SB2155 97TH GENERAL ASSEMBLY


 


 
97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB2155

 

Introduced 2/10/2011, by Sen. Bill Brady

 

SYNOPSIS AS INTRODUCED:
 
820 ILCS 305/8  from Ch. 48, par. 138.8
820 ILCS 305/11  from Ch. 48, par. 138.11
820 ILCS 305/19  from Ch. 48, par. 138.19
820 ILCS 305/25.5

    Amends the Workers' Compensation Act. Provides that the maximum weekly benefit if, after the accidential injury, an employee becomes partially incapacitated from pursuing his or her usual and customary line of employment, shall be 66 2/3% of the State's average weekly wage in covered industries under the Unemployment Insurance Act; such awards being known as wage differential awards shall cease when the employee reaches age 67 or 15 years after the accident. Provides that permanent partial or total disability shall be certified by a physician and demonstrated by use of medically defined objective measurements, that subjective complaints shall not be considered unless supported by and clearly related to objective measurements, and that a specified publication shall be applied in determining the level of disability. Provides that temporary total disability payments shall not exceed 104 weeks if the injured employee's medical impairment rating determined as a percentage of the whole person is less than 70%. Provides that the Illinois Workers' Compensation Commission may recall a decision or settlement when fraud has been determined to be committed related to the case. Provides that the fraud and insurance non-compliance unit of the Division of Insurance of the Department of Financial and Professional Regulation shall employ one or more attorneys as special prosecutors who shall initiate and prosecute any necessary criminal or civil actions. Makes numerous changes regarding employee intoxication, the Attorney General and State's Attorney, posting information on the web regarding unlawful acts, and other changes.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2155LRB097 10093 AEK 50272 b

1    AN ACT concerning employment.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Workers' Compensation Act is amended by
5changing Sections 8, 11, 19, and 25.5 as follows:
 
6    (820 ILCS 305/8)  (from Ch. 48, par. 138.8)
7    Sec. 8. The amount of compensation which shall be paid to
8the employee for an accidental injury not resulting in death
9is:
10    (a) The employer shall provide and pay the negotiated rate,
11if applicable, or the lesser of the health care provider's
12actual charges or according to a fee schedule, subject to
13Section 8.2, in effect at the time the service was rendered for
14all the necessary first aid, medical and surgical services, and
15all necessary medical, surgical and hospital services
16thereafter incurred, limited, however, to that which is
17reasonably required to cure or relieve from the effects of the
18accidental injury. If the employer does not dispute payment of
19first aid, medical, surgical, and hospital services, the
20employer shall make such payment to the provider on behalf of
21the employee. The employer shall also pay for treatment,
22instruction and training necessary for the physical, mental and
23vocational rehabilitation of the employee, including all

 

 

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1maintenance costs and expenses incidental thereto. If as a
2result of the injury the employee is unable to be
3self-sufficient the employer shall further pay for such
4maintenance or institutional care as shall be required.
5    The employee may at any time elect to secure his own
6physician, surgeon and hospital services at the employer's
7expense, or,
8    Upon agreement between the employer and the employees, or
9the employees' exclusive representative, and subject to the
10approval of the Illinois Workers' Compensation Commission, the
11employer shall maintain a list of physicians, to be known as a
12Panel of Physicians, who are accessible to the employees. The
13employer shall post this list in a place or places easily
14accessible to his employees. The employee shall have the right
15to make an alternative choice of physician from such Panel if
16he is not satisfied with the physician first selected. If, due
17to the nature of the injury or its occurrence away from the
18employer's place of business, the employee is unable to make a
19selection from the Panel, the selection process from the Panel
20shall not apply. The physician selected from the Panel may
21arrange for any consultation, referral or other specialized
22medical services outside the Panel at the employer's expense.
23Provided that, in the event the Commission shall find that a
24doctor selected by the employee is rendering improper or
25inadequate care, the Commission may order the employee to
26select another doctor certified or qualified in the medical

 

 

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1field for which treatment is required. If the employee refuses
2to make such change the Commission may relieve the employer of
3his obligation to pay the doctor's charges from the date of
4refusal to the date of compliance.
5    Any vocational rehabilitation counselors who provide
6service under this Act shall have appropriate certifications
7which designate the counselor as qualified to render opinions
8relating to vocational rehabilitation. Vocational
9rehabilitation may include, but is not limited to, counseling
10for job searches, supervising a job search program, and
11vocational retraining including education at an accredited
12learning institution. The employee or employer may petition to
13the Commission to decide disputes relating to vocational
14rehabilitation and the Commission shall resolve any such
15dispute, including payment of the vocational rehabilitation
16program by the employer.
17    The maintenance benefit shall not be less than the
18temporary total disability rate determined for the employee. In
19addition, maintenance shall include costs and expenses
20incidental to the vocational rehabilitation program.
21    When the employee is working light duty on a part-time
22basis or full-time basis and earns less than he or she would be
23earning if employed in the full capacity of the job or jobs,
24then the employee shall be entitled to temporary partial
25disability benefits. Temporary partial disability benefits
26shall be equal to two-thirds of the difference between the

 

 

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1average amount that the employee would be able to earn in the
2full performance of his or her duties in the occupation in
3which he or she was engaged at the time of accident and the
4gross net amount which he or she is earning in the modified job
5provided to the employee by the employer or in any other job
6that the employee is working.
7    Every hospital, physician, surgeon or other person
8rendering treatment or services in accordance with the
9provisions of this Section shall upon written request furnish
10full and complete reports thereof to, and permit their records
11to be copied by, the employer, the employee or his dependents,
12as the case may be, or any other party to any proceeding for
13compensation before the Commission, or their attorneys.
14    Notwithstanding the foregoing, the employer's liability to
15pay for such medical services selected by the employee shall be
16limited to:
17        (1) all first aid and emergency treatment; plus
18        (2) all medical, surgical and hospital services
19    provided by the physician, surgeon or hospital initially
20    chosen by the employee or by any other physician,
21    consultant, expert, institution or other provider of
22    services recommended by said initial service provider or
23    any subsequent provider of medical services in the chain of
24    referrals from said initial service provider; plus
25        (3) all medical, surgical and hospital services
26    provided by any second physician, surgeon or hospital

 

 

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1    subsequently chosen by the employee or by any other
2    physician, consultant, expert, institution or other
3    provider of services recommended by said second service
4    provider or any subsequent provider of medical services in
5    the chain of referrals from said second service provider.
6    Thereafter the employer shall select and pay for all
7    necessary medical, surgical and hospital treatment and the
8    employee may not select a provider of medical services at
9    the employer's expense unless the employer agrees to such
10    selection. At any time the employee may obtain any medical
11    treatment he desires at his own expense. This paragraph
12    shall not affect the duty to pay for rehabilitation
13    referred to above.
14    When an employer and employee so agree in writing, nothing
15in this Act prevents an employee whose injury or disability has
16been established under this Act, from relying in good faith, on
17treatment by prayer or spiritual means alone, in accordance
18with the tenets and practice of a recognized church or
19religious denomination, by a duly accredited practitioner
20thereof, and having nursing services appropriate therewith,
21without suffering loss or diminution of the compensation
22benefits under this Act. However, the employee shall submit to
23all physical examinations required by this Act. The cost of
24such treatment and nursing care shall be paid by the employee
25unless the employer agrees to make such payment.
26    Where the accidental injury results in the amputation of an

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1    hereinafter provided, shall be 100% of the State's average
2    weekly wage in covered industries under the Unemployment
3    Insurance Act in effect on January 1, 1981. Effective
4    January 1, 1984 and on January 1, of each year thereafter
5    the maximum weekly compensation rate, except as
6    hereinafter provided, shall be determined as follows: if
7    during the preceding 12 month period there shall have been
8    an increase in the State's average weekly wage in covered
9    industries under the Unemployment Insurance Act, the
10    weekly compensation rate shall be proportionately
11    increased by the same percentage as the percentage of
12    increase in the State's average weekly wage in covered
13    industries under the Unemployment Insurance Act during
14    such period.
15        From July 1, 1977 and thereafter such maximum weekly
16    compensation rate in death cases under Section 7, and
17    permanent total disability cases under paragraph (f) or
18    subparagraph 18 of paragraph (3) of this Section and for
19    temporary total disability under paragraph (b) of this
20    Section and for amputation of a member or enucleation of an
21    eye under paragraph (e) of this Section shall be increased
22    to 133-1/3% of the State's average weekly wage in covered
23    industries under the Unemployment Insurance Act.
24        For injuries occurring on or after February 1, 2006,
25    the maximum weekly benefit under paragraph (d)1 of this
26    Section shall be 100% of the State's average weekly wage in

 

 

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1    covered industries under the Unemployment Insurance Act.
2    For injuries occurring on or after the effective date of
3    this amendatory Act of the 97th General Assembly, the
4    maximum weekly benefit under paragraph (d)1 of this Section
5    shall be 66 2/3% of the State's average weekly wage in
6    covered industries under the Unemployment Insurance Act.
7        4.1. Any provision herein to the contrary
8    notwithstanding, the weekly compensation rate for
9    compensation payments under subparagraph 18 of paragraph
10    (e) of this Section and under paragraph (f) of this Section
11    and under paragraph (a) of Section 7 and for amputation of
12    a member or enucleation of an eye under paragraph (e) of
13    this Section, shall in no event be less than 50% of the
14    State's average weekly wage in covered industries under the
15    Unemployment Insurance Act.
16        4.2. Any provision to the contrary notwithstanding,
17    the total compensation payable under Section 7 shall not
18    exceed the greater of $500,000 or 25 years.
19        5. For the purpose of this Section this State's average
20    weekly wage in covered industries under the Unemployment
21    Insurance Act on July 1, 1975 is hereby fixed at $228.16
22    per week and the computation of compensation rates shall be
23    based on the aforesaid average weekly wage until modified
24    as hereinafter provided.
25        6. The Department of Employment Security of the State
26    shall on or before the first day of December, 1977, and on

 

 

