Bill Text: IL HB0076 | 2011-2012 | 97th General Assembly | Introduced

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Bill Title: Amends the Workers' Compensation Act. Provides that claimants shall be notified of the specific reason for a denial to pay medical expenses. Provides that if the specific reason is not given, the claim should not be given the rebuttable presumption that the employer shall not be responsible for payment of additional compensation if that denial or refusal to authorize complies with a utilization review program. Increases daily and total additional compensation allowed when an employer or his or her insurance carrier, without good and just cause, fail, neglect, refuse, or unreasonably delay the payment of medical or compensation benefits due. Effective January 1, 2012.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-01-08 - Session Sine Die [HB0076 Detail]

Download: Illinois-2011-HB0076-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 HB0076 Introduced , by Rep. Naomi D. Jakobsson SYNOPSIS AS INTRODUCED:
820 ILCS 305/8.7
820 ILCS 305/19 from Ch. 48, par. 138.19
Amends the Workers' Compensation Act. Provides that claimants shall be notified of the specific reason for a denial to pay medical expenses. Provides that if the specific reason is not given, the claim should not be given the rebuttable presumption that the employer shall not be responsible for payment of additional compensation if that denial or refusal to authorize complies with a utilization review program. Increases daily and total additional compensation allowed when an employer or his or her insurance carrier, without good and just cause, fail, neglect, refuse, or unreasonably delay the payment of medical or compensation benefits due. Effective January 1, 2012.
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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 8.7 and 19 as follows:
(820 ILCS 305/8.7)
Sec. 8.7. Utilization review programs.
(a) As used in this Section:
"Utilization review" means the evaluation of proposed or
provided health care services to determine the appropriateness
of both the level of health care services medically necessary
and the quality of health care services provided to a patient,
including evaluation of their efficiency, efficacy, and
appropriateness of treatment, hospitalization, or office
visits based on medically accepted standards. The evaluation
must be accomplished by means of a system that identifies the
utilization of health care services based on standards of care
or nationally recognized peer review guidelines as well as
nationally recognized 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

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sentence, retrospective review shall be applicable to services
rendered on or after July 20, 2005). Nothing in this Section
applies to prospective review of necessary first aid or
emergency treatment.
(b) No person may conduct a utilization review program for
workers' compensation services in this State unless once every
2 years the person registers the utilization review program
with the Department of 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 Secretary of 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

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

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Only a health care professional may make determinations
regarding the medical necessity of health care services during
the course of utilization review.
When making retrospective reviews, utilization review
programs shall base reviews solely on the medical information
available to the attending physician or ordering provider at
the time the health care services were provided.
(f) If the Department of 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 Secretary of Financial and Professional Regulation

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may by rule establish a registration fee for each person
conducting a utilization review program.
(i) A utilization review will be considered by the
Commission, along with all 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

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pursuant to Section 19(k) of this Act.
(k) 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, the employer shall
notify the claimant of the denial in writing and such
notification shall include the specific reason for the denial.
Any claim for which the employer has not communicated a
specific reason for the denial shall not be considered denied
under this Section.
(Source: P.A. 94-277, eff. 7-20-05; 94-695, eff. 11-16-05.)
(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.

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2. Whenever any claimant misconceives his remedy and
files an application for adjustment of claim under the
Workers' Occupational Diseases Act and it is subsequently
discovered, at any time before final disposition of such
cause that the claim for injury or death which was the
basis for such application should properly have been made
under this Act, then the application so filed under the
Workers' Occupational Diseases Act may be amended in form,
substance or both to assert claim for such disability or
death under this Act and it shall be deemed to have been so
filed as amended on the date of the original filing
thereof, and such compensation may be awarded as is
warranted by the whole evidence pursuant to this Act. When
such amendment is submitted, further or additional
evidence may be heard by the Arbitrator or Commission when
deemed necessary. Nothing in this Section contained shall
be construed to be or permit a waiver of any provisions of
this Act with reference to notice but notice if given shall
be deemed to be a notice under the provisions of this Act
if given within the time required herein.
(b) The Arbitrator shall make such inquiries and
investigations as he or they shall deem necessary and may
examine and inspect all books, papers, records, places, or
premises relating to the questions in dispute and hear such
proper evidence as the parties may submit.
The hearings before the Arbitrator shall be held in the

