respondent in
the application for adjustment of claim. | 34 |
| The application for adjustment
of claim shall state briefly and | 35 |
| in general terms the approximate time
and place and manner of | 36 |
| the loss of the first member.
|
|
|
|
SB1283 Enrolled |
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LRB094 04940 WGH 34969 b |
|
| 1 |
| In its award the Commission or the Arbitrator shall | 2 |
| specifically find
the amount the injured employee shall be | 3 |
| weekly paid, the number of
weeks compensation which shall be | 4 |
| paid by the employer, the date upon
which payments begin out of | 5 |
| the Second Injury Fund provided for in
paragraph (f) of Section | 6 |
| 7 of this Act, the length of time the weekly
payments continue, | 7 |
| the date upon which the pension payments commence and
the | 8 |
| monthly amount of the payments. The Commission shall 30 days | 9 |
| after
the date upon which payments out of the Second Injury | 10 |
| Fund have begun as
provided in the award, and every month | 11 |
| thereafter, prepare and submit to
the State Comptroller a | 12 |
| voucher for payment for all compensation accrued
to that date | 13 |
| at the rate fixed by the Commission. The State Comptroller
| 14 |
| shall draw a warrant to the injured employee along with a | 15 |
| receipt to be
executed by the injured employee and returned to | 16 |
| the Commission. The
endorsed warrant and receipt is a full and | 17 |
| complete acquittance to the
Commission for the payment out of | 18 |
| the Second Injury Fund. No other
appropriation or warrant is | 19 |
| necessary for payment out of the Second
Injury Fund. The Second | 20 |
| Injury Fund is appropriated for the purpose of
making payments | 21 |
| according to the terms of the awards.
| 22 |
| As of July 1, 1980 to July 1, 1982, all claims against and | 23 |
| obligations
of the Second Injury Fund shall become claims | 24 |
| against and obligations of
the Rate Adjustment Fund to the | 25 |
| extent there is insufficient money in the
Second Injury Fund to | 26 |
| pay such claims and obligations. In that case, all
references | 27 |
| to "Second Injury Fund" in this Section shall also include the
| 28 |
| Rate Adjustment Fund.
| 29 |
| (g) Every award for permanent total disability entered by | 30 |
| the
Commission on and after July 1, 1965 under which | 31 |
| compensation payments
shall become due and payable after the | 32 |
| effective date of this amendatory
Act, and every award for | 33 |
| death benefits or permanent total disability
entered by the | 34 |
| Commission on and after the effective date of this
amendatory | 35 |
| Act shall be subject to annual adjustments as to the amount
of | 36 |
| the compensation rate therein provided. Such adjustments shall |
|
|
|
SB1283 Enrolled |
- 31 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| first
be made on July 15, 1977, and all awards made and entered | 2 |
| prior to July
1, 1975 and on July 15 of each year
thereafter. | 3 |
| In all other cases such adjustment shall be made on July 15
of | 4 |
| the second year next following the date of the entry of the | 5 |
| award and
shall further be made on July 15 annually thereafter. | 6 |
| If during the
intervening period from the date of the entry of | 7 |
| the award, or the last
periodic adjustment, there shall have | 8 |
| been an increase in the State's
average weekly wage in covered | 9 |
| industries under the Unemployment
Insurance Act, the weekly | 10 |
| compensation rate shall be proportionately
increased by the | 11 |
| same percentage as the percentage of increase in the
State's | 12 |
| average weekly wage in covered industries under the
| 13 |
| Unemployment Insurance Act. The increase in the compensation | 14 |
| rate
under this paragraph shall in no event bring the total | 15 |
| compensation rate
to an amount greater than the prevailing | 16 |
| maximum rate at the time that the annual adjustment is made. | 17 |
| Such increase
shall be paid in the same manner as herein | 18 |
| provided for payments under
the Second Injury Fund to the | 19 |
| injured employee, or his dependents, as
the case may be, out of | 20 |
| the Rate Adjustment Fund provided
in paragraph (f) of Section 7 | 21 |
| of this Act. Payments shall be made at
the same intervals as | 22 |
| provided in the award or, at the option of the
Commission, may | 23 |
| be made in quarterly payment on the 15th day of January,
April, | 24 |
| July and October of each year. In the event of a decrease in
| 25 |
| such average weekly wage there shall be no change in the then | 26 |
| existing
compensation rate. The within paragraph shall not | 27 |
| apply to cases where
there is disputed liability and in which a | 28 |
| compromise lump sum settlement
between the employer and the | 29 |
| injured employee, or his dependents, as the
case may be, has | 30 |
| been duly approved by the Illinois Workers' Compensation
| 31 |
| Commission.
