Bill Text: IL HB2525 | 2017-2018 | 100th General Assembly | Engrossed


Bill Title: Amends the Employer's Liability Rates Article of the Illinois Insurance Code. Provides that a rate is excessive if it is likely to produce a long run profit that is unreasonably high for the insurance provided or if expenses are unreasonably high in relation to the services rendered. Repeals provisions regarding presumptions that a competitive market exists, determining whether a competitive market exists, and disapproval of rates under specified circumstances. Amends the Workers' Compensation Act. Provides that accidental injuries sustained while traveling to or from work do not arise out of and in the course of employment. Defines "in the course of employment" and "arising out of the employment". Permits an employer to file with the Illinois Workers' Compensation Commission a workers' compensation safety program or a workers' compensation return to work program implemented by the employer. Provides that the Commission may certify any such safety program as a bona fide safety program after reviewing the program. In a provision concerning compensation for the period of temporary total incapacity for work resulting from an accidental injury, provides that (i) injuries to the shoulder shall be considered injuries to part of the arm and (ii) injuries to the hip shall be considered injuries to part of the leg. Contains provisions concerning repetitive and cumulative injuries; permanent partial disability determinations; electronic claims; annual reports by the Commission concerning the state of self-insurance for workers' compensation in Illinois; and duties of the Workers' Compensation Premium Rates Task Force; and other matters. Effective immediately.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Engrossed) 2017-04-27 - Added Co-Sponsor Rep. Katie Stuart [HB2525 Detail]

Download: Illinois-2017-HB2525-Engrossed.html



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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 Illinois Insurance Code is amended by
5changing Sections 456, 457, and 458 and by adding Section 462a
6as follows:
7 (215 ILCS 5/456) (from Ch. 73, par. 1065.3)
8 Sec. 456. Making of rates. (1) All rates shall be made in
9accordance with the following provisions:
10 (a) Due consideration shall be given to past and
11prospective loss experience within and outside this state, to
12catastrophe hazards, if any, to a reasonable margin for profit
13and contingencies, to dividends, savings or unabsorbed premium
14deposits allowed or returned by companies to their
15policyholders, members or subscribers, to past and prospective
16expenses both countrywide and those specially applicable to
17this state, to underwriting practice and judgment and to all
18other relevant factors within and outside this state;
19 (b) The systems of expense provisions included in the rates
20for use by any company or group of companies may differ from
21those of other companies or groups of companies to reflect the
22requirements of the operating methods of any such company or
23group with respect to any kind of insurance, or with respect to

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1any subdivision or combination thereof for which subdivision or
2combination separate expense provisions are applicable;
3 (c) Risks may be grouped by classifications for the
4establishment of rates and minimum premiums. Classification
5rates may be modified to produce rates for individual risks in
6accordance with rating plans which measure variation in hazards
7or expense provisions, or both. Such rating plans may measure
8any differences among risks that have a probable effect upon
9losses or expenses;
10 (d) Rates shall not be excessive, inadequate or unfairly
11discriminatory.
12 A rate in a competitive market is not excessive. A rate in
13a noncompetitive market is excessive if it is likely to produce
14a long run profit that is unreasonably high for the insurance
15provided or if expenses are unreasonably high in relation to
16the services rendered.
17 A rate is not inadequate unless such rate is clearly
18insufficient to sustain projected losses and expenses in the
19class of business to which it applies and the use of such rate
20has or, if continued, will have the effect of substantially
21lessening competition or the tendency to create monopoly in any
22market.
23 Unfair discrimination exists if, after allowing for
24practical limitations, price differentials fail to reflect
25equitably the differences in expected losses and expenses. A
26rate is not unfairly discriminatory because different premiums

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1result for policyholders with like exposures but different
2expenses, or like expenses but different loss exposures, so
3long as the rate reflects the differences with reasonable
4accuracy.
5 (e) The rating plan shall contain a mandatory offer of a
6deductible applicable only to the medical benefit under the
7Workers' Compensation Act. Such deductible offer shall be in a
8minimum amount of at least $1,000 per accident.
9 (f) Any rating plan or program shall include a rule
10permitting 2 or more employers with similar risk
11characteristics, who participate in a loss prevention program
12or safety group, to pool their premium and loss experience in
13determining their rate or premium for such participation in the
14program.
15 (2) Except to the extent necessary to meet the provisions
16of subdivision (d) of subsection (1) of this Section,
17uniformity among companies in any matters within the scope of
18this Section is neither required nor prohibited.
19(Source: P.A. 82-939.)
20 (215 ILCS 5/457) (from Ch. 73, par. 1065.4)
21 Sec. 457. Rate filings. (1) Every Beginning January 1,
221983, every company shall prefile file with the Director every
23manual of classifications, every manual of rules and rates,
24every rating plan and every modification of the foregoing which
25it intends to use. Such filings shall be made at least not

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1later than 30 days before after they become effective. A
2company may satisfy its obligation to make such filings by
3adopting the filing of a licensed rating organization of which
4it is a member or subscriber, filed pursuant to subsection (2)
5of this Section, in total or, with the approval of the
6Director, by notifying the Director in what respects it intends
7to deviate from such filing. If a company intends to deviate
8from the filing of a licensed rating organization of which it
9is a member, the company shall provide the Director with
10supporting information that specifies the basis for the
11requested deviation and provides justification for the
12deviation. Any company adopting a pure premium filed by a
13rating organization pursuant to subsection (2) must file with
14the Director the modification factor it is using for expenses
15and profit so that the final rates in use by such company can
16be determined.
17 (2) Each Beginning January 1, 1983, each licensed rating
18organization must prefile file with the Director every manual
19of classification, every manual of rules and advisory rates,
20every pure premium which has been fully adjusted and fully
21developed, every rating plan and every modification of any of
22the foregoing which it intends to recommend for use to its
23members and subscribers, at least not later than 30 days before
24after such manual, premium, plan or modification thereof takes
25effect. Every licensed rating organization shall also file with
26the Director the rate classification system, all rating rules,

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1rating plans, policy forms, underwriting rules or similar
2materials, and each modification of any of the foregoing which
3it requires its members and subscribers to adhere to not later
4than 30 days before such filings or modifications thereof are
5to take effect. Every such filing shall state the proposed
6effective date thereof and shall indicate the character and
7extent of the coverage contemplated.
8 (3) A filing and any supporting information made pursuant
9to this Section shall be open to public inspection as soon as
10filed after the filing becomes effective.
11 (4) A filing shall not be effective nor used until approved
12by the Director. A filing shall be deemed approved if the
13Director fails to disapprove within 30 days after the filing.
14(Source: P.A. 82-939.)
15 (215 ILCS 5/458) (from Ch. 73, par. 1065.5)
16 Sec. 458. Disapproval of filings. (1) If within 30 thirty
17days of any filing the Director finds that such filing does not
18meet the requirements of this Article, he shall send to the
19company or rating organization which made such filing a written
20notice of disapproval of such filing, specifying therein in
21what respects he finds that such filing fails to meet the
22requirements of this Article and stating when, within a
23reasonable period thereafter, such filing shall be deemed no
24longer effective. A company or rating organization whose filing
25has been disapproved shall be given a hearing upon a written

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1request made within 30 days after the disapproval order. If the
2company or rating organization making the filing shall, prior
3to the expiration of the period prescribed in the notice,
4request a hearing, such filings shall be effective until the
5expiration of a reasonable period specified in any order
6entered thereon. If the rate resulting from such filing be
7unfairly discriminatory or materially inadequate, and the
8difference between such rate and the approved rate equals or
9exceeds the cost of making an adjustment, the Director shall in
10such notice or order direct an adjustment of the premium to be
11made with the policyholder either by refund or collection of
12additional premium. If the policyholder does not accept the
13increased rate, cancellation shall be made on a pro rata basis.
14Any policy issued pursuant to this subsection shall contain a
15provision that the premium thereon shall be subject to
16adjustment upon the basis of the filing finally approved.
17 (2) If at any time subsequent to the applicable review
18period provided for in subsection (1) of this Section, the
19Director finds that a filing does not meet the requirements of
20this Article, he shall, after a hearing held upon not less than
21ten days written notice, specifying the matters to be
22considered at such hearing, to every company and rating
23organization which made such filing, issue an order specifying
24in what respects he finds that such filing fails to meet the
25requirements of this Article, and stating when, within a
26reasonable period thereafter, such filings shall be deemed no

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1longer effective. Copies of said order shall be sent to every
2such company and rating organization. Said order shall not
3affect any contract or policy made or issued prior to the
4expiration of the period set forth in said order.
5 (3) Any person or organization aggrieved with respect to
6any filing which is in effect may make written application to
7the Director for a hearing thereon, provided, however, that the
8company or rating organization that made the filing shall not
9be authorized to proceed under this subsection. Such
10application shall specify the grounds to be relied upon by the
11applicant. If the Director shall find that the application is
12made in good faith, that the applicant would be so aggrieved if
13his grounds are established, and that such grounds otherwise
14justify holding such a hearing, he shall, within thirty days
15after receipt of such application, hold a hearing upon not less
16than ten days written notice to the applicant and to every
17company and rating organization which made such filing.
18 If, after such hearing, the Director finds that the filing
19does not meet the requirements of this Article, he shall issue
20an order specifying in what respects he finds that such filing
21fails to meet the requirements of this Article, and stating
22when, within a reasonable period thereafter, such filing shall
23be deemed no longer effective. Copies of said order shall be
24sent to the applicant and to every such company and rating
25organization. Said order shall not affect any contract or
26policy made or issued prior to the expiration of the period set

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1forth in said order.
2 (4) Whenever an insurer has no legally effective rates as a
3result of the Director's disapproval of rates or other act, the
4Director shall on request of the insurer specify interim rates
5for the insurer that are high enough to protect the interests
6of all parties and may order that a specified portion of the
7premiums be placed in an escrow account approved by him or her.
8When new rates become legally effective, the Director shall
9order the escrowed funds or any overcharge in the interim rates
10to be distributed appropriately, except that refunds to
11policyholders that are de minimis shall not be required.
12(Source: P.A. 82-939.)
13 (215 ILCS 5/462a new)
14 Sec. 462a. Premiums; review.
15 (a) Premiums shall not be excessive. A premium is excessive
16if it is likely to produce a profit that is unreasonably high
17for the insurance provided or if expenses are unreasonably high
18in relation to the coverage or services rendered.
19 (b) At any time, an insured may file a request for review
20of a premium with the Director. The request shall be in such
21form as the Director prescribes and shall specify the grounds
22on which the premium is excessive.
23 If, within 30 days of any proper request for review under
24this Section, the Director finds that the premium does not meet
25the requirements of this Section, he or she shall send to the

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1insurer a written notice of disapproval of premium, specifying
2therein in what respects he or she finds that the premium fails
3to meet the requirements of this Section, stating when, within
4a reasonable period thereafter, the premium shall be deemed no
5longer effective, and ordering an adjustment of the premium. An
6insurer whose premium has been disapproved shall be given a
7hearing upon a written request made within 30 days after the
8disapproval order. If the insurer requests a hearing, the
9premium shall be effective until the expiration of a reasonable
10period specified in any order entered thereon. If, after a
11hearing, the premium is found to be excessive, the Director
12shall order an adjustment of the premium. The insurer shall
13refund to the insured any amount found to be excessive under
14this Section.
15 If the Director finds that a review is not warranted or a
16premium is not excessive, he or she shall provide notice of
17that decision to the insured and the insurer.
18 (c) An insurer shall provide all information requested by
19the Director as he or she determines necessary to assist in
20review of premiums under this Section.
21 (215 ILCS 5/460 rep.)
22 Section 10. The Illinois Insurance Code is amended by
23repealing Section 460.
24 Section 15. The Workers' Compensation Act is amended by

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1changing Sections 1, 8, 8.1b, 8.2a, 14, 19, 25.5, and 29.2 and
2by adding Sections 4e, 8.1, and 29.3 as follows:
3 (820 ILCS 305/1) (from Ch. 48, par. 138.1)
4 Sec. 1. This Act may be cited as the Workers' Compensation
5Act.
6 (a) The term "employer" as used in this Act means:
7 1. The State and each county, city, town, township,
8incorporated village, school district, body politic, or
9municipal corporation therein.
10 2. Every person, firm, public or private corporation,
11including hospitals, public service, eleemosynary, religious
12or charitable corporations or associations who has any person
13in service or under any contract for hire, express or implied,
14oral or written, and who is engaged in any of the enterprises
15or businesses enumerated in Section 3 of this Act, or who at or
16prior to the time of the accident to the employee for which
17compensation under this Act may be claimed, has in the manner
18provided in this Act elected to become subject to the
19provisions of this Act, and who has not, prior to such
20accident, effected a withdrawal of such election in the manner
21provided in this Act.
22 3. Any one engaging in any business or enterprise referred
23to in subsections 1 and 2 of Section 3 of this Act who
24undertakes to do any work enumerated therein, is liable to pay
25compensation to his own immediate employees in accordance with

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1the provisions of this Act, and in addition thereto if he
2directly or indirectly engages any contractor whether
3principal or sub-contractor to do any such work, he is liable
4to pay compensation to the employees of any such contractor or
5sub-contractor unless such contractor or sub-contractor has
6insured, in any company or association authorized under the
7laws of this State to insure the liability to pay compensation
8under this Act, or guaranteed his liability to pay such
9compensation. With respect to any time limitation on the filing
10of claims provided by this Act, the timely filing of a claim
11against a contractor or subcontractor, as the case may be,
12shall be deemed to be a timely filing with respect to all
13persons upon whom liability is imposed by this paragraph.
14 In the event any such person pays compensation under this
15subsection he may recover the amount thereof from the
16contractor or sub-contractor, if any, and in the event the
17contractor pays compensation under this subsection he may
18recover the amount thereof from the sub-contractor, if any.
19 This subsection does not apply in any case where the
20accident occurs elsewhere than on, in or about the immediate
21premises on which the principal has contracted that the work be
22done.
23 4. Where an employer operating under and subject to the
24provisions of this Act loans an employee to another such
25employer and such loaned employee sustains a compensable
26accidental injury in the employment of such borrowing employer

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1and where such borrowing employer does not provide or pay the
2benefits or payments due such injured employee, such loaning
3employer is liable to provide or pay all benefits or payments
4due such employee under this Act and as to such employee the
5liability of such loaning and borrowing employers is joint and
6several, provided that such loaning employer is in the absence
7of agreement to the contrary entitled to receive from such
8borrowing employer full reimbursement for all sums paid or
9incurred pursuant to this paragraph together with reasonable
10attorneys' fees and expenses in any hearings before the
11Illinois Workers' Compensation Commission or in any action to
12secure such reimbursement. Where any benefit is provided or
13paid by such loaning employer the employee has the duty of
14rendering reasonable cooperation in any hearings, trials or
15proceedings in the case, including such proceedings for
16reimbursement.
17 Where an employee files an Application for Adjustment of
18Claim with the Illinois Workers' Compensation Commission
19alleging that his claim is covered by the provisions of the
20preceding paragraph, and joining both the alleged loaning and
21borrowing employers, they and each of them, upon written demand
22by the employee and within 7 days after receipt of such demand,
23shall have the duty of filing with the Illinois Workers'
24Compensation Commission a written admission or denial of the
25allegation that the claim is covered by the provisions of the
26preceding paragraph and in default of such filing or if any

