Bill Text: IL HB2883 | 2011-2012 | 97th General Assembly | Introduced

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Bill Title: Amends the Workers' Compensation Act. Defines "accident" and "injury." Provides that pain or other subjective complaints alone, in the absence of objective relevant medical findings, are not compensable. Deletes language allowing rebuttable presumptions for an employee employed as a firefighter, emergency medical technician (EMT), or paramedic. Deletes language allowing an employee to secure his own physician, surgeon and hospital services at the employer's expense. Provides that the employer shall choose all necessary medical, surgical and hospital services reasonably required to cure or relieve from the effects of the accidental injury at the employer's expense, except upon a finding by the Commission that the employer's choice of medical care threatens life, health, or recovery, then the employee may choose a second physician, surgeon, and hospital services at the employer's expense. Provides for a waiver of employee privacy for the employer to obtain necessary decision making information. Provides for a wage differential award and that such award shall cease when the employee reaches the full retirement age as defined by the Social Security Administration. Provides for reimbursement of out-of-state procedures, treatments, services, products or supplies. Provides for a new medical fee schedule after January 1, 2012, in accordance with the Medicare payment systems (160%). Moves the utilization review program registration and administration to the Department of Insurance. Makes numerous changes regarding employee intoxication, partial or total disability, implants, employment verification documents, and other changes.

Sponsorship: Partisan Bill (Republican 6)

Status: (Failed) 2013-01-08 - Session Sine Die [HB2883 Detail]

Download: Illinois-2011-HB2883-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 HB2883 Introduced 2/22/2011, by Rep. David Reis - Dan Brady - Dwight Kay - Jim Sacia - Dave Winters SYNOPSIS AS INTRODUCED:
See Index
Amends the Workers' Compensation Act. Defines "accident" and "injury." Provides that pain or other subjective complaints alone, in the absence of objective relevant medical findings, are not compensable. Deletes language allowing rebuttable presumptions for an employee employed as a firefighter, emergency medical technician (EMT), or paramedic. Deletes language allowing an employee to secure his own physician, surgeon and hospital services at the employer's expense. Provides that the employer shall choose all necessary medical, surgical and hospital services reasonably required to cure or relieve from the effects of the accidental injury at the employer's expense, except upon a finding by the Commission that the employer's choice of medical care threatens life, health, or recovery, then the employee may choose a second physician, surgeon, and hospital services at the employer's expense. Provides for a waiver of employee privacy for the employer to obtain necessary decision making information. Provides for a wage differential award and that such award shall cease when the employee reaches the full retirement age as defined by the Social Security Administration. Provides for reimbursement of out-of-state procedures, treatments, services, products or supplies. Provides for a new medical fee schedule after January 1, 2012, in accordance with the Medicare payment systems (160%). Moves the utilization review program registration and administration to the Department of Insurance. Makes numerous changes regarding employee intoxication, partial or total disability, implants, employment verification documents, and other changes.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning employment.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Workers' Compensation Act is amended by
changing Sections 1, 6, 8, 8.2, 8.7, 11, 16, and 19 as follows:
(820 ILCS 305/1) (from Ch. 48, par. 138.1)
Sec. 1. This Act may be cited as the Workers' Compensation
Act.
(a) The term "employer" as used in this Act means:
1. The State and each county, city, town, township,
incorporated village, school district, body politic, or
municipal corporation therein.
2. Every person, firm, public or private corporation,
including hospitals, public service, eleemosynary, religious
or charitable corporations or associations who has any person
in service or under any contract for hire, express or implied,
oral or written, and who is engaged in any of the enterprises
or businesses enumerated in Section 3 of this Act, or who at or
prior to the time of the accident to the employee for which
compensation under this Act may be claimed, has in the manner
provided in this Act elected to become subject to the
provisions of this Act, and who has not, prior to such
accident, effected a withdrawal of such election in the manner

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provided in this Act.
3. Any one engaging in any business or enterprise referred
to in subsections 1 and 2 of Section 3 of this Act who
undertakes to do any work enumerated therein, is liable to pay
compensation to his own immediate employees in accordance with
the provisions of this Act, and in addition thereto if he
directly or indirectly engages any contractor whether
principal or sub-contractor to do any such work, he is liable
to pay compensation to the employees of any such contractor or
sub-contractor unless such contractor or sub-contractor has
insured, in any company or association authorized under the
laws of this State to insure the liability to pay compensation
under this Act, or guaranteed his liability to pay such
compensation. With respect to any time limitation on the filing
of claims provided by this Act, the timely filing of a claim
against a contractor or subcontractor, as the case may be,
shall be deemed to be a timely filing with respect to all
persons upon whom liability is imposed by this paragraph.
In the event any such person pays compensation under this
subsection he may recover the amount thereof from the
contractor or sub-contractor, if any, and in the event the
contractor pays compensation under this subsection he may
recover the amount thereof from the sub-contractor, if any.
This subsection does not apply in any case where the
accident occurs elsewhere than on, in or about the immediate
premises on which the principal has contracted that the work be

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done.
4. Where an employer operating under and subject to the
provisions of this Act loans an employee to another such
employer and such loaned employee sustains a compensable
accidental injury in the employment of such borrowing employer
and where such borrowing employer does not provide or pay the
benefits or payments due such injured employee, such loaning
employer is liable to provide or pay all benefits or payments
due such employee under this Act and as to such employee the
liability of such loaning and borrowing employers is joint and
several, provided that such loaning employer is in the absence
of agreement to the contrary entitled to receive from such
borrowing employer full reimbursement for all sums paid or
incurred pursuant to this paragraph together with reasonable
attorneys' fees and expenses in any hearings before the
Illinois Workers' Compensation Commission or in any action to
secure such reimbursement. Where any benefit is provided or
paid by such loaning employer the employee has the duty of
rendering reasonable cooperation in any hearings, trials or
proceedings in the case, including such proceedings for
reimbursement.
Where an employee files an Application for Adjustment of
Claim with the Illinois Workers' Compensation Commission
alleging that his claim is covered by the provisions of the
preceding paragraph, and joining both the alleged loaning and
borrowing employers, they and each of them, upon written demand

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by the employee and within 7 days after receipt of such demand,
shall have the duty of filing with the Illinois Workers'
Compensation Commission a written admission or denial of the
allegation that the claim is covered by the provisions of the
preceding paragraph and in default of such filing or if any
such denial be ultimately determined not to have been bona fide
then the provisions of Paragraph K of Section 19 of this Act
shall apply.
An employer whose business or enterprise or a substantial
part thereof consists of hiring, procuring or furnishing
employees to or for other employers operating under and subject
to the provisions of this Act for the performance of the work
of such other employers and who pays such employees their
salary or wages notwithstanding that they are doing the work of
such other employers shall be deemed a loaning employer within
the meaning and provisions of this Section.
(b) The term "employee" as used in this Act means:
1. Every person in the service of the State, including
members of the General Assembly, members of the Commerce
Commission, members of the Illinois Workers' Compensation
Commission, and all persons in the service of the University of
Illinois, county, including deputy sheriffs and assistant
state's attorneys, city, town, township, incorporated village
or school district, body politic, or municipal corporation
therein, whether by election, under appointment or contract of
hire, express or implied, oral or written, including all

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members of the Illinois National Guard while on active duty in
the service of the State, and all probation personnel of the
Juvenile Court appointed pursuant to Article VI of the Juvenile
Court Act of 1987, and including any official of the State, any
county, city, town, township, incorporated village, school
district, body politic or municipal corporation therein except
any duly appointed member of a police department in any city
whose population exceeds 200,000 according to the last Federal
or State census, and except any member of a fire insurance
patrol maintained by a board of underwriters in this State. A
duly appointed member of a fire department in any city, the
population of which exceeds 200,000 according to the last
federal or State census, is an employee under this Act only
with respect to claims brought under paragraph (c) of Section
8.
One employed by a contractor who has contracted with the
State, or a county, city, town, township, incorporated village,
school district, body politic or municipal corporation
therein, through its representatives, is not considered as an
employee of the State, county, city, town, township,
incorporated village, school district, body politic or
municipal corporation which made the contract.
2. Every person in the service of another under any
contract of hire, express or implied, oral or written,
including persons whose employment is outside of the State of
Illinois where the contract of hire is made within the State of

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Illinois, persons whose employment results in fatal or
non-fatal injuries within the State of Illinois where the
contract of hire is made outside of the State of Illinois, and
persons whose employment is principally localized within the
State of Illinois, regardless of the place of the accident or
the place where the contract of hire was made, and including
aliens, and minors who, for the purpose of this Act are
considered the same and have the same power to contract,
receive payments and give quittances therefor, as adult
employees.
3. Every sole proprietor and every partner of a business
may elect to be covered by this Act.
An employee or his dependents under this Act who shall have
a cause of action by reason of any injury, disablement or death
arising out of and in the course of his employment may elect to
pursue his remedy in the State where injured or disabled, or in
the State where the contract of hire is made, or in the State
where the employment is principally localized.
However, any employer may elect to provide and pay
compensation to any employee other than those engaged in the
usual course of the trade, business, profession or occupation
of the employer by complying with Sections 2 and 4 of this Act.
Employees are not included within the provisions of this Act
when excluded by the laws of the United States relating to
liability of employers to their employees for personal injuries
where such laws are held to be exclusive.

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The term "employee" does not include persons performing
services as real estate broker, broker-salesman, or salesman
when such persons are paid by commission only.
(c) "Commission" means the Industrial Commission created
by Section 5 of "The Civil Administrative Code of Illinois",
approved March 7, 1917, as amended, or the Illinois Workers'
Compensation Commission created by Section 13 of this Act.
(d) The term "accident" as used in this Act means an
occurrence arising out of the employment resulting from a risk
incidental to the employment and in the course of the
employment at a time and place and under circumstances
reasonably required by the employment.
(e) The term "injury" as used in this Act means a condition
or impairment that arises out of and in the course of
employment. An injury, its occupational cause, and any
resulting manifestations or disability must be established to a
reasonable degree of medical certainty, based on objective
relevant medical findings, and the accidental compensable
injury must be the major contributing cause of any resulting
injuries. For the purposes of this Section, "major contributing
cause" means the cause which is more than 50% responsible for
the injury as compared to all other causes combined for which
treatment or benefits are sought. In cases involving
occupational disease or repetitive exposure, both causation
and sufficient exposure to support causation must be proven by
clear and convincing evidence. Pain or other subjective

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complaints alone, in the absence of objective relevant medical
findings, are not compensable. For the purposes of this
Section, "objective relevant medical findings" are those
objective findings that correlate to the subjective complaints
of the injured employee and are confirmed by physical
examination findings or diagnostic testing. Establishment of
the causal relationship between a compensable accident and
injuries for conditions that are not readily observable must be
by medical evidence only, as demonstrated by physical
examination findings or diagnostic testing. A major
contributing cause must be demonstrated by medical evidence
only.
(Source: P.A. 93-721, eff. 1-1-05.)
(820 ILCS 305/6) (from Ch. 48, par. 138.6)
Sec. 6. (a) Every employer within the provisions of this
Act, shall, under the rules and regulations prescribed by the
Commission, post printed notices in their respective places of
employment in such number and at such places as may be
determined by the Commission, containing such information
relative to this Act as in the judgment of the Commission may
be necessary to aid employees to safeguard their rights under
this Act in event of injury.
In addition thereto, the employer shall post in a
conspicuous place on the place of the employment a printed or
typewritten notice stating whether he is insured or whether he

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has qualified and is operating as a self-insured employer. In
the event the employer is insured, the notice shall state the
name and address of his insurance carrier, the number of the
insurance policy, its effective date and the date of
termination. In the event of the termination of the policy for
any reason prior to the termination date stated, the posted
notice shall promptly be corrected accordingly. In the event
the employer is operating as a self-insured employer the notice
shall state the name and address of the company, if any,
servicing the compensation payments of the employer, and the
name and address of the person in charge of making compensation
payments.
(b) Every employer subject to this Act shall maintain
accurate records of work-related deaths, injuries and illness
other than minor injuries requiring only first aid treatment
and which do not involve medical treatment, loss of
consciousness, restriction of work or motion, or transfer to
another job and file with the Commission, in writing, a report
of all accidental deaths, injuries and illnesses arising out of
and in the course of the employment resulting in the loss of
more than 3 scheduled work days. In the case of death such
report shall be made no later than 2 working days following the
accidental death. In all other cases such report shall be made
between the 15th and 25th of each month unless required to be
made sooner by rule of the Commission. In case the injury
results in permanent disability, a further report shall be made

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as soon as it is determined that such permanent disability has
resulted or will result from the injury. All reports shall
state the date of the injury, including the time of day or
night, the nature of the employer's business, the name,
address, age, sex, conjugal condition of the injured person,
the specific occupation of the injured person, the direct cause
of the injury and the nature of the accident, the character of
the injury, the length of disability, and in case of death the
length of disability before death, the wages of the injured
person, whether compensation has been paid to the injured
person, or to his or her legal representative or his heirs or
next of kin, the amount of compensation paid, the amount paid
for physicians', surgeons' and hospital bills, and by whom
paid, and the amount paid for funeral or burial expenses if
known. The reports shall be made on forms and in the manner as
prescribed by the Commission and shall contain such further
information as the Commission shall deem necessary and require.
The making of these reports releases the employer from making
such reports to any other officer of the State and shall
satisfy the reporting provisions as contained in the "Health
and Safety Act" and "An Act in relation to safety inspections
and education in industrial and commercial establishments and
to repeal an Act therein named", approved July 18, 1955, as now
or hereafter amended. The reports filed with the Commission
pursuant to this Section shall be made available by the
Commission to the Director of Labor or his representatives and

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to all other departments of the State of Illinois which shall
require such information for the proper discharge of their
official duties. Failure to file with the Commission any of the
reports required in this Section is a petty offense.
Except as provided in this paragraph, all reports filed
hereunder shall be confidential and any person having access to
such records filed with the Illinois Workers' Compensation
Commission as herein required, who shall release any
information therein contained including the names or otherwise
identify any persons sustaining injuries or disabilities, or
give access to such information to any unauthorized person,
shall be subject to discipline or discharge, and in addition
shall be guilty of a Class B misdemeanor. The Commission shall
compile and distribute to interested persons aggregate
statistics, taken from the reports filed hereunder. The
aggregate statistics shall not give the names or otherwise
identify persons sustaining injuries or disabilities or the
employer of any injured or disabled person.
(c) Notice of the accident shall be given to the employer
as soon as practicable, but not later than 45 days after the
accident. Provided:
(1) In case of the legal disability of the employee or any
dependent of a deceased employee who may be entitled to
compensation under the provisions of this Act, the limitations
of time by this Act provided do not begin to run against such
person under legal disability until a guardian has been