| 32 |
| Provided, that in cases of awards entered by the Commission | 33 |
| for
injuries occurring before July 1, 1975, the increases in | 34 |
| the
compensation rate adjusted under the foregoing provision of | 35 |
| this
paragraph (g) shall be limited to increases in the State's | 36 |
| average
weekly wage in covered industries under the |
|
|
|
SB1283 Enrolled |
- 32 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| Unemployment Insurance Act
occurring after July 1, 1975.
| 2 |
| For every accident occurring on or after July 20, 2005 but | 3 |
| before the effective date of this amendatory Act of the 94th | 4 |
| General Assembly (Senate Bill 1283 of the 94th General | 5 |
| Assembly)
after the effective date of this amendatory Act of | 6 |
| the 94th General Assembly , the annual adjustments to the | 7 |
| compensation rate in awards for death benefits or permanent | 8 |
| total disability, as provided in this Act, shall be paid by the | 9 |
| employer. The adjustment shall be made by the employer on July | 10 |
| 15 of the second year next following the date of the entry of | 11 |
| the award and shall further be made on July 15 annually | 12 |
| thereafter. If during the intervening period from the date of | 13 |
| the entry of the award, or the last periodic adjustment, there | 14 |
| shall have been an increase in the State's average weekly wage | 15 |
| in covered industries under the Unemployment Insurance Act, the | 16 |
| employer shall increase the weekly compensation rate | 17 |
| proportionately by the same percentage as the percentage of | 18 |
| increase in the State's average weekly wage in covered | 19 |
| industries under the Unemployment Insurance Act. The increase | 20 |
| in the compensation rate under this paragraph shall in no event | 21 |
| bring the total compensation rate to an amount greater than the | 22 |
| prevailing maximum rate at the time that the annual adjustment | 23 |
| is made. In the event of a decrease in such average weekly wage | 24 |
| there shall be no change in the then existing compensation | 25 |
| rate. Such increase shall be paid by the employer in the same | 26 |
| manner and at the same intervals as the payment of compensation | 27 |
| in the award. This paragraph shall not apply to cases where | 28 |
| there is disputed liability and in which a compromise lump sum | 29 |
| settlement between the employer and the injured employee, or | 30 |
| his or her dependents, as the case may be, has been duly | 31 |
| approved by the Illinois Workers' Compensation Commission. | 32 |
| The annual adjustments for every award of death benefits or | 33 |
| permanent total disability involving accidents occurring | 34 |
| before July 20, 2005 and accidents occurring on or after the | 35 |
| effective date of this amendatory Act of the 94th General | 36 |
| Assembly (Senate Bill 1283 of the 94th General Assembly)
the |
|
|
|
SB1283 Enrolled |
- 33 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| effective date of this amendatory Act of the 94th General | 2 |
| Assembly shall continue to be paid from the Rate Adjustment | 3 |
| Fund pursuant to this paragraph and Section 7(f) of this Act.
| 4 |
| (h) In case death occurs from any cause before the total
| 5 |
| compensation to which the employee would have been entitled has | 6 |
| been
paid, then in case the employee leaves any widow, widower, | 7 |
| child, parent
(or any grandchild, grandparent or other lineal | 8 |
| heir or any collateral
heir dependent at the time of the | 9 |
| accident upon the earnings of the
employee to the extent of 50% | 10 |
| or more of total dependency) such
compensation shall be paid to | 11 |
| the beneficiaries of the deceased employee
and distributed as | 12 |
| provided in paragraph (g) of Section 7.
| 13 |
| (h-1) In case an injured employee is under legal disability
| 14 |
| at the time when any right or privilege accrues to him or her | 15 |
| under this
Act, a guardian may be appointed pursuant to law, | 16 |
| and may, on behalf
of such person under legal disability, claim | 17 |
| and exercise any
such right or privilege with the same effect | 18 |
| as if the employee himself
or herself had claimed or exercised | 19 |
| the right or privilege. No limitations
of time provided by this | 20 |
| Act run so long as the employee who is under legal
disability | 21 |
| is without a conservator or guardian.