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1    or before the first day of June, 1978, and on the first day
2    of each December and June of each year thereafter, publish
3    the State's average weekly wage in covered industries under
4    the Unemployment Insurance Act and the Illinois Workers'
5    Compensation Commission shall on the 15th day of January,
6    1978 and on the 15th day of July, 1978 and on the 15th day
7    of each January and July of each year thereafter, post and
8    publish the State's average weekly wage in covered
9    industries under the Unemployment Insurance Act as last
10    determined and published by the Department of Employment
11    Security. The amount when so posted and published shall be
12    conclusive and shall be applicable as the basis of
13    computation of compensation rates until the next posting
14    and publication as aforesaid.
15        7. The payment of compensation by an employer or his
16    insurance carrier to an injured employee shall not
17    constitute an admission of the employer's liability to pay
18    compensation.
19    (c) For any serious and permanent disfigurement to the
20hand, head, face, neck, arm, leg below the knee or the chest
21above the axillary line, the employee is entitled to
22compensation for such disfigurement, the amount determined by
23agreement at any time or by arbitration under this Act, at a
24hearing not less than 6 months after the date of the accidental
25injury, which amount shall not exceed 150 weeks (if the
26accidental injury occurs on or after the effective date of this

 

 

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1amendatory Act of the 94th General Assembly but before February
21, 2006) or 162 weeks (if the accidental injury occurs on or
3after February 1, 2006) at the applicable rate provided in
4subparagraph 2.1 of paragraph (b) of this Section.
5    No compensation is payable under this paragraph where
6compensation is payable under paragraphs (d), (e) or (f) of
7this Section.
8    A duly appointed member of a fire department in a city, the
9population of which exceeds 200,000 according to the last
10federal or State census, is eligible for compensation under
11this paragraph only where such serious and permanent
12disfigurement results from burns.
13    (d) 1. If, after the accidental injury has been sustained,
14the employee as a result thereof becomes partially
15incapacitated from pursuing his usual and customary line of
16employment, he shall, except in cases compensated under the
17specific schedule set forth in paragraph (e) of this Section,
18receive compensation for the duration of his disability,
19subject to the limitations as to maximum amounts fixed in
20paragraph (b) of this Section, equal to 66-2/3% of the
21difference between the average amount which he would be able to
22earn in the full performance of his duties in the occupation in
23which he was engaged at the time of the accident and the
24average amount which he is earning or is able to earn in some
25suitable employment or business after the accident. For
26injuries sustained on or after the effective date of this

 

 

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1amendatory Act of the 97th General Assembly, awards made
2pursuant to this subparagraph shall be known as a wage
3differential award and shall cease when the employee reaches
4age 67 or 15 years after the accident, whichever comes first.
5    2. If, as a result of the accident, the employee sustains
6serious and permanent injuries not covered by paragraphs (c)
7and (e) of this Section or having sustained injuries covered by
8the aforesaid paragraphs (c) and (e), he shall have sustained
9in addition thereto other injuries which injuries do not
10incapacitate him from pursuing the duties of his employment but
11which would disable him from pursuing other suitable
12occupations, or which have otherwise resulted in physical
13impairment; or if such injuries partially incapacitate him from
14pursuing the duties of his usual and customary line of
15employment but do not result in an impairment of earning
16capacity, or having resulted in an impairment of earning
17capacity, the employee elects to waive his right to recover
18under the foregoing subparagraph 1 of paragraph (d) of this
19Section then in any of the foregoing events, he shall receive
20in addition to compensation for temporary total disability
21under paragraph (b) of this Section, compensation at the rate
22provided in subparagraph 2.1 of paragraph (b) of this Section
23for that percentage of 500 weeks that the partial disability
24resulting from the injuries covered by this paragraph bears to
25total disability. If the employee shall have sustained a
26fracture of one or more vertebra or fracture of the skull, the

 

 

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1amount of compensation allowed under this Section shall be not
2less than 6 weeks for a fractured skull and 6 weeks for each
3fractured vertebra, and in the event the employee shall have
4sustained a fracture of any of the following facial bones:
5nasal, lachrymal, vomer, zygoma, maxilla, palatine or
6mandible, the amount of compensation allowed under this Section
7shall be not less than 2 weeks for each such fractured bone,
8and for a fracture of each transverse process not less than 3
9weeks. In the event such injuries shall result in the loss of a
10kidney, spleen or lung, the amount of compensation allowed
11under this Section shall be not less than 10 weeks for each
12such organ. Compensation awarded under this subparagraph 2
13shall not take into consideration injuries covered under
14paragraphs (c) and (e) of this Section and the compensation
15provided in this paragraph shall not affect the employee's
16right to compensation payable under paragraphs (b), (c) and (e)
17of this Section for the disabilities therein covered.
18    (e) For accidental injuries in the following schedule, the
19employee shall receive compensation for the period of temporary
20total incapacity for work resulting from such accidental
21injury, under subparagraph 1 of paragraph (b) of this Section,
22and shall receive in addition thereto compensation for a
23further period for the specific loss herein mentioned, but
24shall not receive any compensation under any other provisions
25of this Act. The following listed amounts apply to either the
26loss of or the permanent and complete loss of use of the member

 

 

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1specified, such compensation for the length of time as follows:
2        1. Thumb-
3            70 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            76 weeks if the accidental injury occurs on or
7        after February 1, 2006.
8        2. First, or index finger-
9            40 weeks if the accidental injury occurs on or
10        after the effective date of this amendatory Act of the
11        94th General Assembly but before February 1, 2006.
12            43 weeks if the accidental injury occurs on or
13        after February 1, 2006.
14        3. Second, or middle finger-
15            35 weeks if the accidental injury occurs on or
16        after the effective date of this amendatory Act of the
17        94th General Assembly but before February 1, 2006.
18            38 weeks if the accidental injury occurs on or
19        after February 1, 2006.
20        4. Third, or ring finger-
21            25 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            27 weeks if the accidental injury occurs on or
25        after February 1, 2006.
26        5. Fourth, or little finger-

 

 

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1            20 weeks if the accidental injury occurs on or
2        after the effective date of this amendatory Act of the
3        94th General Assembly but before February 1, 2006.
4            22 weeks if the accidental injury occurs on or
5        after February 1, 2006.
6        6. Great toe-
7            35 weeks if the accidental injury occurs on or
8        after the effective date of this amendatory Act of the
9        94th General Assembly but before February 1, 2006.
10            38 weeks if the accidental injury occurs on or
11        after February 1, 2006.
12        7. Each toe other than great toe-
13            12 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            13 weeks if the accidental injury occurs on or
17        after February 1, 2006.
18        8. The loss of the first or distal phalanx of the thumb
19    or of any finger or toe shall be considered to be equal to
20    the loss of one-half of such thumb, finger or toe and the
21    compensation payable shall be one-half of the amount above
22    specified. The loss of more than one phalanx shall be
23    considered as the loss of the entire thumb, finger or toe.
24    In no case shall the amount received for more than one
25    finger exceed the amount provided in this schedule for the
26    loss of a hand.

 

 

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1        9. Hand-
2            190 weeks if the accidental injury occurs on or
3        after the effective date of this amendatory Act of the
4        94th General Assembly but before February 1, 2006.
5            205 weeks if the accidental injury occurs on or
6        after February 1, 2006.
7        The loss of 2 or more digits, or one or more phalanges
8    of 2 or more digits, of a hand may be compensated on the
9    basis of partial loss of use of a hand, provided, further,
10    that the loss of 4 digits, or the loss of use of 4 digits,
11    in the same hand shall constitute the complete loss of a
12    hand.
13        10. Arm-
14            235 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            253 weeks if the accidental injury occurs on or
18        after February 1, 2006.
19        Where an accidental injury results in the amputation of
20    an arm below the elbow, such injury shall be compensated as
21    a loss of an arm. Where an accidental injury results in the
22    amputation of an arm above the elbow, compensation for an
23    additional 15 weeks (if the accidental injury occurs on or
24    after the effective date of this amendatory Act of the 94th
25    General Assembly but before February 1, 2006) or an
26    additional 17 weeks (if the accidental injury occurs on or

 

 

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1    after February 1, 2006) shall be paid, except where the
2    accidental injury results in the amputation of an arm at
3    the shoulder joint, or so close to shoulder joint that an
4    artificial arm cannot be used, or results in the
5    disarticulation of an arm at the shoulder joint, in which
6    case compensation for an additional 65 weeks (if the
7    accidental injury occurs on or after the effective date of
8    this amendatory Act of the 94th General Assembly but before
9    February 1, 2006) or an additional 70 weeks (if the
10    accidental injury occurs on or after February 1, 2006)
11    shall be paid.
12        11. Foot-
13            155 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            167 weeks if the accidental injury occurs on or
17        after February 1, 2006.
18        12. Leg-
19            200 weeks if the accidental injury occurs on or
20        after the effective date of this amendatory Act of the
21        94th General Assembly but before February 1, 2006.
22            215 weeks if the accidental injury occurs on or
23        after February 1, 2006.
24        Where an accidental injury results in the amputation of
25    a leg below the knee, such injury shall be compensated as
26    loss of a leg. Where an accidental injury results in the

 

 

SB2155- 20 -LRB097 10093 AEK 50272 b

1    amputation of a leg above the knee, compensation for an
2    additional 25 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 27 weeks (if the accidental injury occurs on or
6    after February 1, 2006) shall be paid, except where the
7    accidental injury results in the amputation of a leg at the
8    hip joint, or so close to the hip joint that an artificial
9    leg cannot be used, or results in the disarticulation of a
10    leg at the hip joint, in which case compensation for an
11    additional 75 weeks (if the accidental injury occurs on or
12    after the effective date of this amendatory Act of the 94th
13    General Assembly but before February 1, 2006) or an
14    additional 81 weeks (if the accidental injury occurs on or
15    after February 1, 2006) shall be paid.
16        13. Eye-
17            150 weeks if the accidental injury occurs on or
18        after the effective date of this amendatory Act of the
19        94th General Assembly but before February 1, 2006.
20            162 weeks if the accidental injury occurs on or
21        after February 1, 2006.
22        Where an accidental injury results in the enucleation
23    of an eye, compensation for an additional 10 weeks (if the
24    accidental injury occurs on or after the effective date of
25    this amendatory Act of the 94th General Assembly but before
26    February 1, 2006) or an additional 11 weeks (if the

 

 

SB2155- 21 -LRB097 10093 AEK 50272 b

1    accidental injury occurs on or after February 1, 2006)
2    shall be paid.
3        14. Loss of hearing of one ear-
4            50 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            54 weeks if the accidental injury occurs on or
8        after February 1, 2006.
9        Total and permanent loss of hearing of both ears-
10            200 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            215 weeks if the accidental injury occurs on or
14        after February 1, 2006.
15        15. Testicle-
16            50 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            54 weeks if the accidental injury occurs on or
20        after February 1, 2006.
21        Both testicles-
22            150 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            162 weeks if the accidental injury occurs on or
26        after February 1, 2006.