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appointed.
(2) In cases of injuries sustained by exposure to
radiological materials or equipment, notice shall be given to
the employer within 90 days subsequent to the time that the
employee knows or suspects that he has received an excessive
dose of radiation.
No defect or inaccuracy of such notice shall be a bar to
the maintenance of proceedings on arbitration or otherwise by
the employee unless the employer proves that he is unduly
prejudiced in such proceedings by such defect or inaccuracy.
Notice of the accident shall give the approximate date and
place of the accident, if known, and may be given orally or in
writing.
(d) Every employer shall notify each injured employee who
has been granted compensation under the provisions of Section 8
of this Act of his rights to rehabilitation services and advise
him of the locations of available public rehabilitation centers
and any other such services of which the employer has
knowledge.
In any case, other than one where the injury was caused by
exposure to radiological materials or equipment or asbestos
unless the application for compensation is filed with the
Commission within 3 years after the date of the accident, where
no compensation has been paid, or within 2 years after the date
of the last payment of compensation, where any has been paid,
whichever shall be later, the right to file such application

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shall be barred.
In any case of injury caused by exposure to radiological
materials or equipment or asbestos, unless application for
compensation is filed with the Commission within 25 years after
the last day that the employee was employed in an environment
of hazardous radiological activity or asbestos, the right to
file such application shall be barred.
If in any case except one where the injury was caused by
exposure to radiological materials or equipment or asbestos,
the accidental injury results in death application for
compensation for death may be filed with the Commission within
3 years after the date of death where no compensation has been
paid or within 2 years after the date of the last payment of
compensation where any has been paid, whichever shall be later,
but not thereafter.
If an accidental injury caused by exposure to radiological
material or equipment or asbestos results in death within 25
years after the last day that the employee was so exposed
application for compensation for death may be filed with the
Commission within 3 years after the date of death, where no
compensation has been paid, or within 2 years after the date of
the last payment of compensation where any has been paid,
whichever shall be later, but not thereafter.
(e) Any contract or agreement made by any employer or his
agent or attorney with any employee or any other beneficiary of
any claim under the provisions of this Act within 7 days after

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the injury shall be presumed to be fraudulent.
(f) (Blank). Any condition or impairment of health of an
employee employed as a firefighter, emergency medical
technician (EMT), or paramedic which results directly or
indirectly from any bloodborne pathogen, lung or respiratory
disease or condition, heart or vascular disease or condition,
hypertension, tuberculosis, or cancer resulting in any
disability (temporary, permanent, total, or partial) to the
employee shall be rebuttably presumed to arise out of and in
the course of the employee's firefighting, EMT, or paramedic
employment and, further, shall be rebuttably presumed to be
causally connected to the hazards or exposures of the
employment. This presumption shall also apply to any hernia or
hearing loss suffered by an employee employed as a firefighter,
EMT, or paramedic. However, this presumption shall not apply to
any employee who has been employed as a firefighter, EMT, or
paramedic for less than 5 years at the time he or she files an
Application for Adjustment of Claim concerning this condition
or impairment with the Illinois Workers' Compensation
Commission. The Finding and Decision of the Illinois Workers'
Compensation Commission under only the rebuttable presumption
provision of this subsection shall not be admissible or be
deemed res judicata in any disability claim under the Illinois
Pension Code arising out of the same medical condition;
however, this sentence makes no change to the law set forth in
Krohe v. City of Bloomington, 204 Ill.2d 392.

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(Source: P.A. 95-316, eff. 1-1-08.)
(820 ILCS 305/8) (from Ch. 48, par. 138.8)
Sec. 8. The amount of compensation which shall be paid to
the employee for an accidental injury not resulting in death
is:
(a) The employer shall provide and pay the negotiated rate,
if applicable, or the lesser of the health care provider's
actual charges or according to a fee schedule, subject to
Section 8.2, in effect at the time the service was rendered for
all the necessary first aid, medical and surgical services, and
all necessary medical, surgical and hospital services
thereafter incurred, limited, however, to that which is
reasonably required to cure or relieve from the effects of the
accidental injury. If the employer does not dispute payment of
first aid, medical, surgical, and hospital services, the
employer shall make such payment to the provider on behalf of
the employee. The employer shall also pay for treatment,
instruction and training necessary for the physical, mental and
vocational rehabilitation of the employee, including all
maintenance costs and expenses incidental thereto. If as a
result of the injury the employee is unable to be
self-sufficient the employer shall further pay for such
maintenance or institutional care as shall be required.
The employer shall choose all necessary medical, surgical
and hospital services reasonably required to cure or relieve

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from the effects of the accidental injury, at the employer's
expense. The employee shall cooperate with and adhere to the
plan of care or treatment recommendations of the providers
selected by the employer, unless the proposed care and
treatment threatens the life, health or recovery of the injured
employee. Upon a finding by the Commission, that the employer's
choice of medical care threatens the life, health, or recovery
of the injured employee, the employee may then choose a second
physician, surgeon, and hospital services at the employer's
expense. Initial emergency services, taking place within 45
days of the accident, shall not constitute a choice of
physician, surgeon, or hospital services by the employer or
employee. employee may at any time elect to secure his own
physician, surgeon and hospital services at the employer's
expense, or,
Notwithstanding the foregoing, upon Upon agreement between
the employer and the employees, or the employees' exclusive
representative, and subject to the approval of the Illinois
Workers' Compensation Commission, the employer shall maintain
a list of physicians, to be known as a Panel of Physicians, who
are accessible to the employees. The employer shall post this
list in a place or places easily accessible to his employees.
The employee shall have the right to make an alternative choice
of physician from such Panel if he is not satisfied with the
physician first selected. If, due to the nature of the injury
or its occurrence away from the employer's place of business,

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the employee is unable to make a selection from the Panel, the
selection process from the Panel shall not apply. The physician
selected from the Panel may arrange for any consultation,
referral or other specialized medical services outside the
Panel at the employer's expense. Provided that, in the event
the Commission shall find that a doctor selected by the
employee is rendering improper or inadequate care, the
Commission may order the employee to select another doctor
certified or qualified in the medical field for which treatment
is required. If the employee refuses to make such change the
Commission may relieve the employer of his obligation to pay
the doctor's charges from the date of refusal to the date of
compliance.
Any vocational rehabilitation counselors who provide
service under this Act shall have appropriate certifications
which designate the counselor as qualified to render opinions
relating to vocational rehabilitation. Vocational
rehabilitation may include, but is not limited to, counseling
for job searches, supervising a job search program, and
vocational retraining including education at an accredited
learning institution. The employee or employer may petition to
the Commission to decide disputes relating to vocational
rehabilitation and the Commission shall resolve any such
dispute, including payment of the vocational rehabilitation
program by the employer.
The maintenance benefit shall not be less than the

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temporary total disability rate determined for the employee. In
addition, maintenance shall include costs and expenses
incidental to the vocational rehabilitation program.
When the employee is working light duty on a part-time
basis or full-time basis and earns less than he or she would be
earning if employed in the full capacity of the job or jobs,
then the employee shall be entitled to temporary partial
disability benefits. Temporary partial disability benefits
shall be equal to two-thirds of the difference between the
average amount that the employee would be able to earn in the
full performance of his or her duties in the occupation in
which he or she was engaged at the time of accident and the net
amount which he or she is earning in the modified job provided
to the employee by the employer or in any other job that the
employee is working.
Every hospital, physician, surgeon or other person
rendering treatment or services in accordance with the
provisions of this Section shall upon written request furnish
full and complete reports thereof to, and permit their records
to be copied by, the employer, the employee or his dependents,
as the case may be, or any other party to any proceeding for
compensation before the Commission, or their attorneys.
When an employee makes a claim for benefits under the Act,
he or she waives their privacy privilege with any treating
provider to the extent solely to allow the employer to obtain
from a treating provider the necessary information to determine

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whether the condition of ill-being in question for which
treatment is sought is work related, what that treatment is for
purposes of approval of care, and whether or not, based upon
the condition of ill-being, the employee is entitled to other
benefits. The employer shall be entitled to contact the
treating provider to seek information and answers from the
treating provider regarding whether the condition of ill-being
in question for which treatment is sought is work related, what
that treatment or course of treatment is for purposes of
approval of care, and the return to work options that the
employer may have for the employee.
Notwithstanding the foregoing, the employer's liability to
pay for such medical services selected by the employer or
employee shall be limited to:
(1) all first aid and emergency treatment; plus
(2) all medical, surgical and hospital services
provided by the physician, surgeon or hospital initially
chosen by the employer employee or by any other physician,
consultant, expert, institution or other provider of
services recommended by said initial service provider or
any subsequent provider of medical services in the chain of
referrals from said initial service provider; plus
(3) all medical, surgical and hospital services
provided by any second physician, surgeon or hospital
subsequently chosen by the employee or by any other
physician, consultant, expert, institution or other

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provider of services recommended by said second service
provider or any subsequent provider of medical services in
the chain of referrals from said second service provider.
Thereafter the employer shall select and pay for all
necessary medical, surgical and hospital treatment and the
employee may not select a provider of medical services at
the employer's expense unless the employer agrees to such
selection. At any time the employee may obtain any medical
treatment he or she desires at his or her own expense. This
paragraph shall not affect the duty to pay for
rehabilitation referred to above.
When an employer and employee so agree in writing, nothing
in this Act prevents an employee whose injury or disability has
been established under this Act, from relying in good faith, on
treatment by prayer or spiritual means alone, in accordance
with the tenets and practice of a recognized church or
religious denomination, by a duly accredited practitioner
thereof, and having nursing services appropriate therewith,
without suffering loss or diminution of the compensation
benefits under this Act. However, the employee shall submit to
all physical examinations required by this Act. The cost of
such treatment and nursing care shall be paid by the employee
unless the employer agrees to make such payment.
Where the accidental injury results in the amputation of an
arm, hand, leg or foot, or the enucleation of an eye, or the
loss of any of the natural teeth, the employer shall furnish an

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artificial of any such members lost or damaged in accidental
injury arising out of and in the course of employment, and
shall also furnish the necessary braces in all proper and
necessary cases. In cases of the loss of a member or members by
amputation, the employer shall, whenever necessary, maintain
in good repair, refit or replace the artificial limbs during
the lifetime of the employee. Where the accidental injury
accompanied by physical injury results in damage to a denture,
eye glasses or contact eye lenses, or where the accidental
injury results in damage to an artificial member, the employer
shall replace or repair such denture, glasses, lenses, or
artificial member.
The furnishing by the employer of any such services or
appliances is not an admission of liability on the part of the
employer to pay compensation.
The furnishing of any such services or appliances or the
servicing thereof by the employer is not the payment of
compensation.
(b) If the period of temporary total incapacity for work
lasts more than 3 working days, weekly compensation as
hereinafter provided shall be paid beginning on the 4th day of
such temporary total incapacity and continuing as long as the
total temporary incapacity lasts. In cases where the temporary
total incapacity for work continues for a period of 14 days or
more from the day of the accident compensation shall commence
on the day after the accident.

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1. The compensation rate for temporary total
incapacity under this paragraph (b) of this Section shall
be equal to 66 2/3% of the employee's average weekly wage
computed in accordance with Section 10, provided that it
shall be not less than 66 2/3% of the sum of the Federal
minimum wage under the Fair Labor Standards Act, or the
Illinois minimum wage under the Minimum Wage Law, whichever
is more, multiplied by 40 hours. This percentage rate shall
be increased by 10% for each spouse and child, not to
exceed 100% of the total minimum wage calculation,
nor exceed the employee's average weekly wage computed in
accordance with the provisions of Section 10, whichever is
less.
2. The compensation rate in all cases other than for
temporary total disability under this paragraph (b), and
other than for serious and permanent disfigurement under
paragraph (c) and other than for permanent partial
disability under subparagraph (2) of paragraph (d) or under
paragraph (e), of this Section shall be equal to 66 2/3% of
the employee's average weekly wage computed in accordance
with the provisions of Section 10, provided that it shall
be not less than 66 2/3% of the sum of the Federal minimum
wage under the Fair Labor Standards Act, or the Illinois
minimum wage under the Minimum Wage Law, whichever is more,
multiplied by 40 hours. This percentage rate shall be
increased by 10% for each spouse and child, not to exceed

HB2883 - 23 - LRB097 10781 AEK 51211 b
100% of the total minimum wage calculation,
nor exceed the employee's average weekly wage computed in
accordance with the provisions of Section 10, whichever is
less.
2.1. The compensation rate in all cases of serious and
permanent disfigurement under paragraph (c) and of
permanent partial disability under subparagraph (2) of
paragraph (d) or under paragraph (e) of this Section shall
be equal to 60% of the employee's average weekly wage
computed in accordance with the provisions of Section 10,
provided that it shall be not less than 66 2/3% of the sum
of the Federal minimum wage under the Fair Labor Standards
Act, or the Illinois minimum wage under the Minimum Wage
Law, whichever is more, multiplied by 40 hours. This
percentage rate shall be increased by 10% for each spouse
and child, not to exceed 100% of the total minimum wage
calculation,
nor exceed the employee's average weekly wage computed in
accordance with the provisions of Section 10, whichever is
less.
3. As used in this Section the term "child" means a
child of the employee including any child legally adopted
before the accident or whom at the time of the accident the
employee was under legal obligation to support or to whom
the employee stood in loco parentis, and who at the time of
the accident was under 18 years of age and not emancipated.