| 22 |
| (i) In case the injured employee is under 16 years of age | 23 |
| at the
time of the accident and is illegally employed, the | 24 |
| amount of
compensation payable under paragraphs (b), (c), (d), | 25 |
| (e) and (f) of this
Section is increased 50%.
| 26 |
| However, where an employer has on file an employment | 27 |
| certificate
issued pursuant to the Child Labor Law or work | 28 |
| permit issued pursuant
to the Federal Fair Labor Standards Act, | 29 |
| as amended, or a birth
certificate properly and duly issued, | 30 |
| such certificate, permit or birth
certificate is conclusive | 31 |
| evidence as to the age of the injured minor
employee for the | 32 |
| purposes of this Section.
| 33 |
| Nothing herein contained repeals or amends the provisions | 34 |
| of the
Child Labor Law relating to the employment of minors | 35 |
| under the age of 16 years.
| 36 |
| (j) 1. In the event the injured employee receives benefits,
|
|
|
|
SB1283 Enrolled |
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LRB094 04940 WGH 34969 b |
|
| 1 |
| including medical, surgical or hospital benefits under any | 2 |
| group plan
covering non-occupational disabilities contributed | 3 |
| to wholly or
partially by the employer, which benefits should | 4 |
| not have been payable
if any rights of recovery existed under | 5 |
| this Act, then such amounts so
paid to the employee from any | 6 |
| such group plan as shall be consistent
with, and limited to, | 7 |
| the provisions of paragraph 2 hereof, shall be
credited to or | 8 |
| against any compensation payment for temporary total
| 9 |
| incapacity for work or any medical, surgical or hospital | 10 |
| benefits made
or to be made under this Act. In such event, the | 11 |
| period of time for
giving notice of accidental injury and | 12 |
| filing application for adjustment
of claim does not commence to | 13 |
| run until the termination of such
payments. This paragraph does | 14 |
| not apply to payments made under any
group plan which would | 15 |
| have been payable irrespective of an accidental
injury under | 16 |
| this Act. Any employer receiving such credit shall keep
such | 17 |
| employee safe and harmless from any and all claims or | 18 |
| liabilities
that may be made against him by reason of having | 19 |
| received such payments
only to the extent of such credit.
| 20 |
| Any excess benefits paid to or on behalf of a State | 21 |
| employee by the
State Employees' Retirement System under | 22 |
| Article 14 of the Illinois Pension
Code on a death claim or | 23 |
| disputed disability claim shall be credited
against any | 24 |
| payments made or to be made by the State of Illinois to or on
| 25 |
| behalf of such employee under this Act, except for payments for | 26 |
| medical
expenses which have already been incurred at the time | 27 |
| of the award. The
State of Illinois shall directly reimburse | 28 |
| the State Employees' Retirement
System to the extent of such | 29 |
| credit.
| 30 |
| 2. Nothing contained in this Act shall be construed to give | 31 |
| the
employer or the insurance carrier the right to credit for | 32 |
| any benefits
or payments received by the employee other than | 33 |
| compensation payments
provided by this Act, and where the | 34 |
| employee receives payments other
than compensation payments, | 35 |
| whether as full or partial salary, group
insurance benefits, | 36 |
| bonuses, annuities or any other payments, the
employer or |
|
|
|
SB1283 Enrolled |
- 35 - |
LRB094 04940 WGH 34969 b |
|
| 1 |
| insurance carrier shall receive credit for each such payment
| 2 |
| only to the extent of the compensation that would have been | 3 |
| payable
during the period covered by such payment.
| 4 |
| 3. The extension of time for the filing of an Application | 5 |
| for
Adjustment of Claim as provided in paragraph 1 above shall | 6 |
| not apply to
those cases where the time for such filing had | 7 |
| expired prior to the date
on which payments or benefits | 8 |
| enumerated herein have been initiated or
resumed. Provided | 9 |
| however that this paragraph 3 shall apply only to
cases wherein | 10 |
| the payments or benefits hereinabove enumerated shall be
| 11 |
| received after July 1, 1969.