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1such denial be ultimately determined not to have been bona fide
2then the provisions of Paragraph K of Section 19 of this Act
3shall apply.
4 An employer whose business or enterprise or a substantial
5part thereof consists of hiring, procuring or furnishing
6employees to or for other employers operating under and subject
7to the provisions of this Act for the performance of the work
8of such other employers and who pays such employees their
9salary or wages notwithstanding that they are doing the work of
10such other employers shall be deemed a loaning employer within
11the meaning and provisions of this Section.
12 (b) The term "employee" as used in this Act means:
13 1. Every person in the service of the State, including
14members of the General Assembly, members of the Commerce
15Commission, members of the Illinois Workers' Compensation
16Commission, and all persons in the service of the University of
17Illinois, county, including deputy sheriffs and assistant
18state's attorneys, city, town, township, incorporated village
19or school district, body politic, or municipal corporation
20therein, whether by election, under appointment or contract of
21hire, express or implied, oral or written, including all
22members of the Illinois National Guard while on active duty in
23the service of the State, and all probation personnel of the
24Juvenile Court appointed pursuant to Article VI of the Juvenile
25Court Act of 1987, and including any official of the State, any
26county, city, town, township, incorporated village, school

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1district, body politic or municipal corporation therein except
2any duly appointed member of a police department in any city
3whose population exceeds 500,000 according to the last Federal
4or State census, and except any member of a fire insurance
5patrol maintained by a board of underwriters in this State. A
6duly appointed member of a fire department in any city, the
7population of which exceeds 500,000 according to the last
8federal or State census, is an employee under this Act only
9with respect to claims brought under paragraph (c) of Section
108.
11 One employed by a contractor who has contracted with the
12State, or a county, city, town, township, incorporated village,
13school district, body politic or municipal corporation
14therein, through its representatives, is not considered as an
15employee of the State, county, city, town, township,
16incorporated village, school district, body politic or
17municipal corporation which made the contract.
18 2. Every person in the service of another under any
19contract of hire, express or implied, oral or written,
20including persons whose employment is outside of the State of
21Illinois where the contract of hire is made within the State of
22Illinois, persons whose employment results in fatal or
23non-fatal injuries within the State of Illinois where the
24contract of hire is made outside of the State of Illinois, and
25persons whose employment is principally localized within the
26State of Illinois, regardless of the place of the accident or

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1the place where the contract of hire was made, and including
2aliens, and minors who, for the purpose of this Act are
3considered the same and have the same power to contract,
4receive payments and give quittances therefor, as adult
5employees.
6 3. Every sole proprietor and every partner of a business
7may elect to be covered by this Act.
8 An employee or his dependents under this Act who shall have
9a cause of action by reason of any injury, disablement or death
10arising out of and in the course of his employment may elect to
11pursue his remedy in the State where injured or disabled, or in
12the State where the contract of hire is made, or in the State
13where the employment is principally localized.
14 However, any employer may elect to provide and pay
15compensation to any employee other than those engaged in the
16usual course of the trade, business, profession or occupation
17of the employer by complying with Sections 2 and 4 of this Act.
18Employees are not included within the provisions of this Act
19when excluded by the laws of the United States relating to
20liability of employers to their employees for personal injuries
21where such laws are held to be exclusive.
22 The term "employee" does not include persons performing
23services as real estate broker, broker-salesman, or salesman
24when such persons are paid by commission only.
25 (c) "Commission" means the Industrial Commission created
26by Section 5 of "The Civil Administrative Code of Illinois",

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1approved March 7, 1917, as amended, or the Illinois Workers'
2Compensation Commission created by Section 13 of this Act.
3 (d) To obtain compensation under this Act, an employee
4bears the burden of showing, by a preponderance of the
5evidence, that he or she has sustained accidental injuries
6arising out of and in the course of the employment. Except as
7provided in subsection (e) of this Section, accidental injuries
8sustained while traveling to or from work do not arise out of
9and in the course of employment.
10 For the purposes of this subsection (d):
11 "In the course of employment" refers to the time, place,
12and circumstances surrounding the accidental injuries.
13 "Arising out of the employment" refers to causal
14connection. It must be shown that the injury had its origin in
15some risk connected with, or incidental to, the employment so
16as to create a causal connection between the employment and the
17accidental injuries. An injury arises out of the employment if,
18at the time of the occurrence, the employee was performing acts
19he or she was instructed to perform by his or her employer,
20acts which he or she had a common law or statutory duty to
21perform, or acts which the employee might reasonably be
22expected to perform incident to his or her assigned duties. A
23risk is incidental to the employment where it belongs to or is
24connected with what an employee has to do in fulfilling his or
25her duties.
26 (e) Where an employee is required to travel away from his

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1or her employer's premises in order to perform his or her job,
2the traveling employee's accidental injuries arise out of his
3or her employment, and are in the course of his or her
4employment, when the conduct in which he or she was engaged at
5the time of the injury is reasonable and when that conduct
6might have been anticipated or foreseen by the employer.
7Accidental injuries while traveling do not occur in the course
8of employment if the accident occurs during a purely personal
9deviation or personal errand unless such deviation or errand is
10insubstantial.
11 In determining whether an employee was required to travel
12away from his or her employer's premises in order to perform
13his or her job, along with all other relevant factors, the
14following factors may be considered: whether the employer had
15knowledge that the employee may be required to travel to
16perform the job; whether the employer furnished any mode of
17transportation to or from the employee; whether the employee
18received, or the employer paid or agreed to pay, any
19remuneration or reimbursement for costs or expenses of any form
20of travel; whether the employer in any way directed the course
21or method of travel; whether the employer in any way assisted
22the employee in making any travel arrangements; whether the
23employer furnished lodging or in any way reimbursed the
24employee for lodging; and whether the employer received any
25benefit from the employee traveling.
26(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,

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1eff. 7-13-12.)
2 (820 ILCS 305/4e new)
3 Sec. 4e. Safety programs and return to work programs;
4recalculation of premiums and waiver of self-insurers fee.
5 (a) An employer may file with the Commission a workers'
6compensation safety program or a workers' compensation return
7to work program implemented by the employer. The Commission may
8certify any such safety program as a bona fide safety program
9after reviewing the program for the following minimum
10requirements: adequate safety training for employees;
11establishment of joint employer-employee safety committees;
12use of safety devices; and consultation with safety
13organizations. The Commission may certify any such return to
14work program as a bona fide return to work program after
15reviewing the program for the following minimum requirements:
16light duty or restricted duty work; leave of absence policy;
17and full duty return to work policy. The Commission shall
18notify the Department of Insurance of the certification.
19 (b) Upon receipt of a certification notice from the
20Commission under this Section related to an employer that
21provides workers' compensation through an insurer, the
22Director of Insurance shall immediately direct in writing the
23employer's workers' compensation insurer to recalculate the
24workers' compensation premium rates for the employer so that
25those premium rates incorporate and take into account the

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1certified program.
2 (c) If any workers' compensation safety program or a
3workers' compensation return to work program implemented by a
4self-insured employer is certified under this Section, the
5annual fee under Section 4d of this Act shall be reduced by 30%
6for the self-insured employer as long as the workers'
7compensation safety program or a workers' compensation return
8to work program continues. The self-insured employer shall
9certify the continuation of the program by each July 1 after
10the waiver is obtained.
11 (820 ILCS 305/8) (from Ch. 48, par. 138.8)
12 Sec. 8. The amount of compensation which shall be paid to
13the employee for an accidental injury not resulting in death
14is:
15 (a) The employer shall provide and pay the negotiated rate,
16if applicable, or the lesser of the health care provider's
17actual charges or according to a fee schedule, subject to
18Section 8.2, in effect at the time the service was rendered for
19all the necessary first aid, medical and surgical services, and
20all necessary medical, surgical and hospital services
21thereafter incurred, limited, however, to that which is
22reasonably required to cure or relieve from the effects of the
23accidental injury, even if a health care provider sells,
24transfers, or otherwise assigns an account receivable for
25procedures, treatments, or services covered under this Act. If

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1the employer does not dispute payment of first aid, medical,
2surgical, and hospital services, the employer shall make such
3payment to the provider on behalf of the employee. The employer
4shall also pay for treatment, instruction and training
5necessary for the physical, mental and vocational
6rehabilitation of the employee, including all maintenance
7costs and expenses incidental thereto. If as a result of the
8injury the employee is unable to be self-sufficient the
9employer shall further pay for such maintenance or
10institutional care as shall be required.
11 The employee may at any time elect to secure his own
12physician, surgeon and hospital services at the employer's
13expense, or,
14 Upon agreement between the employer and the employees, or
15the employees' exclusive representative, and subject to the
16approval of the Illinois Workers' Compensation Commission, the
17employer shall maintain a list of physicians, to be known as a
18Panel of Physicians, who are accessible to the employees. The
19employer shall post this list in a place or places easily
20accessible to his employees. The employee shall have the right
21to make an alternative choice of physician from such Panel if
22he is not satisfied with the physician first selected. If, due
23to the nature of the injury or its occurrence away from the
24employer's place of business, the employee is unable to make a
25selection from the Panel, the selection process from the Panel
26shall not apply. The physician selected from the Panel may

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1arrange for any consultation, referral or other specialized
2medical services outside the Panel at the employer's expense.
3Provided that, in the event the Commission shall find that a
4doctor selected by the employee is rendering improper or
5inadequate care, the Commission may order the employee to
6select another doctor certified or qualified in the medical
7field for which treatment is required. If the employee refuses
8to make such change the Commission may relieve the employer of
9his obligation to pay the doctor's charges from the date of
10refusal to the date of compliance.
11 Any vocational rehabilitation counselors who provide
12service under this Act shall have appropriate certifications
13which designate the counselor as qualified to render opinions
14relating to vocational rehabilitation. Vocational
15rehabilitation may include, but is not limited to, counseling
16for job searches, supervising a job search program, and
17vocational retraining including education at an accredited
18learning institution. The employee or employer may petition to
19the Commission to decide disputes relating to vocational
20rehabilitation and the Commission shall resolve any such
21dispute, including payment of the vocational rehabilitation
22program by the employer.
23 The maintenance benefit shall not be less than the
24temporary total disability rate determined for the employee. In
25addition, maintenance shall include costs and expenses
26incidental to the vocational rehabilitation program.

HB2525 Engrossed- 22 -LRB100 06927 JLS 16978 b
1 When the employee is working light duty on a part-time
2basis or full-time basis and earns less than he or she would be
3earning if employed in the full capacity of the job or jobs,
4then the employee shall be entitled to temporary partial
5disability benefits. Temporary partial disability benefits
6shall be equal to two-thirds of the difference between the
7average amount that the employee would be able to earn in the
8full performance of his or her duties in the occupation in
9which he or she was engaged at the time of accident and the
10gross amount which he or she is earning in the modified job
11provided to the employee by the employer or in any other job
12that the employee is working.
13 Every hospital, physician, surgeon or other person
14rendering treatment or services in accordance with the
15provisions of this Section shall upon written request furnish
16full and complete reports thereof to, and permit their records
17to be copied by, the employer, the employee or his dependents,
18as the case may be, or any other party to any proceeding for
19compensation before the Commission, or their attorneys.
20 Notwithstanding the foregoing, the employer's liability to
21pay for such medical services selected by the employee shall be
22limited to:
23 (1) all first aid and emergency treatment; plus
24 (2) all medical, surgical and hospital services
25 provided by the physician, surgeon or hospital initially
26 chosen by the employee or by any other physician,

HB2525 Engrossed- 23 -LRB100 06927 JLS 16978 b
1 consultant, expert, institution or other provider of
2 services recommended by said initial service provider or
3 any subsequent provider of medical services in the chain of
4 referrals from said initial service provider; plus
5 (3) all medical, surgical and hospital services
6 provided by any second physician, surgeon or hospital
7 subsequently chosen by the employee or by any other
8 physician, consultant, expert, institution or other
9 provider of services recommended by said second service
10 provider or any subsequent provider of medical services in
11 the chain of referrals from said second service provider.
12 Thereafter the employer shall select and pay for all
13 necessary medical, surgical and hospital treatment and the
14 employee may not select a provider of medical services at
15 the employer's expense unless the employer agrees to such
16 selection. At any time the employee may obtain any medical
17 treatment he desires at his own expense. This paragraph
18 shall not affect the duty to pay for rehabilitation
19 referred to above.
20 (4) The following shall apply for injuries occurring on
21 or after June 28, 2011 (the effective date of Public Act
22 97-18) and only when an employer has an approved preferred
23 provider program pursuant to Section 8.1a on the date the
24 employee sustained his or her accidental injuries:
25 (A) The employer shall, in writing, on a form
26 promulgated by the Commission, inform the employee of

HB2525 Engrossed- 24 -LRB100 06927 JLS 16978 b
1 the preferred provider program;
2 (B) Subsequent to the report of an injury by an
3 employee, the employee may choose in writing at any
4 time to decline the preferred provider program, in
5 which case that would constitute one of the two choices
6 of medical providers to which the employee is entitled
7 under subsection (a)(2) or (a)(3); and
8 (C) Prior to the report of an injury by an
9 employee, when an employee chooses non-emergency
10 treatment from a provider not within the preferred
11 provider program, that would constitute the employee's
12 one choice of medical providers to which the employee
13 is entitled under subsection (a)(2) or (a)(3).
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

HB2525 Engrossed- 25 -LRB100 06927 JLS 16978 b
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

HB2525 Engrossed- 26 -LRB100 06927 JLS 16978 b
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, nor
13 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,

HB2525 Engrossed- 27 -LRB100 06927 JLS 16978 b
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, nor exceed the
4 employee's average weekly wage computed in accordance with
5 the provisions of Section 10, whichever is less.
6 2.1. The compensation rate in all cases of serious and
7 permanent disfigurement under paragraph (c) and of
8 permanent partial disability under subparagraph (2) of
9 paragraph (d) or under paragraph (e) of this Section shall
10 be equal to 60% of the employee's average weekly wage
11 computed in accordance with the provisions of Section 10,
12 provided that it shall be not less than 66 2/3% of the sum
13 of the Federal minimum wage under the Fair Labor Standards
14 Act, or the Illinois minimum wage under the Minimum Wage
15 Law, whichever is more, multiplied by 40 hours. This
16 percentage rate shall be increased by 10% for each spouse
17 and child, not to exceed 100% of the total minimum wage
18 calculation, nor exceed the employee's average weekly wage
19 computed in accordance with the provisions of Section 10,
20 whichever is less.
21 3. As used in this Section the term "child" means a
22 child of the employee including any child legally adopted
23 before the accident or whom at the time of the accident the
24 employee was under legal obligation to support or to whom
25 the employee stood in loco parentis, and who at the time of
26 the accident was under 18 years of age and not emancipated.