HB2883 - 24 - LRB097 10781 AEK 51211 b
The term "children" means the plural of "child".
4. All weekly compensation rates provided under
subparagraphs 1, 2 and 2.1 of this paragraph (b) of this
Section shall be subject to the following limitations:
The maximum weekly compensation rate from July 1, 1975,
except as hereinafter provided, shall be 100% of the
State's average weekly wage in covered industries under the
Unemployment Insurance Act, that being the wage that most
closely approximates the State's average weekly wage.
The maximum weekly compensation rate, for the period
July 1, 1984, through June 30, 1987, except as hereinafter
provided, shall be $293.61. Effective July 1, 1987 and on
July 1 of each year thereafter the maximum weekly
compensation rate, except as hereinafter provided, shall
be determined as follows: if during the preceding 12 month
period there shall have been an increase in the State's
average weekly wage in covered industries under the
Unemployment Insurance Act, the weekly compensation rate
shall be proportionately increased by the same percentage
as the percentage of increase in the State's average weekly
wage in covered industries under the Unemployment
Insurance Act during such period.
The maximum weekly compensation rate, for the period
January 1, 1981 through December 31, 1983, except as
hereinafter provided, shall be 100% of the State's average
weekly wage in covered industries under the Unemployment

HB2883 - 25 - LRB097 10781 AEK 51211 b
Insurance Act in effect on January 1, 1981. Effective
January 1, 1984 and on January 1, of each year thereafter
the maximum weekly compensation rate, except as
hereinafter provided, shall be determined as follows: if
during the preceding 12 month period there shall have been
an increase in the State's average weekly wage in covered
industries under the Unemployment Insurance Act, the
weekly compensation rate shall be proportionately
increased by the same percentage as the percentage of
increase in the State's average weekly wage in covered
industries under the Unemployment Insurance Act during
such period.
From July 1, 1977 and thereafter such maximum weekly
compensation rate in death cases under Section 7, and
permanent total disability cases under paragraph (f) or
subparagraph 18 of paragraph (3) of this Section and for
temporary total disability under paragraph (b) of this
Section and for amputation of a member or enucleation of an
eye under paragraph (e) of this Section shall be increased
to 133-1/3% of the State's average weekly wage in covered
industries under the Unemployment Insurance Act.
For injuries occurring on or after February 1, 2006,
the maximum weekly benefit under paragraph (d)1 of this
Section shall be 100% of the State's average weekly wage in
covered industries under the Unemployment Insurance Act.
4.1. Any provision herein to the contrary

HB2883 - 26 - LRB097 10781 AEK 51211 b
notwithstanding, the weekly compensation rate for
compensation payments under subparagraph 18 of paragraph
(e) of this Section and under paragraph (f) of this Section
and under paragraph (a) of Section 7 and for amputation of
a member or enucleation of an eye under paragraph (e) of
this Section, shall in no event be less than 50% of the
State's average weekly wage in covered industries under the
Unemployment Insurance Act.
4.2. Any provision to the contrary notwithstanding,
the total compensation payable under Section 7 shall not
exceed the greater of $500,000 or 25 years.
5. For the purpose of this Section this State's average
weekly wage in covered industries under the Unemployment
Insurance Act on July 1, 1975 is hereby fixed at $228.16
per week and the computation of compensation rates shall be
based on the aforesaid average weekly wage until modified
as hereinafter provided.
6. The Department of Employment Security of the State
shall on or before the first day of December, 1977, and on
or before the first day of June, 1978, and on the first day
of each December and June of each year thereafter, publish
the State's average weekly wage in covered industries under
the Unemployment Insurance Act and the Illinois Workers'
Compensation Commission shall on the 15th day of January,
1978 and on the 15th day of July, 1978 and on the 15th day
of each January and July of each year thereafter, post and

HB2883 - 27 - LRB097 10781 AEK 51211 b
publish the State's average weekly wage in covered
industries under the Unemployment Insurance Act as last
determined and published by the Department of Employment
Security. The amount when so posted and published shall be
conclusive and shall be applicable as the basis of
computation of compensation rates until the next posting
and publication as aforesaid.
7. The payment of compensation by an employer or his
insurance carrier to an injured employee shall not
constitute an admission of the employer's liability to pay
compensation.
(c) For any serious and permanent disfigurement to the
hand, head, face, neck, arm, leg below the knee or the chest
above the axillary line, the employee is entitled to
compensation for such disfigurement, the amount determined by
agreement at any time or by arbitration under this Act, at a
hearing not less than 6 months after the date of the accidental
injury, which amount shall not exceed 150 weeks (if the
accidental injury occurs on or after the effective date of this
amendatory Act of the 94th General Assembly but before February
1, 2006) or 162 weeks (if the accidental injury occurs on or
after February 1, 2006) at the applicable rate provided in
subparagraph 2.1 of paragraph (b) of this Section.
No compensation is payable under this paragraph where
compensation is payable under paragraphs (d), (e) or (f) of
this Section.

HB2883 - 28 - LRB097 10781 AEK 51211 b
A duly appointed member of a fire department in a city, the
population of which exceeds 200,000 according to the last
federal or State census, is eligible for compensation under
this paragraph only where such serious and permanent
disfigurement results from burns.
(d) 1. If, after the accidental injury has been sustained,
the employee as a result thereof becomes partially
incapacitated from pursuing his usual and customary line of
employment, he shall, except in cases compensated under the
specific schedule set forth in paragraph (e) of this Section,
receive compensation for the duration of his disability,
subject to the limitations as to maximum amounts fixed in
paragraph (b) of this Section, equal to 66-2/3% of the
difference between the average amount which he would be able to
earn in the full performance of his duties in the occupation in
which he was engaged at the time of the accident and the
average amount which he is earning or is able to earn in some
suitable employment or business after the accident. For
injuries sustained on or after the effective date of this
Amendatory Act of the 97th General Assembly, awards made
pursuant to this subparagraph shall be known as a wage
differential award and shall cease when the employee reaches
full retirement age as defined by the Social Security
Administration. In addition, after a wage differential award
becomes final, the employer shall, on no more than a quarterly
annual basis, upon written request to the employee, be entitled

HB2883 - 29 - LRB097 10781 AEK 51211 b
to verification of an employee's current employment status and
earnings, including the name and address of the employee's
current employer, rate of pay or method of compensation,
duration of such employment, and true copies of the employee's
paychecks or other evidence of payment for the duration of such
employment. An employer can further request the employee to
sign an authorization to permit the employer to then obtain
from the employee's current employer the employee's earnings
and payroll documentation. The employer may seek to modify or
vacate a wage differential award based on a material increase
in the earnings of the employee during the period that the wage
differential award is in effect. Notwithstanding and in
addition to Section 19(h), a final wage differential award may
at any time be reviewed by the Commission in an evidentiary
hearing at the request of the employer on the grounds that
there has been a subsequent material increase in the average
weekly wage which was the basis of the wage differential award
and the average weekly wage the employee is earning currently
after the accident. After review, the Commission shall modify
or vacate a final wage differential award based where there is
a finding of a material increase in the employee's current job
earnings from the employee's earnings from which the wage
differential award was based upon.
2. If, as a result of the accident, the employee sustains
serious and permanent injuries not covered by paragraphs (c)
and (e) of this Section or having sustained injuries covered by

HB2883 - 30 - LRB097 10781 AEK 51211 b
the aforesaid paragraphs (c) and (e), he shall have sustained
in addition thereto other injuries which injuries do not
incapacitate him from pursuing the duties of his employment but
which would disable him from pursuing other suitable
occupations, or which have otherwise resulted in physical
impairment; or if such injuries partially incapacitate him from
pursuing the duties of his usual and customary line of
employment but do not result in an impairment of earning
capacity, or having resulted in an impairment of earning
capacity, the employee elects to waive his right to recover
under the foregoing subparagraph 1 of paragraph (d) of this
Section then in any of the foregoing events, he shall receive
in addition to compensation for temporary total disability
under paragraph (b) of this Section, compensation at the rate
provided in subparagraph 2.1 of paragraph (b) of this Section
for that percentage of 500 weeks that the partial disability
resulting from the injuries covered by this paragraph bears to
total disability. If the employee shall have sustained a
fracture of one or more vertebra or fracture of the skull, the
amount of compensation allowed under this Section shall be not
less than 6 weeks for a fractured skull and 6 weeks for each
fractured vertebra, and in the event the employee shall have
sustained a fracture of any of the following facial bones:
nasal, lachrymal, vomer, zygoma, maxilla, palatine or
mandible, the amount of compensation allowed under this Section
shall be not less than 2 weeks for each such fractured bone,

HB2883 - 31 - LRB097 10781 AEK 51211 b
and for a fracture of each transverse process not less than 3
weeks. In the event such injuries shall result in the loss of a
kidney, spleen or lung, the amount of compensation allowed
under this Section shall be not less than 10 weeks for each
such organ. Compensation awarded under this subparagraph 2
shall not take into consideration injuries covered under
paragraphs (c) and (e) of this Section and the compensation
provided in this paragraph shall not affect the employee's
right to compensation payable under paragraphs (b), (c) and (e)
of this Section for the disabilities therein covered.
(e) For accidental injuries in the following schedule, the
employee shall receive compensation for the period of temporary
total incapacity for work resulting from such accidental
injury, under subparagraph 1 of paragraph (b) of this Section,
and shall receive in addition thereto compensation for a
further period for the specific loss herein mentioned, but
shall not receive any compensation under any other provisions
of this Act. The following listed amounts apply to either the
loss of or the permanent and complete loss of use of the member
specified, such compensation for the length of time as follows:
1. Thumb-
70 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
76 weeks if the accidental injury occurs on or
after February 1, 2006.

HB2883 - 32 - LRB097 10781 AEK 51211 b
2. First, or index finger-
40 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
43 weeks if the accidental injury occurs on or
after February 1, 2006.
3. Second, or middle finger-
35 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
38 weeks if the accidental injury occurs on or
after February 1, 2006.
4. Third, or ring finger-
25 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
27 weeks if the accidental injury occurs on or
after February 1, 2006.
5. Fourth, or little finger-
20 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
22 weeks if the accidental injury occurs on or
after February 1, 2006.
6. Great toe-
35 weeks if the accidental injury occurs on or

HB2883 - 33 - LRB097 10781 AEK 51211 b
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
38 weeks if the accidental injury occurs on or
after February 1, 2006.
7. Each toe other than great toe-
12 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
13 weeks if the accidental injury occurs on or
after February 1, 2006.
8. The loss of the first or distal phalanx of the thumb
or of any finger or toe shall be considered to be equal to
the loss of one-half of such thumb, finger or toe and the
compensation payable shall be one-half of the amount above
specified. The loss of more than one phalanx shall be
considered as the loss of the entire thumb, finger or toe.
In no case shall the amount received for more than one
finger exceed the amount provided in this schedule for the
loss of a hand.
9. Hand-
190 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
205 weeks if the accidental injury occurs on or
after February 1, 2006.
The loss of 2 or more digits, or one or more phalanges

HB2883 - 34 - LRB097 10781 AEK 51211 b
of 2 or more digits, of a hand may be compensated on the
basis of partial loss of use of a hand, provided, further,
that the loss of 4 digits, or the loss of use of 4 digits,
in the same hand shall constitute the complete loss of a
hand.
10. Arm-
235 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
253 weeks if the accidental injury occurs on or
after February 1, 2006.
Where an accidental injury results in the amputation of
an arm below the elbow, such injury shall be compensated as
a loss of an arm. Where an accidental injury results in the
amputation of an arm above the elbow, compensation for an
additional 15 weeks (if the accidental injury occurs on or
after the effective date of this amendatory Act of the 94th
General Assembly but before February 1, 2006) or an
additional 17 weeks (if the accidental injury occurs on or
after February 1, 2006) shall be paid, except where the
accidental injury results in the amputation of an arm at
the shoulder joint, or so close to shoulder joint that an
artificial arm cannot be used, or results in the
disarticulation of an arm at the shoulder joint, in which
case compensation for an additional 65 weeks (if the
accidental injury occurs on or after the effective date of

HB2883 - 35 - LRB097 10781 AEK 51211 b
this amendatory Act of the 94th General Assembly but before
February 1, 2006) or an additional 70 weeks (if the
accidental injury occurs on or after February 1, 2006)
shall be paid.
11. Foot-
155 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
167 weeks if the accidental injury occurs on or
after February 1, 2006.
12. Leg-
200 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
215 weeks if the accidental injury occurs on or
after February 1, 2006.
Where an accidental injury results in the amputation of
a leg below the knee, such injury shall be compensated as
loss of a leg. Where an accidental injury results in the
amputation of a leg above the knee, compensation for an
additional 25 weeks (if the accidental injury occurs on or
after the effective date of this amendatory Act of the 94th
General Assembly but before February 1, 2006) or an
additional 27 weeks (if the accidental injury occurs on or
after February 1, 2006) shall be paid, except where the
accidental injury results in the amputation of a leg at the

HB2883 - 36 - LRB097 10781 AEK 51211 b
hip joint, or so close to the hip joint that an artificial
leg cannot be used, or results in the disarticulation of a
leg at the hip joint, in which case compensation for an
additional 75 weeks (if the accidental injury occurs on or
after the effective date of this amendatory Act of the 94th
General Assembly but before February 1, 2006) or an
additional 81 weeks (if the accidental injury occurs on or
after February 1, 2006) shall be paid.
13. Eye-
150 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
162 weeks if the accidental injury occurs on or
after February 1, 2006.
Where an accidental injury results in the enucleation
of an eye, compensation for an additional 10 weeks (if the
accidental injury occurs on or after the effective date of
this amendatory Act of the 94th General Assembly but before
February 1, 2006) or an additional 11 weeks (if the
accidental injury occurs on or after February 1, 2006)
shall be paid.
14. Loss of hearing of one ear-
50 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
54 weeks if the accidental injury occurs on or

HB2883 - 37 - LRB097 10781 AEK 51211 b
after February 1, 2006.
Total and permanent loss of hearing of both ears-
200 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
215 weeks if the accidental injury occurs on or
after February 1, 2006.
15. Testicle-
50 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
54 weeks if the accidental injury occurs on or
after February 1, 2006.
Both testicles-
150 weeks if the accidental injury occurs on or
after the effective date of this amendatory Act of the
94th General Assembly but before February 1, 2006.
162 weeks if the accidental injury occurs on or
after February 1, 2006.
16. For the permanent partial loss of use of a member
or sight of an eye, or hearing of an ear, compensation
during that proportion of the number of weeks in the
foregoing schedule provided for the loss of such member or
sight of an eye, or hearing of an ear, which the partial
loss of use thereof bears to the total loss of use of such
member, or sight of eye, or hearing of an ear.