 

 

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1        16. For the permanent partial loss of use of a member
2    or sight of an eye, or hearing of an ear, compensation
3    during that proportion of the number of weeks in the
4    foregoing schedule provided for the loss of such member or
5    sight of an eye, or hearing of an ear, which the partial
6    loss of use thereof bears to the total loss of use of such
7    member, or sight of eye, or hearing of an ear.
8            (a) Loss of hearing for compensation purposes
9        shall be confined to the frequencies of 1,000, 2,000
10        and 3,000 cycles per second. Loss of hearing ability
11        for frequency tones above 3,000 cycles per second are
12        not to be considered as constituting disability for
13        hearing.
14            (b) The percent of hearing loss, for purposes of
15        the determination of compensation claims for
16        occupational deafness, shall be calculated as the
17        average in decibels for the thresholds of hearing for
18        the frequencies of 1,000, 2,000 and 3,000 cycles per
19        second. Pure tone air conduction audiometric
20        instruments, approved by nationally recognized
21        authorities in this field, shall be used for measuring
22        hearing loss. If the losses of hearing average 30
23        decibels or less in the 3 frequencies, such losses of
24        hearing shall not then constitute any compensable
25        hearing disability. If the losses of hearing average 85
26        decibels or more in the 3 frequencies, then the same

 

 

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1        shall constitute and be total or 100% compensable
2        hearing loss.
3            (c) In measuring hearing impairment, the lowest
4        measured losses in each of the 3 frequencies shall be
5        added together and divided by 3 to determine the
6        average decibel loss. For every decibel of loss
7        exceeding 30 decibels an allowance of 1.82% shall be
8        made up to the maximum of 100% which is reached at 85
9        decibels.
10            (d) If a hearing loss is established to have
11        existed on July 1, 1975 by audiometric testing the
12        employer shall not be liable for the previous loss so
13        established nor shall he be liable for any loss for
14        which compensation has been paid or awarded.
15            (e) No consideration shall be given to the question
16        of whether or not the ability of an employee to
17        understand speech is improved by the use of a hearing
18        aid.
19            (f) No claim for loss of hearing due to industrial
20        noise shall be brought against an employer or allowed
21        unless the employee has been exposed for a period of
22        time sufficient to cause permanent impairment to noise
23        levels in excess of the following:
24Sound Level DBA
25Slow ResponseHours Per Day
26908

 

 

SB2155- 24 -LRB097 10093 AEK 50272 b

1926
2954
3973
41002
51021-1/2
61051
71101/2
81151/4
9        This subparagraph (f) shall not be applied in cases of
10    hearing loss resulting from trauma or explosion.
11        17. In computing the compensation to be paid to any
12    employee who, before the accident for which he claims
13    compensation, had before that time sustained an injury
14    resulting in the loss by amputation or partial loss by
15    amputation of any member, including hand, arm, thumb or
16    fingers, leg, foot or any toes, such loss or partial loss
17    of any such member shall be deducted from any award made
18    for the subsequent injury. For the permanent loss of use or
19    the permanent partial loss of use of any such member or the
20    partial loss of sight of an eye, for which compensation has
21    been paid, then such loss shall be taken into consideration
22    and deducted from any award for the subsequent injury.
23        18. The specific case of loss of both hands, both arms,
24    or both feet, or both legs, or both eyes, or of any two
25    thereof, or the permanent and complete loss of the use
26    thereof, constitutes total and permanent disability, to be

 

 

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1    compensated according to the compensation fixed by
2    paragraph (f) of this Section. These specific cases of
3    total and permanent disability do not exclude other cases.
4        Any employee who has previously suffered the loss or
5    permanent and complete loss of the use of any of such
6    members, and in a subsequent independent accident loses
7    another or suffers the permanent and complete loss of the
8    use of any one of such members the employer for whom the
9    injured employee is working at the time of the last
10    independent accident is liable to pay compensation only for
11    the loss or permanent and complete loss of the use of the
12    member occasioned by the last independent accident.
13        19. In a case of specific loss and the subsequent death
14    of such injured employee from other causes than such injury
15    leaving a widow, widower, or dependents surviving before
16    payment or payment in full for such injury, then the amount
17    due for such injury is payable to the widow or widower and,
18    if there be no widow or widower, then to such dependents,
19    in the proportion which such dependency bears to total
20    dependency.
21    Beginning July 1, 1980, and every 6 months thereafter, the
22Commission shall examine the Second Injury Fund and when, after
23deducting all advances or loans made to such Fund, the amount
24therein is $500,000 then the amount required to be paid by
25employers pursuant to paragraph (f) of Section 7 shall be
26reduced by one-half. When the Second Injury Fund reaches the

 

 

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1sum of $600,000 then the payments shall cease entirely.
2However, when the Second Injury Fund has been reduced to
3$400,000, payment of one-half of the amounts required by
4paragraph (f) of Section 7 shall be resumed, in the manner
5herein provided, and when the Second Injury Fund has been
6reduced to $300,000, payment of the full amounts required by
7paragraph (f) of Section 7 shall be resumed, in the manner
8herein provided. The Commission shall make the changes in
9payment effective by general order, and the changes in payment
10become immediately effective for all cases coming before the
11Commission thereafter either by settlement agreement or final
12order, irrespective of the date of the accidental injury.
13    On August 1, 1996 and on February 1 and August 1 of each
14subsequent year, the Commission shall examine the special fund
15designated as the "Rate Adjustment Fund" and when, after
16deducting all advances or loans made to said fund, the amount
17therein is $4,000,000, the amount required to be paid by
18employers pursuant to paragraph (f) of Section 7 shall be
19reduced by one-half. When the Rate Adjustment Fund reaches the
20sum of $5,000,000 the payment therein shall cease entirely.
21However, when said Rate Adjustment Fund has been reduced to
22$3,000,000 the amounts required by paragraph (f) of Section 7
23shall be resumed in the manner herein provided.
24    (f) In case of complete disability, which renders the
25employee wholly and permanently incapable of work, or in the
26specific case of total and permanent disability as provided in

 

 

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1subparagraph 18 of paragraph (e) of this Section, compensation
2shall be payable at the rate provided in subparagraph 2 of
3paragraph (b) of this Section for life.
4    An employee entitled to benefits under paragraph (f) of
5this Section shall also be entitled to receive from the Rate
6Adjustment Fund provided in paragraph (f) of Section 7 of the
7supplementary benefits provided in paragraph (g) of this
8Section 8.
9    If any employee who receives an award under this paragraph
10afterwards returns to work or is able to do so, and earns or is
11able to earn as much as before the accident, payments under
12such award shall cease. If such employee returns to work, or is
13able to do so, and earns or is able to earn part but not as much
14as before the accident, such award shall be modified so as to
15conform to an award under paragraph (d) of this Section. If
16such award is terminated or reduced under the provisions of
17this paragraph, such employees have the right at any time
18within 30 months after the date of such termination or
19reduction to file petition with the Commission for the purpose
20of determining whether any disability exists as a result of the
21original accidental injury and the extent thereof.
22    Disability as enumerated in subdivision 18, paragraph (e)
23of this Section is considered complete disability.
24    If an employee who had previously incurred loss or the
25permanent and complete loss of use of one member, through the
26loss or the permanent and complete loss of the use of one hand,

 

 

SB2155- 28 -LRB097 10093 AEK 50272 b

1one arm, one foot, one leg, or one eye, incurs permanent and
2complete disability through the loss or the permanent and
3complete loss of the use of another member, he shall receive,
4in addition to the compensation payable by the employer and
5after such payments have ceased, an amount from the Second
6Injury Fund provided for in paragraph (f) of Section 7, which,
7together with the compensation payable from the employer in
8whose employ he was when the last accidental injury was
9incurred, will equal the amount payable for permanent and
10complete disability as provided in this paragraph of this
11Section.
12    The custodian of the Second Injury Fund provided for in
13paragraph (f) of Section 7 shall be joined with the employer as
14a party respondent in the application for adjustment of claim.
15The application for adjustment of claim shall state briefly and
16in general terms the approximate time and place and manner of
17the loss of the first member.
18    In its award the Commission or the Arbitrator shall
19specifically find the amount the injured employee shall be
20weekly paid, the number of weeks compensation which shall be
21paid by the employer, the date upon which payments begin out of
22the Second Injury Fund provided for in paragraph (f) of Section
237 of this Act, the length of time the weekly payments continue,
24the date upon which the pension payments commence and the
25monthly amount of the payments. The Commission shall 30 days
26after the date upon which payments out of the Second Injury

 

 

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1Fund have begun as provided in the award, and every month
2thereafter, prepare and submit to the State Comptroller a
3voucher for payment for all compensation accrued to that date
4at the rate fixed by the Commission. The State Comptroller
5shall draw a warrant to the injured employee along with a
6receipt to be executed by the injured employee and returned to
7the Commission. The endorsed warrant and receipt is a full and
8complete acquittance to the Commission for the payment out of
9the Second Injury Fund. No other appropriation or warrant is
10necessary for payment out of the Second Injury Fund. The Second
11Injury Fund is appropriated for the purpose of making payments
12according to the terms of the awards.
13    As of July 1, 1980 to July 1, 1982, all claims against and
14obligations of the Second Injury Fund shall become claims
15against and obligations of the Rate Adjustment Fund to the
16extent there is insufficient money in the Second Injury Fund to
17pay such claims and obligations. In that case, all references
18to "Second Injury Fund" in this Section shall also include the
19Rate Adjustment Fund.
20    (g) Every award for permanent total disability entered by
21the Commission on and after July 1, 1965 under which
22compensation payments shall become due and payable after the
23effective date of this amendatory Act, and every award for
24death benefits or permanent total disability entered by the
25Commission on and after the effective date of this amendatory
26Act shall be subject to annual adjustments as to the amount of