HB2525 Engrossed- 28 -LRB100 06927 JLS 16978 b
1 The term "children" means the plural of "child".
2 4. All weekly compensation rates provided under
3 subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
4 Section shall be subject to the following limitations:
5 The maximum weekly compensation rate from July 1, 1975,
6 except as hereinafter provided, shall be 100% of the
7 State's average weekly wage in covered industries under the
8 Unemployment Insurance Act, that being the wage that most
9 closely approximates the State's average weekly wage.
10 The maximum weekly compensation rate, for the period
11 July 1, 1984, through June 30, 1987, except as hereinafter
12 provided, shall be $293.61. Effective July 1, 1987 and on
13 July 1 of each year thereafter the maximum weekly
14 compensation rate, except as hereinafter provided, shall
15 be determined as follows: if during the preceding 12 month
16 period there shall have been an increase in the State's
17 average weekly wage in covered industries under the
18 Unemployment Insurance Act, the weekly compensation rate
19 shall be proportionately increased by the same percentage
20 as the percentage of increase in the State's average weekly
21 wage in covered industries under the Unemployment
22 Insurance Act during such period.
23 The maximum weekly compensation rate, for the period
24 January 1, 1981 through December 31, 1983, except as
25 hereinafter provided, shall be 100% of the State's average
26 weekly wage in covered industries under the Unemployment

HB2525 Engrossed- 29 -LRB100 06927 JLS 16978 b
1 Insurance Act in effect on January 1, 1981. Effective
2 January 1, 1984 and on January 1, of each year thereafter
3 the maximum weekly compensation rate, except as
4 hereinafter provided, shall be determined as follows: if
5 during the preceding 12 month period there shall have been
6 an increase in the State's average weekly wage in covered
7 industries under the Unemployment Insurance Act, the
8 weekly compensation rate shall be proportionately
9 increased by the same percentage as the percentage of
10 increase in the State's average weekly wage in covered
11 industries under the Unemployment Insurance Act during
12 such period.
13 From July 1, 1977 and thereafter such maximum weekly
14 compensation rate in death cases under Section 7, and
15 permanent total disability cases under paragraph (f) or
16 subparagraph 18 of paragraph (3) of this Section and for
17 temporary total disability under paragraph (b) of this
18 Section and for amputation of a member or enucleation of an
19 eye under paragraph (e) of this Section shall be increased
20 to 133-1/3% of the State's average weekly wage in covered
21 industries under the Unemployment Insurance Act.
22 For injuries occurring on or after February 1, 2006,
23 the maximum weekly benefit under paragraph (d)1 of this
24 Section shall be 100% of the State's average weekly wage in
25 covered industries under the Unemployment Insurance Act.
26 4.1. Any provision herein to the contrary

HB2525 Engrossed- 30 -LRB100 06927 JLS 16978 b
1 notwithstanding, the weekly compensation rate for
2 compensation payments under subparagraph 18 of paragraph
3 (e) of this Section and under paragraph (f) of this Section
4 and under paragraph (a) of Section 7 and for amputation of
5 a member or enucleation of an eye under paragraph (e) of
6 this Section, shall in no event be less than 50% of the
7 State's average weekly wage in covered industries under the
8 Unemployment Insurance Act.
9 4.2. Any provision to the contrary notwithstanding,
10 the total compensation payable under Section 7 shall not
11 exceed the greater of $500,000 or 25 years.
12 5. For the purpose of this Section this State's average
13 weekly wage in covered industries under the Unemployment
14 Insurance Act on July 1, 1975 is hereby fixed at $228.16
15 per week and the computation of compensation rates shall be
16 based on the aforesaid average weekly wage until modified
17 as hereinafter provided.
18 6. The Department of Employment Security of the State
19 shall on or before the first day of December, 1977, and on
20 or before the first day of June, 1978, and on the first day
21 of each December and June of each year thereafter, publish
22 the State's average weekly wage in covered industries under
23 the Unemployment Insurance Act and the Illinois Workers'
24 Compensation Commission shall on the 15th day of January,
25 1978 and on the 15th day of July, 1978 and on the 15th day
26 of each January and July of each year thereafter, post and

HB2525 Engrossed- 31 -LRB100 06927 JLS 16978 b
1 publish the State's average weekly wage in covered
2 industries under the Unemployment Insurance Act as last
3 determined and published by the Department of Employment
4 Security. The amount when so posted and published shall be
5 conclusive and shall be applicable as the basis of
6 computation of compensation rates until the next posting
7 and publication as aforesaid.
8 7. The payment of compensation by an employer or his
9 insurance carrier to an injured employee shall not
10 constitute an admission of the employer's liability to pay
11 compensation.
12 (c) For any serious and permanent disfigurement to the
13hand, head, face, neck, arm, leg below the knee or the chest
14above the axillary line, the employee is entitled to
15compensation for such disfigurement, the amount determined by
16agreement at any time or by arbitration under this Act, at a
17hearing not less than 6 months after the date of the accidental
18injury, which amount shall not exceed 150 weeks (if the
19accidental injury occurs on or after the effective date of this
20amendatory Act of the 94th General Assembly but before February
211, 2006) or 162 weeks (if the accidental injury occurs on or
22after February 1, 2006) at the applicable rate provided in
23subparagraph 2.1 of paragraph (b) of this Section.
24 No compensation is payable under this paragraph where
25compensation is payable under paragraphs (d), (e) or (f) of
26this Section.

HB2525 Engrossed- 32 -LRB100 06927 JLS 16978 b
1 A duly appointed member of a fire department in a city, the
2population of which exceeds 500,000 according to the last
3federal or State census, is eligible for compensation under
4this paragraph only where such serious and permanent
5disfigurement results from burns.
6 (d) 1. If, after the accidental injury has been sustained,
7the employee as a result thereof becomes partially
8incapacitated from pursuing his usual and customary line of
9employment, he shall, except in cases compensated under the
10specific schedule set forth in paragraph (e) of this Section,
11receive compensation for the duration of his disability,
12subject to the limitations as to maximum amounts fixed in
13paragraph (b) of this Section, equal to 66-2/3% of the
14difference between the average amount which he would be able to
15earn in the full performance of his duties in the occupation in
16which he was engaged at the time of the accident and the
17average amount which he is earning or is able to earn in some
18suitable employment or business after the accident. For
19accidental injuries that occur on or after September 1, 2011,
20an award for wage differential under this subsection shall be
21effective only until the employee reaches the age of 67 or 5
22years from the date the award becomes final, whichever is
23later.
24 2. If, as a result of the accident, the employee sustains
25serious and permanent injuries not covered by paragraphs (c)
26and (e) of this Section or having sustained injuries covered by

HB2525 Engrossed- 33 -LRB100 06927 JLS 16978 b
1the aforesaid paragraphs (c) and (e), he shall have sustained
2in addition thereto other injuries which injuries do not
3incapacitate him from pursuing the duties of his employment but
4which would disable him from pursuing other suitable
5occupations, or which have otherwise resulted in physical
6impairment; or if such injuries partially incapacitate him from
7pursuing the duties of his usual and customary line of
8employment but do not result in an impairment of earning
9capacity, or having resulted in an impairment of earning
10capacity, the employee elects to waive his right to recover
11under the foregoing subparagraph 1 of paragraph (d) of this
12Section then in any of the foregoing events, he shall receive
13in addition to compensation for temporary total disability
14under paragraph (b) of this Section, compensation at the rate
15provided in subparagraph 2.1 of paragraph (b) of this Section
16for that percentage of 500 weeks that the partial disability
17resulting from the injuries covered by this paragraph bears to
18total disability. If the employee shall have sustained a
19fracture of one or more vertebra or fracture of the skull, the
20amount of compensation allowed under this Section shall be not
21less than 6 weeks for a fractured skull and 6 weeks for each
22fractured vertebra, and in the event the employee shall have
23sustained a fracture of any of the following facial bones:
24nasal, lachrymal, vomer, zygoma, maxilla, palatine or
25mandible, the amount of compensation allowed under this Section
26shall be not less than 2 weeks for each such fractured bone,

HB2525 Engrossed- 34 -LRB100 06927 JLS 16978 b
1and for a fracture of each transverse process not less than 3
2weeks. In the event such injuries shall result in the loss of a
3kidney, spleen or lung, the amount of compensation allowed
4under this Section shall be not less than 10 weeks for each
5such organ. Compensation awarded under this subparagraph 2
6shall not take into consideration injuries covered under
7paragraphs (c) and (e) of this Section and the compensation
8provided in this paragraph shall not affect the employee's
9right to compensation payable under paragraphs (b), (c) and (e)
10of this Section for the disabilities therein covered.
11 (e) For accidental injuries in the following schedule, the
12employee shall receive compensation for the period of temporary
13total incapacity for work resulting from such accidental
14injury, under subparagraph 1 of paragraph (b) of this Section,
15and shall receive in addition thereto compensation for a
16further period for the specific loss herein mentioned, but
17shall not receive any compensation under any other provisions
18of this Act. The following listed amounts apply to either the
19loss of or the permanent and complete loss of use of the member
20specified, such compensation for the length of time as follows:
21 1. Thumb-
22 70 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 76 weeks if the accidental injury occurs on or
26 after February 1, 2006.

HB2525 Engrossed- 35 -LRB100 06927 JLS 16978 b
1 2. First, or index finger-
2 40 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 43 weeks if the accidental injury occurs on or
6 after February 1, 2006.
7 3. Second, or middle finger-
8 35 weeks if the accidental injury occurs on or
9 after the effective date of this amendatory Act of the
10 94th General Assembly but before February 1, 2006.
11 38 weeks if the accidental injury occurs on or
12 after February 1, 2006.
13 4. Third, or ring finger-
14 25 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 27 weeks if the accidental injury occurs on or
18 after February 1, 2006.
19 5. Fourth, or little finger-
20 20 weeks if the accidental injury occurs on or
21 after the effective date of this amendatory Act of the
22 94th General Assembly but before February 1, 2006.
23 22 weeks if the accidental injury occurs on or
24 after February 1, 2006.
25 6. Great toe-
26 35 weeks if the accidental injury occurs on or

HB2525 Engrossed- 36 -LRB100 06927 JLS 16978 b
1 after the effective date of this amendatory Act of the
2 94th General Assembly but before February 1, 2006.
3 38 weeks if the accidental injury occurs on or
4 after February 1, 2006.
5 7. Each toe other than great toe-
6 12 weeks if the accidental injury occurs on or
7 after the effective date of this amendatory Act of the
8 94th General Assembly but before February 1, 2006.
9 13 weeks if the accidental injury occurs on or
10 after February 1, 2006.
11 8. The loss of the first or distal phalanx of the thumb
12 or of any finger or toe shall be considered to be equal to
13 the loss of one-half of such thumb, finger or toe and the
14 compensation payable shall be one-half of the amount above
15 specified. The loss of more than one phalanx shall be
16 considered as the loss of the entire thumb, finger or toe.
17 In no case shall the amount received for more than one
18 finger exceed the amount provided in this schedule for the
19 loss of a hand.
20 9. Hand-
21 190 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.
24 205 weeks if the accidental injury occurs on or
25 after February 1, 2006.
26 190 weeks if the accidental injury occurs on or

HB2525 Engrossed- 37 -LRB100 06927 JLS 16978 b
1 after June 28, 2011 (the effective date of Public Act
2 97-18) and if the accidental injury involves carpal
3 tunnel syndrome due to repetitive or cumulative
4 trauma, in which case the permanent partial disability
5 shall not exceed 15% loss of use of the hand, except
6 for cause shown by clear and convincing evidence and in
7 which case the award shall not exceed 30% loss of use
8 of the hand.
9 The loss of 2 or more digits, or one or more phalanges
10 of 2 or more digits, of a hand may be compensated on the
11 basis of partial loss of use of a hand, provided, further,
12 that the loss of 4 digits, or the loss of use of 4 digits,
13 in the same hand shall constitute the complete loss of a
14 hand.
15 10. Arm-
16 235 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.
19 253 weeks if the accidental injury occurs on or
20 after February 1, 2006.
21 Where an accidental injury results in the amputation of
22 an arm below the elbow, such injury shall be compensated as
23 a loss of an arm. Where an accidental injury results in the
24 amputation of an arm above the elbow, compensation for an
25 additional 15 weeks (if the accidental injury occurs on or
26 after the effective date of this amendatory Act of the 94th

HB2525 Engrossed- 38 -LRB100 06927 JLS 16978 b
1 General Assembly but before February 1, 2006) or an
2 additional 17 weeks (if the accidental injury occurs on or
3 after February 1, 2006) shall be paid, except where the
4 accidental injury results in the amputation of an arm at
5 the shoulder joint, or so close to shoulder joint that an
6 artificial arm cannot be used, or results in the
7 disarticulation of an arm at the shoulder joint, in which
8 case compensation for an additional 65 weeks (if the
9 accidental injury occurs on or after the effective date of
10 this amendatory Act of the 94th General Assembly but before
11 February 1, 2006) or an additional 70 weeks (if the
12 accidental injury occurs on or after February 1, 2006)
13 shall be paid.
14 For purposes of awards under this subdivision (e),
15 injuries to the shoulder shall be considered injuries to
16 part of the arm.
17 11. Foot-
18 155 weeks if the accidental injury occurs on or
19 after the effective date of this amendatory Act of the
20 94th General Assembly but before February 1, 2006.
21 167 weeks if the accidental injury occurs on or
22 after February 1, 2006.
23 12. Leg-
24 200 weeks if the accidental injury occurs on or
25 after the effective date of this amendatory Act of the
26 94th General Assembly but before February 1, 2006.

HB2525 Engrossed- 39 -LRB100 06927 JLS 16978 b
1 215 weeks if the accidental injury occurs on or
2 after February 1, 2006.
3 Where an accidental injury results in the amputation of
4 a leg below the knee, such injury shall be compensated as
5 loss of a leg. Where an accidental injury results in the
6 amputation of a leg above the knee, compensation for an
7 additional 25 weeks (if the accidental injury occurs on or
8 after the effective date of this amendatory Act of the 94th
9 General Assembly but before February 1, 2006) or an
10 additional 27 weeks (if the accidental injury occurs on or
11 after February 1, 2006) shall be paid, except where the
12 accidental injury results in the amputation of a leg at the
13 hip joint, or so close to the hip joint that an artificial
14 leg cannot be used, or results in the disarticulation of a
15 leg at the hip joint, in which case compensation for an
16 additional 75 weeks (if the accidental injury occurs on or
17 after the effective date of this amendatory Act of the 94th
18 General Assembly but before February 1, 2006) or an
19 additional 81 weeks (if the accidental injury occurs on or
20 after February 1, 2006) shall be paid.
21 For purposes of awards under this subdivision (e),
22 injuries to the hip shall be considered injuries to part of
23 the leg.
24 13. Eye-
25 150 weeks if the accidental injury occurs on or
26 after the effective date of this amendatory Act of the

HB2525 Engrossed- 40 -LRB100 06927 JLS 16978 b
1 94th General Assembly but before February 1, 2006.
2 162 weeks if the accidental injury occurs on or
3 after February 1, 2006.
4 Where an accidental injury results in the enucleation
5 of an eye, compensation for an additional 10 weeks (if the
6 accidental injury occurs on or after the effective date of
7 this amendatory Act of the 94th General Assembly but before
8 February 1, 2006) or an additional 11 weeks (if the
9 accidental injury occurs on or after February 1, 2006)
10 shall be paid.
11 14. Loss of hearing of one ear-
12 50 weeks if the accidental injury occurs on or
13 after the effective date of this amendatory Act of the
14 94th General Assembly but before February 1, 2006.
15 54 weeks if the accidental injury occurs on or
16 after February 1, 2006.
17 Total and permanent loss of hearing of both ears-
18 200 weeks if the accidental injury occurs on or
19 after the effective date of this amendatory Act of the
20 94th General Assembly but before February 1, 2006.
21 215 weeks if the accidental injury occurs on or
22 after February 1, 2006.
23 15. Testicle-
24 50 weeks if the accidental injury occurs on or
25 after the effective date of this amendatory Act of the
26 94th General Assembly but before February 1, 2006.