HB2883 - 38 - LRB097 10781 AEK 51211 b
(a) Loss of hearing for compensation purposes
shall be confined to the frequencies of 1,000, 2,000
and 3,000 cycles per second. Loss of hearing ability
for frequency tones above 3,000 cycles per second are
not to be considered as constituting disability for
hearing.
(b) The percent of hearing loss, for purposes of
the determination of compensation claims for
occupational deafness, shall be calculated as the
average in decibels for the thresholds of hearing for
the frequencies of 1,000, 2,000 and 3,000 cycles per
second. Pure tone air conduction audiometric
instruments, approved by nationally recognized
authorities in this field, shall be used for measuring
hearing loss. If the losses of hearing average 30
decibels or less in the 3 frequencies, such losses of
hearing shall not then constitute any compensable
hearing disability. If the losses of hearing average 85
decibels or more in the 3 frequencies, then the same
shall constitute and be total or 100% compensable
hearing loss.
(c) In measuring hearing impairment, the lowest
measured losses in each of the 3 frequencies shall be
added together and divided by 3 to determine the
average decibel loss. For every decibel of loss
exceeding 30 decibels an allowance of 1.82% shall be

HB2883 - 39 - LRB097 10781 AEK 51211 b
made up to the maximum of 100% which is reached at 85
decibels.
(d) If a hearing loss is established to have
existed on July 1, 1975 by audiometric testing the
employer shall not be liable for the previous loss so
established nor shall he be liable for any loss for
which compensation has been paid or awarded.
(e) No consideration shall be given to the question
of whether or not the ability of an employee to
understand speech is improved by the use of a hearing
aid.
(f) No claim for loss of hearing due to industrial
noise shall be brought against an employer or allowed
unless the employee has been exposed for a period of
time sufficient to cause permanent impairment to noise
levels in excess of the following:
Sound Level DBA
Slow Response Hours Per Day
90 8
92 6
95 4
97 3
100 2
102 1-1/2
105 1
110 1/2

HB2883 - 40 - LRB097 10781 AEK 51211 b
115 1/4
This subparagraph (f) shall not be applied in cases of
hearing loss resulting from trauma or explosion.
17. In computing the compensation to be paid to any
employee who, before the accident for which he claims
compensation, had before that time sustained an injury
resulting in the loss by amputation or partial loss by
amputation of any member, including hand, arm, thumb or
fingers, leg, foot or any toes, such loss or partial loss
of any such member shall be deducted from any award made
for the subsequent injury. For the permanent loss of use or
the permanent partial loss of use of any such member or the
partial loss of sight of an eye, for which compensation has
been paid, then such loss shall be taken into consideration
and deducted from any award for the subsequent injury.
18. The specific case of loss of both hands, both arms,
or both feet, or both legs, or both eyes, or of any two
thereof, or the permanent and complete loss of the use
thereof, constitutes total and permanent disability, to be
compensated according to the compensation fixed by
paragraph (f) of this Section. These specific cases of
total and permanent disability do not exclude other cases.
Any employee who has previously suffered the loss or
permanent and complete loss of the use of any of such
members, and in a subsequent independent accident loses
another or suffers the permanent and complete loss of the

HB2883 - 41 - LRB097 10781 AEK 51211 b
use of any one of such members the employer for whom the
injured employee is working at the time of the last
independent accident is liable to pay compensation only for
the loss or permanent and complete loss of the use of the
member occasioned by the last independent accident.
19. In a case of specific loss and the subsequent death
of such injured employee from other causes than such injury
leaving a widow, widower, or dependents surviving before
payment or payment in full for such injury, then the amount
due for such injury is payable to the widow or widower and,
if there be no widow or widower, then to such dependents,
in the proportion which such dependency bears to total
dependency.
Beginning July 1, 1980, and every 6 months thereafter, the
Commission shall examine the Second Injury Fund and when, after
deducting all advances or loans made to such Fund, the amount
therein is $500,000 then the amount required to be paid by
employers pursuant to paragraph (f) of Section 7 shall be
reduced by one-half. When the Second Injury Fund reaches the
sum of $600,000 then the payments shall cease entirely.
However, when the Second Injury Fund has been reduced to
$400,000, payment of one-half of the amounts required by
paragraph (f) of Section 7 shall be resumed, in the manner
herein provided, and when the Second Injury Fund has been
reduced to $300,000, payment of the full amounts required by
paragraph (f) of Section 7 shall be resumed, in the manner

HB2883 - 42 - LRB097 10781 AEK 51211 b
herein provided. The Commission shall make the changes in
payment effective by general order, and the changes in payment
become immediately effective for all cases coming before the
Commission thereafter either by settlement agreement or final
order, irrespective of the date of the accidental injury.
On August 1, 1996 and on February 1 and August 1 of each
subsequent year, the Commission shall examine the special fund
designated as the "Rate Adjustment Fund" and when, after
deducting all advances or loans made to said fund, the amount
therein is $4,000,000, the amount required to be paid by
employers pursuant to paragraph (f) of Section 7 shall be
reduced by one-half. When the Rate Adjustment Fund reaches the
sum of $5,000,000 the payment therein shall cease entirely.
However, when said Rate Adjustment Fund has been reduced to
$3,000,000 the amounts required by paragraph (f) of Section 7
shall be resumed in the manner herein provided.
(f) In case of complete disability, which renders the
employee wholly and permanently incapable of work, or in the
specific case of total and permanent disability as provided in
subparagraph 18 of paragraph (e) of this Section, compensation
shall be payable at the rate provided in subparagraph 2 of
paragraph (b) of this Section for life.
An employee entitled to benefits under paragraph (f) of
this Section shall also be entitled to receive from the Rate
Adjustment Fund provided in paragraph (f) of Section 7 of the
supplementary benefits provided in paragraph (g) of this

HB2883 - 43 - LRB097 10781 AEK 51211 b
Section 8.
If any employee who receives an award under this paragraph
afterwards returns to work or is able to do so, and earns or is
able to earn as much as before the accident, payments under
such award shall cease. If such employee returns to work, or is
able to do so, and earns or is able to earn part but not as much
as before the accident, such award shall be modified so as to
conform to an award under paragraph (d) of this Section. If
such award is terminated or reduced under the provisions of
this paragraph, such employees have the right at any time
within 30 months after the date of such termination or
reduction to file petition with the Commission for the purpose
of determining whether any disability exists as a result of the
original accidental injury and the extent thereof.
Disability as enumerated in subdivision 18, paragraph (e)
of this Section is considered complete disability.
If an employee who had previously incurred loss or the
permanent and complete loss of use of one member, through the
loss or the permanent and complete loss of the use of one hand,
one arm, one foot, one leg, or one eye, incurs permanent and
complete disability through the loss or the permanent and
complete loss of the use of another member, he shall receive,
in addition to the compensation payable by the employer and
after such payments have ceased, an amount from the Second
Injury Fund provided for in paragraph (f) of Section 7, which,
together with the compensation payable from the employer in

HB2883 - 44 - LRB097 10781 AEK 51211 b
whose employ he was when the last accidental injury was
incurred, will equal the amount payable for permanent and
complete disability as provided in this paragraph of this
Section.
The custodian of the Second Injury Fund provided for in
paragraph (f) of Section 7 shall be joined with the employer as
a party respondent in the application for adjustment of claim.
The application for adjustment of claim shall state briefly and
in general terms the approximate time and place and manner of
the loss of the first member.
In its award the Commission or the Arbitrator shall
specifically find the amount the injured employee shall be
weekly paid, the number of weeks compensation which shall be
paid by the employer, the date upon which payments begin out of
the Second Injury Fund provided for in paragraph (f) of Section
7 of this Act, the length of time the weekly payments continue,
the date upon which the pension payments commence and the
monthly amount of the payments. The Commission shall 30 days
after the date upon which payments out of the Second Injury
Fund have begun as provided in the award, and every month
thereafter, prepare and submit to the State Comptroller a
voucher for payment for all compensation accrued to that date
at the rate fixed by the Commission. The State Comptroller
shall draw a warrant to the injured employee along with a
receipt to be executed by the injured employee and returned to
the Commission. The endorsed warrant and receipt is a full and

HB2883 - 45 - LRB097 10781 AEK 51211 b
complete acquittance to the Commission for the payment out of
the Second Injury Fund. No other appropriation or warrant is
necessary for payment out of the Second Injury Fund. The Second
Injury Fund is appropriated for the purpose of making payments
according to the terms of the awards.
As of July 1, 1980 to July 1, 1982, all claims against and
obligations of the Second Injury Fund shall become claims
against and obligations of the Rate Adjustment Fund to the
extent there is insufficient money in the Second Injury Fund to
pay such claims and obligations. In that case, all references
to "Second Injury Fund" in this Section shall also include the
Rate Adjustment Fund.
(g) Every award for permanent total disability entered by
the Commission on and after July 1, 1965 under which
compensation payments shall become due and payable after the
effective date of this amendatory Act, and every award for
death benefits or permanent total disability entered by the
Commission on and after the effective date of this amendatory
Act shall be subject to annual adjustments as to the amount of
the compensation rate therein provided. Such adjustments shall
first be made on July 15, 1977, and all awards made and entered
prior to July 1, 1975 and on July 15 of each year thereafter.
In all other cases such adjustment shall be made on July 15 of
the second year next following the date of the entry of the
award and shall further be made on July 15 annually thereafter.
If during the intervening period from the date of the entry of

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the award, or the last periodic adjustment, there shall have
been an increase in the State's average weekly wage in covered
industries under the Unemployment Insurance Act, the weekly
compensation rate shall be proportionately increased by the
same percentage as the percentage of increase in the State's
average weekly wage in covered industries under the
Unemployment Insurance Act. The increase in the compensation
rate under this paragraph shall in no event bring the total
compensation rate to an amount greater than the prevailing
maximum rate at the time that the annual adjustment is made.
Such increase shall be paid in the same manner as herein
provided for payments under the Second Injury Fund to the
injured employee, or his dependents, as the case may be, out of
the Rate Adjustment Fund provided in paragraph (f) of Section 7
of this Act. Payments shall be made at the same intervals as
provided in the award or, at the option of the Commission, may
be made in quarterly payment on the 15th day of January, April,
July and October of each year. In the event of a decrease in
such average weekly wage there shall be no change in the then
existing compensation rate. The within paragraph shall not
apply to cases where there is disputed liability and in which a
compromise lump sum settlement between the employer and the
injured employee, or his dependents, as the case may be, has
been duly approved by the Illinois Workers' Compensation
Commission.
Provided, that in cases of awards entered by the Commission

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for injuries occurring before July 1, 1975, the increases in
the compensation rate adjusted under the foregoing provision of
this paragraph (g) shall be limited to increases in the State's
average weekly wage in covered industries under the
Unemployment Insurance Act occurring after July 1, 1975.
For every accident occurring on or after July 20, 2005 but
before the effective date of this amendatory Act of the 94th
General Assembly (Senate Bill 1283 of the 94th General
Assembly), the annual adjustments to the compensation rate in
awards for death benefits or permanent total disability, as
provided in this Act, shall be paid by the employer. The
adjustment shall be made by the employer on July 15 of the
second year next following the date of the entry of the award
and shall further be made on July 15 annually thereafter. If
during the intervening period from the date of the entry of the
award, or the last periodic adjustment, there shall have been
an increase in the State's average weekly wage in covered
industries under the Unemployment Insurance Act, the employer
shall increase the weekly compensation rate proportionately by
the same percentage as the percentage of increase in the
State's average weekly wage in covered industries under the
Unemployment Insurance Act. The increase in the compensation
rate under this paragraph shall in no event bring the total
compensation rate to an amount greater than the prevailing
maximum rate at the time that the annual adjustment is made. In
the event of a decrease in such average weekly wage there shall

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be no change in the then existing compensation rate. Such
increase shall be paid by the employer in the same manner and
at the same intervals as the payment of compensation in the
award. This paragraph shall not apply to cases where there is
disputed liability and in which a compromise lump sum
settlement between the employer and the injured employee, or
his or her dependents, as the case may be, has been duly
approved by the Illinois Workers' Compensation Commission.
The annual adjustments for every award of death benefits or
permanent total disability involving accidents occurring
before July 20, 2005 and accidents occurring on or after the
effective date of this amendatory Act of the 94th General
Assembly (Senate Bill 1283 of the 94th General Assembly) shall
continue to be paid from the Rate Adjustment Fund pursuant to
this paragraph and Section 7(f) of this Act.
(h) In case death occurs from any cause before the total
compensation to which the employee would have been entitled has
been paid, then in case the employee leaves any widow, widower,
child, parent (or any grandchild, grandparent or other lineal
heir or any collateral heir dependent at the time of the
accident upon the earnings of the employee to the extent of 50%
or more of total dependency) such compensation shall be paid to
the beneficiaries of the deceased employee and distributed as
provided in paragraph (g) of Section 7.
(h-1) In case an injured employee is under legal disability
at the time when any right or privilege accrues to him or her

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under this Act, a guardian may be appointed pursuant to law,
and may, on behalf of such person under legal disability, claim
and exercise any such right or privilege with the same effect
as if the employee himself or herself had claimed or exercised
the right or privilege. No limitations of time provided by this
Act run so long as the employee who is under legal disability
is without a conservator or guardian.
(i) In case the injured employee is under 16 years of age
at the time of the accident and is illegally employed, the
amount of compensation payable under paragraphs (b), (c), (d),
(e) and (f) of this Section is increased 50%.
However, where an employer has on file an employment
certificate issued pursuant to the Child Labor Law or work
permit issued pursuant to the Federal Fair Labor Standards Act,
as amended, or a birth certificate properly and duly issued,
such certificate, permit or birth certificate is conclusive
evidence as to the age of the injured minor employee for the
purposes of this Section.
Nothing herein contained repeals or amends the provisions
of the Child Labor Law relating to the employment of minors
under the age of 16 years.
(j) 1. In the event the injured employee receives benefits,
including medical, surgical or hospital benefits under any
group plan covering non-occupational disabilities contributed
to wholly or partially by the employer, which benefits should
not have been payable if any rights of recovery existed under

HB2883 - 50 - LRB097 10781 AEK 51211 b
this Act, then such amounts so paid to the employee from any
such group plan as shall be consistent with, and limited to,
the provisions of paragraph 2 hereof, shall be credited to or
against any compensation payment for temporary total
incapacity for work or any medical, surgical or hospital
benefits made or to be made under this Act. In such event, the
period of time for giving notice of accidental injury and
filing application for adjustment of claim does not commence to
run until the termination of such payments. This paragraph does
not apply to payments made under any group plan which would
have been payable irrespective of an accidental injury under
this Act. Any employer receiving such credit shall keep such
employee safe and harmless from any and all claims or
liabilities that may be made against him by reason of having
received such payments only to the extent of such credit.
Any excess benefits paid to or on behalf of a State
employee by the State Employees' Retirement System under
Article 14 of the Illinois Pension Code on a death claim or
disputed disability claim shall be credited against any
payments made or to be made by the State of Illinois to or on
behalf of such employee under this Act, except for payments for
medical expenses which have already been incurred at the time
of the award. The State of Illinois shall directly reimburse
the State Employees' Retirement System to the extent of such
credit.
2. Nothing contained in this Act shall be construed to give

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the employer or the insurance carrier the right to credit for
any benefits or payments received by the employee other than
compensation payments provided by this Act, and where the
employee receives payments other than compensation payments,
whether as full or partial salary, group insurance benefits,
bonuses, annuities or any other payments, the employer or
insurance carrier shall receive credit for each such payment
only to the extent of the compensation that would have been
payable during the period covered by such payment.
3. The extension of time for the filing of an Application
for Adjustment of Claim as provided in paragraph 1 above shall
not apply to those cases where the time for such filing had
expired prior to the date on which payments or benefits
enumerated herein have been initiated or resumed. Provided
however that this paragraph 3 shall apply only to cases wherein
the payments or benefits hereinabove enumerated shall be
received after July 1, 1969.
(k) For accidental injuries that occur on or after the
effective date of this amendatory Act of the 97th General
Assembly, permanent partial or total disability shall be
certified by a physician and demonstrated by use of medically
defined objective measurements that include, but are not
limited to: loss of range of motion; loss of strength; and
measured atrophy of tissue mass consistent with the injury. In
determining the impairment, subjective complaints shall not be
considered unless supported by and clearly related to objective

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measurements. The most current edition of the American Medical
Association's "Guides to the Evaluation of Permanent
Impairment" shall be applied in determining the level of
disability under this Act.
(Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05;
94-695, eff. 11-16-05.)
(820 ILCS 305/8.2)
Sec. 8.2. Fee schedule.
(a) Except as provided for in subsection (c), for
procedures, treatments, or services covered under this Act and
rendered or to be rendered on and after February 1, 2006 and
until January 1, 2012, the maximum allowable payment shall be
90% of the 80th percentile of charges and fees as determined by
the Commission utilizing information provided by employers'
and insurers' national databases, with a minimum of 12,000,000
Illinois line item charges and fees comprised of health care
provider and hospital charges and fees as of August 1, 2004 but
not earlier than August 1, 2002. These charges and fees are
provider billed amounts and shall not include discounted
charges. The 80th percentile is the point on an ordered data
set from low to high such that 80% of the cases are below or
equal to that point and at most 20% are above or equal to that
point. The Commission shall adjust these historical charges and
fees as of August 1, 2004 by the Consumer Price Index-U for the
period August 1, 2004 through September 30, 2005. The