 

 

SB2155- 30 -LRB097 10093 AEK 50272 b

1the compensation rate therein provided. Such adjustments shall
2first be made on July 15, 1977, and all awards made and entered
3prior to July 1, 1975 and on July 15 of each year thereafter.
4In all other cases such adjustment shall be made on July 15 of
5the second year next following the date of the entry of the
6award and shall further be made on July 15 annually thereafter.
7If during the intervening period from the date of the entry of
8the award, or the last periodic adjustment, there shall have
9been an increase in the State's average weekly wage in covered
10industries under the Unemployment Insurance Act, the weekly
11compensation rate shall be proportionately increased by the
12same percentage as the percentage of increase in the State's
13average weekly wage in covered industries under the
14Unemployment Insurance Act. The increase in the compensation
15rate under this paragraph shall in no event bring the total
16compensation rate to an amount greater than the prevailing
17maximum rate at the time that the annual adjustment is made.
18Such increase shall be paid in the same manner as herein
19provided for payments under the Second Injury Fund to the
20injured employee, or his dependents, as the case may be, out of
21the Rate Adjustment Fund provided in paragraph (f) of Section 7
22of this Act. Payments shall be made at the same intervals as
23provided in the award or, at the option of the Commission, may
24be made in quarterly payment on the 15th day of January, April,
25July and October of each year. In the event of a decrease in
26such average weekly wage there shall be no change in the then

 

 

SB2155- 31 -LRB097 10093 AEK 50272 b

1existing compensation rate. The within paragraph shall not
2apply to cases where there is disputed liability and in which a
3compromise lump sum settlement between the employer and the
4injured employee, or his dependents, as the case may be, has
5been duly approved by the Illinois Workers' Compensation
6Commission.
7    Provided, that in cases of awards entered by the Commission
8for injuries occurring before July 1, 1975, the increases in
9the compensation rate adjusted under the foregoing provision of
10this paragraph (g) shall be limited to increases in the State's
11average weekly wage in covered industries under the
12Unemployment Insurance Act occurring after July 1, 1975.
13    For every accident occurring on or after July 20, 2005 but
14before the effective date of this amendatory Act of the 94th
15General Assembly (Senate Bill 1283 of the 94th General
16Assembly), the annual adjustments to the compensation rate in
17awards for death benefits or permanent total disability, as
18provided in this Act, shall be paid by the employer. The
19adjustment shall be made by the employer on July 15 of the
20second year next following the date of the entry of the award
21and shall further be made on July 15 annually thereafter. If
22during the intervening period from the date of the entry of the
23award, or the last periodic adjustment, there shall have been
24an increase in the State's average weekly wage in covered
25industries under the Unemployment Insurance Act, the employer
26shall increase the weekly compensation rate proportionately by

 

 

SB2155- 32 -LRB097 10093 AEK 50272 b

1the same percentage as the percentage of increase in the
2State's average weekly wage in covered industries under the
3Unemployment Insurance Act. The increase in the compensation
4rate under this paragraph shall in no event bring the total
5compensation rate to an amount greater than the prevailing
6maximum rate at the time that the annual adjustment is made. In
7the event of a decrease in such average weekly wage there shall
8be no change in the then existing compensation rate. Such
9increase shall be paid by the employer in the same manner and
10at the same intervals as the payment of compensation in the
11award. This paragraph shall not apply to cases where there is
12disputed liability and in which a compromise lump sum
13settlement between the employer and the injured employee, or
14his or her dependents, as the case may be, has been duly
15approved by the Illinois Workers' Compensation Commission.
16    The annual adjustments for every award of death benefits or
17permanent total disability involving accidents occurring
18before July 20, 2005 and accidents occurring on or after the
19effective date of this amendatory Act of the 94th General
20Assembly (Senate Bill 1283 of the 94th General Assembly) shall
21continue to be paid from the Rate Adjustment Fund pursuant to
22this paragraph and Section 7(f) of this Act.
23    (h) In case death occurs from any cause before the total
24compensation to which the employee would have been entitled has
25been paid, then in case the employee leaves any widow, widower,
26child, parent (or any grandchild, grandparent or other lineal

 

 

SB2155- 33 -LRB097 10093 AEK 50272 b

1heir or any collateral heir dependent at the time of the
2accident upon the earnings of the employee to the extent of 50%
3or more of total dependency) such compensation shall be paid to
4the beneficiaries of the deceased employee and distributed as
5provided in paragraph (g) of Section 7.
6    (h-1) In case an injured employee is under legal disability
7at the time when any right or privilege accrues to him or her
8under this Act, a guardian may be appointed pursuant to law,
9and may, on behalf of such person under legal disability, claim
10and exercise any such right or privilege with the same effect
11as if the employee himself or herself had claimed or exercised
12the right or privilege. No limitations of time provided by this
13Act run so long as the employee who is under legal disability
14is without a conservator or guardian.
15    (i) In case the injured employee is under 16 years of age
16at the time of the accident and is illegally employed, the
17amount of compensation payable under paragraphs (b), (c), (d),
18(e) and (f) of this Section is increased 50%.
19    However, where an employer has on file an employment
20certificate issued pursuant to the Child Labor Law or work
21permit issued pursuant to the Federal Fair Labor Standards Act,
22as amended, or a birth certificate properly and duly issued,
23such certificate, permit or birth certificate is conclusive
24evidence as to the age of the injured minor employee for the
25purposes of this Section.
26    Nothing herein contained repeals or amends the provisions

 

 

SB2155- 34 -LRB097 10093 AEK 50272 b

1of the Child Labor Law relating to the employment of minors
2under the age of 16 years.
3    (j) 1. In the event the injured employee receives benefits,
4including medical, surgical or hospital benefits under any
5group plan covering non-occupational disabilities contributed
6to wholly or partially by the employer, which benefits should
7not have been payable if any rights of recovery existed under
8this Act, then such amounts so paid to the employee from any
9such group plan as shall be consistent with, and limited to,
10the provisions of paragraph 2 hereof, shall be credited to or
11against any compensation payment for temporary total
12incapacity for work or any medical, surgical or hospital
13benefits made or to be made under this Act. In such event, the
14period of time for giving notice of accidental injury and
15filing application for adjustment of claim does not commence to
16run until the termination of such payments. This paragraph does
17not apply to payments made under any group plan which would
18have been payable irrespective of an accidental injury under
19this Act. Any employer receiving such credit shall keep such
20employee safe and harmless from any and all claims or
21liabilities that may be made against him by reason of having
22received such payments only to the extent of such credit.
23    Any excess benefits paid to or on behalf of a State
24employee by the State Employees' Retirement System under
25Article 14 of the Illinois Pension Code on a death claim or
26disputed disability claim shall be credited against any

 

 

SB2155- 35 -LRB097 10093 AEK 50272 b

1payments made or to be made by the State of Illinois to or on
2behalf of such employee under this Act, except for payments for
3medical expenses which have already been incurred at the time
4of the award. The State of Illinois shall directly reimburse
5the State Employees' Retirement System to the extent of such
6credit.
7    2. Nothing contained in this Act shall be construed to give
8the employer or the insurance carrier the right to credit for
9any benefits or payments received by the employee other than
10compensation payments provided by this Act, and where the
11employee receives payments other than compensation payments,
12whether as full or partial salary, group insurance benefits,
13bonuses, annuities or any other payments, the employer or
14insurance carrier shall receive credit for each such payment
15only to the extent of the compensation that would have been
16payable during the period covered by such payment.
17    3. The extension of time for the filing of an Application
18for Adjustment of Claim as provided in paragraph 1 above shall
19not apply to those cases where the time for such filing had
20expired prior to the date on which payments or benefits
21enumerated herein have been initiated or resumed. Provided
22however that this paragraph 3 shall apply only to cases wherein
23the payments or benefits hereinabove enumerated shall be
24received after July 1, 1969.
25    (k) For accidental injuries that occur on or after the
26effective date of this amendatory Act of the 97th General

 

 

SB2155- 36 -LRB097 10093 AEK 50272 b

1Assembly, permanent partial or total disability shall be
2certified by a physician and demonstrated by use of medically
3defined objective measurements that include, but are not
4limited to: loss of range of motion; loss of strength; and
5measured atrophy of tissue mass consistent with the injury. In
6determining the impairment, subjective complaints shall not be
7considered unless supported by and clearly related to objective
8measurements. The then-current edition of the American Medical
9Association's "Guides to the Evaluation of Permanent
10Impairment" shall be applied in determining the level of
11disability under this Act.
12    (l) Notwithstanding any other provision of this Act, for
13accidental injuries that occur on or after the effective date
14of this amendatory Act of the 97th General Assembly, temporary
15total disability payments shall not exceed 104 weeks if the
16injured employee's medical impairment rating determined as a
17percentage of the whole person based on the then-current
18edition of the American Medical Association's "Guides to the
19Evaluation of Permanent Impairment" is less than 70%. This
20subsection (l) does not apply if the injured employee's medical
21impairment rating determined as a percentage of the whole
22person based on the then-current edition of the American
23Medical Association's "Guides to the Evaluation of Permanent
24Impairment" is 70% or more.
25(Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05;
2694-695, eff. 11-16-05.)
 