| 12 |
| (Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05.)
| 13 |
| (820 ILCS 305/8.2)
| 14 |
| Sec. 8.2. Fee schedule.
| 15 |
| (a) Except as provided for in subsection (c), for | 16 |
| procedures, treatments, or services covered under this Act and | 17 |
| rendered or to be rendered on and after February 1, 2006, the | 18 |
| maximum allowable payment for procedures, treatments, or | 19 |
| services covered under this Act shall be 90% of the 80th | 20 |
| percentile of charges and fees as determined by the Commission | 21 |
| utilizing information provided by employers' and insurers' | 22 |
| national databases, with a minimum of 12,000,000 Illinois line | 23 |
| item charges and fees comprised of health care provider and | 24 |
| hospital charges and fees as of August 1, 2004 but not earlier | 25 |
| than August 1, 2002. These charges and fees are provider billed | 26 |
| amounts and shall not include discounted charges. The 80th | 27 |
| percentile is the point on an ordered data set from low to high | 28 |
| such that 80% of the cases are below or equal to that point and | 29 |
| at most 20% are above or equal to that point. The Commission | 30 |
| shall adjust these historical charges and fees as of August 1, | 31 |
| 2004 by the Consumer Price Index-U for the period August 1, | 32 |
| 2004 through September 30, 2005. The Commission shall establish | 33 |
| fee schedules for procedures, treatments, or services for | 34 |
| hospital inpatient, hospital outpatient, emergency room and | 35 |
| trauma, ambulatory surgical treatment centers, and |
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| professional services. These charges and fees shall be | 2 |
| designated by geozip or any smaller geographic unit. The data | 3 |
| shall in no way identify or tend to identify any patient, | 4 |
| employer, or health care provider. As used in this Section, | 5 |
| "geozip" means a three-digit zip code based on data | 6 |
| similarities, geographical similarities, and frequencies. A | 7 |
| geozip does not cross state boundaries. As used in this | 8 |
| Section, "three-digit zip code" means a geographic area in | 9 |
| which all zip codes have the same first 3 digits. If a geozip | 10 |
| does not have the necessary number of charges and fees to | 11 |
| calculate a valid percentile for a specific procedure, | 12 |
| treatment, or service, the Commission may combine data from the | 13 |
| geozip with up to 4 other geozips that are demographically and | 14 |
| economically similar and exhibit similarities in data and | 15 |
| frequencies until the Commission reaches 9 charges or fees for | 16 |
| that specific procedure, treatment, or service. In cases where | 17 |
| the compiled data contains less than 9 charges or fees for a | 18 |
| procedure, treatment, or service, reimbursement shall occur at | 19 |
| 76% of charges and fees as determined by the Commission in a | 20 |
| manner consistent with the provisions of this paragraph. The | 21 |
| Commission has the authority to set the maximum allowable | 22 |
| payment to providers of out-of-state procedures, treatments, | 23 |
| or services covered under this Act in a manner consistent with | 24 |
| this Section. Not later than September 30 in 2006 and each year | 25 |
| thereafter, the Commission shall automatically increase or | 26 |
| decrease the maximum allowable payment for a procedure, | 27 |
| treatment, or service established and in effect on January 1 of | 28 |
| that year by the percentage change in the Consumer Price | 29 |
| Index-U for the 12 month period ending August 31 of that year. | 30 |
| The increase or decrease shall become effective on January 1 of | 31 |
| the following year. As used in this Section, "Consumer Price | 32 |
| Index-U" means the index published by the Bureau of Labor | 33 |
| Statistics of the U.S. Department of Labor, that measures the | 34 |
| average change in prices of all goods and services purchased by | 35 |
| all urban consumers, U.S. city average, all items, 1982-84=100. | 36 |
| (b) Notwithstanding the provisions of subsection (a), if
|
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| the Commission finds that there is a significant limitation on
| 2 |
| access to quality health care in either a specific field of
| 3 |
| health care services or a specific geographic limitation on
| 4 |
| access to health care, it may change the Consumer Price Index-U
| 5 |
| increase or decrease for that specific field or specific
| 6 |
| geographic limitation on access to health care to address that
| 7 |
| limitation. | 8 |
| (c) The Commission shall establish by rule a process to | 9 |
| review those medical cases or outliers that involve | 10 |
| extra-ordinary treatment to determine whether to make an | 11 |
| additional adjustment to the maximum payment within a fee | 12 |
| schedule for a procedure, treatment, or service. | 13 |
| (d) When a patient notifies a provider that the treatment, | 14 |
| procedure, or service being sought is for a work-related | 15 |
| illness or injury and furnishes the provider the name and | 16 |
| address of the responsible employer, the provider shall bill | 17 |