HB2525 Engrossed- 41 -LRB100 06927 JLS 16978 b
1 54 weeks if the accidental injury occurs on or
2 after February 1, 2006.
3 Both testicles-
4 150 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.
7 162 weeks if the accidental injury occurs on or
8 after February 1, 2006.
9 16. For the permanent partial loss of use of a member
10 or sight of an eye, or hearing of an ear, compensation
11 during that proportion of the number of weeks in the
12 foregoing schedule provided for the loss of such member or
13 sight of an eye, or hearing of an ear, which the partial
14 loss of use thereof bears to the total loss of use of such
15 member, or sight of eye, or hearing of an ear.
16 (a) Loss of hearing for compensation purposes
17 shall be confined to the frequencies of 1,000, 2,000
18 and 3,000 cycles per second. Loss of hearing ability
19 for frequency tones above 3,000 cycles per second are
20 not to be considered as constituting disability for
21 hearing.
22 (b) The percent of hearing loss, for purposes of
23 the determination of compensation claims for
24 occupational deafness, shall be calculated as the
25 average in decibels for the thresholds of hearing for
26 the frequencies of 1,000, 2,000 and 3,000 cycles per

HB2525 Engrossed- 42 -LRB100 06927 JLS 16978 b
1 second. Pure tone air conduction audiometric
2 instruments, approved by nationally recognized
3 authorities in this field, shall be used for measuring
4 hearing loss. If the losses of hearing average 30
5 decibels or less in the 3 frequencies, such losses of
6 hearing shall not then constitute any compensable
7 hearing disability. If the losses of hearing average 85
8 decibels or more in the 3 frequencies, then the same
9 shall constitute and be total or 100% compensable
10 hearing loss.
11 (c) In measuring hearing impairment, the lowest
12 measured losses in each of the 3 frequencies shall be
13 added together and divided by 3 to determine the
14 average decibel loss. For every decibel of loss
15 exceeding 30 decibels an allowance of 1.82% shall be
16 made up to the maximum of 100% which is reached at 85
17 decibels.
18 (d) If a hearing loss is established to have
19 existed on July 1, 1975 by audiometric testing the
20 employer shall not be liable for the previous loss so
21 established nor shall he be liable for any loss for
22 which compensation has been paid or awarded.
23 (e) No consideration shall be given to the question
24 of whether or not the ability of an employee to
25 understand speech is improved by the use of a hearing
26 aid.

HB2525 Engrossed- 43 -LRB100 06927 JLS 16978 b
1 (f) No claim for loss of hearing due to industrial
2 noise shall be brought against an employer or allowed
3 unless the employee has been exposed for a period of
4 time sufficient to cause permanent impairment to noise
5 levels in excess of the following:
6Sound Level DBA
7Slow ResponseHours Per Day
8908
9926
10954
11973
121002
131021-1/2
141051
151101/2
161151/4
17 This subparagraph (f) shall not be applied in cases of
18 hearing loss resulting from trauma or explosion.
19 17. In computing the compensation to be paid to any
20 employee who, before the accident for which he claims
21 compensation, had before that time sustained an injury
22 resulting in the loss by amputation or partial loss by
23 amputation of any member, including hand, arm, thumb or
24 fingers, leg, foot or any toes, such loss or partial loss
25 of any such member shall be deducted from any award made
26 for the subsequent injury. For the permanent loss of use or

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1 the permanent partial loss of use of any such member or the
2 partial loss of sight of an eye, for which compensation has
3 been paid, then such loss shall be taken into consideration
4 and deducted from any award for the subsequent injury.
5 18. The specific case of loss of both hands, both arms,
6 or both feet, or both legs, or both eyes, or of any two
7 thereof, or the permanent and complete loss of the use
8 thereof, constitutes total and permanent disability, to be
9 compensated according to the compensation fixed by
10 paragraph (f) of this Section. These specific cases of
11 total and permanent disability do not exclude other cases.
12 Any employee who has previously suffered the loss or
13 permanent and complete loss of the use of any of such
14 members, and in a subsequent independent accident loses
15 another or suffers the permanent and complete loss of the
16 use of any one of such members the employer for whom the
17 injured employee is working at the time of the last
18 independent accident is liable to pay compensation only for
19 the loss or permanent and complete loss of the use of the
20 member occasioned by the last independent accident.
21 19. In a case of specific loss and the subsequent death
22 of such injured employee from other causes than such injury
23 leaving a widow, widower, or dependents surviving before
24 payment or payment in full for such injury, then the amount
25 due for such injury is payable to the widow or widower and,
26 if there be no widow or widower, then to such dependents,

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1 in the proportion which such dependency bears to total
2 dependency.
3 Beginning July 1, 1980, and every 6 months thereafter, the
4Commission shall examine the Second Injury Fund and when, after
5deducting all advances or loans made to such Fund, the amount
6therein is $500,000 then the amount required to be paid by
7employers pursuant to paragraph (f) of Section 7 shall be
8reduced by one-half. When the Second Injury Fund reaches the
9sum of $600,000 then the payments shall cease entirely.
10However, when the Second Injury Fund has been reduced to
11$400,000, payment of one-half of the amounts required by
12paragraph (f) of Section 7 shall be resumed, in the manner
13herein provided, and when the Second Injury Fund has been
14reduced to $300,000, payment of the full amounts required by
15paragraph (f) of Section 7 shall be resumed, in the manner
16herein provided. The Commission shall make the changes in
17payment effective by general order, and the changes in payment
18become immediately effective for all cases coming before the
19Commission thereafter either by settlement agreement or final
20order, irrespective of the date of the accidental injury.
21 On August 1, 1996 and on February 1 and August 1 of each
22subsequent year, the Commission shall examine the special fund
23designated as the "Rate Adjustment Fund" and when, after
24deducting all advances or loans made to said fund, the amount
25therein is $4,000,000, the amount required to be paid by
26employers pursuant to paragraph (f) of Section 7 shall be

HB2525 Engrossed- 46 -LRB100 06927 JLS 16978 b
1reduced by one-half. When the Rate Adjustment Fund reaches the
2sum of $5,000,000 the payment therein shall cease entirely.
3However, when said Rate Adjustment Fund has been reduced to
4$3,000,000 the amounts required by paragraph (f) of Section 7
5shall be resumed in the manner herein provided.
6 (f) In case of complete disability, which renders the
7employee wholly and permanently incapable of work, or in the
8specific case of total and permanent disability as provided in
9subparagraph 18 of paragraph (e) of this Section, compensation
10shall be payable at the rate provided in subparagraph 2 of
11paragraph (b) of this Section for life.
12 An employee entitled to benefits under paragraph (f) of
13this Section shall also be entitled to receive from the Rate
14Adjustment Fund provided in paragraph (f) of Section 7 of the
15supplementary benefits provided in paragraph (g) of this
16Section 8.
17 If any employee who receives an award under this paragraph
18afterwards returns to work or is able to do so, and earns or is
19able to earn as much as before the accident, payments under
20such award shall cease. If such employee returns to work, or is
21able to do so, and earns or is able to earn part but not as much
22as before the accident, such award shall be modified so as to
23conform to an award under paragraph (d) of this Section. If
24such award is terminated or reduced under the provisions of
25this paragraph, such employees have the right at any time
26within 30 months after the date of such termination or

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1reduction to file petition with the Commission for the purpose
2of determining whether any disability exists as a result of the
3original accidental injury and the extent thereof.
4 Disability as enumerated in subdivision 18, paragraph (e)
5of this Section is considered complete disability.
6 If an employee who had previously incurred loss or the
7permanent and complete loss of use of one member, through the
8loss or the permanent and complete loss of the use of one hand,
9one arm, one foot, one leg, or one eye, incurs permanent and
10complete disability through the loss or the permanent and
11complete loss of the use of another member, he shall receive,
12in addition to the compensation payable by the employer and
13after such payments have ceased, an amount from the Second
14Injury Fund provided for in paragraph (f) of Section 7, which,
15together with the compensation payable from the employer in
16whose employ he was when the last accidental injury was
17incurred, will equal the amount payable for permanent and
18complete disability as provided in this paragraph of this
19Section.
20 The custodian of the Second Injury Fund provided for in
21paragraph (f) of Section 7 shall be joined with the employer as
22a party respondent in the application for adjustment of claim.
23The application for adjustment of claim shall state briefly and
24in general terms the approximate time and place and manner of
25the loss of the first member.
26 In its award the Commission or the Arbitrator shall

HB2525 Engrossed- 48 -LRB100 06927 JLS 16978 b
1specifically find the amount the injured employee shall be
2weekly paid, the number of weeks compensation which shall be
3paid by the employer, the date upon which payments begin out of
4the Second Injury Fund provided for in paragraph (f) of Section
57 of this Act, the length of time the weekly payments continue,
6the date upon which the pension payments commence and the
7monthly amount of the payments. The Commission shall 30 days
8after the date upon which payments out of the Second Injury
9Fund have begun as provided in the award, and every month
10thereafter, prepare and submit to the State Comptroller a
11voucher for payment for all compensation accrued to that date
12at the rate fixed by the Commission. The State Comptroller
13shall draw a warrant to the injured employee along with a
14receipt to be executed by the injured employee and returned to
15the Commission. The endorsed warrant and receipt is a full and
16complete acquittance to the Commission for the payment out of
17the Second Injury Fund. No other appropriation or warrant is
18necessary for payment out of the Second Injury Fund. The Second
19Injury Fund is appropriated for the purpose of making payments
20according to the terms of the awards.
21 As of July 1, 1980 to July 1, 1982, all claims against and
22obligations of the Second Injury Fund shall become claims
23against and obligations of the Rate Adjustment Fund to the
24extent there is insufficient money in the Second Injury Fund to
25pay such claims and obligations. In that case, all references
26to "Second Injury Fund" in this Section shall also include the

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1Rate Adjustment Fund.
2 (g) Every award for permanent total disability entered by
3the Commission on and after July 1, 1965 under which
4compensation payments shall become due and payable after the
5effective date of this amendatory Act, and every award for
6death benefits or permanent total disability entered by the
7Commission on and after the effective date of this amendatory
8Act shall be subject to annual adjustments as to the amount of
9the compensation rate therein provided. Such adjustments shall
10first be made on July 15, 1977, and all awards made and entered
11prior to July 1, 1975 and on July 15 of each year thereafter.
12In all other cases such adjustment shall be made on July 15 of
13the second year next following the date of the entry of the
14award and shall further be made on July 15 annually thereafter.
15If during the intervening period from the date of the entry of
16the award, or the last periodic adjustment, there shall have
17been an increase in the State's average weekly wage in covered
18industries under the Unemployment Insurance Act, the weekly
19compensation rate shall be proportionately increased by the
20same percentage as the percentage of increase in the State's
21average weekly wage in covered industries under the
22Unemployment Insurance Act. The increase in the compensation
23rate under this paragraph shall in no event bring the total
24compensation rate to an amount greater than the prevailing
25maximum rate at the time that the annual adjustment is made.
26Such increase shall be paid in the same manner as herein

HB2525 Engrossed- 50 -LRB100 06927 JLS 16978 b
1provided for payments under the Second Injury Fund to the
2injured employee, or his dependents, as the case may be, out of
3the Rate Adjustment Fund provided in paragraph (f) of Section 7
4of this Act. Payments shall be made at the same intervals as
5provided in the award or, at the option of the Commission, may
6be made in quarterly payment on the 15th day of January, April,
7July and October of each year. In the event of a decrease in
8such average weekly wage there shall be no change in the then
9existing compensation rate. The within paragraph shall not
10apply to cases where there is disputed liability and in which a
11compromise lump sum settlement between the employer and the
12injured employee, or his dependents, as the case may be, has
13been duly approved by the Illinois Workers' Compensation
14Commission.
15 Provided, that in cases of awards entered by the Commission
16for injuries occurring before July 1, 1975, the increases in
17the compensation rate adjusted under the foregoing provision of
18this paragraph (g) shall be limited to increases in the State's
19average weekly wage in covered industries under the
20Unemployment Insurance Act occurring after July 1, 1975.
21 For every accident occurring on or after July 20, 2005 but
22before the effective date of this amendatory Act of the 94th
23General Assembly (Senate Bill 1283 of the 94th General
24Assembly), the annual adjustments to the compensation rate in
25awards for death benefits or permanent total disability, as
26provided in this Act, shall be paid by the employer. The

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1adjustment shall be made by the employer on July 15 of the
2second year next following the date of the entry of the award
3and shall further be made on July 15 annually thereafter. If
4during the intervening period from the date of the entry of the
5award, or the last periodic adjustment, there shall have been
6an increase in the State's average weekly wage in covered
7industries under the Unemployment Insurance Act, the employer
8shall increase the weekly compensation rate proportionately by
9the same percentage as the percentage of increase in the
10State's average weekly wage in covered industries under the
11Unemployment Insurance Act. The increase in the compensation
12rate under this paragraph shall in no event bring the total
13compensation rate to an amount greater than the prevailing
14maximum rate at the time that the annual adjustment is made. In
15the event of a decrease in such average weekly wage there shall
16be no change in the then existing compensation rate. Such
17increase shall be paid by the employer in the same manner and
18at the same intervals as the payment of compensation in the
19award. This paragraph shall not apply to cases where there is
20disputed liability and in which a compromise lump sum
21settlement between the employer and the injured employee, or
22his or her dependents, as the case may be, has been duly
23approved by the Illinois Workers' Compensation Commission.
24 The annual adjustments for every award of death benefits or
25permanent total disability involving accidents occurring
26before July 20, 2005 and accidents occurring on or after the

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1effective date of this amendatory Act of the 94th General
2Assembly (Senate Bill 1283 of the 94th General Assembly) shall
3continue to be paid from the Rate Adjustment Fund pursuant to
4this paragraph and Section 7(f) of this Act.
5 (h) In case death occurs from any cause before the total
6compensation to which the employee would have been entitled has
7been paid, then in case the employee leaves any widow, widower,
8child, parent (or any grandchild, grandparent or other lineal
9heir or any collateral heir dependent at the time of the
10accident upon the earnings of the employee to the extent of 50%
11or more of total dependency) such compensation shall be paid to
12the beneficiaries of the deceased employee and distributed as
13provided in paragraph (g) of Section 7.
14 (h-1) In case an injured employee is under legal disability
15at the time when any right or privilege accrues to him or her
16under this Act, a guardian may be appointed pursuant to law,
17and may, on behalf of such person under legal disability, claim
18and exercise any such right or privilege with the same effect
19as if the employee himself or herself had claimed or exercised
20the right or privilege. No limitations of time provided by this
21Act run so long as the employee who is under legal disability
22is without a conservator or guardian.
23 (i) In case the injured employee is under 16 years of age
24at the time of the accident and is illegally employed, the
25amount of compensation payable under paragraphs (b), (c), (d),
26(e) and (f) of this Section is increased 50%.