 

 

SB2155- 37 -LRB097 10093 AEK 50272 b

1    (820 ILCS 305/11)  (from Ch. 48, par. 138.11)
2    Sec. 11. The compensation herein provided, together with
3the provisions of this Act, shall be the measure of the
4responsibility of any employer engaged in any of the
5enterprises or businesses enumerated in Section 3 of this Act,
6or of any employer who is not engaged in any such enterprises
7or businesses, but who has elected to provide and pay
8compensation for accidental injuries sustained by any employee
9arising out of and in the course of the employment according to
10the provisions of this Act, and whose election to continue
11under this Act, has not been nullified by any action of his
12employees as provided for in this Act.
13    Accidental injuries incurred while participating in
14voluntary recreational programs including but not limited to
15athletic events, parties and picnics do not arise out of and in
16the course of the employment even though the employer pays some
17or all of the cost thereof. This exclusion shall not apply in
18the event that the injured employee was ordered or assigned by
19his employer to participate in the program.
20    Accidental injuries incurred while participating as a
21patient in a drug or alcohol rehabilitation program do not
22arise out of and in the course of employment even though the
23employer pays some or all of the costs thereof.
24    Any injury to or disease or death of an employee arising
25from the administration of a vaccine, including without

 

 

SB2155- 38 -LRB097 10093 AEK 50272 b

1limitation smallpox vaccine, to prepare for, or as a response
2to, a threatened or potential bioterrorist incident to the
3employee as part of a voluntary inoculation program in
4connection with the person's employment or in connection with
5any governmental program or recommendation for the inoculation
6of workers in the employee's occupation, geographical area, or
7other category that includes the employee is deemed to arise
8out of and in the course of the employment for all purposes
9under this Act. This paragraph added by this amendatory Act of
10the 93rd General Assembly is declarative of existing law and is
11not a new enactment.
12    There shall be a rebuttable presumption that no benefits
13under this Act shall be payable if (i) the employee's
14intoxication is the proximate cause of the employee's
15accidental injury or (ii) at the time the employee incurred
16accidental injury, the employee was so intoxicated that the
17intoxication constituted a departure from the employment.
18Admissible evidence of the concentration of (1) alcohol, (2)
19cannabis as defined in the Cannabis Control Act, (3) a
20controlled substance listed in the Illinois Controlled
21Substances Act, or (4) an intoxicating compound listed in the
22Use of Intoxicating Compounds Act in the employee's blood,
23breath, or urine at the time the employee incurred the
24accidental injury shall be considered in any hearing under this
25Act to determine whether the employee was intoxicated at the
26time the employee incurred the accidental injuries.

 

 

SB2155- 39 -LRB097 10093 AEK 50272 b

1Intoxication shall be defined as 0.08% or more by weight of
2alcohol in the employee's blood, breath, or urine or if there
3is any evidence of impairment due to the unlawful or
4unauthorized use of (1) cannabis as defined in the Cannabis
5Control Act, (2) a controlled substance listed in the Illinois
6Controlled Substances Act, or (3) an intoxicating compound
7listed in the Use of Intoxicating Compounds Act. If the
8employee refuses to submit to testing of blood, breath, or
9urine as soon as practical after the accident, he or she shall
10be considered to have been intoxicated at the time of the
11accident. Percentage by weight of alcohol in the blood shall be
12based on grams of alcohol per 100 milliliters of blood.
13Percentage by weight of alcohol in the breath shall be based
14upon grams of alcohol per 210 liters of breath. Any testing
15that has not been performed by an accredited or certified
16testing laboratory shall not be admissible in any hearing under
17this Act to determine whether the employee was intoxicated at
18the time the employee incurred the accidental injury.
19    All sample collection and testing for alcohol and drugs
20under this Section shall be performed in accordance with rules
21to be adopted by the Commission. These rules shall ensure:
22        (1) compliance with the National Labor Relations Act
23    regarding collective bargaining agreements or regulations
24    promulgated by the United States Department of
25    Transportation;
26        (2) that samples are collected and tested in

 

 

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1    conformance with national and State legal and regulatory
2    standards for the privacy of the individual being tested,
3    and in a manner reasonably calculated to prevent
4    substitutions or interference with the collection or
5    testing of reliable sample;
6        (3) that split testing procedures are utilized;
7        (4) sample collection is documented, and the
8    documentation procedures include:
9            (A) the labeling of samples in a manner so as to
10        reasonably preclude the probability of erroneous
11        identification of test result; and
12            (B) an opportunity for the employee to provide
13        notification of any information which he or she
14        considers relevant to the test, including
15        identification of currently or recently used
16        prescription or nonprescription drugs and other
17        relevant medical information;
18        (5) that sample collection, storage, and
19    transportation to the place of testing is performed in a
20    manner so as to reasonably preclude the probability of
21    sample contamination or adulteration; and
22        (6) that chemical analyses of blood, urine, breath, or
23    other bodily substance are performed according to
24    nationally scientifically accepted analytical methods and
25    procedures.
26(Source: P.A. 93-829, eff. 7-28-04.)
 

 

 

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1    (820 ILCS 305/19)  (from Ch. 48, par. 138.19)
2    Sec. 19. Any disputed questions of law or fact shall be
3determined as herein provided.
4    (a) It shall be the duty of the Commission upon
5notification that the parties have failed to reach an
6agreement, to designate an Arbitrator.
7        1. Whenever any claimant misconceives his remedy and
8    files an application for adjustment of claim under this Act
9    and it is subsequently discovered, at any time before final
10    disposition of such cause, that the claim for disability or
11    death which was the basis for such application should
12    properly have been made under the Workers' Occupational
13    Diseases Act, then the provisions of Section 19, paragraph
14    (a-1) of the Workers' Occupational Diseases Act having
15    reference to such application shall apply.
16        2. Whenever any claimant misconceives his remedy and
17    files an application for adjustment of claim under the
18    Workers' Occupational Diseases Act and it is subsequently
19    discovered, at any time before final disposition of such
20    cause that the claim for injury or death which was the
21    basis for such application should properly have been made
22    under this Act, then the application so filed under the
23    Workers' Occupational Diseases Act may be amended in form,
24    substance or both to assert claim for such disability or
25    death under this Act and it shall be deemed to have been so

 

 

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

 

 

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

 

 

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1transcript of evidence. Such agreed statement of facts or
2correct transcript of evidence, as the case may be, shall be
3authenticated by the signatures of the parties or their
4attorneys, and in the event they do not agree as to the
5correctness of the transcript of evidence it shall be
6authenticated by the signature of the Arbitrator designated by
7the Commission.
8    Whether the employee is working or not, if the employee is
9not receiving or has not received medical, surgical, or
10hospital services or other services or compensation as provided
11in paragraph (a) of Section 8, or compensation as provided in
12paragraph (b) of Section 8, the employee may at any time
13petition for an expedited hearing by an Arbitrator on the issue
14of whether or not he or she is entitled to receive payment of
15the services or compensation. Provided the employer continues
16to pay compensation pursuant to paragraph (b) of Section 8, the
17employer may at any time petition for an expedited hearing on
18the issue of whether or not the employee is entitled to receive
19medical, surgical, or hospital services or other services or
20compensation as provided in paragraph (a) of Section 8, or
21compensation as provided in paragraph (b) of Section 8. When an
22employer has petitioned for an expedited hearing, the employer
23shall continue to pay compensation as provided in paragraph (b)
24of Section 8 unless the arbitrator renders a decision that the
25employee is not entitled to the benefits that are the subject
26of the expedited hearing or unless the employee's treating

 

 

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1physician has released the employee to return to work at his or
2her regular job with the employer or the employee actually
3returns to work at any other job. If the arbitrator renders a
4decision that the employee is not entitled to the benefits that
5are the subject of the expedited hearing, a petition for review
6filed by the employee shall receive the same priority as if the
7employee had filed a petition for an expedited hearing by an
8Arbitrator. Neither party shall be entitled to an expedited
9hearing when the employee has returned to work and the sole
10issue in dispute amounts to less than 12 weeks of unpaid
11compensation pursuant to paragraph (b) of Section 8.
12    Expedited hearings shall have priority over all other
13petitions and shall be heard by the Arbitrator and Commission
14with all convenient speed. Any party requesting an expedited
15hearing shall give notice of a request for an expedited hearing
16under this paragraph. A copy of the Application for Adjustment
17of Claim shall be attached to the notice. The Commission shall
18adopt rules and procedures under which the final decision of
19the Commission under this paragraph is filed not later than 180
20days from the date that the Petition for Review is filed with
21the Commission.
22    Where 2 or more insurance carriers, private self-insureds,
23or a group workers' compensation pool under Article V 3/4 of
24the Illinois Insurance Code dispute coverage for the same
25injury, any such insurance carrier, private self-insured, or
26group workers' compensation pool may request an expedited

 

 

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1hearing pursuant to this paragraph to determine the issue of
2coverage, provided coverage is the only issue in dispute and
3all other issues are stipulated and agreed to and further
4provided that all compensation benefits including medical
5benefits pursuant to Section 8(a) continue to be paid to or on
6behalf of petitioner. Any insurance carrier, private
7self-insured, or group workers' compensation pool that is
8determined to be liable for coverage for the injury in issue
9shall reimburse any insurance carrier, private self-insured,
10or group workers' compensation pool that has paid benefits to
11or on behalf of petitioner for the injury.
12    (b-1) If the employee is not receiving medical, surgical or
13hospital services as provided in paragraph (a) of Section 8 or
14compensation as provided in paragraph (b) of Section 8, the
15employee, in accordance with Commission Rules, may file a
16petition for an emergency hearing by an Arbitrator on the issue
17of whether or not he is entitled to receive payment of such
18compensation or services as provided therein. Such petition
19shall have priority over all other petitions and shall be heard
20by the Arbitrator and Commission with all convenient speed.
21    Such petition shall contain the following information and
22shall be served on the employer at least 15 days before it is
23filed:
24        (i) the date and approximate time of accident;
25        (ii) the approximate location of the accident;
26        (iii) a description of the accident;

 

 