HB2883 - 53 - LRB097 10781 AEK 51211 b
Commission shall establish fee schedules for procedures,
treatments, or services for hospital inpatient, hospital
outpatient, emergency room and trauma, ambulatory surgical
treatment centers, and professional services. These charges
and fees shall be designated by geozip or any smaller
geographic unit. The data shall in no way identify or tend to
identify any patient, employer, or health care provider. As
used in this Section, "geozip" means a three-digit zip code
based on data similarities, geographical similarities, and
frequencies. A geozip does not cross state boundaries. As used
in this Section, "three-digit zip code" means a geographic area
in which all zip codes have the same first 3 digits. If a
geozip does not have the necessary number of charges and fees
to calculate a valid percentile for a specific procedure,
treatment, or service, the Commission may combine data from the
geozip with up to 4 other geozips that are demographically and
economically similar and exhibit similarities in data and
frequencies until the Commission reaches 9 charges or fees for
that specific procedure, treatment, or service. In cases where
the compiled data contains fewer less than 9 charges or fees
for a procedure, treatment, or service, reimbursement shall
occur at 76% of charges and fees as determined by the
Commission in a manner consistent with the provisions of this
paragraph. Providers of out-of-state procedures, treatments,
services, products, or supplies shall be reimbursed at the
lesser of that State's fee schedule amount or the fee schedule

HB2883 - 54 - LRB097 10781 AEK 51211 b
amount that would apply to the region where the employer is
located. If no fee schedule exists in that State, the provider
shall be reimbursed at the lesser of the actual charge or the
fee schedule amount that would apply to the region where the
employer is located. If out-of-state treatment is being
undertaken and the employer is also located outside the State
of Illinois, the provider shall be reimbursed at the lesser of
the actual charge or the fee schedule amount that would apply
to the location of the accident. The Commission has the
authority to set the maximum allowable payment to providers of
out-of-state procedures, treatments, or services covered under
this Act in a manner consistent with this Section. Not later
than September 30 in 2006 and each year thereafter, the
Commission shall automatically increase or decrease the
maximum allowable payment for a procedure, treatment, or
service established and in effect on January 1 of that year by
the percentage change in the Consumer Price Index-U for the 12
month period ending August 31 of that year. The increase or
decrease shall become effective on January 1 of the following
year. As used in this Section, "Consumer Price Index-U" means
the index published by the Bureau of Labor Statistics of the
U.S. Department of Labor, that measures the average change in
prices of all goods and services purchased by all urban
consumers, U.S. city average, all items, 1982-84=100.
(a-1) Except as provided for in subparagraph (c), for
procedures, treatments, or services covered under this Act and

HB2883 - 55 - LRB097 10781 AEK 51211 b
rendered or to be rendered on and after January 1, 2012, The
Commission shall adopt a medical fee schedule in accordance
with the fee-related structure and rules of the relevant
Medicare payment systems. Maximum reasonable fees shall be 160%
of the estimated aggregate fees prescribed in the relevant
Medicare payment system for the same class of services.
To ensure a reasonable standard of access to services and
care for injured employees, the Commission may adopt different
conversion factors, diagnostic related group weights, and
other factors affecting payment amounts from those used in the
Medicare payment system, provided estimated aggregate fees do
not exceed 160% of the estimated aggregate fees paid for the
same class of services in the relevant Medicare payment system.
If the Commission determines that a medical treatment,
facility use, product, or service is not covered by a Medicare
payment system, the Commission shall establish maximum fees for
that item, provided that the maximum fee paid shall not exceed
160% of the fees paid by Medicare for services that require
comparable resources.
The medical fee schedule shall be adjusted to conform to
any relevant changes in the Medicare payment systems no later
than 60 days after the effective date of those changes.
Providers of out-of-state procedures, treatments,
services, products, or supplies shall be reimbursed at the
lesser of that State's fee schedule amount or the fee schedule
amount that would apply to the region where the employer is

HB2883 - 56 - LRB097 10781 AEK 51211 b
located. If no fee schedule exists in that State, the provider
shall be reimbursed at the lesser of the actual charge or the
fee schedule amount that would apply to the region where the
employer is located.
Nothing in this Section shall prohibit an employer or
insurer from contracting with a medical provider for
reimbursement rates different from those prescribed in the
medical fee schedule.
(b) Notwithstanding the provisions of subsection (a), if
the Commission finds that there is a significant limitation on
access to quality health care in either a specific field of
health care services or a specific geographic limitation on
access to health care, it may change the Consumer Price Index-U
increase or decrease for that specific field or specific
geographic limitation on access to health care to address that
limitation.
(c) The Commission shall establish by rule a process to
review those medical cases or outliers that involve
extra-ordinary treatment to determine whether to make an
additional adjustment to the maximum payment within a fee
schedule for a procedure, treatment, or service.
(c-1) For services provided on or after the effective date
of this Amendatory Act of the 97th General Assembly until
January 1, 2012, implants shall be reimbursed at 25% above the
net manufacturer's invoice price less rebates, plus actual
reasonable and customary shipping charges whether or not the

HB2883 - 57 - LRB097 10781 AEK 51211 b
implant charge is submitted by a provider in conjunction with a
bill for all other services associated with the implant,
submitted by a provider on a separate claim form, submitted by
a distributor, or submitted by the manufacturer of the implant.
"Implants" include the following codes or any substantially
similar updated code as determined by the Commission: 0274
(prosthetics/orthotics); 0275 (pacemaker); 0276 (lens
implant); 0278 (implants); 0540 and 0545 (ambulance);
0624(investigational devices); and 0636 (drugs requiring
detailed coding). Non-implantable devices or supplies within
these codes shall be reimbursed at 65% of actual charge, which
is the provider's normal rates under its standard chargemaster.
A standard chargemaster is the provider's list of charges for
procedures, treatments, products, supplies, or services used
to bill payers in a consistent manner.
(d) When a patient notifies a provider that the treatment,
procedure, or service being sought is for a work-related
illness or injury and furnishes the provider the name and
address of the responsible employer, the provider shall bill
the employer directly. The employer shall make payment and
providers shall submit bills and records in accordance with the
provisions of this Section. All payments to providers for
treatment provided pursuant to this Act shall be made within 60
days of receipt of the bills as long as the claim contains
substantially all the required data elements necessary to
adjudicate the bills. In the case of nonpayment to a provider

HB2883 - 58 - LRB097 10781 AEK 51211 b
within 60 days of receipt of the bill which contained
substantially all of the required data elements necessary to
adjudicate the bill or nonpayment to a provider of a portion of
such a bill up to the lesser of the actual charge or the
payment level set by the Commission in the fee schedule
established in this Section, the bill, or portion of the bill,
shall incur interest at a rate of 1% per month payable to the
provider.
(e) Except as provided in subsections (e-5), (e-10), and
(e-15), a provider shall not hold an employee liable for costs
related to a non-disputed procedure, treatment, or service
rendered in connection with a compensable injury. The
provisions of subsections (e-5), (e-10), (e-15), and (e-20)
shall not apply if an employee provides information to the
provider regarding participation in a group health plan. If the
employee participates in a group health plan, the provider may
submit a claim for services to the group health plan. If the
claim for service is covered by the group health plan, the
employee's responsibility shall be limited to applicable
deductibles, co-payments, or co-insurance. Except as provided
under subsections (e-5), (e-10), (e-15), and (e-20), a provider
shall not bill or otherwise attempt to recover from the
employee the difference between the provider's charge and the
amount paid by the employer or the insurer on a compensable
injury.
(e-5) If an employer notifies a provider that the employer

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does not consider the illness or injury to be compensable under
this Act, the provider may seek payment of the provider's
actual charges from the employee for any procedure, treatment,
or service rendered. Once an employee informs the provider that
there is an application filed with the Commission to resolve a
dispute over payment of such charges, the provider shall cease
any and all efforts to collect payment for the services that
are the subject of the dispute. Any statute of limitations or
statute of repose applicable to the provider's efforts to
collect payment from the employee shall be tolled from the date
that the employee files the application with the Commission
until the date that the provider is permitted to resume
collection efforts under the provisions of this Section.
(e-10) If an employer notifies a provider that the employer
will pay only a portion of a bill for any procedure, treatment,
or service rendered in connection with a compensable illness or
disease, the provider may seek payment from the employee for
the remainder of the amount of the bill up to the lesser of the
actual charge, negotiated rate, if applicable, or the payment
level set by the Commission in the fee schedule established in
this Section. Once an employee informs the provider that there
is an application filed with the Commission to resolve a
dispute over payment of such charges, the provider shall cease
any and all efforts to collect payment for the services that
are the subject of the dispute. Any statute of limitations or
statute of repose applicable to the provider's efforts to

HB2883 - 60 - LRB097 10781 AEK 51211 b
collect payment from the employee shall be tolled from the date
that the employee files the application with the Commission
until the date that the provider is permitted to resume
collection efforts under the provisions of this Section.
(e-15) When there is a dispute over the compensability of
or amount of payment for a procedure, treatment, or service,
and a case is pending or proceeding before an Arbitrator or the
Commission, the provider may mail the employee reminders that
the employee will be responsible for payment of any procedure,
treatment or service rendered by the provider. The reminders
must state that they are not bills, to the extent practicable
include itemized information, and state that the employee need
not pay until such time as the provider is permitted to resume
collection efforts under this Section. The reminders shall not
be provided to any credit rating agency. The reminders may
request that the employee furnish the provider with information
about the proceeding under this Act, such as the file number,
names of parties, and status of the case. If an employee fails
to respond to such request for information or fails to furnish
the information requested within 90 days of the date of the
reminder, the provider is entitled to resume any and all
efforts to collect payment from the employee for the services
rendered to the employee and the employee shall be responsible
for payment of any outstanding bills for a procedure,
treatment, or service rendered by a provider.
(e-20) Upon a final award or judgment by an Arbitrator or

HB2883 - 61 - LRB097 10781 AEK 51211 b
the Commission, or a settlement agreed to by the employer and
the employee, a provider may resume any and all efforts to
collect payment from the employee for the services rendered to
the employee and the employee shall be responsible for payment
of any outstanding bills for a procedure, treatment, or service
rendered by a provider as well as the interest awarded under
subsection (d) of this Section. In the case of a procedure,
treatment, or service deemed compensable, the provider shall
not require a payment rate, excluding the interest provisions
under subsection (d), greater than the lesser of the actual
charge or the payment level set by the Commission in the fee
schedule established in this Section. Payment for services
deemed not covered or not compensable under this Act is the
responsibility of the employee unless a provider and employee
have agreed otherwise in writing. Services not covered or not
compensable under this Act are not subject to the fee schedule
in this Section.
(f) Nothing in this Act shall prohibit an employer or
insurer from contracting with a health care provider or group
of health care providers for reimbursement levels for benefits
under this Act different from those provided in this Section.
(g) On or before January 1, 2015 2010 the Commission shall
provide to the Governor and General Assembly a report regarding
the implementation of the medical fee schedule indicating the
impact on medical costs for employers and access to care for
employees and the index used for annual adjustment to that

HB2883 - 62 - LRB097 10781 AEK 51211 b
schedule as described in this Section.
(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)
(820 ILCS 305/8.7)
Sec. 8.7. Utilization review programs.
(a) As used in this Section:
"Utilization review" means the evaluation of proposed or
provided health care services to determine the appropriateness
of both the level of health care services medically necessary
and the quality of health care services provided to a patient,
including evaluation of their efficiency, efficacy, and
appropriateness of treatment, hospitalization, or office
visits based on medically accepted standards. The evaluation
must be accomplished by means of a system that identifies the
utilization of health care services based on nationally
recognized standards of care or nationally recognized peer
review guidelines as well as nationally recognized treatment
guidelines and evidence-based medicine evidence based upon
standards as provided in this Act. Utilization techniques may
include prospective review, second opinions, concurrent
review, discharge planning, peer review, independent medical
examinations, and retrospective review (for purposes of this
sentence, retrospective review shall be applicable to services
rendered on or after July 20, 2005). Nothing in this Section
applies to prospective review of necessary first aid or
emergency treatment.

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(b) No person may conduct a utilization review program for
workers' compensation services in this State unless once every
2 years the person registers the utilization review program
with the Department of Insurance Financial and Professional
Regulation and certifies compliance with the Workers'
Compensation Utilization Management standards or Health
Utilization Management Standards of URAC sufficient to achieve
URAC accreditation or submits evidence of accreditation by URAC
for its Workers' Compensation Utilization Management Standards
or Health Utilization Management Standards. Nothing in this Act
shall be construed to require an employer or insurer or its
subcontractors to become URAC accredited.
(c) In addition, the Director Secretary of Insurance
Financial and Professional Regulation may certify alternative
utilization review standards of national accreditation
organizations or entities in order for plans to comply with
this Section. Any alternative utilization review standards
shall meet or exceed those standards required under subsection
(b).
(d) This registration shall include submission of all of
the following information regarding utilization review program
activities:
(1) The name, address, and telephone number of the
utilization review programs.
(2) The organization and governing structure of the
utilization review programs.

HB2883 - 64 - LRB097 10781 AEK 51211 b
(3) The number of lives for which utilization review is
conducted by each utilization review program.
(4) Hours of operation of each utilization review
program.
(5) Description of the grievance process for each
utilization review program.
(6) Number of covered lives for which utilization
review was conducted for the previous calendar year for
each utilization review program.
(7) Written policies and procedures for protecting
confidential information according to applicable State and
federal laws for each utilization review program.
(e) A utilization review program shall have written
procedures to ensure that patient-specific information
obtained during the process of utilization review will be:
(1) kept confidential in accordance with applicable
State and federal laws; and
(2) shared only with the employee, the employee's
designee, and the employee's health care provider, and
those who are authorized by law to receive the information.
Summary data shall not be considered confidential if it
does not provide information to allow identification of
individual patients or health care providers.
Only a health care professional may make determinations
regarding the medical necessity of health care services during
the course of utilization review.