| the employer directly. The employer shall make payment and | 18 |
| providers shall submit bills and records in accordance with the | 19 |
| provisions of this Section. All payments to providers for | 20 |
| treatment provided pursuant to this Act shall be made within 60 | 21 |
| days of receipt of the bills as long as the claim contains | 22 |
| substantially all the required data elements necessary to | 23 |
| adjudicate the bills. In the case of nonpayment to a provider | 24 |
| within 60 days of receipt of the bill which contained | 25 |
| substantially all of the required data elements necessary to | 26 |
| adjudicate the bill or nonpayment to a provider of a portion of | 27 |
| such a bill up to the lesser of the actual charge or the | 28 |
| payment level set by the Commission in the fee schedule | 29 |
| established in this Section, the bill, or portion of the bill, | 30 |
| shall incur interest at a rate of 1% per month payable to the | 31 |
| provider. | 32 |
| (e) Except as provided in subsections (e-5), (e-10), and | 33 |
| (e-15), a provider shall not hold an employee liable for costs | 34 |
| related to a non-disputed procedure, treatment, or service | 35 |
| rendered in connection with a compensable injury. The | 36 |
| provisions of subsections (e-5), (e-10), (e-15), and (e-20) |
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| shall not apply if an employee provides information to the | 2 |
| provider regarding participation in a group health plan. If the | 3 |
| employee participates in a group health plan, the provider may | 4 |
| submit a claim for services to the group health plan. If the | 5 |
| claim for service is covered by the group health plan, the | 6 |
| employee's responsibility shall be limited to applicable | 7 |
| deductibles, co-payments, or co-insurance. Except as provided | 8 |
| under subsections (e-5), (e-10), (e-15), and (e-20), a provider | 9 |
| shall not bill or otherwise attempt to recover from the | 10 |
| employee the difference between the provider's charge and the | 11 |
| amount paid by the employer or the insurer on a compensable | 12 |
| injury. | 13 |
| (e-5) If an employer notifies a provider that the employer | 14 |
| does not consider the illness or injury to be compensable under | 15 |
| this Act, the provider may seek payment of the provider's | 16 |
| actual charges from the employee for any procedure, treatment, | 17 |
| or service rendered. Once an employee informs the provider that | 18 |
| there is an application filed with the Commission to resolve a | 19 |
| dispute over payment of such charges, the provider shall cease | 20 |
| any and all efforts to collect payment for the services that | 21 |
| are the subject of the dispute. Any statute of limitations or | 22 |
| statute of repose applicable to the provider's efforts to | 23 |
| collect payment from the employee shall be tolled from the date | 24 |
| that the employee files the application with the Commission | 25 |
| until the date that the provider is permitted to resume | 26 |
| collection efforts under the provisions of this Section. | 27 |
| (e-10) If an employer notifies a provider that the employer | 28 |
| will pay only a portion of a bill for any procedure, treatment, | 29 |
| or service rendered in connection with a compensable illness or | 30 |
| disease, the provider may seek payment from the employee for | 31 |
| the remainder of the amount of the bill up to the lesser of the | 32 |
| actual charge, negotiated rate, if applicable, or the payment | 33 |
| level set by the Commission in the fee schedule established in | 34 |
| this Section. Once an employee informs the provider that there | 35 |
| is an application filed with the Commission to resolve a | 36 |
| dispute over payment of such charges, the provider shall cease |
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| any and all efforts to collect payment for the services that | 2 |
| are the subject of the dispute. Any statute of limitations or | 3 |
| statute of repose applicable to the provider's efforts to | 4 |
| collect payment from the employee shall be tolled from the date | 5 |
| that the employee files the application with the Commission | 6 |
| until the date that the provider is permitted to resume | 7 |
| collection efforts under the provisions of this Section. | 8 |
| (e-15) When there is a dispute over the compensability of | 9 |
| or amount of payment for a procedure, treatment, or service, | 10 |
| and a case is pending or proceeding before an Arbitrator or the | 11 |
| Commission, the provider may mail the employee reminders that | 12 |
| the employee will be responsible for payment of any procedure, | 13 |
| treatment or service rendered by the provider. The reminders | 14 |
| must state that they are not bills, to the extent practicable | 15 |
| include itemized information, and state that the employee need | 16 |
| not pay until such time as the provider is permitted to resume | 17 |
| collection efforts under this Section. The reminders shall not | 18 |
| be provided to any credit rating agency. The reminders may | 19 |
| request that the employee furnish the provider with information | 20 |