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vicinity where the injury occurred after 10 days' notice of the
time and place of such hearing shall have been given to each of
the parties or their attorneys of record.
The Arbitrator may find that the disabling condition is
temporary and has not yet reached a permanent condition and may
order the payment of compensation up to the date of the
hearing, which award shall be reviewable and enforceable in the
same manner as other awards, and in no instance be a bar to a
further hearing and determination of a further amount of
temporary total compensation or of compensation for permanent
disability, but shall be conclusive as to all other questions
except the nature and extent of said disability.
The decision of the Arbitrator shall be filed with the
Commission which Commission shall immediately send to each
party or his attorney a copy of such decision, together with a
notification of the time when it was filed. As of the effective
date of this amendatory Act of the 94th General Assembly, all
decisions of the Arbitrator shall set forth in writing findings
of fact and conclusions of law, separately stated, if requested
by either party. Unless a petition for review is filed by
either party within 30 days after the receipt by such party of
the copy of the decision and notification of time when filed,
and unless such party petitioning for a review shall within 35
days after the receipt by him of the copy of the decision, file
with the Commission either an agreed statement of the facts
appearing upon the hearing before the Arbitrator, or if such

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

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employer may at any time petition for an expedited hearing on
the issue of whether or not the employee is entitled to receive
medical, surgical, or hospital services or other services or
compensation as provided in paragraph (a) of Section 8, or
compensation as provided in paragraph (b) of Section 8. When an
employer has petitioned for an expedited hearing, the employer
shall continue to pay compensation as provided in paragraph (b)
of Section 8 unless the arbitrator renders a decision that the
employee is not entitled to the benefits that are the subject
of the expedited hearing or unless the employee's treating
physician has released the employee to return to work at his or
her regular job with the employer or the employee actually
returns to work at any other job. If the arbitrator renders a
decision that the employee is not entitled to the benefits that
are the subject of the expedited hearing, a petition for review
filed by the employee shall receive the same priority as if the
employee had filed a petition for an expedited hearing by an
Arbitrator. Neither party shall be entitled to an expedited
hearing when the employee has returned to work and the sole
issue in dispute amounts to less than 12 weeks of unpaid
compensation pursuant to paragraph (b) of Section 8.
Expedited hearings shall have priority over all other
petitions and shall be heard by the Arbitrator and Commission
with all convenient speed. Any party requesting an expedited
hearing shall give notice of a request for an expedited hearing
under this paragraph. A copy of the Application for Adjustment

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of Claim shall be attached to the notice. The Commission shall
adopt rules and procedures under which the final decision of
the Commission under this paragraph is filed not later than 180
days from the date that the Petition for Review is filed with
the Commission.
Where 2 or more insurance carriers, private self-insureds,
or a group workers' compensation pool under Article V 3/4 of
the Illinois Insurance Code dispute coverage for the same
injury, any such insurance carrier, private self-insured, or
group workers' compensation pool may request an expedited
hearing pursuant to this paragraph to determine the issue of
coverage, provided coverage is the only issue in dispute and
all other issues are stipulated and agreed to and further
provided that all compensation benefits including medical
benefits pursuant to Section 8(a) continue to be paid to or on
behalf of petitioner. Any insurance carrier, private
self-insured, or group workers' compensation pool that is
determined to be liable for coverage for the injury in issue
shall reimburse any insurance carrier, private self-insured,
or group workers' compensation pool that has paid benefits to
or on behalf of petitioner for the injury.
(b-1) If the employee is not receiving medical, surgical or
hospital services as provided in paragraph (a) of Section 8 or
compensation as provided in paragraph (b) of Section 8, the
employee, in accordance with Commission Rules, may file a
petition for an emergency hearing by an Arbitrator on the issue

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of whether or not he is entitled to receive payment of such
compensation or services as provided therein. Such petition
shall have priority over all other petitions and shall be heard
by the Arbitrator and Commission with all convenient speed.
Such petition shall contain the following information and
shall be served on the employer at least 15 days before it is
filed:
(i) the date and approximate time of accident;
(ii) the approximate location of the accident;
(iii) a description of the accident;
(iv) the nature of the injury incurred by the employee;
(v) the identity of the person, if known, to whom the
accident was reported and the date on which it was
reported;
(vi) the name and title of the person, if known,
representing the employer with whom the employee conferred
in any effort to obtain compensation pursuant to paragraph
(b) of Section 8 of this Act or medical, surgical or
hospital services pursuant to paragraph (a) of Section 8 of
this Act and the date of such conference;
(vii) a statement that the employer has refused to pay
compensation pursuant to paragraph (b) of Section 8 of this
Act or for medical, surgical or hospital services pursuant
to paragraph (a) of Section 8 of this Act;
(viii) the name and address, if known, of each witness
to the accident and of each other person upon whom the