HB2883 - 65 - LRB097 10781 AEK 51211 b
When making retrospective reviews, utilization review
programs shall base reviews solely on the medical information
available to the attending physician or ordering provider at
the time the health care services were provided.
(f) If the Department of Insurance Financial and
Professional Regulation finds that a utilization review
program is not in compliance with this Section, the Department
shall issue a corrective action plan and allow a reasonable
amount of time for compliance with the plan. If the utilization
review program does not come into compliance, the Department
may issue a cease and desist order. Before issuing a cease and
desist order under this Section, the Department shall provide
the utilization review program with a written notice of the
reasons for the order and allow a reasonable amount of time to
supply additional information demonstrating compliance with
the requirements of this Section and to request a hearing. The
hearing notice shall be sent by certified mail, return receipt
requested, and the hearing shall be conducted in accordance
with the Illinois Administrative Procedure Act.
(g) A utilization review program subject to a corrective
action may continue to conduct business until a final decision
has been issued by the Department.
(h) The Department of Insurance Secretary of Financial and
Professional Regulation may by rule establish a registration
fee for each person conducting a utilization review program.
(i) Upon receipt of written notice that the employer or the

HB2883 - 66 - LRB097 10781 AEK 51211 b
employer's agent or insurer wishes to invoke the utilization
review process, the provider of medical, surgical or hospital
services shall submit to the utilization review, following URAC
procedural guidelines and appeal process. If the provider fails
to cooperate with the utilization review of proposed treatment
or services, the charges for the treatment or service shall not
be compensable or collectible against the employer, the
employer's agent or insurer, or the employee. When an employer
denies payment of or refuses to authorize payment of first aid,
medical, surgical, or hospital services under Section 8(a) of
this Act that complies with subsection (b) of this Section,
that denial or refusal to authorize shall create a rebuttable
presumption that the extent and scope of medical treatment is
excessive or unnecessary. The Commission shall deny payment for
any service which the utilization review has determined subject
to subsection (a) of this Section to be excessive and
unnecessary unless the presumption is rebutted by establishing
by a preponderance of the evidence that a variance from the
standards of care or guidelines used pursuant to subsection (a)
of this Section is reasonably required to cure and relieve the
employee from the effects of his or her injury or that the
utilization review did not comply with subsection (b) of this
Section. This subsection shall apply to medical, surgical, or
hospital services rendered on or after the effective date of
this Amendatory Act of the 97th General Assembly. A utilization
review will be considered by the Commission, along with all

HB2883 - 67 - LRB097 10781 AEK 51211 b
other evidence and in the same manner as all other evidence, in
the determination of the reasonableness and necessity of the
medical bills or treatment. Nothing in this Section shall be
construed to diminish the rights of employees to reasonable and
necessary medical treatment or employee choice of health care
provider under Section 8(a) or the rights of employers to
medical examinations under Section 12.
(j) When an employer denies payment of or refuses to
authorize payment of first aid, medical, surgical, or hospital
services under Section 8(a) of this Act, if that denial or
refusal to authorize complies with a utilization review program
registered under this Section and complies with all other
requirements of this Section, then there shall be a rebuttable
presumption that the employer shall not be responsible for
payment of additional compensation pursuant to Section 19(k) of
this Act and if that denial or refusal to authorize does not
comply with a utilization review program registered under this
Section and does not comply with all other requirements of this
Section, then that will be considered by the Commission, along
with all other evidence and in the same manner as all other
evidence, in the determination of whether the employer may be
responsible for the payment of additional compensation
pursuant to Section 19(k) of this Act.
(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)
(820 ILCS 305/11) (from Ch. 48, par. 138.11)

HB2883 - 68 - LRB097 10781 AEK 51211 b
Sec. 11. The compensation herein provided, together with
the provisions of this Act, shall be the measure of the
responsibility of any employer engaged in any of the
enterprises or businesses enumerated in Section 3 of this Act,
or of any employer who is not engaged in any such enterprises
or businesses, but who has elected to provide and pay
compensation for accidental injuries sustained by any employee
arising out of and in the course of the employment according to
the provisions of this Act, and whose election to continue
under this Act, has not been nullified by any action of his
employees as provided for in this Act.
Accidental injuries incurred while participating in
voluntary recreational programs including but not limited to
athletic events, parties and picnics do not arise out of and in
the course of the employment even though the employer pays some
or all of the cost thereof. This exclusion shall not apply in
the event that the injured employee was ordered or assigned by
his employer to participate in the program.
Accidental injuries incurred while participating as a
patient in a drug or alcohol rehabilitation program do not
arise out of and in the course of employment even though the
employer pays some or all of the costs thereof.
Any injury to or disease or death of an employee arising
from the administration of a vaccine, including without
limitation smallpox vaccine, to prepare for, or as a response
to, a threatened or potential bioterrorist incident to the

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employee as part of a voluntary inoculation program in
connection with the person's employment or in connection with
any governmental program or recommendation for the inoculation
of workers in the employee's occupation, geographical area, or
other category that includes the employee is deemed to arise
out of and in the course of the employment for all purposes
under this Act. This paragraph added by this amendatory Act of
the 93rd General Assembly is declarative of existing law and is
not a new enactment.
There shall be a rebuttable presumption that no benefits
under this Act shall be payable if (i) the employee's
intoxication is the proximate cause of the employee's
accidental injury or (ii) at the time the employee incurred
accidental injury, the employee was so intoxicated that the
intoxication constituted a departure from the employment.
Admissible evidence of the concentration of (1) alcohol, (2)
cannabis as defined in the Cannabis Control Act, (3) a
controlled substance listed in the Illinois Controlled
Substances Act, or (4) an intoxicating compound listed in the
Use of Intoxicating Compounds Act in the employee's blood,
breath, or urine at the time the employee incurred the
accidental injury shall be considered in any hearing under this
Act to determine whether the employee was intoxicated at the
time the employee incurred the accidental injuries.
Intoxication shall be defined as 0.08% or more by weight of
alcohol in the employee's blood, breath, or urine or if there

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is any evidence of impairment due to the unlawful or
unauthorized use of (1) cannabis as defined in the Cannabis
Control Act, (2) a controlled substance listed in the Illinois
Controlled Substances Act, or (3) an intoxicating compound
listed in the Use of Intoxicating Compounds Act. If the
employee refuses to submit to testing of blood, breath, or
urine as soon as practical after the accident, he or she shall
be considered to have been intoxicated at the time of the
accident. Percentage by weight of alcohol in the blood shall be
based on grams of alcohol per 100 milliliters of blood.
Percentage by weight of alcohol in the breath shall be based
upon grams of alcohol per 210 liters of breath. Any testing
that has not been performed by an accredited or certified
testing laboratory shall not be admissible in any hearing under
this Act to determine whether the employee was intoxicated at
the time the employee incurred the accidental injury.
All sample collection and testing for alcohol and drugs
under this Section shall be performed in accordance with rules
to be adopted by the Commission. These rules shall ensure:
(1) compliance with the National Labor Relations Act
regarding collective bargaining agreements or regulations
promulgated by the United States Department of
Transportation;
(2) that samples are collected and tested in
conformance with national and State legal and regulatory
standards for the privacy of the individual being tested,

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and in a manner reasonably calculated to prevent
substitutions or interference with the collection or
testing of reliable sample;
(3) that split testing procedures are utilized;
(4) sample collection is documented, and the
documentation procedures include:
(A) the labeling of samples in a manner so as to
reasonably preclude the probability of erroneous
identification of test result; and
(B) an opportunity for the employee to provide
notification of any information which he or she
considers relevant to the test, including
identification of currently or recently used
prescription or nonprescription drugs and other
relevant medical information;
(5) that sample collection, storage, and
transportation to the place of testing is performed in a
manner so as to reasonably preclude the probability of
sample contamination or adulteration; and
(6) that chemical analyses of blood, urine, breath, or
other bodily substance are performed according to
nationally scientifically accepted analytical methods and
procedures.
(Source: P.A. 93-829, eff. 7-28-04.)
(820 ILCS 305/16) (from Ch. 48, par. 138.16)

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Sec. 16. The Commission shall make and publish procedural
rules and orders for carrying out the duties imposed upon it by
law and for determining the extent of disability sustained,
which rules and orders shall be deemed prima facie reasonable
and valid.
The process and procedure before the Commission shall be as
simple and summary as reasonably may be.
The Commission upon application of either party may issue
dedimus potestatem directed to a commissioner, notary public,
justice of the peace or any other officer authorized by law to
administer oaths, to take the depositions of such witness or
witnesses as may be necessary in the judgment of such
applicant. Such dedimus potestatem may issue to any of the
officers aforesaid in any state or territory of the United
States. When the deposition of any witness resident of a
foreign country is desired to be taken, the dedimus shall be
directed to and the deposition taken before a consul, vice
consul or other authorized representative of the government of
the United States of America, whose station is in the country
where the witness whose deposition is to be taken resides. In
countries where the government of the United States has no
consul or other diplomatic representative, then depositions in
such case shall be taken through the appropriate judicial
authority of that country; or where treaties provide for other
methods of taking depositions, then the same may be taken as in
such treaties provided. The Commission shall have the power to

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adopt necessary rules to govern the issue of such dedimus
potestatem.
The Commission, or any member thereof, or any Arbitrator
designated by the Commission shall have the power to administer
oaths, subpoena and examine witnesses; to issue subpoenas duces
tecum, requiring the production of such books, papers, records,
including but not limited to employment verification documents
pursuant to subsection 8(d)1 of this Act, and documents as may
be evidence of any matter under inquiry and to examine and
inspect the same and such places or premises as may relate to
the question in dispute. The Commission, or any member thereof,
or any Arbitrator designated by the Commission, shall on
written request of either party to the dispute, issue subpoenas
for the attendance of such witnesses and production of such
books, papers, records, including but not limited to employment
verification documents pursuant to subsection 8(d)1 of this
Act, and documents as shall be designated in the applications,
and the parties applying for such subpoena shall advance the
officer and witness fees provided for in civil actions pending
in circuit courts of this State, except as otherwise provided
by Section 20 of this Act. Service of such subpoena shall be
made by any sheriff or other person. In case any person refuses
to comply with an order of the Commission or subpoenas issued
by it or by any member thereof, or any Arbitrator designated by
the Commission or to permit an inspection of places or
premises, or to produce any books, papers, records or

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documents, or any witness refuses to testify to any matters
regarding which he or she may be lawfully interrogated, the
Circuit Court of the county in which the hearing or matter is
pending, on application of any member of the Commission or any
Arbitrator designated by the Commission, shall compel
obedience by attachment proceedings, as for contempt, as in a
case of disobedience of the requirements of a subpoena from
such court on a refusal to testify therein.
The records, reports, and bills kept by a treating
hospital, treating physician, or other treating healthcare
provider that renders treatment to the employee as a result of
accidental injuries in question, certified to as true and
correct by the hospital, physician, or other healthcare
provider or by designated agents of the hospital, physician, or
other healthcare provider, showing the medical and surgical
treatment given an injured employee by such hospital,
physician, or other healthcare provider, shall be admissible
without any further proof as evidence of the medical and
surgical matters stated therein, but shall not be conclusive
proof of such matters. There shall be a rebuttable presumption
that any such records, reports, and bills received in response
to Commission subpoena are certified to be true and correct.
This paragraph does not restrict, limit, or prevent the
admissibility of records, reports, or bills that are otherwise
admissible. This provision does not apply to reports prepared
by treating providers for use in litigation.

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The Commission at its expense shall provide an official
court reporter to take the testimony and record of proceedings
at the hearings before an Arbitrator or the Commission, who
shall furnish a transcript of such testimony or proceedings to
either party requesting it, upon payment therefor at the rate
of $1.00 per page for the original and 35 cents per page for
each copy of such transcript. Payment for photostatic copies of
exhibits shall be extra. If the Commission has determined, as
provided in Section 20 of this Act, that the employee is a poor
person, a transcript of such testimony and proceedings,
including photostatic copies of exhibits, shall be furnished to
such employee at the Commission's expense.
The Commission shall have the power to determine the
reasonableness and fix the amount of any fee of compensation
charged by any person, including attorneys, physicians,
surgeons and hospitals, for any service performed in connection
with this Act, or for which payment is to be made under this
Act or rendered in securing any right under this Act.
Whenever the Commission shall find that the employer, his
or her agent, service company or insurance carrier has been
guilty of delay or unfairness towards an employee in the
adjustment, settlement or payment of benefits due such employee
within the purview of the provisions of paragraph (c) of
Section 4 of this Act; or has been guilty of unreasonable or
vexatious delay, intentional under-payment of compensation
benefits, or has engaged in frivolous defenses which do not

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present a real controversy, within the purview of the
provisions of paragraph (k) of Section 19 of this Act, the
Commission may assess all or any part of the attorney's fees
and costs against such employer and his or her insurance
carrier.
(Source: P.A. 94-277, eff. 7-20-05.)
(820 ILCS 305/19) (from Ch. 48, par. 138.19)
Sec. 19. Any disputed questions of law or fact shall be
determined as herein provided.
(a) It shall be the duty of the Commission upon
notification that the parties have failed to reach an
agreement, to designate an Arbitrator.
1. Whenever any claimant misconceives his remedy and
files an application for adjustment of claim under this Act
and it is subsequently discovered, at any time before final
disposition of such cause, that the claim for disability or
death which was the basis for such application should
properly have been made under the Workers' Occupational
Diseases Act, then the provisions of Section 19, paragraph
(a-1) of the Workers' Occupational Diseases Act having
reference to such application shall apply.
2. Whenever any claimant misconceives his remedy and
files an application for adjustment of claim under the
Workers' Occupational Diseases Act and it is subsequently
discovered, at any time before final disposition of such

HB2883 - 77 - LRB097 10781 AEK 51211 b
cause that the claim for injury or death which was the
basis for such application should properly have been made
under this Act, then the application so filed under the
Workers' Occupational Diseases Act may be amended in form,
substance or both to assert claim for such disability or
death under this Act and it shall be deemed to have been so
filed as amended on the date of the original filing
thereof, and such compensation may be awarded as is
warranted by the whole evidence pursuant to this Act. When
such amendment is submitted, further or additional
evidence may be heard by the Arbitrator or Commission when
deemed necessary. Nothing in this Section contained shall
be construed to be or permit a waiver of any provisions of
this Act with reference to notice but notice if given shall
be deemed to be a notice under the provisions of this Act
if given within the time required herein.
(b) The Arbitrator shall make such inquiries and
investigations as he or they shall deem necessary and may
examine and inspect all books, papers, records, places, or
premises relating to the questions in dispute and hear such
proper evidence as the parties may submit.
The hearings before the Arbitrator shall be held in the
vicinity where the injury occurred after 10 days' notice of the
time and place of such hearing shall have been given to each of
the parties or their attorneys of record.
The Arbitrator may find that the disabling condition is

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temporary and has not yet reached a permanent condition and may
order the payment of compensation up to the date of the
hearing, which award shall be reviewable and enforceable in the
same manner as other awards, and in no instance be a bar to a
further hearing and determination of a further amount of
temporary total compensation or of compensation for permanent
disability, but shall be conclusive as to all other questions
except the nature and extent of said disability.
The decision of the Arbitrator shall be filed with the
Commission which Commission shall immediately send to each
party or his attorney a copy of such decision, together with a
notification of the time when it was filed. As of the effective
date of this amendatory Act of the 94th General Assembly, all
decisions of the Arbitrator shall set forth in writing findings
of fact and conclusions of law, separately stated, if requested
by either party. Unless a petition for review is filed by
either party within 30 days after the receipt by such party of
the copy of the decision and notification of time when filed,
and unless such party petitioning for a review shall within 35
days after the receipt by him of the copy of the decision, file
with the Commission either an agreed statement of the facts
appearing upon the hearing before the Arbitrator, or if such
party shall so elect a correct transcript of evidence of the
proceedings at such hearings, then the decision shall become
the decision of the Commission and in the absence of fraud
shall be conclusive. The Petition for Review shall contain a