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1        (iv) the nature of the injury incurred by the employee;
2        (v) the identity of the person, if known, to whom the
3    accident was reported and the date on which it was
4    reported;
5        (vi) the name and title of the person, if known,
6    representing the employer with whom the employee conferred
7    in any effort to obtain compensation pursuant to paragraph
8    (b) of Section 8 of this Act or medical, surgical or
9    hospital services pursuant to paragraph (a) of Section 8 of
10    this Act and the date of such conference;
11        (vii) a statement that the employer has refused to pay
12    compensation pursuant to paragraph (b) of Section 8 of this
13    Act or for medical, surgical or hospital services pursuant
14    to paragraph (a) of Section 8 of this Act;
15        (viii) the name and address, if known, of each witness
16    to the accident and of each other person upon whom the
17    employee will rely to support his allegations;
18        (ix) the dates of treatment related to the accident by
19    medical practitioners, and the names and addresses of such
20    practitioners, including the dates of treatment related to
21    the accident at any hospitals and the names and addresses
22    of such hospitals, and a signed authorization permitting
23    the employer to examine all medical records of all
24    practitioners and hospitals named pursuant to this
25    paragraph;
26        (x) a copy of a signed report by a medical

 

 

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1    practitioner, relating to the employee's current inability
2    to return to work because of the injuries incurred as a
3    result of the accident or such other documents or
4    affidavits which show that the employee is entitled to
5    receive compensation pursuant to paragraph (b) of Section 8
6    of this Act or medical, surgical or hospital services
7    pursuant to paragraph (a) of Section 8 of this Act. Such
8    reports, documents or affidavits shall state, if possible,
9    the history of the accident given by the employee, and
10    describe the injury and medical diagnosis, the medical
11    services for such injury which the employee has received
12    and is receiving, the physical activities which the
13    employee cannot currently perform as a result of any
14    impairment or disability due to such injury, and the
15    prognosis for recovery;
16        (xi) complete copies of any reports, records,
17    documents and affidavits in the possession of the employee
18    on which the employee will rely to support his allegations,
19    provided that the employer shall pay the reasonable cost of
20    reproduction thereof;
21        (xii) a list of any reports, records, documents and
22    affidavits which the employee has demanded by subpoena and
23    on which he intends to rely to support his allegations;
24        (xiii) a certification signed by the employee or his
25    representative that the employer has received the petition
26    with the required information 15 days before filing.

 

 

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

 

 

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1and place of any examination scheduled to be made pursuant to
2such Section.
3    Any employer who does not timely file and serve a written
4response without good cause may not introduce any evidence to
5dispute any claim of the employee but may cross examine the
6employee or any witness brought by the employee and otherwise
7be heard.
8    No document or other evidence not previously identified by
9either party with the petition or written response, or by any
10other means before the hearing, may be introduced into evidence
11without good cause. If, at the hearing, material information is
12discovered which was not previously disclosed, the Arbitrator
13may extend the time for closing proof on the motion of a party
14for a reasonable period of time which may be more than 30 days.
15No evidence may be introduced pursuant to this paragraph as to
16permanent disability. No award may be entered for permanent
17disability pursuant to this paragraph. Either party may
18introduce into evidence the testimony taken by deposition of
19any medical practitioner.
20    The Commission shall adopt rules, regulations and
21procedures whereby the final decision of the Commission is
22filed not later than 90 days from the date the petition for
23review is filed but in no event later than 180 days from the
24date the petition for an emergency hearing is filed with the
25Illinois Workers' Compensation Commission.
26    All service required pursuant to this paragraph (b-1) must

 

 

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1be by personal service or by certified mail and with evidence
2of receipt. In addition for the purposes of this paragraph, all
3service on the employer must be at the premises where the
4accident occurred if the premises are owned or operated by the
5employer. Otherwise service must be at the employee's principal
6place of employment by the employer. If service on the employer
7is not possible at either of the above, then service shall be
8at the employer's principal place of business. After initial
9service in each case, service shall be made on the employer's
10attorney or designated representative.
11    (c) (1) At a reasonable time in advance of and in
12connection with the hearing under Section 19(e) or 19(h), the
13Commission may on its own motion order an impartial physical or
14mental examination of a petitioner whose mental or physical
15condition is in issue, when in the Commission's discretion it
16appears that such an examination will materially aid in the
17just determination of the case. The examination shall be made
18by a member or members of a panel of physicians chosen for
19their special qualifications by the Illinois State Medical
20Society. The Commission shall establish procedures by which a
21physician shall be selected from such list.
22    (2) Should the Commission at any time during the hearing
23find that compelling considerations make it advisable to have
24an examination and report at that time, the commission may in
25its discretion so order.
26    (3) A copy of the report of examination shall be given to

 

 

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1the Commission and to the attorneys for the parties.
2    (4) Either party or the Commission may call the examining
3physician or physicians to testify. Any physician so called
4shall be subject to cross-examination.
5    (5) The examination shall be made, and the physician or
6physicians, if called, shall testify, without cost to the
7parties. The Commission shall determine the compensation and
8the pay of the physician or physicians. The compensation for
9this service shall not exceed the usual and customary amount
10for such service.
11    (6) The fees and payment thereof of all attorneys and
12physicians for services authorized by the Commission under this
13Act shall, upon request of either the employer or the employee
14or the beneficiary affected, be subject to the review and
15decision of the Commission.
16    (d) If any employee shall persist in insanitary or
17injurious practices which tend to either imperil or retard his
18recovery or shall refuse to submit to such medical, surgical,
19or hospital treatment as is reasonably essential to promote his
20recovery, the Commission may, in its discretion, reduce or
21suspend the compensation of any such injured employee. However,
22when an employer and employee so agree in writing, the
23foregoing provision shall not be construed to authorize the
24reduction or suspension of compensation of an employee who is
25relying in good faith, on treatment by prayer or spiritual
26means alone, in accordance with the tenets and practice of a

 

 

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1recognized church or religious denomination, by a duly
2accredited practitioner thereof.
3    (e) This paragraph shall apply to all hearings before the
4Commission. Such hearings may be held in its office or
5elsewhere as the Commission may deem advisable. The taking of
6testimony on such hearings may be had before any member of the
7Commission. If a petition for review and agreed statement of
8facts or transcript of evidence is filed, as provided herein,
9the Commission shall promptly review the decision of the
10Arbitrator and all questions of law or fact which appear from
11the statement of facts or transcript of evidence.
12    In all cases in which the hearing before the arbitrator is
13held after December 18, 1989, no additional evidence shall be
14introduced by the parties before the Commission on review of
15the decision of the Arbitrator. In reviewing decisions of an
16arbitrator the Commission shall award such temporary
17compensation, permanent compensation and other payments as are
18due under this Act. The Commission shall file in its office its
19decision thereon, and shall immediately send to each party or
20his attorney a copy of such decision and a notification of the
21time when it was filed. Decisions shall be filed within 60 days
22after the Statement of Exceptions and Supporting Brief and
23Response thereto are required to be filed or oral argument
24whichever is later.
25    In the event either party requests oral argument, such
26argument shall be had before a panel of 3 members of the

 

 

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1Commission (or before all available members pursuant to the
2determination of 7 members of the Commission that such argument
3be held before all available members of the Commission)
4pursuant to the rules and regulations of the Commission. A
5panel of 3 members, which shall be comprised of not more than
6one representative citizen of the employing class and not more
7than one representative citizen of the employee class, shall
8hear the argument; provided that if all the issues in dispute
9are solely the nature and extent of the permanent partial
10disability, if any, a majority of the panel may deny the
11request for such argument and such argument shall not be held;
12and provided further that 7 members of the Commission may
13determine that the argument be held before all available
14members of the Commission. A decision of the Commission shall
15be approved by a majority of Commissioners present at such
16hearing if any; provided, if no such hearing is held, a
17decision of the Commission shall be approved by a majority of a
18panel of 3 members of the Commission as described in this
19Section. The Commission shall give 10 days' notice to the
20parties or their attorneys of the time and place of such taking
21of testimony and of such argument.
22    In any case the Commission in its decision may find
23specially upon any question or questions of law or fact which
24shall be submitted in writing by either party whether ultimate
25or otherwise; provided that on issues other than nature and
26extent of the disability, if any, the Commission in its

 

 

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1decision shall find specially upon any question or questions of
2law or fact, whether ultimate or otherwise, which are submitted
3in writing by either party; provided further that not more than
45 such questions may be submitted by either party. Any party
5may, within 20 days after receipt of notice of the Commission's
6decision, or within such further time, not exceeding 30 days,
7as the Commission may grant, file with the Commission either an
8agreed statement of the facts appearing upon the hearing, or,
9if such party shall so elect, a correct transcript of evidence
10of the additional proceedings presented before the Commission,
11in which report the party may embody a correct statement of
12such other proceedings in the case as such party may desire to
13have reviewed, such statement of facts or transcript of
14evidence to be authenticated by the signature of the parties or
15their attorneys, and in the event that they do not agree, then
16the authentication of such transcript of evidence shall be by
17the signature of any member of the Commission.
18    If a reporter does not for any reason furnish a transcript
19of the proceedings before the Arbitrator in any case for use on
20a hearing for review before the Commission, within the
21limitations of time as fixed in this Section, the Commission
22may, in its discretion, order a trial de novo before the
23Commission in such case upon application of either party. The
24applications for adjustment of claim and other documents in the
25nature of pleadings filed by either party, together with the
26decisions of the Arbitrator and of the Commission and the

 

 

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1statement of facts or transcript of evidence hereinbefore
2provided for in paragraphs (b) and (c) shall be the record of
3the proceedings of the Commission, and shall be subject to
4review as hereinafter provided.
5    At the request of either party or on its own motion, the
6Commission shall set forth in writing the reasons for the
7decision, including findings of fact and conclusions of law
8separately stated. The Commission shall by rule adopt a format
9for written decisions for the Commission and arbitrators. The
10written decisions shall be concise and shall succinctly state
11the facts and reasons for the decision. The Commission may
12adopt in whole or in part, the decision of the arbitrator as
13the decision of the Commission. When the Commission does so
14adopt the decision of the arbitrator, it shall do so by order.
15Whenever the Commission adopts part of the arbitrator's
16decision, but not all, it shall include in the order the
17reasons for not adopting all of the arbitrator's decision. When
18a majority of a panel, after deliberation, has arrived at its
19decision, the decision shall be filed as provided in this
20Section without unnecessary delay, and without regard to the
21fact that a member of the panel has expressed an intention to
22dissent. Any member of the panel may file a dissent. Any
23dissent shall be filed no later than 10 days after the decision
24of the majority has been filed.
25    Decisions rendered by the Commission and dissents, if any,
26shall be published together by the Commission. The conclusions