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

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

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following information: (i) complete copies of any reports,
records, documents and affidavits in the possession of the
employer on which the employer intends to rely in support of
his response, (ii) a list of any reports, records, documents
and affidavits which the employer has demanded by subpoena and
on which the employer intends to rely in support of his
response, (iii) the name and address of each witness on whom
the employer will rely to support his response, and (iv) the
names and addresses of any medical practitioners selected by
the employer pursuant to Section 12 of this Act and the time
and place of any examination scheduled to be made pursuant to
such Section.
Any employer who does not timely file and serve a written
response without good cause may not introduce any evidence to
dispute any claim of the employee but may cross examine the
employee or any witness brought by the employee and otherwise
be heard.
No document or other evidence not previously identified by
either party with the petition or written response, or by any
other means before the hearing, may be introduced into evidence
without good cause. If, at the hearing, material information is
discovered which was not previously disclosed, the Arbitrator
may extend the time for closing proof on the motion of a party
for a reasonable period of time which may be more than 30 days.
No evidence may be introduced pursuant to this paragraph as to
permanent disability. No award may be entered for permanent

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disability pursuant to this paragraph. Either party may
introduce into evidence the testimony taken by deposition of
any medical practitioner.
The Commission shall adopt rules, regulations and
procedures whereby the final decision of the Commission is
filed not later than 90 days from the date the petition for
review is filed but in no event later than 180 days from the
date the petition for an emergency hearing is filed with the
Illinois Workers' Compensation Commission.
All service required pursuant to this paragraph (b-1) must
be by personal service or by certified mail and with evidence
of receipt. In addition for the purposes of this paragraph, all
service on the employer must be at the premises where the
accident occurred if the premises are owned or operated by the
employer. Otherwise service must be at the employee's principal
place of employment by the employer. If service on the employer
is not possible at either of the above, then service shall be
at the employer's principal place of business. After initial
service in each case, service shall be made on the employer's
attorney or designated representative.
(c) (1) At a reasonable time in advance of and in
connection with the hearing under Section 19(e) or 19(h), the
Commission may on its own motion order an impartial physical or
mental examination of a petitioner whose mental or physical
condition is in issue, when in the Commission's discretion it
appears that such an examination will materially aid in the

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just determination of the case. The examination shall be made
by a member or members of a panel of physicians chosen for
their special qualifications by the Illinois State Medical
Society. The Commission shall establish procedures by which a
physician shall be selected from such list.
(2) Should the Commission at any time during the hearing
find that compelling considerations make it advisable to have
an examination and report at that time, the commission may in
its discretion so order.
(3) A copy of the report of examination shall be given to
the Commission and to the attorneys for the parties.
(4) Either party or the Commission may call the examining
physician or physicians to testify. Any physician so called
shall be subject to cross-examination.
(5) The examination shall be made, and the physician or
physicians, if called, shall testify, without cost to the
parties. The Commission shall determine the compensation and
the pay of the physician or physicians. The compensation for
this service shall not exceed the usual and customary amount
for such service.
(6) The fees and payment thereof of all attorneys and
physicians for services authorized by the Commission under this
Act shall, upon request of either the employer or the employee
or the beneficiary affected, be subject to the review and
decision of the Commission.
(d) If any employee shall persist in insanitary or

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injurious practices which tend to either imperil or retard his
recovery or shall refuse to submit to such medical, surgical,
or hospital treatment as is reasonably essential to promote his
recovery, the Commission may, in its discretion, reduce or
suspend the compensation of any such injured employee. However,
when an employer and employee so agree in writing, the
foregoing provision shall not be construed to authorize the
reduction or suspension of compensation of an employee who is
relying in good faith, on treatment by prayer or spiritual
means alone, in accordance with the tenets and practice of a
recognized church or religious denomination, by a duly
accredited practitioner thereof.
(e) This paragraph shall apply to all hearings before the
Commission. Such hearings may be held in its office or
elsewhere as the Commission may deem advisable. The taking of
testimony on such hearings may be had before any member of the
Commission. If a petition for review and agreed statement of
facts or transcript of evidence is filed, as provided herein,
the Commission shall promptly review the decision of the
Arbitrator and all questions of law or fact which appear from
the statement of facts or transcript of evidence.
In all cases in which the hearing before the arbitrator is
held after December 18, 1989, no additional evidence shall be
introduced by the parties before the Commission on review of
the decision of the Arbitrator. In reviewing decisions of an
arbitrator the Commission shall award such temporary