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1 However, where an employer has on file an employment
2certificate issued pursuant to the Child Labor Law or work
3permit issued pursuant to the Federal Fair Labor Standards Act,
4as amended, or a birth certificate properly and duly issued,
5such certificate, permit or birth certificate is conclusive
6evidence as to the age of the injured minor employee for the
7purposes of this Section.
8 Nothing herein contained repeals or amends the provisions
9of the Child Labor Law relating to the employment of minors
10under the age of 16 years.
11 (j) 1. In the event the injured employee receives benefits,
12including medical, surgical or hospital benefits under any
13group plan covering non-occupational disabilities contributed
14to wholly or partially by the employer, which benefits should
15not have been payable if any rights of recovery existed under
16this Act, then such amounts so paid to the employee from any
17such group plan as shall be consistent with, and limited to,
18the provisions of paragraph 2 hereof, shall be credited to or
19against any compensation payment for temporary total
20incapacity for work or any medical, surgical or hospital
21benefits made or to be made under this Act. In such event, the
22period of time for giving notice of accidental injury and
23filing application for adjustment of claim does not commence to
24run until the termination of such payments. This paragraph does
25not apply to payments made under any group plan which would
26have been payable irrespective of an accidental injury under

HB2525 Engrossed- 54 -LRB100 06927 JLS 16978 b
1this Act. Any employer receiving such credit shall keep such
2employee safe and harmless from any and all claims or
3liabilities that may be made against him by reason of having
4received such payments only to the extent of such credit.
5 Any excess benefits paid to or on behalf of a State
6employee by the State Employees' Retirement System under
7Article 14 of the Illinois Pension Code on a death claim or
8disputed disability claim shall be credited against any
9payments made or to be made by the State of Illinois to or on
10behalf of such employee under this Act, except for payments for
11medical expenses which have already been incurred at the time
12of the award. The State of Illinois shall directly reimburse
13the State Employees' Retirement System to the extent of such
14credit.
15 2. Nothing contained in this Act shall be construed to give
16the employer or the insurance carrier the right to credit for
17any benefits or payments received by the employee other than
18compensation payments provided by this Act, and where the
19employee receives payments other than compensation payments,
20whether as full or partial salary, group insurance benefits,
21bonuses, annuities or any other payments, the employer or
22insurance carrier shall receive credit for each such payment
23only to the extent of the compensation that would have been
24payable during the period covered by such payment.
25 3. The extension of time for the filing of an Application
26for Adjustment of Claim as provided in paragraph 1 above shall

HB2525 Engrossed- 55 -LRB100 06927 JLS 16978 b
1not apply to those cases where the time for such filing had
2expired prior to the date on which payments or benefits
3enumerated herein have been initiated or resumed. Provided
4however that this paragraph 3 shall apply only to cases wherein
5the payments or benefits hereinabove enumerated shall be
6received after July 1, 1969.
7(Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813,
8eff. 7-13-12.)
9 (820 ILCS 305/8.1 new)
10 Sec. 8.1. Repetitive and cumulative injuries; right of
11contribution.
12 (a) Any accidental injury which results from repetitive or
13cumulative trauma and occurs within 3 months after the employee
14begins his or her employment shall not be considered by a
15workers' compensation insurer in setting the premium rate for
16the employer.
17 (b) If an award is made for benefits in connection with
18repetitive or cumulative injury resulting from employment with
19more than one employer, the employer liable for award or its
20insurer is entitled to contributions or reimbursement from each
21of the employee's prior employers which are subject to this Act
22or their insurers for the prior employer's pro rata share of
23responsibility as determined by the Commission. The right to
24contribution or reimbursement under this Section shall not
25delay, diminish, restrict, or alter in any way the benefits to

HB2525 Engrossed- 56 -LRB100 06927 JLS 16978 b
1which the employee or his or her dependents are entitled under
2this Act. At any time within one year after the Commission or
3the Arbitrator has made an award for benefits in connection
4with repetitive or cumulative injury, the employer liable under
5the award or its insurer may institute proceedings before the
6Commission for the purpose of determining the right of
7contribution or reimbursement. The proceeding shall not delay,
8diminish, restrict, or alter in any way the benefits to which
9the employee or his or her dependents are entitled under this
10Act, but shall be limited to a determination of the respective
11contribution or reimbursement rights and the responsibilities
12of all the employers joined in the proceeding. The employee has
13the duty of rendering reasonable cooperation in any of such
14proceeding.
15 (c) No contribution or reimbursement may be sought for any
16payment of benefits more than 2 years after the employer
17seeking contribution or reimbursement has made the payment.
18 (d) This Section shall apply only to injuries occurring on
19or after the effective date of this amendatory Act of the 100th
20General Assembly.
21 (e) The Commission shall adopt emergency rules under
22Section 5-45 of the Illinois Administrative Procedure Act to
23implement the provisions of this Section to implement this
24Section.
25 (820 ILCS 305/8.1b)

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1 Sec. 8.1b. Determination of permanent partial disability.
2For accidental injuries that occur on or after September 1,
32011, permanent partial disability shall be established using
4the following criteria:
5 (a) A physician licensed to practice medicine in all of its
6branches preparing a permanent partial disability impairment
7report shall report the level of impairment in writing. The
8report shall include an evaluation of medically defined and
9professionally appropriate measurements of impairment that
10include, but are not limited to: loss of range of motion; loss
11of strength; measured atrophy of tissue mass consistent with
12the injury; and any other measurements that establish the
13nature and extent of the impairment. The most current edition
14of the American Medical Association's "Guides to the Evaluation
15of Permanent Impairment" shall be used by the physician in
16determining the level of impairment.
17 (b) In determining the level of permanent partial
18disability, the Commission shall base its determination on the
19following factors: (i) the reported level of impairment
20pursuant to subsection (a) if such a report exists and is
21admitted into evidence; (ii) the occupation of the injured
22employee; (iii) the age of the employee at the time of the
23injury; (iv) the employee's future earning capacity; and (v)
24evidence of disability corroborated by the treating medical
25records or examination under Section 12 of this Act. Where an
26impairment report exists and is admitted into evidence, it must

HB2525 Engrossed- 58 -LRB100 06927 JLS 16978 b
1be considered by the Commission in its determination. No single
2enumerated factor shall be the sole determinant of disability.
3In determining the level of disability, the relevance and
4weight of any factors used in addition to the level of
5impairment as reported by the physician must be explained in a
6written order.
7 (c) A report of impairment prepared pursuant to subsection
8(a) is not required for an arbitrator or the Commission to make
9an award for permanent partial disability or permanent total
10disability benefits or any award for benefits under subsection
11(c) of Section 8 or subsection (d) of Section 8 of this Act or
12to approve a Settlement Contract Lump Sum Petition.
13(Source: P.A. 97-18, eff. 6-28-11.)
14 (820 ILCS 305/8.2a)
15 Sec. 8.2a. Electronic claims.
16 (a) The Director of Insurance shall adopt rules to do all
17of the following:
18 (1) Ensure that all health care providers and
19 facilities submit medical bills for payment on
20 standardized forms.
21 (2) Require acceptance by employers and insurers of
22 electronic claims for payment of medical services.
23 (3) Ensure confidentiality of medical information
24 submitted on electronic claims for payment of medical
25 services.

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1 (4) Ensure that health care providers have at least 15
2 business days to comply with records requested by employers
3 and insurers for the authorization of the payment of
4 workers' compensation claims.
5 (5) Ensure that health care providers are responsible
6 for supplying only those medical records pertaining to the
7 provider's own claims that are minimally necessary under
8 the federal Health Insurance Portability and
9 Accountability Act of 1996.
10 (6) Provide that any electronically submitted bill
11 determined to be complete but not paid or objected to
12 within 30 days shall be subject to penalties pursuant to
13 Section 8.2(d)(3) of this Act to be entered by the
14 Commission.
15 (7) Provide that the Department of Insurance shall
16 impose an administrative fine if it determines that an
17 employer or insurer has failed to comply with the
18 electronic claims acceptance and response process. The
19 amount of the administrative fine shall be no greater than
20 $1,000 per each violation, but shall not exceed $10,000 for
21 identical violations during a calendar year.
22 (b) To the extent feasible, standards adopted pursuant to
23subdivision (a) shall be consistent with existing standards
24under the federal Health Insurance Portability and
25Accountability Act of 1996 and standards adopted under the
26Illinois Health Information Exchange and Technology Act.

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1 (c) The rules requiring employers and insurers to accept
2electronic claims for payment of medical services shall be
3proposed on or before January 1, 2012, and shall require all
4employers and insurers to accept electronic claims for payment
5of medical services on or before June 30, 2012. The Director of
6Insurance shall adopt rules by June 30, 2017 to implement the
7changes to this Section made by this amendatory Act of the
8100th General Assembly. The Commission, with assistance from
9the Department and the Medical Fee Advisory Board, shall
10publish on its Internet website a companion guide to assist
11with compliance with electronic claims rules. The Medical Fee
12Advisory Board shall periodically review the companion guide.
13 (d) The Director of Insurance shall by rule establish
14criteria for granting exceptions to employers, insurance
15carriers, and health care providers who are unable to submit or
16accept medical bills electronically.
17(Source: P.A. 97-18, eff. 6-28-11.)
18 (820 ILCS 305/14) (from Ch. 48, par. 138.14)
19 Sec. 14. The Commission shall appoint a secretary, an
20assistant secretary, and arbitrators and shall employ such
21assistants and clerical help as may be necessary. Arbitrators
22shall be appointed pursuant to this Section, notwithstanding
23any provision of the Personnel Code.
24 Each arbitrator appointed after June 28, 2011 shall be
25required to demonstrate in writing his or her knowledge of and

HB2525 Engrossed- 61 -LRB100 06927 JLS 16978 b
1expertise in the law of and judicial processes of the Workers'
2Compensation Act and the Workers' Occupational Diseases Act.
3 A formal training program for newly-hired arbitrators
4shall be implemented. The training program shall include the
5following:
6 (a) substantive and procedural aspects of the
7 arbitrator position;
8 (b) current issues in workers' compensation law and
9 practice;
10 (c) medical lectures by specialists in areas such as
11 orthopedics, ophthalmology, psychiatry, rehabilitation
12 counseling;
13 (d) orientation to each operational unit of the
14 Illinois Workers' Compensation Commission;
15 (e) observation of experienced arbitrators conducting
16 hearings of cases, combined with the opportunity to discuss
17 evidence presented and rulings made;
18 (f) the use of hypothetical cases requiring the trainee
19 to issue judgments as a means to evaluating knowledge and
20 writing ability;
21 (g) writing skills;
22 (h) professional and ethical standards pursuant to
23 Section 1.1 of this Act;
24 (i) detection of workers' compensation fraud and
25 reporting obligations of Commission employees and
26 appointees;

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1 (j) standards of evidence-based medical treatment and
2 best practices for measuring and improving quality and
3 health care outcomes in the workers' compensation system,
4 including but not limited to the use of the American
5 Medical Association's "Guides to the Evaluation of
6 Permanent Impairment" and the practice of utilization
7 review; and
8 (k) substantive and procedural aspects of coal
9 workers' pneumoconiosis (black lung) cases.
10 A formal and ongoing professional development program
11including, but not limited to, the above-noted areas shall be
12implemented to keep arbitrators informed of recent
13developments and issues and to assist them in maintaining and
14enhancing their professional competence. Each arbitrator shall
15complete 20 hours of training in the above-noted areas during
16every 2 years such arbitrator shall remain in office.
17 Each arbitrator shall devote full time to his or her duties
18and shall serve when assigned as an acting Commissioner when a
19Commissioner is unavailable in accordance with the provisions
20of Section 13 of this Act. Any arbitrator who is an
21attorney-at-law shall not engage in the practice of law, nor
22shall any arbitrator hold any other office or position of
23profit under the United States or this State or any municipal
24corporation or political subdivision of this State.
25Notwithstanding any other provision of this Act to the
26contrary, an arbitrator who serves as an acting Commissioner in

HB2525 Engrossed- 63 -LRB100 06927 JLS 16978 b
1accordance with the provisions of Section 13 of this Act shall
2continue to serve in the capacity of Commissioner until a
3decision is reached in every case heard by that arbitrator
4while serving as an acting Commissioner.
5 Notwithstanding any other provision of this Section, the
6term of all arbitrators serving on June 28, 2011 (the effective
7date of Public Act 97-18), including any arbitrators on
8administrative leave, shall terminate at the close of business
9on July 1, 2011, but the incumbents shall continue to exercise
10all of their duties until they are reappointed or their
11successors are appointed.
12 On and after June 28, 2011 (the effective date of Public
13Act 97-18), arbitrators shall be appointed to 3-year terms as
14follows:
15 (1) All appointments shall be made by the Governor with
16 the advice and consent of the Senate.
17 (2) For their initial appointments, 12 arbitrators
18 shall be appointed to terms expiring July 1, 2012; 12
19 arbitrators shall be appointed to terms expiring July 1,
20 2013; and all additional arbitrators shall be appointed to
21 terms expiring July 1, 2014. Thereafter, all arbitrators
22 shall be appointed to 3-year terms.
23 Upon the expiration of a term, the Chairman shall evaluate
24the performance of the arbitrator and may recommend to the
25Governor that he or she be reappointed to a second or
26subsequent term by the Governor with the advice and consent of

HB2525 Engrossed- 64 -LRB100 06927 JLS 16978 b
1the Senate.
2 Each arbitrator appointed on or after June 28, 2011 (the
3effective date of Public Act 97-18) and who has not previously
4served as an arbitrator for the Commission shall be required to
5be authorized to practice law in this State by the Supreme
6Court, and to maintain this authorization throughout his or her
7term of employment.
8 The performance of all arbitrators shall be reviewed by the
9Chairman on an annual basis. The Chairman shall allow input
10from the Commissioners in all such reviews.
11 The Commission shall assign no fewer than 3 arbitrators to
12each hearing site. The Commission shall establish a procedure
13to ensure that the arbitrators assigned to each hearing site
14are assigned cases on a random basis. The Chairman of the
15Commission shall have discretion to assign and reassign
16arbitrators to each hearing sites as needed. No arbitrator
17shall hear cases in any county, other than Cook County, for
18more than 2 years in each 3-year term.
19 The Secretary and each arbitrator shall receive a per annum
20salary of $4,000 less than the per annum salary of members of
21The Illinois Workers' Compensation Commission as provided in
22Section 13 of this Act, payable in equal monthly installments.
23 The members of the Commission, Arbitrators and other
24employees whose duties require them to travel, shall have
25reimbursed to them their actual traveling expenses and
26disbursements made or incurred by them in the discharge of

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1their official duties while away from their place of residence
2in the performance of their duties.
3 The Commission shall provide itself with a seal for the
4authentication of its orders, awards and proceedings upon which
5shall be inscribed the name of the Commission and the words
6"Illinois--Seal".
7 The Secretary or Assistant Secretary, under the direction
8of the Commission, shall have charge and custody of the seal of
9the Commission and also have charge and custody of all records,
10files, orders, proceedings, decisions, awards and other
11documents on file with the Commission. He shall furnish
12certified copies, under the seal of the Commission, of any such
13records, files, orders, proceedings, decisions, awards and
14other documents on file with the Commission as may be required.
15Certified copies so furnished by the Secretary or Assistant
16Secretary shall be received in evidence before the Commission
17or any Arbitrator thereof, and in all courts, provided that the
18original of such certified copy is otherwise competent and
19admissible in evidence. The Secretary or Assistant Secretary
20shall perform such other duties as may be prescribed from time
21to time by the Commission.
22(Source: P.A. 98-40, eff. 6-28-13; 99-642, eff. 7-28-16.)
23 (820 ILCS 305/19) (from Ch. 48, par. 138.19)
24 Sec. 19. Any disputed questions of law or fact shall be
25determined as herein provided.