| about the proceeding under this Act, such as the file number, | 21 |
| names of parties, and status of the case. If an employee fails | 22 |
| to respond to such request for information or fails to furnish | 23 |
| the information requested within 90 days of the date of the | 24 |
| reminder, the provider is entitled to resume any and all | 25 |
| efforts to collect payment from the employee for the services | 26 |
| rendered to the employee and the employee shall be responsible | 27 |
| for payment of any outstanding bills for a procedure, | 28 |
| treatment, or service rendered by a provider. | 29 |
| (e-20) Upon a final award or judgment by an Arbitrator or | 30 |
| the Commission, or a settlement agreed to by the employer and | 31 |
| the employee, a provider may resume any and all efforts to | 32 |
| collect payment from the employee for the services rendered to | 33 |
| the employee and the employee shall be responsible for payment | 34 |
| of any outstanding bills for a procedure, treatment, or service | 35 |
| rendered by a provider as well as the interest awarded under | 36 |
| subsection (d) of this Section. In the case of a procedure, |
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| treatment, or service deemed compensable, the provider shall | 2 |
| not require a payment rate, excluding the interest provisions | 3 |
| under subsection (d), greater than the lesser of the actual | 4 |
| charge or the payment level set by the Commission in the fee | 5 |
| schedule established in this Section. Payment for services | 6 |
| deemed not covered or not compensable under this Act is the | 7 |
| responsibility of the employee unless a provider and employee | 8 |
| have agreed otherwise in writing. Services not covered or not | 9 |
| compensable under this Act are not subject to the fee schedule | 10 |
| in this Section. | 11 |
| (f) Nothing in this Act shall prohibit an employer or
| 12 |
| insurer from contracting with a health care provider or group
| 13 |
| of health care providers for reimbursement levels for benefits | 14 |
| under this Act different
from those provided in this Section. | 15 |
| (g) On or before January 1, 2010 the Commission shall | 16 |
| provide to the Governor and General Assembly a report regarding | 17 |
| the implementation of the medical fee schedule and the index | 18 |
| used for annual adjustment to that schedule as described in | 19 |
| this Section.
| 20 |
| (Source: P.A. 94-277, eff. 7-20-05.) | 21 |
| (820 ILCS 305/8.7) | 22 |
| Sec. 8.7. Utilization review programs. | 23 |
| (a) As used in this Section: | 24 |
| "Utilization review" means the evaluation of proposed or | 25 |
| provided health care services to determine the appropriateness | 26 |
| of both the level of health care services medically necessary | 27 |
| and the quality of health care services provided to a patient, | 28 |
| including evaluation of their efficiency, efficacy, and | 29 |
| appropriateness of treatment, hospitalization, or office | 30 |
| visits based on medically accepted standards. The evaluation | 31 |
| must be accomplished by means of a system that identifies the | 32 |
| utilization of health care services based on standards of care | 33 |
| or nationally recognized peer review guidelines as well as | 34 |
| nationally recognized evidence based upon standards as | 35 |
| provided in this Act. Utilization techniques may include |
|
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| prospective review, second opinions, concurrent review, | 2 |
| discharge planning, peer review, independent medical | 3 |
| examinations, and retrospective review (for purposes of this | 4 |
| sentence, retrospective review shall be applicable to services | 5 |
| rendered on or after July 20, 2005) . Nothing in this Section | 6 |
| applies to prospective review of necessary first aid or | 7 |
| emergency treatment. | 8 |
| (b) No person may conduct a utilization review program for | 9 |
| workers' compensation services in this State unless once every | 10 |
| 2 years the person registers the utilization review program | 11 |
| with the Department of Financial and Professional Regulation | 12 |
| and certifies compliance with the Workers' Compensation | 13 |
| Utilization Management standards or Health Utilization | 14 |
| Management Standards of URAC sufficient to achieve URAC | 15 |
| accreditation or submits evidence of accreditation by URAC for | 16 |
| its Workers' Compensation Utilization Management Standards or | 17 |
| Health Utilization Management Standards. Nothing in this Act | 18 |
| shall be construed to require an employer or insurer or its | 19 |
| subcontractors to become URAC accredited. | 20 |
| (c) In addition, the Secretary of Financial and | 21 |
| Professional Regulation may certify alternative utilization | 22 |
| review standards of national accreditation organizations or | 23 |
| entities in order for plans to comply with this Section. Any | 24 |
| alternative utilization review standards shall meet or exceed | 25 |
| those standards required under subsection (b). | 26 |
| (d) This registration shall include submission of all of | 27 |