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compensation, permanent compensation and other payments as are
due under this Act. The Commission shall file in its office its
decision thereon, and shall immediately send to each party or
his attorney a copy of such decision and a notification of the
time when it was filed. Decisions shall be filed within 60 days
after the Statement of Exceptions and Supporting Brief and
Response thereto are required to be filed or oral argument
whichever is later.
In the event either party requests oral argument, such
argument shall be had before a panel of 3 members of the
Commission (or before all available members pursuant to the
determination of 7 members of the Commission that such argument
be held before all available members of the Commission)
pursuant to the rules and regulations of the Commission. A
panel of 3 members, which shall be comprised of not more than
one representative citizen of the employing class and not more
than one representative citizen of the employee class, shall
hear the argument; provided that if all the issues in dispute
are solely the nature and extent of the permanent partial
disability, if any, a majority of the panel may deny the
request for such argument and such argument shall not be held;
and provided further that 7 members of the Commission may
determine that the argument be held before all available
members of the Commission. A decision of the Commission shall
be approved by a majority of Commissioners present at such
hearing if any; provided, if no such hearing is held, a

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decision of the Commission shall be approved by a majority of a
panel of 3 members of the Commission as described in this
Section. The Commission shall give 10 days' notice to the
parties or their attorneys of the time and place of such taking
of testimony and of such argument.
In any case the Commission in its decision may find
specially upon any question or questions of law or fact which
shall be submitted in writing by either party whether ultimate
or otherwise; provided that on issues other than nature and
extent of the disability, if any, the Commission in its
decision shall find specially upon any question or questions of
law or fact, whether ultimate or otherwise, which are submitted
in writing by either party; provided further that not more than
5 such questions may be submitted by either party. Any party
may, within 20 days after receipt of notice of the Commission's
decision, or within such further time, not exceeding 30 days,
as the Commission may grant, file with the Commission either an
agreed statement of the facts appearing upon the hearing, or,
if such party shall so elect, a correct transcript of evidence
of the additional proceedings presented before the Commission,
in which report the party may embody a correct statement of
such other proceedings in the case as such party may desire to
have reviewed, such statement of facts or transcript of
evidence to be authenticated by the signature of the parties or
their attorneys, and in the event that they do not agree, then
the authentication of such transcript of evidence shall be by

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the signature of any member of the Commission.
If a reporter does not for any reason furnish a transcript
of the proceedings before the Arbitrator in any case for use on
a hearing for review before the Commission, within the
limitations of time as fixed in this Section, the Commission
may, in its discretion, order a trial de novo before the
Commission in such case upon application of either party. The
applications for adjustment of claim and other documents in the
nature of pleadings filed by either party, together with the
decisions of the Arbitrator and of the Commission and the
statement of facts or transcript of evidence hereinbefore
provided for in paragraphs (b) and (c) shall be the record of
the proceedings of the Commission, and shall be subject to
review as hereinafter provided.
At the request of either party or on its own motion, the
Commission shall set forth in writing the reasons for the
decision, including findings of fact and conclusions of law
separately stated. The Commission shall by rule adopt a format
for written decisions for the Commission and arbitrators. The
written decisions shall be concise and shall succinctly state
the facts and reasons for the decision. The Commission may
adopt in whole or in part, the decision of the arbitrator as
the decision of the Commission. When the Commission does so
adopt the decision of the arbitrator, it shall do so by order.
Whenever the Commission adopts part of the arbitrator's
decision, but not all, it shall include in the order the