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1 (a) It shall be the duty of the Commission upon
2notification that the parties have failed to reach an
3agreement, to designate an Arbitrator.
4 1. Whenever any claimant misconceives his remedy and
5 files an application for adjustment of claim under this Act
6 and it is subsequently discovered, at any time before final
7 disposition of such cause, that the claim for disability or
8 death which was the basis for such application should
9 properly have been made under the Workers' Occupational
10 Diseases Act, then the provisions of Section 19, paragraph
11 (a-1) of the Workers' Occupational Diseases Act having
12 reference to such application shall apply.
13 2. Whenever any claimant misconceives his remedy and
14 files an application for adjustment of claim under the
15 Workers' Occupational Diseases Act and it is subsequently
16 discovered, at any time before final disposition of such
17 cause that the claim for injury or death which was the
18 basis for such application should properly have been made
19 under this Act, then the application so filed under the
20 Workers' Occupational Diseases Act may be amended in form,
21 substance or both to assert claim for such disability or
22 death under this Act and it shall be deemed to have been so
23 filed as amended on the date of the original filing
24 thereof, and such compensation may be awarded as is
25 warranted by the whole evidence pursuant to this Act. When
26 such amendment is submitted, further or additional

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

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

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1correctness of the transcript of evidence it shall be
2authenticated by the signature of the Arbitrator designated by
3the Commission.
4 Whether the employee is working or not, if the employee is
5not receiving or has not received medical, surgical, or
6hospital services or other services or compensation as provided
7in paragraph (a) of Section 8, or compensation as provided in
8paragraph (b) of Section 8, the employee may at any time
9petition for an expedited hearing by an Arbitrator on the issue
10of whether or not he or she is entitled to receive payment of
11the services or compensation. Provided the employer continues
12to pay compensation pursuant to paragraph (b) of Section 8, the
13employer may at any time petition for an expedited hearing on
14the issue of whether or not the employee is entitled to receive
15medical, surgical, or hospital services or other services or
16compensation as provided in paragraph (a) of Section 8, or
17compensation as provided in paragraph (b) of Section 8. When an
18employer has petitioned for an expedited hearing, the employer
19shall continue to pay compensation as provided in paragraph (b)
20of Section 8 unless the arbitrator renders a decision that the
21employee is not entitled to the benefits that are the subject
22of the expedited hearing or unless the employee's treating
23physician has released the employee to return to work at his or
24her regular job with the employer or the employee actually
25returns to work at any other job. If the arbitrator renders a
26decision that the employee is not entitled to the benefits that

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

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

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

HB2525 Engrossed- 73 -LRB100 06927 JLS 16978 b
1 receive compensation pursuant to paragraph (b) of Section 8
2 of this Act or medical, surgical or hospital services
3 pursuant to paragraph (a) of Section 8 of this Act. Such
4 reports, documents or affidavits shall state, if possible,
5 the history of the accident given by the employee, and
6 describe the injury and medical diagnosis, the medical
7 services for such injury which the employee has received
8 and is receiving, the physical activities which the
9 employee cannot currently perform as a result of any
10 impairment or disability due to such injury, and the
11 prognosis for recovery;
12 (xi) complete copies of any reports, records,
13 documents and affidavits in the possession of the employee
14 on which the employee will rely to support his allegations,
15 provided that the employer shall pay the reasonable cost of
16 reproduction thereof;
17 (xii) a list of any reports, records, documents and
18 affidavits which the employee has demanded by subpoena and
19 on which he intends to rely to support his allegations;
20 (xiii) a certification signed by the employee or his
21 representative that the employer has received the petition
22 with the required information 15 days before filing.
23 Fifteen days after receipt by the employer of the petition
24with the required information the employee may file said
25petition and required information and shall serve notice of the
26filing upon the employer. The employer may file a motion

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1addressed to the sufficiency of the petition. If an objection
2has been filed to the sufficiency of the petition, the
3arbitrator shall rule on the objection within 2 working days.
4If such an objection is filed, the time for filing the final
5decision of the Commission as provided in this paragraph shall
6be tolled until the arbitrator has determined that the petition
7is sufficient.
8 The employer shall, within 15 days after receipt of the
9notice that such petition is filed, file with the Commission
10and serve on the employee or his representative a written
11response to each claim set forth in the petition, including the
12legal and factual basis for each disputed allegation and the
13following information: (i) complete copies of any reports,
14records, documents and affidavits in the possession of the
15employer on which the employer intends to rely in support of
16his response, (ii) a list of any reports, records, documents
17and affidavits which the employer has demanded by subpoena and
18on which the employer intends to rely in support of his
19response, (iii) the name and address of each witness on whom
20the employer will rely to support his response, and (iv) the
21names and addresses of any medical practitioners selected by
22the employer pursuant to Section 12 of this Act and the time
23and place of any examination scheduled to be made pursuant to
24such Section.
25 Any employer who does not timely file and serve a written
26response without good cause may not introduce any evidence to

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

HB2525 Engrossed- 76 -LRB100 06927 JLS 16978 b
1employer. Otherwise service must be at the employee's principal
2place of employment by the employer. If service on the employer
3is not possible at either of the above, then service shall be
4at the employer's principal place of business. After initial
5service in each case, service shall be made on the employer's
6attorney or designated representative.
7 (c)(1) At a reasonable time in advance of and in connection
8with the hearing under Section 19(e) or 19(h), the Commission
9may on its own motion order an impartial physical or mental
10examination of a petitioner whose mental or physical condition
11is in issue, when in the Commission's discretion it appears
12that such an examination will materially aid in the just
13determination of the case. The examination shall be made by a
14member or members of a panel of physicians chosen for their
15special qualifications by the Illinois State Medical Society.
16The Commission shall establish procedures by which a physician
17shall be selected from such list.
18 (2) Should the Commission at any time during the hearing
19find that compelling considerations make it advisable to have
20an examination and report at that time, the commission may in
21its discretion so order.
22 (3) A copy of the report of examination shall be given to
23the Commission and to the attorneys for the parties.
24 (4) Either party or the Commission may call the examining
25physician or physicians to testify. Any physician so called
26shall be subject to cross-examination.

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

HB2525 Engrossed- 78 -LRB100 06927 JLS 16978 b
1elsewhere as the Commission may deem advisable. The taking of
2testimony on such hearings may be had before any member of the
3Commission. If a petition for review and agreed statement of
4facts or transcript of evidence is filed, as provided herein,
5the Commission shall promptly review the decision of the
6Arbitrator and all questions of law or fact which appear from
7the statement of facts or transcript of evidence.
8 In all cases in which the hearing before the arbitrator is
9held after December 18, 1989, no additional evidence shall be
10introduced by the parties before the Commission on review of
11the decision of the Arbitrator. In reviewing decisions of an
12arbitrator the Commission shall award such temporary
13compensation, permanent compensation and other payments as are
14due under this Act. The Commission shall file in its office its
15decision thereon, and shall immediately send to each party or
16his attorney a copy of such decision and a notification of the
17time when it was filed. Decisions shall be filed within 60 days
18after the Statement of Exceptions and Supporting Brief and
19Response thereto are required to be filed or oral argument
20whichever is later.
21 In the event either party requests oral argument, such
22argument shall be had before a panel of 3 members of the
23Commission (or before all available members pursuant to the
24determination of 7 members of the Commission that such argument
25be held before all available members of the Commission)
26pursuant to the rules and regulations of the Commission. A

HB2525 Engrossed- 79 -LRB100 06927 JLS 16978 b
1panel of 3 members, which shall be comprised of not more than
2one representative citizen of the employing class and not more
3than one representative citizen of the employee class, shall
4hear the argument; provided that if all the issues in dispute
5are solely the nature and extent of the permanent partial
6disability, if any, a majority of the panel may deny the
7request for such argument and such argument shall not be held;
8and provided further that 7 members of the Commission may
9determine that the argument be held before all available
10members of the Commission. A decision of the Commission shall
11be approved by a majority of Commissioners present at such
12hearing if any; provided, if no such hearing is held, a
13decision of the Commission shall be approved by a majority of a
14panel of 3 members of the Commission as described in this
15Section. The Commission shall give 10 days' notice to the
16parties or their attorneys of the time and place of such taking
17of testimony and of such argument.
18 In any case the Commission in its decision may find
19specially upon any question or questions of law or fact which
20shall be submitted in writing by either party whether ultimate
21or otherwise; provided that on issues other than nature and
22extent of the disability, if any, the Commission in its
23decision shall find specially upon any question or questions of
24law or fact, whether ultimate or otherwise, which are submitted
25in writing by either party; provided further that not more than
265 such questions may be submitted by either party. Any party

HB2525 Engrossed- 80 -LRB100 06927 JLS 16978 b
1may, within 20 days after receipt of notice of the Commission's
2decision, or within such further time, not exceeding 30 days,
3as the Commission may grant, file with the Commission either an
4agreed statement of the facts appearing upon the hearing, or,
5if such party shall so elect, a correct transcript of evidence
6of the additional proceedings presented before the Commission,
7in which report the party may embody a correct statement of
8such other proceedings in the case as such party may desire to
9have reviewed, such statement of facts or transcript of
10evidence to be authenticated by the signature of the parties or
11their attorneys, and in the event that they do not agree, then
12the authentication of such transcript of evidence shall be by
13the signature of any member of the Commission.
14 If a reporter does not for any reason furnish a transcript
15of the proceedings before the Arbitrator in any case for use on
16a hearing for review before the Commission, within the
17limitations of time as fixed in this Section, the Commission
18may, in its discretion, order a trial de novo before the
19Commission in such case upon application of either party. The
20applications for adjustment of claim and other documents in the
21nature of pleadings filed by either party, together with the
22decisions of the Arbitrator and of the Commission and the
23statement of facts or transcript of evidence hereinbefore
24provided for in paragraphs (b) and (c) shall be the record of
25the proceedings of the Commission, and shall be subject to
26review as hereinafter provided.

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

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1powers, according to the provisions of paragraph (e) of this
2Section shall, in the absence of fraud, be conclusive unless
3reviewed as in this paragraph hereinafter provided. However,
4the Arbitrator or the Commission may on his or its own motion,
5or on the motion of either party, correct any clerical error or
6errors in computation within 15 days after the date of receipt
7of any award by such Arbitrator or any decision on review of
8the Commission and shall have the power to recall the original
9award on arbitration or decision on review, and issue in lieu
10thereof such corrected award or decision. Where such correction
11is made the time for review herein specified shall begin to run
12from the date of the receipt of the corrected award or
13decision.
14 (1) Except in cases of claims against the State of
15 Illinois other than those claims under Section 18.1, in
16 which case the decision of the Commission shall not be
17 subject to judicial review, the Circuit Court of the county
18 where any of the parties defendant may be found, or if none
19 of the parties defendant can be found in this State then
20 the Circuit Court of the county where the accident
21 occurred, shall by summons to the Commission have power to
22 review all questions of law and fact presented by such
23 record.
24 A proceeding for review shall be commenced within 20
25 days of the receipt of notice of the decision of the
26 Commission. The summons shall be issued by the clerk of

HB2525 Engrossed- 83 -LRB100 06927 JLS 16978 b
1 such court upon written request returnable on a designated
2 return day, not less than 10 or more than 60 days from the
3 date of issuance thereof, and the written request shall
4 contain the last known address of other parties in interest
5 and their attorneys of record who are to be served by
6 summons. Service upon any member of the Commission or the
7 Secretary or the Assistant Secretary thereof shall be
8 service upon the Commission, and service upon other parties
9 in interest and their attorneys of record shall be by
10 summons, and such service shall be made upon the Commission
11 and other parties in interest by mailing notices of the
12 commencement of the proceedings and the return day of the
13 summons to the office of the Commission and to the last
14 known place of residence of other parties in interest or
15 their attorney or attorneys of record. The clerk of the
16 court issuing the summons shall on the day of issue mail
17 notice of the commencement of the proceedings which shall
18 be done by mailing a copy of the summons to the office of
19 the Commission, and a copy of the summons to the other
20 parties in interest or their attorney or attorneys of
21 record and the clerk of the court shall make certificate
22 that he has so sent said notices in pursuance of this
23 Section, which shall be evidence of service on the
24 Commission and other parties in interest.
25 The Commission shall not be required to certify the
26 record of their proceedings to the Circuit Court, unless

HB2525 Engrossed- 84 -LRB100 06927 JLS 16978 b
1 the party commencing the proceedings for review in the
2 Circuit Court as above provided, shall file with the
3 Commission notice of intent to file for review in Circuit
4 Court. It shall be the duty of the Commission upon such
5 filing of notice of intent to file for review in the
6 Circuit Court to prepare a true and correct copy of such
7 testimony and a true and correct copy of all other matters
8 contained in such record and certified to by the Secretary
9 or Assistant Secretary thereof. The changes made to this
10 subdivision (f)(1) by this amendatory Act of the 98th
11 General Assembly apply to any Commission decision entered
12 after the effective date of this amendatory Act of the 98th
13 General Assembly.
14 No request for a summons may be filed and no summons
15 shall issue unless the party seeking to review the decision
16 of the Commission shall exhibit to the clerk of the Circuit
17 Court proof of filing with the Commission of the notice of
18 the intent to file for review in the Circuit Court or an
19 affidavit of the attorney setting forth that notice of
20 intent to file for review in the Circuit Court has been
21 given in writing to the Secretary or Assistant Secretary of
22 the Commission.
23 (2) No such summons shall issue unless the one against
24 whom the Commission shall have rendered an award for the
25 payment of money shall upon the filing of his written
26 request for such summons file with the clerk of the court a

HB2525 Engrossed- 85 -LRB100 06927 JLS 16978 b
1 bond conditioned that if he shall not successfully
2 prosecute the review, he will pay the award and the costs
3 of the proceedings in the courts. The amount of the bond
4 shall be fixed by any member of the Commission and the
5 surety or sureties of the bond shall be approved by the
6 clerk of the court. The acceptance of the bond by the clerk
7 of the court shall constitute evidence of his approval of
8 the bond.
9 The State of Illinois, including its constitutional
10 officers, boards, commissions, agencies, public
11 institutions of higher learning, and funds administered by
12 the treasurer ex officio, and every Every county, city,
13 town, township, incorporated village, school district,
14 body politic or municipal corporation against whom the
15 Commission shall have rendered an award for the payment of
16 money shall not be required to file a bond to secure the
17 payment of the award and the costs of the proceedings in
18 the court to authorize the court to issue such summons.
19 The court may confirm or set aside the decision of the
20 Commission. If the decision is set aside and the facts
21 found in the proceedings before the Commission are
22 sufficient, the court may enter such decision as is
23 justified by law, or may remand the cause to the Commission
24 for further proceedings and may state the questions
25 requiring further hearing, and give such other
26 instructions as may be proper. Appeals shall be taken to