| the following information regarding utilization review program | 28 |
| activities: | 29 |
| (1) The name, address, and telephone number of the | 30 |
| utilization review programs. | 31 |
| (2) The organization and governing structure of the | 32 |
| utilization review programs. | 33 |
| (3) The number of lives for which utilization review is | 34 |
| conducted by each utilization review program. | 35 |
| (4) Hours of operation of each utilization review | 36 |
| program. |
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| (5) Description of the grievance process for each | 2 |
| utilization review program. | 3 |
| (6) Number of covered lives for which utilization | 4 |
| review was conducted for the previous calendar year for | 5 |
| each utilization review program. | 6 |
| (7) Written policies and procedures for protecting | 7 |
| confidential information according to applicable State and | 8 |
| federal laws for each utilization review program. | 9 |
| (e) A utilization review program shall have written | 10 |
| procedures to ensure that patient-specific information | 11 |
| obtained during the process of utilization review will be: | 12 |
| (1) kept confidential in accordance with applicable | 13 |
| State and federal laws; and | 14 |
| (2) shared only with the employee, the employee's | 15 |
| designee, and the employee's health care provider, and | 16 |
| those who are authorized by law to receive the information. | 17 |
| Summary data shall not be considered confidential if it | 18 |
| does not provide information to allow identification of | 19 |
| individual patients or health care providers. | 20 |
| Only a health care professional may make determinations | 21 |
| regarding the medical necessity of health care services during | 22 |
| the course of utilization review. | 23 |
| When making retrospective reviews, utilization review | 24 |
| programs shall base reviews solely on the medical information | 25 |
| available to the attending physician or ordering provider at | 26 |
| the time the health care services were provided. | 27 |
| (f) If the Department of Financial and Professional | 28 |
| Regulation finds that a utilization review program is not in | 29 |
| compliance with this Section, the Department shall issue a | 30 |
| corrective action plan and allow a reasonable amount of time | 31 |
| for compliance with the plan. If the utilization review program | 32 |
| does not come into compliance, the Department may issue a cease | 33 |
| and desist order. Before issuing a cease and desist order under | 34 |
| this Section, the Department shall provide the utilization | 35 |
| review program with a written notice of the reasons for the | 36 |
| order and allow a reasonable amount of time to supply |
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| additional information demonstrating compliance with the | 2 |
| requirements of this Section and to request a hearing. The | 3 |
| hearing notice shall be sent by certified mail, return receipt | 4 |
| requested, and the hearing shall be conducted in accordance | 5 |
| with the Illinois Administrative Procedure Act. | 6 |
| (g) A utilization review program subject to a corrective | 7 |
| action may continue to conduct business until a final decision | 8 |
| has been issued by the Department. | 9 |
| (h) The Secretary of Financial and Professional Regulation | 10 |
| may by rule establish a registration fee for each person | 11 |
| conducting a utilization review program. | 12 |
| (i) A utilization review will be considered by the | 13 |
| Commission, along with all other evidence and in the same | 14 |
| manner as all other evidence, in the determination of the | 15 |
| reasonableness and necessity of the medical bills or treatment. | 16 |
| Nothing in this Section shall be construed to diminish the | 17 |
| rights of employees to reasonable and necessary medical | 18 |
| treatment or employee choice of health care provider under | 19 |
| Section 8(a) or the rights of employers to medical examinations | 20 |
| under Section 12. | 21 |
| (j) When an employer denies payment of or refuses to | 22 |
| authorize payment of first aid, medical, surgical, or hospital | 23 |
| services under Section 8(a) of this Act, if that denial or | 24 |
| refusal to authorize complies with a utilization review program | 25 |
| registered under this Section and complies with all other | 26 |
| requirements of this Section, then there shall be a rebuttable | 27 |
| presumption that the employer shall not be responsible for | 28 |
| payment of additional compensation pursuant to Section 19(k) of | 29 |
| this Act and if that denial or refusal to authorize does not | 30 |
| comply with a utilization review program registered under this | 31 |
| Section and does not comply with all other requirements of this | 32 |
| Section, then that will be considered by the Commission, along | 33 |
| with all other evidence and in the same manner as all other | 34 |
| evidence, in the determination of whether the employer may be | 35 |
| responsible for the payment of additional compensation | 36 |
| pursuant to Section 19(k) of this Act.