HB2883 - 79 - LRB097 10781 AEK 51211 b
statement of the petitioning party's specific exceptions to the
decision of the arbitrator. The jurisdiction of the Commission
to review the decision of the arbitrator shall not be limited
to the exceptions stated in the Petition for Review. The
Commission, or any member thereof, may grant further time not
exceeding 30 days, in which to file such agreed statement or
transcript of evidence. Such agreed statement of facts or
correct transcript of evidence, as the case may be, shall be
authenticated by the signatures of the parties or their
attorneys, and in the event they do not agree as to the
correctness of the transcript of evidence it shall be
authenticated by the signature of the Arbitrator designated by
the Commission.
Whether the employee is working or not, if the employee is
not receiving or has not received medical, surgical, or
hospital services or other services or compensation as provided
in paragraph (a) of Section 8, or compensation as provided in
paragraph (b) of Section 8, the employee may at any time
petition for an expedited hearing by an Arbitrator on the issue
of whether or not he or she is entitled to receive payment of
the services or compensation. Provided the employer continues
to pay compensation pursuant to paragraph (b) of Section 8, the
employer may at any time petition for an expedited hearing on
the issue of whether or not the employee is entitled to receive
medical, surgical, or hospital services or other services or
compensation as provided in paragraph (a) of Section 8, or

HB2883 - 80 - LRB097 10781 AEK 51211 b
compensation as provided in paragraph (b) of Section 8. When an
employer has petitioned for an expedited hearing, the employer
shall continue to pay compensation as provided in paragraph (b)
of Section 8 unless the arbitrator renders a decision that the
employee is not entitled to the benefits that are the subject
of the expedited hearing or unless the employee's treating
physician has released the employee to return to work at his or
her regular job with the employer or the employee actually
returns to work at any other job. If the arbitrator renders a
decision that the employee is not entitled to the benefits that
are the subject of the expedited hearing, a petition for review
filed by the employee shall receive the same priority as if the
employee had filed a petition for an expedited hearing by an
Arbitrator. Neither party shall be entitled to an expedited
hearing when the employee has returned to work and the sole
issue in dispute amounts to less than 12 weeks of unpaid
compensation pursuant to paragraph (b) of Section 8.
Expedited hearings shall have priority over all other
petitions and shall be heard by the Arbitrator and Commission
with all convenient speed. Any party requesting an expedited
hearing shall give notice of a request for an expedited hearing
under this paragraph. A copy of the Application for Adjustment
of Claim shall be attached to the notice. The Commission shall
adopt rules and procedures under which the final decision of
the Commission under this paragraph is filed not later than 180
days from the date that the Petition for Review is filed with

HB2883 - 81 - LRB097 10781 AEK 51211 b
the Commission.
Where 2 or more insurance carriers, private self-insureds,
or a group workers' compensation pool under Article V 3/4 of
the Illinois Insurance Code dispute coverage for the same
injury, any such insurance carrier, private self-insured, or
group workers' compensation pool may request an expedited
hearing pursuant to this paragraph to determine the issue of
coverage, provided coverage is the only issue in dispute and
all other issues are stipulated and agreed to and further
provided that all compensation benefits including medical
benefits pursuant to Section 8(a) continue to be paid to or on
behalf of petitioner. Any insurance carrier, private
self-insured, or group workers' compensation pool that is
determined to be liable for coverage for the injury in issue
shall reimburse any insurance carrier, private self-insured,
or group workers' compensation pool that has paid benefits to
or on behalf of petitioner for the injury.
(b-1) If the employee is not receiving medical, surgical or
hospital services as provided in paragraph (a) of Section 8 or
compensation as provided in paragraph (b) of Section 8, the
employee, in accordance with Commission Rules, may file a
petition for an emergency hearing by an Arbitrator on the issue
of whether or not he is entitled to receive payment of such
compensation or services as provided therein. Such petition
shall have priority over all other petitions and shall be heard
by the Arbitrator and Commission with all convenient speed.

HB2883 - 82 - LRB097 10781 AEK 51211 b
Such petition shall contain the following information and
shall be served on the employer at least 15 days before it is
filed:
(i) the date and approximate time of accident;
(ii) the approximate location of the accident;
(iii) a description of the accident;
(iv) the nature of the injury incurred by the employee;
(v) the identity of the person, if known, to whom the
accident was reported and the date on which it was
reported;
(vi) the name and title of the person, if known,
representing the employer with whom the employee conferred
in any effort to obtain compensation pursuant to paragraph
(b) of Section 8 of this Act or medical, surgical or
hospital services pursuant to paragraph (a) of Section 8 of
this Act and the date of such conference;
(vii) a statement that the employer has refused to pay
compensation pursuant to paragraph (b) of Section 8 of this
Act or for medical, surgical or hospital services pursuant
to paragraph (a) of Section 8 of this Act;
(viii) the name and address, if known, of each witness
to the accident and of each other person upon whom the
employee will rely to support his allegations;
(ix) the dates of treatment related to the accident by
medical practitioners, and the names and addresses of such
practitioners, including the dates of treatment related to

HB2883 - 83 - LRB097 10781 AEK 51211 b
the accident at any hospitals and the names and addresses
of such hospitals, and a signed authorization permitting
the employer to examine all medical records of all
practitioners and hospitals named pursuant to this
paragraph;
(x) a copy of a signed report by a medical
practitioner, relating to the employee's current inability
to return to work because of the injuries incurred as a
result of the accident or such other documents or
affidavits which show that the employee is entitled to
receive compensation pursuant to paragraph (b) of Section 8
of this Act or medical, surgical or hospital services
pursuant to paragraph (a) of Section 8 of this Act. Such
reports, documents or affidavits shall state, if possible,
the history of the accident given by the employee, and
describe the injury and medical diagnosis, the medical
services for such injury which the employee has received
and is receiving, the physical activities which the
employee cannot currently perform as a result of any
impairment or disability due to such injury, and the
prognosis for recovery;
(xi) complete copies of any reports, records,
documents and affidavits in the possession of the employee
on which the employee will rely to support his allegations,
provided that the employer shall pay the reasonable cost of
reproduction thereof;

HB2883 - 84 - LRB097 10781 AEK 51211 b
(xii) a list of any reports, records, documents and
affidavits which the employee has demanded by subpoena and
on which he intends to rely to support his allegations;
(xiii) a certification signed by the employee or his
representative that the employer has received the petition
with the required information 15 days before filing.
Fifteen days after receipt by the employer of the petition
with the required information the employee may file said
petition and required information and shall serve notice of the
filing upon the employer. The employer may file a motion
addressed to the sufficiency of the petition. If an objection
has been filed to the sufficiency of the petition, the
arbitrator shall rule on the objection within 2 working days.
If such an objection is filed, the time for filing the final
decision of the Commission as provided in this paragraph shall
be tolled until the arbitrator has determined that the petition
is sufficient.
The employer shall, within 15 days after receipt of the
notice that such petition is filed, file with the Commission
and serve on the employee or his representative a written
response to each claim set forth in the petition, including the
legal and factual basis for each disputed allegation and the
following information: (i) complete copies of any reports,
records, documents and affidavits in the possession of the
employer on which the employer intends to rely in support of
his response, (ii) a list of any reports, records, documents

HB2883 - 85 - LRB097 10781 AEK 51211 b
and affidavits which the employer has demanded by subpoena and
on which the employer intends to rely in support of his
response, (iii) the name and address of each witness on whom
the employer will rely to support his response, and (iv) the
names and addresses of any medical practitioners selected by
the employer pursuant to Section 12 of this Act and the time
and place of any examination scheduled to be made pursuant to
such Section.
Any employer who does not timely file and serve a written
response without good cause may not introduce any evidence to
dispute any claim of the employee but may cross examine the
employee or any witness brought by the employee and otherwise
be heard.
No document or other evidence not previously identified by
either party with the petition or written response, or by any
other means before the hearing, may be introduced into evidence
without good cause. If, at the hearing, material information is
discovered which was not previously disclosed, the Arbitrator
may extend the time for closing proof on the motion of a party
for a reasonable period of time which may be more than 30 days.
No evidence may be introduced pursuant to this paragraph as to
permanent disability. No award may be entered for permanent
disability pursuant to this paragraph. Either party may
introduce into evidence the testimony taken by deposition of
any medical practitioner.
The Commission shall adopt rules, regulations and

HB2883 - 86 - LRB097 10781 AEK 51211 b
procedures whereby the final decision of the Commission is
filed not later than 90 days from the date the petition for
review is filed but in no event later than 180 days from the
date the petition for an emergency hearing is filed with the
Illinois Workers' Compensation Commission.
All service required pursuant to this paragraph (b-1) must
be by personal service or by certified mail and with evidence
of receipt. In addition for the purposes of this paragraph, all
service on the employer must be at the premises where the
accident occurred if the premises are owned or operated by the
employer. Otherwise service must be at the employee's principal
place of employment by the employer. If service on the employer
is not possible at either of the above, then service shall be
at the employer's principal place of business. After initial
service in each case, service shall be made on the employer's
attorney or designated representative.
(c) (1) At a reasonable time in advance of and in
connection with the hearing under Section 19(e) or 19(h), the
Commission may on its own motion order an impartial physical or
mental examination of a petitioner whose mental or physical
condition is in issue, when in the Commission's discretion it
appears that such an examination will materially aid in the
just determination of the case. The examination shall be made
by a member or members of a panel of physicians chosen for
their special qualifications by the Illinois State Medical
Society. The Commission shall establish procedures by which a

HB2883 - 87 - LRB097 10781 AEK 51211 b
physician shall be selected from such list.
(2) Should the Commission at any time during the hearing
find that compelling considerations make it advisable to have
an examination and report at that time, the commission may in
its discretion so order.
(3) A copy of the report of examination shall be given to
the Commission and to the attorneys for the parties.
(4) Either party or the Commission may call the examining
physician or physicians to testify. Any physician so called
shall be subject to cross-examination.
(5) The examination shall be made, and the physician or
physicians, if called, shall testify, without cost to the
parties. The Commission shall determine the compensation and
the pay of the physician or physicians. The compensation for
this service shall not exceed the usual and customary amount
for such service.
(6) The fees and payment thereof of all attorneys and
physicians for services authorized by the Commission under this
Act shall, upon request of either the employer or the employee
or the beneficiary affected, be subject to the review and
decision of the Commission.
(d) If any employee shall persist in insanitary or
injurious practices which tend to either imperil or retard his
recovery or shall refuse to submit to such medical, surgical,
or hospital treatment as is reasonably essential to promote his
recovery, the Commission may, in its discretion, reduce or

HB2883 - 88 - LRB097 10781 AEK 51211 b
suspend the compensation of any such injured employee. However,
when an employer and employee so agree in writing, the
foregoing provision shall not be construed to authorize the
reduction or suspension of compensation of an employee who is
relying in good faith, on treatment by prayer or spiritual
means alone, in accordance with the tenets and practice of a
recognized church or religious denomination, by a duly
accredited practitioner thereof.
(e) This paragraph shall apply to all hearings before the
Commission. Such hearings may be held in its office or
elsewhere as the Commission may deem advisable. The taking of
testimony on such hearings may be had before any member of the
Commission. If a petition for review and agreed statement of
facts or transcript of evidence is filed, as provided herein,
the Commission shall promptly review the decision of the
Arbitrator and all questions of law or fact which appear from
the statement of facts or transcript of evidence.
In all cases in which the hearing before the arbitrator is
held after December 18, 1989, no additional evidence shall be
introduced by the parties before the Commission on review of
the decision of the Arbitrator. In reviewing decisions of an
arbitrator the Commission shall award such temporary
compensation, permanent compensation and other payments as are
due under this Act. The Commission shall file in its office its
decision thereon, and shall immediately send to each party or
his attorney a copy of such decision and a notification of the

HB2883 - 89 - LRB097 10781 AEK 51211 b
time when it was filed. Decisions shall be filed within 60 days
after the Statement of Exceptions and Supporting Brief and
Response thereto are required to be filed or oral argument
whichever is later.
In the event either party requests oral argument, such
argument shall be had before a panel of 3 members of the
Commission (or before all available members pursuant to the
determination of 7 members of the Commission that such argument
be held before all available members of the Commission)
pursuant to the rules and regulations of the Commission. A
panel of 3 members, which shall be comprised of not more than
one representative citizen of the employing class and not more
than one representative citizen of the employee class, shall
hear the argument; provided that if all the issues in dispute
are solely the nature and extent of the permanent partial
disability, if any, a majority of the panel may deny the
request for such argument and such argument shall not be held;
and provided further that 7 members of the Commission may
determine that the argument be held before all available
members of the Commission. A decision of the Commission shall
be approved by a majority of Commissioners present at such
hearing if any; provided, if no such hearing is held, a
decision of the Commission shall be approved by a majority of a
panel of 3 members of the Commission as described in this
Section. The Commission shall give 10 days' notice to the
parties or their attorneys of the time and place of such taking

HB2883 - 90 - LRB097 10781 AEK 51211 b
of testimony and of such argument.
In any case the Commission in its decision may find
specially upon any question or questions of law or fact which
shall be submitted in writing by either party whether ultimate
or otherwise; provided that on issues other than nature and
extent of the disability, if any, the Commission in its
decision shall find specially upon any question or questions of
law or fact, whether ultimate or otherwise, which are submitted
in writing by either party; provided further that not more than
5 such questions may be submitted by either party. Any party
may, within 20 days after receipt of notice of the Commission's
decision, or within such further time, not exceeding 30 days,
as the Commission may grant, file with the Commission either an
agreed statement of the facts appearing upon the hearing, or,
if such party shall so elect, a correct transcript of evidence
of the additional proceedings presented before the Commission,
in which report the party may embody a correct statement of
such other proceedings in the case as such party may desire to
have reviewed, such statement of facts or transcript of
evidence to be authenticated by the signature of the parties or
their attorneys, and in the event that they do not agree, then
the authentication of such transcript of evidence shall be by
the signature of any member of the Commission.
If a reporter does not for any reason furnish a transcript
of the proceedings before the Arbitrator in any case for use on
a hearing for review before the Commission, within the