 

 

SB2155- 57 -LRB097 10093 AEK 50272 b

1of law set out in such decisions shall be regarded as
2precedents by arbitrators for the purpose of achieving a more
3uniform administration of this Act.
4    (f) The decision of the Commission acting within its
5powers, according to the provisions of paragraph (e) of this
6Section shall, in the absence of fraud, be conclusive unless
7reviewed as in this paragraph hereinafter provided. However,
8the Arbitrator or the Commission may on his or its own motion,
9or on the motion of either party, correct any clerical error or
10errors in computation within 15 days after the date of receipt
11of any award by such Arbitrator or any decision on review of
12the Commission and shall have the power to recall the original
13award on arbitration or decision on review, and issue in lieu
14thereof such corrected award or decision. Where such correction
15is made the time for review herein specified shall begin to run
16from the date of the receipt of the corrected award or
17decision.
18    The Commission may recall a decision or settlement when
19fraud has been determined to be committed related to the case.
20The Commission shall implement a rule to establish a process
21for recalling a decision or settlement that is subject to
22recall due to fraud.
23        (1) Except in cases of claims against the State of
24    Illinois, in which case the decision of the Commission
25    shall not be subject to judicial review, the Circuit Court
26    of the county where any of the parties defendant may be

 

 

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

 

 

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1    the Commission, and a copy of the summons to the other
2    parties in interest or their attorney or attorneys of
3    record and the clerk of the court shall make certificate
4    that he has so sent said notices in pursuance of this
5    Section, which shall be evidence of service on the
6    Commission and other parties in interest.
7        The Commission shall not be required to certify the
8    record of their proceedings to the Circuit Court, unless
9    the party commencing the proceedings for review in the
10    Circuit Court as above provided, shall pay to the
11    Commission the sum of 80 per page of testimony taken
12    before the Commission, and 35 per page of all other
13    matters contained in such record, except as otherwise
14    provided by Section 20 of this Act. Payment for photostatic
15    copies of exhibit shall be extra. It shall be the duty of
16    the Commission upon such payment, or failure to pay as
17    permitted under Section 20 of this Act, to prepare a true
18    and correct typewritten copy of such testimony and a true
19    and correct copy of all other matters contained in such
20    record and certified to by the Secretary or Assistant
21    Secretary thereof.
22        In its decision on review the Commission shall
23    determine in each particular case the amount of the
24    probable cost of the record to be filed as a part of the
25    summons in that case and no request for a summons may be
26    filed and no summons shall issue unless the party seeking

 

 

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1    to review the decision of the Commission shall exhibit to
2    the clerk of the Circuit Court proof of payment by filing a
3    receipt showing payment or an affidavit of the attorney
4    setting forth that payment has been made of the sums so
5    determined to the Secretary or Assistant Secretary of the
6    Commission, except as otherwise provided by Section 20 of
7    this Act.
8        (2) No such summons shall issue unless the one against
9    whom the Commission shall have rendered an award for the
10    payment of money shall upon the filing of his written
11    request for such summons file with the clerk of the court a
12    bond conditioned that if he shall not successfully
13    prosecute the review, he will pay the award and the costs
14    of the proceedings in the courts. The amount of the bond
15    shall be fixed by any member of the Commission and the
16    surety or sureties of the bond shall be approved by the
17    clerk of the court. The acceptance of the bond by the clerk
18    of the court shall constitute evidence of his approval of
19    the bond.
20        Every county, city, town, township, incorporated
21    village, school district, body politic or municipal
22    corporation against whom the Commission shall have
23    rendered an award for the payment of money shall not be
24    required to file a bond to secure the payment of the award
25    and the costs of the proceedings in the court to authorize
26    the court to issue such summons.

 

 

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1        The court may confirm or set aside the decision of the
2    Commission. If the decision is set aside and the facts
3    found in the proceedings before the Commission are
4    sufficient, the court may enter such decision as is
5    justified by law, or may remand the cause to the Commission
6    for further proceedings and may state the questions
7    requiring further hearing, and give such other
8    instructions as may be proper. Appeals shall be taken to
9    the Appellate Court in accordance with Supreme Court Rules
10    22(g) and 303. Appeals shall be taken from the Appellate
11    Court to the Supreme Court in accordance with Supreme Court
12    Rule 315.
13        It shall be the duty of the clerk of any court
14    rendering a decision affecting or affirming an award of the
15    Commission to promptly furnish the Commission with a copy
16    of such decision, without charge.
17        The decision of a majority of the members of the panel
18    of the Commission, shall be considered the decision of the
19    Commission.
20    (g) Except in the case of a claim against the State of
21Illinois, either party may present a certified copy of the
22award of the Arbitrator, or a certified copy of the decision of
23the Commission when the same has become final, when no
24proceedings for review are pending, providing for the payment
25of compensation according to this Act, to the Circuit Court of
26the county in which such accident occurred or either of the

 

 

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

 

 

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1the request of either the employer or the employee, on the
2ground that the disability of the employee has subsequently
3recurred, increased, diminished or ended.
4    However, as to accidents occurring subsequent to July 1,
51955, which are covered by any agreement or award under this
6Act providing for compensation in installments made as a result
7of such accident, such agreement or award may at any time
8within 30 months, or 60 months in the case of an award under
9Section 8(d)1, after such agreement or award be reviewed by the
10Commission at the request of either the employer or the
11employee on the ground that the disability of the employee has
12subsequently recurred, increased, diminished or ended.
13    On such review, compensation payments may be
14re-established, increased, diminished or ended. The Commission
15shall give 15 days' notice to the parties of the hearing for
16review. Any employee, upon any petition for such review being
17filed by the employer, shall be entitled to one day's notice
18for each 100 miles necessary to be traveled by him in attending
19the hearing of the Commission upon the petition, and 3 days in
20addition thereto. Such employee shall, at the discretion of the
21Commission, also be entitled to 5 cents per mile necessarily
22traveled by him within the State of Illinois in attending such
23hearing, not to exceed a distance of 300 miles, to be taxed by
24the Commission as costs and deposited with the petition of the
25employer.
26    When compensation which is payable in accordance with an

 

 

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

 

 

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1compensation, or proceedings have been instituted or carried on
2by the one liable to pay the compensation, which do not present
3a real controversy, but are merely frivolous or for delay, then
4the Commission may award compensation additional to that
5otherwise payable under this Act equal to 50% of the amount
6payable at the time of such award. Failure to pay compensation
7in accordance with the provisions of Section 8, paragraph (b)
8of this Act, shall be considered unreasonable delay.
9    When determining whether this subsection (k) shall apply,
10the Commission shall consider whether an Arbitrator has
11determined that the claim is not compensable or whether the
12employer has made payments under Section 8(j).
13    (l) If the employee has made written demand for payment of
14benefits under Section 8(a) or Section 8(b), the employer shall
15have 14 days after receipt of the demand to set forth in
16writing the reason for the delay. In the case of demand for
17payment of medical benefits under Section 8(a), the time for
18the employer to respond shall not commence until the expiration
19of the allotted 60 days specified under Section 8.2(d). In case
20the employer or his or her insurance carrier shall without good
21and just cause fail, neglect, refuse, or unreasonably delay the
22payment of benefits under Section 8(a) or Section 8(b), the
23Arbitrator or the Commission shall allow to the employee
24additional compensation in the sum of $30 per day for each day
25that the benefits under Section 8(a) or Section 8(b) have been
26so withheld or refused, not to exceed $10,000. A delay in

 

 

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1payment of 14 days or more shall create a rebuttable
2presumption of unreasonable delay.
3    (m) If the commission finds that an accidental injury was
4directly and proximately caused by the employer's wilful
5violation of a health and safety standard under the Health and
6Safety Act in force at the time of the accident, the arbitrator
7or the Commission shall allow to the injured employee or his
8dependents, as the case may be, additional compensation equal
9to 25% of the amount which otherwise would be payable under the
10provisions of this Act exclusive of this paragraph. The
11additional compensation herein provided shall be allowed by an
12appropriate increase in the applicable weekly compensation
13rate.
14    (n) After June 30, 1984, decisions of the Illinois Workers'
15Compensation Commission reviewing an award of an arbitrator of
16the Commission shall draw interest at a rate equal to the yield
17on indebtedness issued by the United States Government with a
1826-week maturity next previously auctioned on the day on which
19the decision is filed. Said rate of interest shall be set forth
20in the Arbitrator's Decision. Interest shall be drawn from the
21date of the arbitrator's award on all accrued compensation due
22the employee through the day prior to the date of payments.
23However, when an employee appeals an award of an Arbitrator or
24the Commission, and the appeal results in no change or a
25decrease in the award, interest shall not further accrue from
26the date of such appeal.

 

 

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1    The employer or his insurance carrier may tender the
2payments due under the award to stop the further accrual of
3interest on such award notwithstanding the prosecution by
4either party of review, certiorari, appeal to the Supreme Court
5or other steps to reverse, vacate or modify the award.
6    (o) By the 15th day of each month each insurer providing
7coverage for losses under this Act shall notify each insured
8employer of any compensable claim incurred during the preceding
9month and the amounts paid or reserved on the claim including a
10summary of the claim and a brief statement of the reasons for
11compensability. A cumulative report of all claims incurred
12during a calendar year or continued from the previous year
13shall be furnished to the insured employer by the insurer
14within 30 days after the end of that calendar year.
15    The insured employer may challenge, in proceeding before
16the Commission, payments made by the insurer without
17arbitration and payments made after a case is determined to be
18noncompensable. If the Commission finds that the case was not
19compensable, the insurer shall purge its records as to that
20employer of any loss or expense associated with the claim,
21reimburse the employer for attorneys' fees arising from the
22challenge and for any payment required of the employer to the
23Rate Adjustment Fund or the Second Injury Fund, and may not
24reflect the loss or expense for rate making purposes. The
25employee shall not be required to refund the challenged
26payment. The decision of the Commission may be reviewed in the

 

 

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

 

 

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1award. The decision of the arbitrator under this subsection (p)
2shall be considered the decision of the Commission and
3proceedings for review of questions of law arising from the
4decision may be commenced by either party pursuant to
5subsection (f) of Section 19. The Advisory Board established
6under Section 13.1 shall compile a list of certified Commission
7arbitrators, each of whom shall be approved by at least 7
8members of the Advisory Board. The chairman shall select 5
9persons from such list to serve as arbitrators under this
10subsection (p). By agreement, the parties shall select one
11arbitrator from among the 5 persons selected by the chairman
12except that if the parties do not agree on an arbitrator from
13among the 5 persons, the parties may, by agreement, select an
14arbitrator of the American Arbitration Association, whose fee
15shall be paid by the State in accordance with rules promulgated
16by the Commission. Arbitration under this subsection (p) shall
17be voluntary.
18(Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05.)
 