|
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| (Source: P.A. 94-277, eff. 7-20-05.)
| 2 |
| (820 ILCS 305/13.1) (from Ch. 48, par. 138.13-1)
| 3 |
| Sec. 13.1. (a) There is created a Workers' Compensation | 4 |
| Advisory Board
hereinafter referred to as the Advisory Board. | 5 |
| After the effective date of this amendatory Act of the 94th | 6 |
| General Assembly, the Advisory Board shall consist of 12 | 7 |
| members
appointed by the Governor with the advice and consent | 8 |
| of the Senate. Six
members of the Advisory Board shall be
| 9 |
| representative citizens chosen from the employee class, and 6 | 10 |
| members shall be
representative citizens chosen from the | 11 |
| employing class. The Chairman of the Commission shall serve as | 12 |
| the ex officio Chairman of the Advisory Board. After the | 13 |
| effective date of this amendatory Act of the 94th General | 14 |
| Assembly, each member of the Advisory Board shall serve a
term | 15 |
| ending on the third Monday in January 2007 and shall continue | 16 |
| to serve until his or her successor is appointed and qualified. | 17 |
| Members of the Advisory Board shall thereafter be appointed for | 18 |
| 4 year terms from the third Monday in January of the year of | 19 |
| their appointment, and until their successors are appointed and | 20 |
| qualified.
Seven members
of the Advisory Board shall constitute | 21 |
| a quorum to do business, but in no
case shall there be less | 22 |
| than one representative from each class. A vacancy on the | 23 |
| Advisory Board shall be
filled by the Governor for the | 24 |
| unexpired term.
| 25 |
| (b) Members of the Advisory Board shall receive no | 26 |
| compensation for
their services but shall be reimbursed for | 27 |
| expenses incurred in the
performance of their duties by the | 28 |
| Commission from appropriations made to
the Commission for such | 29 |
| purpose.
| 30 |
| (c) The Advisory Board shall aid the Commission in | 31 |
| formulating policies,
discussing problems, setting priorities | 32 |
| of expenditures , reviewing advisory rates filed by an advisory | 33 |
| organization as defined in Section 463 of the Illinois | 34 |
| Insurance Code, and establishing
short and long range | 35 |
| administrative goals. Prior to making appointments to the |
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| Commission, the Governor shall request that the Advisory Board | 2 |
| make recommendations as to candidates to consider for | 3 |
| appointment and the Advisory Board may then make such | 4 |
| recommendations.
| 5 |
| (Source: P.A. 94-277, eff. 7-20-05.)
| 6 |
| Section 95. Construction. Nothing in this Act shall be | 7 |
| construed to accelerate or otherwise supersede the provisions | 8 |
| of Section 95 of Public Act 94-277 regarding the applicability | 9 |
| of the amendatory changes to subsections (a) and (b) of Section | 10 |
| 8 of the Workers' Compensation Act that were made by Public Act | 11 |
| 94-277.
| 12 |
| Section 99. Effective date. This Act takes effect upon | 13 |
| becoming law.
|
|