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reasons for not adopting all of the arbitrator's decision. When
a majority of a panel, after deliberation, has arrived at its
decision, the decision shall be filed as provided in this
Section without unnecessary delay, and without regard to the
fact that a member of the panel has expressed an intention to
dissent. Any member of the panel may file a dissent. Any
dissent shall be filed no later than 10 days after the decision
of the majority has been filed.
Decisions rendered by the Commission and dissents, if any,
shall be published together by the Commission. The conclusions
of law set out in such decisions shall be regarded as
precedents by arbitrators for the purpose of achieving a more
uniform administration of this Act.
(f) The decision of the Commission acting within its
powers, according to the provisions of paragraph (e) of this
Section shall, in the absence of fraud, be conclusive unless
reviewed as in this paragraph hereinafter provided. However,
the Arbitrator or the Commission may on his or its own motion,
or on the motion of either party, correct any clerical error or
errors in computation within 15 days after the date of receipt
of any award by such Arbitrator or any decision on review of
the Commission and shall have the power to recall the original
award on arbitration or decision on review, and issue in lieu
thereof such corrected award or decision. Where such correction
is made the time for review herein specified shall begin to run
from the date of the receipt of the corrected award or

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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
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

HB0076 - 24 - LRB097 03120 AEK 43155 b
known place of residence of other parties in interest or
their attorney or attorneys of record. The clerk of the
court issuing the summons shall on the day of issue mail
notice of the commencement of the proceedings which shall
be done by mailing a copy of the summons to the office of
the Commission, and a copy of the summons to the other
parties in interest or their attorney or attorneys of
record and the clerk of the court shall make certificate
that he has so sent said notices in pursuance of this
Section, which shall be evidence of service on the
Commission and other parties in interest.
The Commission shall not be required to certify the
record of their proceedings to the Circuit Court, unless
the party commencing the proceedings for review in the
Circuit Court as above provided, shall pay to the
Commission the sum of 80¢ per page of testimony taken
before the Commission, and 35¢ per page of all other
matters contained in such record, except as otherwise
provided by Section 20 of this Act. Payment for photostatic
copies of exhibit shall be extra. It shall be the duty of
the Commission upon such payment, or failure to pay as
permitted under Section 20 of this Act, to prepare a true
and correct typewritten copy of such testimony and a true
and correct copy of all other matters contained in such
record and certified to by the Secretary or Assistant
Secretary thereof.

HB0076 - 25 - LRB097 03120 AEK 43155 b
In its decision on review the Commission shall
determine in each particular case the amount of the
probable cost of the record to be filed as a part of the
summons in that case and no request for a summons may be
filed and no summons shall issue unless the party seeking
to review the decision of the Commission shall exhibit to
the clerk of the Circuit Court proof of payment by filing a
receipt showing payment or an affidavit of the attorney
setting forth that payment has been made of the sums so
determined to the Secretary or Assistant Secretary of the
Commission, except as otherwise provided by Section 20 of
this Act.
(2) No such summons shall issue unless the one against
whom the Commission shall have rendered an award for the
payment of money shall upon the filing of his written
request for such summons file with the clerk of the court a
bond conditioned that if he shall not successfully
prosecute the review, he will pay the award and the costs
of the proceedings in the courts. The amount of the bond
shall be fixed by any member of the Commission and the
surety or sureties of the bond shall be approved by the
clerk of the court. The acceptance of the bond by the clerk
of the court shall constitute evidence of his approval of
the bond.
Every county, city, town, township, incorporated
village, school district, body politic or municipal

HB0076 - 26 - LRB097 03120 AEK 43155 b
corporation against whom the Commission shall have
rendered an award for the payment of money shall not be
required to file a bond to secure the payment of the award
and the costs of the proceedings in the court to authorize
the court to issue such summons.
The court may confirm or set aside the decision of the
Commission. If the decision is set aside and the facts
found in the proceedings before the Commission are
sufficient, the court may enter such decision as is
justified by law, or may remand the cause to the Commission
for further proceedings and may state the questions
requiring further hearing, and give such other
instructions as may be proper. Appeals shall be taken to
the Appellate Court in accordance with Supreme Court Rules
22(g) and 303. Appeals shall be taken from the Appellate
Court to the Supreme Court in accordance with Supreme Court
Rule 315.
It shall be the duty of the clerk of any court
rendering a decision affecting or affirming an award of the
Commission to promptly furnish the Commission with a copy
of such decision, without charge.
The decision of a majority of the members of the panel
of the Commission, shall be considered the decision of the
Commission.
(g) Except in the case of a claim against the State of
Illinois, either party may present a certified copy of the