HB2883 - 91 - LRB097 10781 AEK 51211 b
limitations of time as fixed in this Section, the Commission
may, in its discretion, order a trial de novo before the
Commission in such case upon application of either party. The
applications for adjustment of claim and other documents in the
nature of pleadings filed by either party, together with the
decisions of the Arbitrator and of the Commission and the
statement of facts or transcript of evidence hereinbefore
provided for in paragraphs (b) and (c) shall be the record of
the proceedings of the Commission, and shall be subject to
review as hereinafter provided.
At the request of either party or on its own motion, the
Commission shall set forth in writing the reasons for the
decision, including findings of fact and conclusions of law
separately stated. The Commission shall by rule adopt a format
for written decisions for the Commission and arbitrators. The
written decisions shall be concise and shall succinctly state
the facts and reasons for the decision. The Commission may
adopt in whole or in part, the decision of the arbitrator as
the decision of the Commission. When the Commission does so
adopt the decision of the arbitrator, it shall do so by order.
Whenever the Commission adopts part of the arbitrator's
decision, but not all, it shall include in the order the
reasons for not adopting all of the arbitrator's decision. When
a majority of a panel, after deliberation, has arrived at its
decision, the decision shall be filed as provided in this
Section without unnecessary delay, and without regard to the

HB2883 - 92 - LRB097 10781 AEK 51211 b
fact that a member of the panel has expressed an intention to
dissent. Any member of the panel may file a dissent. Any
dissent shall be filed no later than 10 days after the decision
of the majority has been filed.
Decisions rendered by the Commission and dissents, if any,
shall be published together by the Commission. The conclusions
of law set out in such decisions shall be regarded as
precedents by arbitrators for the purpose of achieving a more
uniform administration of this Act.
(f) The decision of the Commission acting within its
powers, according to the provisions of paragraph (e) of this
Section shall, in the absence of fraud, be conclusive unless
reviewed as in this paragraph hereinafter provided. However,
the Arbitrator or the Commission may on his or its own motion,
or on the motion of either party, correct any clerical error or
errors in computation within 15 days after the date of receipt
of any award by such Arbitrator or any decision on review of
the Commission and shall have the power to recall the original
award on arbitration or decision on review, and issue in lieu
thereof such corrected award or decision. Where such correction
is made the time for review herein specified shall begin to run
from the date of the receipt of the corrected award or
decision.
(1) Except in cases of claims against the State of
Illinois, in which case the decision of the Commission
shall not be subject to judicial review, the Circuit Court

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of the county where any of the parties defendant may be
found, or if none of the parties defendant can be found in
this State then the Circuit Court of the county where the
accident occurred, shall by summons to the Commission have
power to review all questions of law and fact presented by
such record.
A proceeding for review shall be commenced within 20
days of the receipt of notice of the decision of the
Commission. The summons shall be issued by the clerk of
such court upon written request returnable on a designated
return day, not less than 10 or more than 60 days from the
date of issuance thereof, and the written request shall
contain the last known address of other parties in interest
and their attorneys of record who are to be served by
summons. Service upon any member of the Commission or the
Secretary or the Assistant Secretary thereof shall be
service upon the Commission, and service upon other parties
in interest and their attorneys of record shall be by
summons, and such service shall be made upon the Commission
and other parties in interest by mailing notices of the
commencement of the proceedings and the return day of the
summons to the office of the Commission and to the last
known place of residence of other parties in interest or
their attorney or attorneys of record. The clerk of the
court issuing the summons shall on the day of issue mail
notice of the commencement of the proceedings which shall

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be done by mailing a copy of the summons to the office of
the Commission, and a copy of the summons to the other
parties in interest or their attorney or attorneys of
record and the clerk of the court shall make certificate
that he has so sent said notices in pursuance of this
Section, which shall be evidence of service on the
Commission and other parties in interest.
The Commission shall not be required to certify the
record of their proceedings to the Circuit Court, unless
the party commencing the proceedings for review in the
Circuit Court as above provided, shall pay to the
Commission the sum of 80� per page of testimony taken
before the Commission, and 35� per page of all other
matters contained in such record, except as otherwise
provided by Section 20 of this Act. Payment for photostatic
copies of exhibit shall be extra. It shall be the duty of
the Commission upon such payment, or failure to pay as
permitted under Section 20 of this Act, to prepare a true
and correct typewritten copy of such testimony and a true
and correct copy of all other matters contained in such
record and certified to by the Secretary or Assistant
Secretary thereof.
In its decision on review the Commission shall
determine in each particular case the amount of the
probable cost of the record to be filed as a part of the
summons in that case and no request for a summons may be

HB2883 - 95 - LRB097 10781 AEK 51211 b
filed and no summons shall issue unless the party seeking
to review the decision of the Commission shall exhibit to
the clerk of the Circuit Court proof of payment by filing a
receipt showing payment or an affidavit of the attorney
setting forth that payment has been made of the sums so
determined to the Secretary or Assistant Secretary of the
Commission, except as otherwise provided by Section 20 of
this Act.
(2) No such summons shall issue unless the one against
whom the Commission shall have rendered an award for the
payment of money shall upon the filing of his written
request for such summons file with the clerk of the court a
bond conditioned that if he shall not successfully
prosecute the review, he will pay the award and the costs
of the proceedings in the courts. The amount of the bond
shall be fixed by any member of the Commission and the
surety or sureties of the bond shall be approved by the
clerk of the court. The acceptance of the bond by the clerk
of the court shall constitute evidence of his approval of
the bond.
Every county, city, town, township, incorporated
village, school district, body politic or municipal
corporation against whom the Commission shall have
rendered an award for the payment of money shall not be
required to file a bond to secure the payment of the award
and the costs of the proceedings in the court to authorize

HB2883 - 96 - LRB097 10781 AEK 51211 b
the court to issue such summons.
The court may confirm or set aside the decision of the
Commission. If the decision is set aside and the facts
found in the proceedings before the Commission are
sufficient, the court may enter such decision as is
justified by law, or may remand the cause to the Commission
for further proceedings and may state the questions
requiring further hearing, and give such other
instructions as may be proper. Appeals shall be taken to
the Appellate Court in accordance with Supreme Court Rules
22(g) and 303. Appeals shall be taken from the Appellate
Court to the Supreme Court in accordance with Supreme Court
Rule 315.
It shall be the duty of the clerk of any court
rendering a decision affecting or affirming an award of the
Commission to promptly furnish the Commission with a copy
of such decision, without charge.
The decision of a majority of the members of the panel
of the Commission, shall be considered the decision of the
Commission.
(g) Except in the case of a claim against the State of
Illinois, either party may present a certified copy of the
award of the Arbitrator, or a certified copy of the decision of
the Commission when the same has become final, when no
proceedings for review are pending, providing for the payment
of compensation according to this Act, to the Circuit Court of

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

HB2883 - 98 - LRB097 10781 AEK 51211 b
after such agreement or award be reviewed by the Commission at
the request of either the employer or the employee, on the
ground that the disability of the employee has subsequently
recurred, increased, diminished or ended.
However, as to accidents occurring subsequent to July 1,
1955, which are covered by any agreement or award under this
Act providing for compensation in installments made as a result
of such accident, such agreement or award may at any time
within 30 months, or 60 months in the case of an award under
Section 8(d)1, after such agreement or award be reviewed by the
Commission at the request of either the employer or the
employee on the ground that the disability of the employee has
subsequently recurred, increased, diminished or ended. The
employer at any time may seek review by the Commission of any
final award under Section 8(d)1 of this Act where there is a
material increase in earnings by the employee.
On such review, compensation payments may be
re-established, increased, diminished or ended. The Commission
shall give 15 days' notice to the parties of the hearing for
review. Any employee, upon any petition for such review being
filed by the employer, shall be entitled to one day's notice
for each 100 miles necessary to be traveled by him in attending
the hearing of the Commission upon the petition, and 3 days in
addition thereto. Such employee shall, at the discretion of the
Commission, also be entitled to 5 cents per mile necessarily
traveled by him within the State of Illinois in attending such

HB2883 - 99 - LRB097 10781 AEK 51211 b
hearing, not to exceed a distance of 300 miles, to be taxed by
the Commission as costs and deposited with the petition of the
employer.
When compensation which is payable in accordance with an
award or settlement contract approved by the Commission, is
ordered paid in a lump sum by the Commission, no review shall
be had as in this paragraph mentioned.
(i) Each party, upon taking any proceedings or steps
whatsoever before any Arbitrator, Commission or court, shall
file with the Commission his address, or the name and address
of any agent upon whom all notices to be given to such party
shall be served, either personally or by registered mail,
addressed to such party or agent at the last address so filed
with the Commission. In the event such party has not filed his
address, or the name and address of an agent as above provided,
service of any notice may be had by filing such notice with the
Commission.
(j) Whenever in any proceeding testimony has been taken or
a final decision has been rendered and after the taking of such
testimony or after such decision has become final, the injured
employee dies, then in any subsequent proceedings brought by
the personal representative or beneficiaries of the deceased
employee, such testimony in the former proceeding may be
introduced with the same force and effect as though the witness
having so testified were present in person in such subsequent
proceedings and such final decision, if any, shall be taken as

HB2883 - 100 - LRB097 10781 AEK 51211 b
final adjudication of any of the issues which are the same in
both proceedings.
(k) In case where there has been any unreasonable or
vexatious delay of payment or intentional underpayment of
compensation, or proceedings have been instituted or carried on
by the one liable to pay the compensation, which do not present
a real controversy, but are merely frivolous or for delay, then
the Commission may award compensation additional to that
otherwise payable under this Act equal to 50% of the amount
payable at the time of such award. Failure to pay compensation
in accordance with the provisions of Section 8, paragraph (b)
of this Act, shall be considered unreasonable delay.
When determining whether this subsection (k) shall apply,
the Commission shall consider whether an Arbitrator has
determined that the claim is not compensable or whether the
employer has made payments under Section 8(j).
(l) If the employee has made written demand for payment of
benefits under Section 8(a) or Section 8(b), the employer shall
have 14 days after receipt of the demand to set forth in
writing the reason for the delay. In the case of demand for
payment of medical benefits under Section 8(a), the time for
the employer to respond shall not commence until the expiration
of the allotted 60 days specified under Section 8.2(d). In case
the employer or his or her insurance carrier shall without good
and just cause fail, neglect, refuse, or unreasonably delay the
payment of benefits under Section 8(a) or Section 8(b), the

HB2883 - 101 - LRB097 10781 AEK 51211 b
Arbitrator or the Commission shall allow to the employee
additional compensation in the sum of $30 per day for each day
that the benefits under Section 8(a) or Section 8(b) have been
so withheld or refused, not to exceed $10,000. A delay in
payment of 14 days or more shall create a rebuttable
presumption of unreasonable delay.
(m) If the commission finds that an accidental injury was
directly and proximately caused by the employer's wilful
violation of a health and safety standard under the Health and
Safety Act in force at the time of the accident, the arbitrator
or the Commission shall allow to the injured employee or his
dependents, as the case may be, additional compensation equal
to 25% of the amount which otherwise would be payable under the
provisions of this Act exclusive of this paragraph. The
additional compensation herein provided shall be allowed by an
appropriate increase in the applicable weekly compensation
rate.
(n) After June 30, 1984, decisions of the Illinois Workers'
Compensation Commission reviewing an award of an arbitrator of
the Commission shall draw interest at a rate equal to the yield
on indebtedness issued by the United States Government with a
26-week maturity next previously auctioned on the day on which
the decision is filed. Said rate of interest shall be set forth
in the Arbitrator's Decision. Interest shall be drawn from the
date of the arbitrator's award on all accrued compensation due
the employee through the day prior to the date of payments.

HB2883 - 102 - LRB097 10781 AEK 51211 b
However, when an employee appeals an award of an Arbitrator or
the Commission, and the appeal results in no change or a
decrease in the award, interest shall not further accrue from
the date of such appeal.
The employer or his insurance carrier may tender the
payments due under the award to stop the further accrual of
interest on such award notwithstanding the prosecution by
either party of review, certiorari, appeal to the Supreme Court
or other steps to reverse, vacate or modify the award.
(o) By the 15th day of each month each insurer providing
coverage for losses under this Act shall notify each insured
employer of any compensable claim incurred during the preceding
month and the amounts paid or reserved on the claim including a
summary of the claim and a brief statement of the reasons for
compensability. A cumulative report of all claims incurred
during a calendar year or continued from the previous year
shall be furnished to the insured employer by the insurer
within 30 days after the end of that calendar year.
The insured employer may challenge, in proceeding before
the Commission, payments made by the insurer without
arbitration and payments made after a case is determined to be
noncompensable. If the Commission finds that the case was not
compensable, the insurer shall purge its records as to that
employer of any loss or expense associated with the claim,
reimburse the employer for attorneys' fees arising from the
challenge and for any payment required of the employer to the

HB2883 - 103 - LRB097 10781 AEK 51211 b
Rate Adjustment Fund or the Second Injury Fund, and may not
reflect the loss or expense for rate making purposes. The
employee shall not be required to refund the challenged
payment. The decision of the Commission may be reviewed in the
same manner as in arbitrated cases. No challenge may be
initiated under this paragraph more than 3 years after the
payment is made. An employer may waive the right of challenge
under this paragraph on a case by case basis.
(p) After filing an application for adjustment of claim but
prior to the hearing on arbitration the parties may voluntarily
agree to submit such application for adjustment of claim for
decision by an arbitrator under this subsection (p) where such
application for adjustment of claim raises only a dispute over
temporary total disability, permanent partial disability or
medical expenses. Such agreement shall be in writing in such
form as provided by the Commission. Applications for adjustment
of claim submitted for decision by an arbitrator under this
subsection (p) shall proceed according to rule as established
by the Commission. The Commission shall promulgate rules
including, but not limited to, rules to ensure that the parties
are adequately informed of their rights under this subsection
(p) and of the voluntary nature of proceedings under this
subsection (p). The findings of fact made by an arbitrator
acting within his or her powers under this subsection (p) in
the absence of fraud shall be conclusive. However, the
arbitrator may on his own motion, or the motion of either

HB2883 - 104 - LRB097 10781 AEK 51211 b
party, correct any clerical errors or errors in computation
within 15 days after the date of receipt of such award of the
arbitrator and shall have the power to recall the original
award on arbitration, and issue in lieu thereof such corrected
award. The decision of the arbitrator under this subsection (p)
shall be considered the decision of the Commission and
proceedings for review of questions of law arising from the
decision may be commenced by either party pursuant to
subsection (f) of Section 19. The Advisory Board established
under Section 13.1 shall compile a list of certified Commission
arbitrators, each of whom shall be approved by at least 7
members of the Advisory Board. The chairman shall select 5
persons from such list to serve as arbitrators under this
subsection (p). By agreement, the parties shall select one
arbitrator from among the 5 persons selected by the chairman
except that if the parties do not agree on an arbitrator from
among the 5 persons, the parties may, by agreement, select an
arbitrator of the American Arbitration Association, whose fee
shall be paid by the State in accordance with rules promulgated
by the Commission. Arbitration under this subsection (p) shall
be voluntary.
(Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05.)
HB2883 - 105 - LRB097 10781 AEK 51211 b
INDEX
Statutes amended in order of appearance