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1 the Appellate Court in accordance with Supreme Court Rules
2 22(g) and 303. Appeals shall be taken from the Appellate
3 Court to the Supreme Court in accordance with Supreme Court
4 Rule 315.
5 It shall be the duty of the clerk of any court
6 rendering a decision affecting or affirming an award of the
7 Commission to promptly furnish the Commission with a copy
8 of such decision, without charge.
9 The decision of a majority of the members of the panel
10 of the Commission, shall be considered the decision of the
11 Commission.
12 (g) Except in the case of a claim against the State of
13Illinois, either party may present a certified copy of the
14award of the Arbitrator, or a certified copy of the decision of
15the Commission when the same has become final, when no
16proceedings for review are pending, providing for the payment
17of compensation according to this Act, to the Circuit Court of
18the county in which such accident occurred or either of the
19parties are residents, whereupon the court shall enter a
20judgment in accordance therewith. In a case where the employer
21refuses to pay compensation according to such final award or
22such final decision upon which such judgment is entered the
23court shall in entering judgment thereon, tax as costs against
24him the reasonable costs and attorney fees in the arbitration
25proceedings and in the court entering the judgment for the
26person in whose favor the judgment is entered, which judgment

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1and costs taxed as therein provided shall, until and unless set
2aside, have the same effect as though duly entered in an action
3duly tried and determined by the court, and shall with like
4effect, be entered and docketed. The Circuit Court shall have
5power at any time upon application to make any such judgment
6conform to any modification required by any subsequent decision
7of the Supreme Court upon appeal, or as the result of any
8subsequent proceedings for review, as provided in this Act.
9 Judgment shall not be entered until 15 days' notice of the
10time and place of the application for the entry of judgment
11shall be served upon the employer by filing such notice with
12the Commission, which Commission shall, in case it has on file
13the address of the employer or the name and address of its
14agent upon whom notices may be served, immediately send a copy
15of the notice to the employer or such designated agent.
16 (h) An agreement or award under this Act providing for
17compensation in installments, may at any time within 18 months
18after such agreement or award be reviewed by the Commission at
19the request of either the employer or the employee, on the
20ground that the disability of the employee has subsequently
21recurred, increased, diminished or ended.
22 However, as to accidents occurring subsequent to July 1,
231955, which are covered by any agreement or award under this
24Act providing for compensation in installments made as a result
25of such accident, such agreement or award may at any time
26within 30 months, or 60 months in the case of an award under

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1Section 8(d)1, after such agreement or award be reviewed by the
2Commission at the request of either the employer or the
3employee on the ground that the disability of the employee has
4subsequently recurred, increased, diminished or ended.
5 On such review, compensation payments may be
6re-established, increased, diminished or ended. The Commission
7shall give 15 days' notice to the parties of the hearing for
8review. Any employee, upon any petition for such review being
9filed by the employer, shall be entitled to one day's notice
10for each 100 miles necessary to be traveled by him in attending
11the hearing of the Commission upon the petition, and 3 days in
12addition thereto. Such employee shall, at the discretion of the
13Commission, also be entitled to 5 cents per mile necessarily
14traveled by him within the State of Illinois in attending such
15hearing, not to exceed a distance of 300 miles, to be taxed by
16the Commission as costs and deposited with the petition of the
17employer.
18 When compensation which is payable in accordance with an
19award or settlement contract approved by the Commission, is
20ordered paid in a lump sum by the Commission, no review shall
21be had as in this paragraph mentioned.
22 (i) Each party, upon taking any proceedings or steps
23whatsoever before any Arbitrator, Commission or court, shall
24file with the Commission his address, or the name and address
25of any agent upon whom all notices to be given to such party
26shall be served, either personally or by registered mail,

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1addressed to such party or agent at the last address so filed
2with the Commission. In the event such party has not filed his
3address, or the name and address of an agent as above provided,
4service of any notice may be had by filing such notice with the
5Commission.
6 (j) Whenever in any proceeding testimony has been taken or
7a final decision has been rendered and after the taking of such
8testimony or after such decision has become final, the injured
9employee dies, then in any subsequent proceedings brought by
10the personal representative or beneficiaries of the deceased
11employee, such testimony in the former proceeding may be
12introduced with the same force and effect as though the witness
13having so testified were present in person in such subsequent
14proceedings and such final decision, if any, shall be taken as
15final adjudication of any of the issues which are the same in
16both proceedings.
17 (k) In case where there has been any unreasonable or
18vexatious delay of payment or intentional underpayment of
19compensation, or proceedings have been instituted or carried on
20by the one liable to pay the compensation, which do not present
21a real controversy, but are merely frivolous or for delay, then
22the Commission may award compensation additional to that
23otherwise payable under this Act equal to 50% of the amount
24payable at the time of such award. Failure to pay compensation
25in accordance with the provisions of Section 8, paragraph (b)
26of this Act, shall be considered unreasonable delay.

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1 When determining whether this subsection (k) shall apply,
2the Commission shall consider whether an Arbitrator has
3determined that the claim is not compensable or whether the
4employer has made payments under Section 8(j).
5 (k-1) In a case where there has been unreasonable or
6vexatious delay of authorization of medical treatment, the
7Commission may award compensation additional to that otherwise
8payable under this Act in the sum of $30 per day for each day
9that the benefits under Section 8(a) have been so withheld or
10refused, not to exceed $10,000 or the total amount due per
11Section 8.2 for treatment to be rendered whichever is less.
12 Unless utilization review under Section 8.7 or Section 12
13examination is, or has been, requested, a delay in
14authorization of 14 days or more from the employer's receipt of
15all appropriate records and data elements needed to allow the
16employer to make a determination whether to authorize such care
17shall create a rebuttable presumption of unreasonable delay.
18 This subsection (k-1) is the only penalty provision within
19the Act applicable to delay of authorization of medical
20treatment and shall apply only to health care services provided
21or proposed to be provided on or after the effective date of
22this amendatory Act of the 100th General Assembly.
23 (l) If the employee has made written demand for payment of
24benefits under Section 8(a) or Section 8(b), the employer shall
25have 14 days after receipt of the demand to set forth in
26writing the reason for the delay. In the case of demand for

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1payment of medical benefits under Section 8(a), the time for
2the employer to respond shall not commence until the expiration
3of the allotted 30 days specified under Section 8.2(d). In case
4the employer or his or her insurance carrier shall without good
5and just cause fail, neglect, refuse, or unreasonably delay the
6payment of benefits under Section 8(a) or Section 8(b), the
7Arbitrator or the Commission shall allow to the employee
8additional compensation in the sum of $30 per day for each day
9that the benefits under Section 8(a) or Section 8(b) have been
10so withheld or refused, not to exceed $10,000. A delay in
11payment of 14 days or more shall create a rebuttable
12presumption of unreasonable delay.
13 (m) If the commission finds that an accidental injury was
14directly and proximately caused by the employer's wilful
15violation of a health and safety standard under the Health and
16Safety Act or the Occupational Safety and Health Act in force
17at the time of the accident, the arbitrator or the Commission
18shall allow to the injured employee or his dependents, as the
19case may be, additional compensation equal to 25% of the amount
20which otherwise would be payable under the provisions of this
21Act exclusive of this paragraph. The additional compensation
22herein provided shall be allowed by an appropriate increase in
23the applicable weekly compensation rate.
24 (n) After June 30, 1984, decisions of the Illinois Workers'
25Compensation Commission reviewing an award of an arbitrator of
26the Commission shall draw interest at a rate equal to the yield

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1on indebtedness issued by the United States Government with a
226-week maturity next previously auctioned on the day on which
3the decision is filed. Said rate of interest shall be set forth
4in the Arbitrator's Decision. Interest shall be drawn from the
5date of the arbitrator's award on all accrued compensation due
6the employee through the day prior to the date of payments.
7However, when an employee appeals an award of an Arbitrator or
8the Commission, and the appeal results in no change or a
9decrease in the award, interest shall not further accrue from
10the date of such appeal.
11 The employer or his insurance carrier may tender the
12payments due under the award to stop the further accrual of
13interest on such award notwithstanding the prosecution by
14either party of review, certiorari, appeal to the Supreme Court
15or other steps to reverse, vacate or modify the award.
16 (o) By the 15th day of each month each insurer providing
17coverage for losses under this Act shall notify each insured
18employer of any compensable claim incurred during the preceding
19month and the amounts paid or reserved on the claim including a
20summary of the claim and a brief statement of the reasons for
21compensability. A cumulative report of all claims incurred
22during a calendar year or continued from the previous year
23shall be furnished to the insured employer by the insurer
24within 30 days after the end of that calendar year.
25 The insured employer may challenge, in proceeding before
26the Commission, payments made by the insurer without

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1arbitration and payments made after a case is determined to be
2noncompensable. If the Commission finds that the case was not
3compensable, the insurer shall purge its records as to that
4employer of any loss or expense associated with the claim,
5reimburse the employer for attorneys' fees arising from the
6challenge and for any payment required of the employer to the
7Rate Adjustment Fund or the Second Injury Fund, and may not
8reflect the loss or expense for rate making purposes. The
9employee shall not be required to refund the challenged
10payment. The decision of the Commission may be reviewed in the
11same manner as in arbitrated cases. No challenge may be
12initiated under this paragraph more than 3 years after the
13payment is made. An employer may waive the right of challenge
14under this paragraph on a case by case basis.
15 (p) After filing an application for adjustment of claim but
16prior to the hearing on arbitration the parties may voluntarily
17agree to submit such application for adjustment of claim for
18decision by an arbitrator under this subsection (p) where such
19application for adjustment of claim raises only a dispute over
20temporary total disability, permanent partial disability or
21medical expenses. Such agreement shall be in writing in such
22form as provided by the Commission. Applications for adjustment
23of claim submitted for decision by an arbitrator under this
24subsection (p) shall proceed according to rule as established
25by the Commission. The Commission shall promulgate rules
26including, but not limited to, rules to ensure that the parties

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1are adequately informed of their rights under this subsection
2(p) and of the voluntary nature of proceedings under this
3subsection (p). The findings of fact made by an arbitrator
4acting within his or her powers under this subsection (p) in
5the absence of fraud shall be conclusive. However, the
6arbitrator may on his own motion, or the motion of either
7party, correct any clerical errors or errors in computation
8within 15 days after the date of receipt of such award of the
9arbitrator and shall have the power to recall the original
10award on arbitration, and issue in lieu thereof such corrected
11award. The decision of the arbitrator under this subsection (p)
12shall be considered the decision of the Commission and
13proceedings for review of questions of law arising from the
14decision may be commenced by either party pursuant to
15subsection (f) of Section 19. The Advisory Board established
16under Section 13.1 shall compile a list of certified Commission
17arbitrators, each of whom shall be approved by at least 7
18members of the Advisory Board. The chairman shall select 5
19persons from such list to serve as arbitrators under this
20subsection (p). By agreement, the parties shall select one
21arbitrator from among the 5 persons selected by the chairman
22except that if the parties do not agree on an arbitrator from
23among the 5 persons, the parties may, by agreement, select an
24arbitrator of the American Arbitration Association, whose fee
25shall be paid by the State in accordance with rules promulgated
26by the Commission. Arbitration under this subsection (p) shall

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1be voluntary.
2(Source: P.A. 97-18, eff. 6-28-11; 98-40, eff. 6-28-13; 98-874,
3eff. 1-1-15.)
4 (820 ILCS 305/25.5)
5 Sec. 25.5. Unlawful acts; penalties.
6 (a) It is unlawful for any person, company, corporation,
7insurance carrier, healthcare provider, or other entity to:
8 (1) Intentionally present or cause to be presented any
9 false or fraudulent claim for the payment of any workers'
10 compensation benefit.
11 (2) Intentionally make or cause to be made any false or
12 fraudulent material statement or material representation
13 for the purpose of obtaining or denying any workers'
14 compensation benefit.
15 (3) Intentionally make or cause to be made any false or
16 fraudulent statements with regard to entitlement to
17 workers' compensation benefits with the intent to prevent
18 an injured worker from making a legitimate claim for any
19 workers' compensation benefits.
20 (4) Intentionally prepare or provide an invalid,
21 false, or counterfeit certificate of insurance as proof of
22 workers' compensation insurance.
23 (5) Intentionally make or cause to be made any false or
24 fraudulent material statement or material representation
25 for the purpose of obtaining workers' compensation

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1 insurance at less than the proper amount rate for that
2 insurance.
3 (6) Intentionally make or cause to be made any false or
4 fraudulent material statement or material representation
5 on an initial or renewal self-insurance application or
6 accompanying financial statement for the purpose of
7 obtaining self-insurance status or reducing the amount of
8 security that may be required to be furnished pursuant to
9 Section 4 of this Act.
10 (7) Intentionally make or cause to be made any false or
11 fraudulent material statement to the Department of
12 Insurance's fraud and insurance non-compliance unit in the
13 course of an investigation of fraud or insurance
14 non-compliance.
15 (8) Intentionally assist, abet, solicit, or conspire
16 with any person, company, or other entity to commit any of
17 the acts in paragraph (1), (2), (3), (4), (5), (6), or (7)
18 of this subsection (a).
19 (9) Intentionally present a bill or statement for the
20 payment for medical services that were not provided.
21 For the purposes of paragraphs (2), (3), (5), (6), (7), and
22(9), the term "statement" includes any writing, notice, proof
23of injury, bill for services, hospital or doctor records and
24reports, or X-ray and test results.
25 (b) Sentences for violations of subsection (a) are as
26follows:

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1 (1) A violation in which the value of the property
2 obtained or attempted to be obtained is $300 or less is a
3 Class A misdemeanor.
4 (2) A violation in which the value of the property
5 obtained or attempted to be obtained is more than $300 but
6 not more than $10,000 is a Class 3 felony.
7 (3) A violation in which the value of the property
8 obtained or attempted to be obtained is more than $10,000
9 but not more than $100,000 is a Class 2 felony.
10 (4) A violation in which the value of the property
11 obtained or attempted to be obtained is more than $100,000
12 is a Class 1 felony.
13 (4.5) A violation of paragraph (3), (4), or (7) of
14 subsection (a) in which the offender did not attempt to
15 obtain any workers' compensation benefits or other
16 property of value is a Class A misdemeanor.
17 (4.7) A violation of paragraph (8) of subsection (a)
18 shall be subject to the same penalty as the offense to
19 which the offender assisted, abetted, solicited, or
20 conspired.
21 (5) A person convicted under this Section shall be
22 ordered to pay monetary restitution to the insurance
23 company or self-insured entity or any other person for any
24 financial loss sustained as a result of a violation of this
25 Section, including any court costs and attorney fees. An
26 order of restitution also includes expenses incurred and