HB0076 - 27 - LRB097 03120 AEK 43155 b
award of the Arbitrator, or a certified copy of the decision of
the Commission when the same has become final, when no
proceedings for review are pending, providing for the payment
of compensation according to this Act, to the Circuit Court of
the county in which such accident occurred or either of the
parties are residents, whereupon the court shall enter a
judgment in accordance therewith. In a case where the employer
refuses to pay compensation according to such final award or
such final decision upon which such judgment is entered the
court shall in entering judgment thereon, tax as costs against
him the reasonable costs and attorney fees in the arbitration
proceedings and in the court entering the judgment for the
person in whose favor the judgment is entered, which judgment
and costs taxed as therein provided shall, until and unless set
aside, have the same effect as though duly entered in an action
duly tried and determined by the court, and shall with like
effect, be entered and docketed. The Circuit Court shall have
power at any time upon application to make any such judgment
conform to any modification required by any subsequent decision
of the Supreme Court upon appeal, or as the result of any
subsequent proceedings for review, as provided in this Act.
Judgment shall not be entered until 15 days' notice of the
time and place of the application for the entry of judgment
shall be served upon the employer by filing such notice with
the Commission, which Commission shall, in case it has on file
the address of the employer or the name and address of its

HB0076 - 28 - LRB097 03120 AEK 43155 b
agent upon whom notices may be served, immediately send a copy
of the notice to the employer or such designated agent.
(h) An agreement or award under this Act providing for
compensation in installments, may at any time within 18 months
after such agreement or award be reviewed by the Commission at
the request of either the employer or the employee, on the
ground that the disability of the employee has subsequently
recurred, increased, diminished or ended.
However, as to accidents occurring subsequent to July 1,
1955, which are covered by any agreement or award under this
Act providing for compensation in installments made as a result
of such accident, such agreement or award may at any time
within 30 months, or 60 months in the case of an award under
Section 8(d)1, after such agreement or award be reviewed by the
Commission at the request of either the employer or the
employee on the ground that the disability of the employee has
subsequently recurred, increased, diminished or ended.
On such review, compensation payments may be
re-established, increased, diminished or ended. The Commission
shall give 15 days' notice to the parties of the hearing for
review. Any employee, upon any petition for such review being
filed by the employer, shall be entitled to one day's notice
for each 100 miles necessary to be traveled by him in attending
the hearing of the Commission upon the petition, and 3 days in
addition thereto. Such employee shall, at the discretion of the
Commission, also be entitled to 5 cents per mile necessarily

HB0076 - 29 - LRB097 03120 AEK 43155 b
traveled by him within the State of Illinois in attending such
hearing, not to exceed a distance of 300 miles, to be taxed by
the Commission as costs and deposited with the petition of the
employer.
When compensation which is payable in accordance with an
award or settlement contract approved by the Commission, is
ordered paid in a lump sum by the Commission, no review shall
be had as in this paragraph mentioned.
(i) Each party, upon taking any proceedings or steps
whatsoever before any Arbitrator, Commission or court, shall
file with the Commission his address, or the name and address
of any agent upon whom all notices to be given to such party
shall be served, either personally or by registered mail,
addressed to such party or agent at the last address so filed
with the Commission. In the event such party has not filed his
address, or the name and address of an agent as above provided,
service of any notice may be had by filing such notice with the
Commission.
(j) Whenever in any proceeding testimony has been taken or
a final decision has been rendered and after the taking of such
testimony or after such decision has become final, the injured
employee dies, then in any subsequent proceedings brought by
the personal representative or beneficiaries of the deceased
employee, such testimony in the former proceeding may be
introduced with the same force and effect as though the witness
having so testified were present in person in such subsequent

HB0076 - 30 - LRB097 03120 AEK 43155 b
proceedings and such final decision, if any, shall be taken as
final adjudication of any of the issues which are the same in
both proceedings.
(k) In case where there has been any unreasonable or
vexatious delay of payment or intentional underpayment of
compensation, or proceedings have been instituted or carried on
by the one liable to pay the compensation, which do not present
a real controversy, but are merely frivolous or for delay, then
the Commission may award compensation additional to that
otherwise payable under this Act equal to 50% of the amount
payable at the time of such award. Failure to pay compensation
in accordance with the provisions of Section 8, paragraph (b)
of this Act, shall be considered unreasonable delay.
When determining whether this subsection (k) shall apply,
the Commission shall consider whether an Arbitrator has
determined that the claim is not compensable or whether the
employer has made payments under Section 8(j).
(l) If the employee has made written demand for payment of
benefits under Section 8(a) or Section 8(b), the employer shall
have 14 days after receipt of the demand to set forth in
writing the reason for the delay. In the case of demand for
payment of medical benefits under Section 8(a), the time for
the employer to respond shall not commence until the expiration
of the allotted 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