19    (820 ILCS 305/25.5)
20    Sec. 25.5. Unlawful acts; penalties.
21    (a) It is unlawful for any person, company, corporation,
22insurance carrier, healthcare provider, or other entity to:
23        (1) Intentionally present or cause to be presented any
24    false or fraudulent claim for the payment of any workers'
25    compensation benefit.

 

 

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1        (2) Intentionally make or cause to be made any false or
2    fraudulent material statement or material representation
3    for the purpose of obtaining or denying any workers'
4    compensation benefit.
5        (3) Intentionally make or cause to be made any false or
6    fraudulent statements with regard to entitlement to
7    workers' compensation benefits with the intent to prevent
8    an injured worker from making a legitimate claim for any
9    workers' compensation benefits.
10        (4) Intentionally prepare or provide an invalid,
11    false, or counterfeit certificate of insurance as proof of
12    workers' compensation insurance.
13        (5) Intentionally make or cause to be made any false or
14    fraudulent material statement or material representation
15    for the purpose of obtaining workers' compensation
16    insurance at less than the proper rate for that insurance.
17        (6) Intentionally make or cause to be made any false or
18    fraudulent material statement or material representation
19    on an initial or renewal self-insurance application or
20    accompanying financial statement for the purpose of
21    obtaining self-insurance status or reducing the amount of
22    security that may be required to be furnished pursuant to
23    Section 4 of this Act.
24        (7) Intentionally make or cause to be made any false or
25    fraudulent material statement to the Division of
26    Insurance's fraud and insurance non-compliance unit in the

 

 

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1    course of an investigation of fraud or insurance
2    non-compliance.
3        (8) Intentionally assist, abet, solicit, or conspire
4    with any person, company, or other entity to commit any of
5    the acts in paragraph (1), (2), (3), (4), (5), (6), or (7)
6    of this subsection (a).
7    For the purposes of paragraphs (2), (3), (5), (6), and (7),
8the term "statement" includes any writing, notice, proof of
9injury, bill for services, hospital or doctor records and
10reports, or X-ray and test results.
11    (b) Any person violating subsection (a) is guilty of a
12Class 4 felony. Any person or entity convicted of any violation
13of this Section shall be ordered to pay complete restitution to
14any person or entity so defrauded in addition to any fine or
15sentence imposed as a result of the conviction.
16    (c) The Division of Insurance of the Department of
17Financial and Professional Regulation shall establish a fraud
18and insurance non-compliance unit responsible for
19investigating incidences of fraud and insurance non-compliance
20pursuant to this Section. The size of the staff of the unit
21shall be subject to appropriation by the General Assembly. It
22shall be the duty of the fraud and insurance non-compliance
23unit to determine the identity of insurance carriers,
24employers, employees, or other persons or entities who have
25violated the fraud and insurance non-compliance provisions of
26this Section and any prosecution thereof. The fraud and

 

 

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1insurance non-compliance unit shall report violations of the
2fraud and insurance non-compliance provisions of this Section
3to the Attorney General or to the State's Attorney of the
4county in which the offense allegedly occurred, either of whom
5has the authority to prosecute violations under this Section.
6    The fraud and insurance non-compliance unit shall employ
7one or more attorneys licensed to practice law in Illinois as
8special prosecutors who shall initiate and prosecute any
9necessary criminal or civil actions in any court or tribunal of
10competent jurisdiction in this State. The special prosecutors
11may also assist State's Attorneys in prosecuting violations of
12this Section, without charge to the county.
13    With respect to the subject of any investigation being
14conducted, the fraud and insurance non-compliance unit shall
15have the general power of subpoena of the Division of
16Insurance.
17    (d) Any person may report allegations of insurance
18non-compliance and fraud pursuant to this Section to the
19Division of Insurance's fraud and insurance non-compliance
20unit whose duty it shall be to investigate the report. The unit
21shall notify the Commission of reports of insurance
22non-compliance. Any person reporting an allegation of
23insurance non-compliance or fraud against either an employee or
24employer under this Section must identify himself. Except as
25provided in this subsection and in subsection (e), all reports
26shall remain confidential except to refer an investigation to

 

 

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1the Attorney General or State's Attorney for prosecution or if
2the fraud and insurance non-compliance unit's investigation
3reveals that the conduct reported may be in violation of other
4laws or regulations of the State of Illinois, the unit may
5report such conduct to the appropriate governmental agency
6charged with administering such laws and regulations. Any
7person who intentionally makes a false report under this
8Section to the fraud and insurance non-compliance unit is
9guilty of a Class A misdemeanor.
10    (e) In order for the fraud and insurance non-compliance
11unit to investigate a report of fraud by an employee, (i) the
12employee must have filed with the Commission an Application for
13Adjustment of Claim and the employee must have either received
14or attempted to receive benefits under this Act that are
15related to the reported fraud or (ii) the employee must have
16made a written demand for the payment of benefits that are
17related to the reported fraud. Upon receipt of a report of
18fraud, the employee or employer shall receive immediate notice
19of the reported conduct, including the verified name and
20address of the complainant if that complainant is connected to
21the case and the nature of the reported conduct. The fraud and
22insurance non-compliance unit shall resolve all reports of
23fraud against employees or employers within 120 days of receipt
24of the report. There shall be no immunity, under this Act or
25otherwise, for any person who files a false report or who files
26a report without good and just cause. Confidentiality of

 

 

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1medical information shall be strictly maintained.
2Investigations that are not referred for prosecution shall be
3immediately expunged and shall not be disclosed except that the
4employee or employer who was the subject of the report and the
5person making the report shall be notified that the
6investigation is being closed, at which time the name of any
7complainant not connected to the case shall be disclosed to the
8employee or the employer. When an investigation is referred for
9prosecution the employee or employer who was the subject of the
10report and the person making the report shall immediately be
11notified that the investigation has been referred for
12prosecution. It is unlawful for any employer, insurance
13carrier, or service adjustment company to file or threaten to
14file a report of fraud against an employee because of the
15exercise by the employee of the rights and remedies granted to
16the employee by this Act.
17    When the Attorney General or a State's Attorney declines to
18prosecute a referral from the fraud and insurance
19non-compliance unit of an alleged violation of this Section,
20the Attorney General or the State's Attorney declining
21prosecution shall provide in writing a response to the unit
22within 30 days of such decision setting forth the reasons and
23basis for the decision. The unit shall provide the response to
24the employer.
25    For purposes of this subsection (e), "employer" means any
26employer, insurance carrier, third party administrator,

 

 

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1self-insured, or similar entity.
2    For purposes of this subsection (e), "complainant" refers
3to the person contacting the fraud and insurance non-compliance
4unit to initiate the complaint.
5    (f) Any person convicted of fraud related to workers'
6compensation pursuant to this Section shall be subject to the
7penalties prescribed in the Criminal Code of 1961 and shall be
8ineligible to receive or retain any compensation, disability,
9or medical benefits as defined in this Act if the compensation,
10disability, or medical benefits were owed or received as a
11result of fraud for which the recipient of the compensation,
12disability, or medical benefit was convicted. This subsection
13applies to accidental injuries or diseases that occur on or
14after the effective date of this amendatory Act of the 94th
15General Assembly.
16    (f-1) The Department of Insurance shall post all of the
17following information on its Internet Web site for each person
18convicted of a violation of the unlawful actions provided in
19this Section:
20        (1) The name, case number, county or court, and other
21    identifying information with respect to the case.
22        (2) The full name of the defendant.
23        (3) The city and county of the defendant's last known
24    residence or business address.
25        (4) The date of conviction.
26        (5) A description of the offense.

 

 

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1        (6) The amount of money alleged to have been defrauded.
2        (7) A description of the punishment imposed, including
3    the length of any sentence of imprisonment and the amount
4    of any fine imposed.
5    The information required to be posted under this subsection
6shall be maintained on the Department's Web site for a period
7of 5 years from the date of conviction or until the Department
8is notified in writing by the person that the conviction has
9been reversed or expunged.
10    (g) Civil liability. Any person convicted of fraud who
11knowingly obtains, attempts to obtain, or causes to be obtained
12any benefits under this Act by the making of a false claim or
13who knowingly misrepresents any material fact shall be civilly
14liable to the payor of benefits or the insurer or the payor's
15or insurer's subrogee or assignee in an amount equal to 3 times
16the value of the benefits or insurance coverage wrongfully
17obtained or twice the value of the benefits or insurance
18coverage attempted to be obtained, plus reasonable attorney's
19fees and expenses incurred by the payor or the payor's subrogee
20or assignee who successfully brings a claim under this
21subsection. This subsection applies to accidental injuries or
22diseases that occur on or after the effective date of this
23amendatory Act of the 94th General Assembly. This subsection
24shall not bar any plaintiff from attempting to secure civil
25remedies provided under this Section or any other law.
26    (h) All proceedings under this Section shall be reported by

 

 

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1the fraud and insurance non-compliance unit on an annual basis
2to the Workers' Compensation Advisory Board.
3(Source: P.A. 94-277, eff. 7-20-05.)