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1 paid by the State of Illinois or an insurance company or
2 self-insured entity in connection with any medical
3 evaluation or treatment services.
4 For the purposes of this Section, where the exact value of
5property obtained or attempted to be obtained is either not
6alleged or is not specifically set by the terms of a policy of
7insurance, the value of the property shall be the fair market
8replacement value of the property claimed to be lost, the
9reasonable costs of reimbursing a vendor or other claimant for
10services to be rendered, or both. Notwithstanding the
11foregoing, an insurance company, self-insured entity, or any
12other person suffering financial loss sustained as a result of
13violation of this Section may seek restitution, including court
14costs and attorney's fees in a civil action in a court of
15competent jurisdiction.
16 (c) The Department of Insurance shall establish a fraud and
17insurance non-compliance unit responsible for investigating
18incidences of fraud and insurance non-compliance pursuant to
19this Section. The size of the staff of the unit shall be
20subject to appropriation by the General Assembly. It shall be
21the duty of the fraud and insurance non-compliance unit to
22determine the identity of insurance carriers, employers,
23employees, or other persons or entities who have violated the
24fraud and insurance non-compliance provisions of this Section.
25The fraud and insurance non-compliance unit shall report
26violations of the fraud and insurance non-compliance

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1provisions of this Section to the Special Prosecutions Bureau
2of the Criminal Division of the Office of the Attorney General
3or to the State's Attorney of the county in which the offense
4allegedly occurred, either of whom has the authority to
5prosecute violations under this Section.
6 With respect to the subject of any investigation being
7conducted, the fraud and insurance non-compliance unit shall
8have the general power of subpoena of the Department of
9Insurance, including the authority to issue a subpoena to a
10medical provider, pursuant to Section 8-802 of the Code of
11Civil Procedure.
12 (d) Any person may report allegations of insurance
13non-compliance and fraud pursuant to this Section to the
14Department of Insurance's fraud and insurance non-compliance
15unit whose duty it shall be to investigate the report. The unit
16shall notify the Commission of reports of insurance
17non-compliance. Any person reporting an allegation of
18insurance non-compliance or fraud against either an employee or
19employer under this Section must identify himself. Except as
20provided in this subsection and in subsection (e), all reports
21shall remain confidential except to refer an investigation to
22the Attorney General or State's Attorney for prosecution or if
23the fraud and insurance non-compliance unit's investigation
24reveals that the conduct reported may be in violation of other
25laws or regulations of the State of Illinois, the unit may
26report such conduct to the appropriate governmental agency

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1charged with administering such laws and regulations. Any
2person who intentionally makes a false report under this
3Section to the fraud and insurance non-compliance unit is
4guilty of a Class A misdemeanor.
5 (e) In order for the fraud and insurance non-compliance
6unit to investigate a report of fraud related to an employee's
7claim, (i) the employee must have filed with the Commission an
8Application for Adjustment of Claim and the employee must have
9either received or attempted to receive benefits under this Act
10that are related to the reported fraud or (ii) the employee
11must have made a written demand for the payment of benefits
12that are related to the reported fraud. There shall be no
13immunity, under this Act or otherwise, for any person who files
14a false report or who files a report without good and just
15cause. Confidentiality of medical information shall be
16strictly maintained. Investigations that are not referred for
17prosecution shall be destroyed upon the expiration of the
18statute of limitations for the acts under investigation and
19shall not be disclosed except that the person making the report
20shall be notified that the investigation is being closed. It is
21unlawful for any employer, insurance carrier, service
22adjustment company, third party administrator, self-insured,
23or similar entity to file or threaten to file a report of fraud
24against an employee because of the exercise by the employee of
25the rights and remedies granted to the employee by this Act.
26 (e-5) The fraud and insurance non-compliance unit shall

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1procure and implement a system utilizing advanced analytics
2inclusive of predictive modeling, data mining, social network
3analysis, and scoring algorithms for the detection and
4prevention of fraud, waste, and abuse on or before January 1,
52012. The fraud and insurance non-compliance unit shall procure
6this system using a request for proposals process governed by
7the Illinois Procurement Code and rules adopted under that
8Code. The fraud and insurance non-compliance unit shall provide
9a report to the President of the Senate, Speaker of the House
10of Representatives, Minority Leader of the House of
11Representatives, Minority Leader of the Senate, Governor,
12Chairman of the Commission, and Director of Insurance on or
13before July 1, 2012 and annually thereafter detailing its
14activities and providing recommendations regarding
15opportunities for additional fraud waste and abuse detection
16and prevention.
17 (e-7) By July 1, 2017 and thereafter, the fraud and
18insurance non-compliance unit shall employ at least 10
19investigators to investigate insurance non-compliance and
20fraud pursuant to this Section.
21 (f) Any person convicted of fraud related to workers'
22compensation pursuant to this Section shall be subject to the
23penalties prescribed in the Criminal Code of 2012 and shall be
24ineligible to receive or retain any compensation, disability,
25or medical benefits as defined in this Act if the compensation,
26disability, or medical benefits were owed or received as a

HB2525 Engrossed- 102 -LRB100 06927 JLS 16978 b
1result of fraud for which the recipient of the compensation,
2disability, or medical benefit was convicted. This subsection
3applies to accidental injuries or diseases that occur on or
4after the effective date of this amendatory Act of the 94th
5General Assembly.
6 (g) Civil liability. Any person convicted of fraud who
7knowingly obtains, attempts to obtain, or causes to be obtained
8any benefits under this Act by the making of a false claim or
9who knowingly misrepresents any material fact shall be civilly
10liable to the payor of benefits or the insurer or the payor's
11or insurer's subrogee or assignee in an amount equal to 3 times
12the value of the benefits or insurance coverage wrongfully
13obtained or twice the value of the benefits or insurance
14coverage attempted to be obtained, plus reasonable attorney's
15fees and expenses incurred by the payor or the payor's subrogee
16or assignee who successfully brings a claim under this
17subsection. This subsection applies to accidental injuries or
18diseases that occur on or after the effective date of this
19amendatory Act of the 94th General Assembly.
20 (h) The fraud and insurance non-compliance unit shall
21submit a written report on an annual basis to the Chairman of
22the Commission, the Workers' Compensation Advisory Board, the
23General Assembly, the Governor, and the Attorney General by
24January 1 and July 1 of each year. This report shall include,
25at the minimum, the following information:
26 (1) The number of allegations of insurance

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1 non-compliance and fraud reported to the fraud and
2 insurance non-compliance unit.
3 (2) The source of the reported allegations
4 (individual, employer, or other).
5 (3) The number of allegations investigated by the fraud
6 and insurance non-compliance unit.
7 (4) The number of criminal referrals made in accordance
8 with this Section and the entity to which the referral was
9 made.
10 (5) All proceedings under this Section.
11(Source: P.A. 97-18, eff. 6-28-11; 97-1150, eff. 1-25-13.)
12 (820 ILCS 305/29.2)
13 Sec. 29.2. Insurance and self-insurance oversight.
14 (a) The Department of Insurance shall annually submit to
15the Governor, the Chairman of the Commission, the President of
16the Senate, the Speaker of the House of Representatives, the
17Minority Leader of the Senate, and the Minority Leader of the
18House of Representatives a written report that details the
19state of the workers' compensation insurance market in
20Illinois. The report shall be completed by April 1 of each
21year, beginning in 2012, or later if necessary data or analyses
22are only available to the Department at a later date. The
23report shall be posted on the Department of Insurance's
24Internet website. Information to be included in the report
25shall be for the preceding calendar year. The report shall

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1include, at a minimum, the following:
2 (1) Gross premiums collected by workers' compensation
3 carriers in Illinois and the national rank of Illinois
4 based on premium volume.
5 (2) The number of insurance companies actively engaged
6 in Illinois in the workers' compensation insurance market,
7 including both holding companies and subsidiaries or
8 affiliates, and the national rank of Illinois based on
9 number of competing insurers.
10 (3) The total number of insured participants in the
11 Illinois workers' compensation assigned risk insurance
12 pool, and the size of the assigned risk pool as a
13 proportion of the total Illinois workers' compensation
14 insurance market.
15 (4) The advisory organization premium rate for
16 workers' compensation insurance in Illinois for the
17 previous year.
18 (5) The advisory organization prescribed assigned risk
19 pool premium rate.
20 (6) The total amount of indemnity payments made by
21 workers' compensation insurers in Illinois.
22 (7) The total amount of medical payments made by
23 workers' compensation insurers in Illinois, and the
24 national rank of Illinois based on average cost of medical
25 claims per injured worker.
26 (8) The gross profitability of workers' compensation

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1 insurers in Illinois, and the national rank of Illinois
2 based on profitability of workers' compensation insurers.
3 (9) The loss ratio of workers' compensation insurers in
4 Illinois and the national rank of Illinois based on the
5 loss ratio of workers' compensation insurers. For purposes
6 of this loss ratio calculation, the denominator shall
7 include all premiums and other fees collected by workers'
8 compensation insurers and the numerator shall include the
9 total amount paid by the insurer for care or compensation
10 to injured workers.
11 (10) The growth of total paid indemnity benefits by
12 temporary total disability, scheduled and non-scheduled
13 permanent partial disability, and total disability.
14 (11) The number of injured workers receiving wage loss
15 differential awards and the average wage loss differential
16 award payout.
17 (12) Illinois' rank, relative to other states, for:
18 (i) the maximum and minimum temporary total
19 disability benefit level;
20 (ii) the maximum and minimum scheduled and
21 non-scheduled permanent partial disability benefit
22 level;
23 (iii) the maximum and minimum total disability
24 benefit level; and
25 (iv) the maximum and minimum death benefit level.
26 (13) The aggregate growth of medical benefit payout by

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1 non-hospital providers and hospitals.
2 (14) The aggregate growth of medical utilization for
3 the top 10 most common injuries to specific body parts by
4 non-hospital providers and hospitals.
5 (15) The percentage of injured workers filing claims at
6 the Commission that are represented by an attorney.
7 (16) The total amount paid by injured workers for
8 attorney representation.
9 (a-5) The Commission shall annually submit to the Governor
10and the General Assembly a written report that details the
11state of self-insurance for workers' compensation in Illinois.
12The report shall be based on the types of information collected
13by the Commission or the Department of Insurance from
14self-insurers, as of the effective date of this amendatory Act
15of the 100th General Assembly. The report shall be completed by
16April 1 of each year, beginning in 2017. The report shall be
17posted on the Commission's Internet website. Information to be
18included in the report shall be for the preceding calendar
19year. The report shall include, at a minimum, the following in
20the aggregate:
21 (1) The number of employers that self-insure for
22 workers' compensation;
23 (2) The total number of employees covered by
24 self-insurance;
25 (3) The total amount of indemnity payments made by
26 self-insureds;

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1 (4) The total number of claims on which indemnity
2 payments were made by self-insureds;
3 (5) The total amount of medical payments made by
4 self-insureds;
5 (6) The total number of claims on which medical
6 payments were made by self-insureds;
7 (7) The total number of claims on which both indemnity
8 and medical payments were made by self-insureds;
9 (8) The median of the injured workers' weekly wage of
10 self-insureds employees;
11 (9) The growth of total paid indemnity benefits by
12 temporary total disability, scheduled and non-scheduled
13 permanent partial disability, and total disability;
14 (10) Illinois' rank, relative to other states, for:
15 (i) the maximum and minimum temporary total
16 disability benefit levels;
17 (ii) the maximum and minimum scheduled and
18 non-scheduled permanent partial disability benefit
19 levels;
20 (iii) the maximum and minimum total disability
21 benefit levels; and
22 (iv) the maximum and minimum death benefit levels;
23 and
24 (11) The aggregate growth of medical benefit payouts by
25 non-hospital providers and hospitals.
26 (b) The Director of Insurance shall promulgate rules

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1requiring each insurer licensed to write workers' compensation
2coverage in the State to record and report the following
3information on an aggregate basis to the Department of
4Insurance before March 1 of each year, relating to claims in
5the State opened within the prior calendar year:
6 (1) The number of claims opened.
7 (2) The number of reported medical only claims.
8 (3) The number of contested claims.
9 (4) The number of claims for which the employee has
10 attorney representation.
11 (5) The number of claims with lost time and the number
12 of claims for which temporary total disability was paid.
13 (6) The number of claim adjusters employed to adjust
14 workers' compensation claims.
15 (7) The number of claims for which temporary total
16 disability was not paid within 14 days from the first full
17 day off, regardless of reason.
18 (8) The number of medical bills paid 60 days or later
19 from date of service and the average days paid on those
20 paid after 60 days for the previous calendar year.
21 (9) The number of claims in which in-house defense
22 counsel participated, and the total amount spent on
23 in-house legal services.
24 (10) The number of claims in which outside defense
25 counsel participated, and the total amount paid to outside
26 defense counsel.

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1 (11) The total amount billed to employers for bill
2 review.
3 (12) The total amount billed to employers for fee
4 schedule savings.
5 (13) The total amount charged to employers for any and
6 all managed care fees.
7 (14) The number of claims involving in-house medical
8 nurse case management, and the total amount spent on
9 in-house medical nurse case management.
10 (15) The number of claims involving outside medical
11 nurse case management, and the total amount paid for
12 outside medical nurse case management.
13 (16) The total amount paid for Independent Medical
14 exams.
15 (17) The total amount spent on in-house Utilization
16 Review for the previous calendar year.
17 (18) The total amount paid for outside Utilization
18 Review for the previous calendar year.
19 The Department shall make the submitted information
20publicly available on the Department's Internet website or such
21other media as appropriate in a form useful for consumers.
22(Source: P.A. 97-18, eff. 6-28-11.)
23 (820 ILCS 305/29.3 new)
24 Sec. 29.3. Workers' Compensation Premium Rates Task Force.
25 (a) There is created the Workers' Compensation Premium

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1Rates Task Force consisting of 12 members appointed as follows:
22 legislative members appointed by the Speaker of the House of
3Representatives; 2 legislative members appointed by the
4Minority Leader of the House of Representatives; 2 legislative
5members appointed by the President of the Senate; 2 legislative
6members appointed by the Minority Leader of the Senate; and one
7member appointed by the Governor from each of the following
8organizations: (i) a statewide association representing
9retailers; (ii) a statewide association representing
10manufacturers; (iii) a statewide association representing
11labor interests; and (iv) a statewide association representing
12injured workers. The members of the Task Force shall be
13appointed by April 1, 2017. Two co-chairpersons, representing
14different political parties, shall be selected by the members
15of the Task Force. Members of the Task Force shall receive no
16compensation for their service on the Task Force.
17 (b) The Task Force shall study the National Council on
18Compensation Insurance's recommendations for workers'
19compensation premium rates, the extent to which Illinois
20employers' actual premiums reflect these recommended rates.
21The Task Force shall also study the feasibility of establishing
22a competitive nonprofit, independent public corporation to
23provide workers' compensation insurance and the impact that the
24corporation would have on insurance rates and premiums. The
25Department of Insurance shall provide administrative support
26to the Task Force.

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1 (c) The Task Force shall report its findings and
2recommendations to the General Assembly no later than December
331, 2017.
4 (d) This Section is repealed December 31, 2018.
5 Section 99. Effective date. This Act takes effect upon
6becoming law.

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1 INDEX
2 Statutes amended in order of appearance