HB0076 - 31 - LRB097 03120 AEK 43155 b
payment of benefits under Section 8(a) or Section 8(b), the
Arbitrator or the Commission shall allow to the employee
additional compensation in the sum of $100 $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 $33,000 $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

HB0076 - 32 - LRB097 03120 AEK 43155 b
the employee through the day prior to the date of payments.
However, when an employee appeals an award of an Arbitrator or
the Commission, and the appeal results in no change or a
decrease in the award, interest shall not further accrue from
the date of such appeal.
The employer or his insurance carrier may tender the
payments due under the award to stop the further accrual of
interest on such award notwithstanding the prosecution by
either party of review, certiorari, appeal to the Supreme Court
or other steps to reverse, vacate or modify the award.
(o) By the 15th day of each month each insurer providing
coverage for losses under this Act shall notify each insured
employer of any compensable claim incurred during the preceding
month and the amounts paid or reserved on the claim including a
summary of the claim and a brief statement of the reasons for
compensability. A cumulative report of all claims incurred
during a calendar year or continued from the previous year
shall be furnished to the insured employer by the insurer
within 30 days after the end of that calendar year.
The insured employer may challenge, in proceeding before
the Commission, payments made by the insurer without
arbitration and payments made after a case is determined to be
noncompensable. If the Commission finds that the case was not
compensable, the insurer shall purge its records as to that
employer of any loss or expense associated with the claim,
reimburse the employer for attorneys' fees arising from the

HB0076 - 33 - LRB097 03120 AEK 43155 b
challenge and for any payment required of the employer to the
Rate Adjustment Fund or the Second Injury Fund, and may not
reflect the loss or expense for rate making purposes. The
employee shall not be required to refund the challenged
payment. The decision of the Commission may be reviewed in the
same manner as in arbitrated cases. No challenge may be
initiated under this paragraph more than 3 years after the
payment is made. An employer may waive the right of challenge
under this paragraph on a case by case basis.
(p) After filing an application for adjustment of claim but
prior to the hearing on arbitration the parties may voluntarily
agree to submit such application for adjustment of claim for
decision by an arbitrator under this subsection (p) where such
application for adjustment of claim raises only a dispute over
temporary total disability, permanent partial disability or
medical expenses. Such agreement shall be in writing in such
form as provided by the Commission. Applications for adjustment
of claim submitted for decision by an arbitrator under this
subsection (p) shall proceed according to rule as established
by the Commission. The Commission shall promulgate rules
including, but not limited to, rules to ensure that the parties
are adequately informed of their rights under this subsection
(p) and of the voluntary nature of proceedings under this
subsection (p). The findings of fact made by an arbitrator
acting within his or her powers under this subsection (p) in
the absence of fraud shall be conclusive. However, the

HB0076 - 34 - LRB097 03120 AEK 43155 b
arbitrator may on his own motion, or the motion of either
party, correct any clerical errors or errors in computation
within 15 days after the date of receipt of such award of the
arbitrator and shall have the power to recall the original
award on arbitration, and issue in lieu thereof such corrected
award. The decision of the arbitrator under this subsection (p)
shall be considered the decision of the Commission and
proceedings for review of questions of law arising from the
decision may be commenced by either party pursuant to
subsection (f) of Section 19. The Advisory Board established
under Section 13.1 shall compile a list of certified Commission
arbitrators, each of whom shall be approved by at least 7
members of the Advisory Board. The chairman shall select 5
persons from such list to serve as arbitrators under this
subsection (p). By agreement, the parties shall select one
arbitrator from among the 5 persons selected by the chairman
except that if the parties do not agree on an arbitrator from
among the 5 persons, the parties may, by agreement, select an
arbitrator of the American Arbitration Association, whose fee
shall be paid by the State in accordance with rules promulgated
by the Commission. Arbitration under this subsection (p) shall
be voluntary.
(Source: P.A. 93-721, eff. 1-1-05; 94-277, eff. 7-20-05.)
Section 99. Effective date. This Act takes effect January
1, 2012.