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Public Act 103-0590 | ||||
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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 Illinois Insurance Code is amended by | ||||
changing Section 416 as follows: | ||||
(215 ILCS 5/416) | ||||
Sec. 416. Illinois Workers' Compensation Commission | ||||
Operations Fund Surcharge. | ||||
(a) As of July 30, 2004 (the effective date of Public Act | ||||
93-840), every company licensed or authorized by the Illinois | ||||
Department of Insurance and insuring employers' liabilities | ||||
arising under the Workers' Compensation Act or the Workers' | ||||
Occupational Diseases Act shall remit to the Director a | ||||
surcharge based upon the annual direct written premium, as | ||||
reported under Section 136 of this Act, of the company in the | ||||
manner provided in this Section. Such proceeds shall be | ||||
deposited into the Illinois Workers' Compensation Commission | ||||
Operations Fund as established in the Workers' Compensation | ||||
Act. If a company survives or was formed by a merger, | ||||
consolidation, reorganization, or reincorporation, the direct | ||||
written premiums of all companies party to the merger, | ||||
consolidation, reorganization, or reincorporation shall, for | ||||
purposes of determining the amount of the fee imposed by this |
Section, be regarded as those of the surviving or new company. | ||
(b) Beginning (1) Except as provided in subsection (b)(2) | ||
of this Section, beginning on July 30, 2004 (the effective | ||
date of Public Act 93-840) and on July 1 of each year | ||
thereafter through 2023 , the Director shall charge an annual | ||
Illinois Workers' Compensation Commission Operations Fund | ||
Surcharge from every company subject to subsection (a) of this | ||
Section equal to 1.01% of its direct written premium for | ||
insuring employers' liabilities arising under the Workers' | ||
Compensation Act or Workers' Occupational Diseases Act as | ||
reported in each company's annual statement filed for the | ||
previous year as required by Section 136. Within 15 days after | ||
the effective date of this amendatory Act of the 103rd General | ||
Assembly and on July 1 of each year thereafter, the Director | ||
shall charge an annual Illinois Workers' Compensation | ||
Commission Operations Fund Surcharge from every company | ||
subject to subsection (a) of this Section equal to 1.092% of | ||
its direct written premium for insuring employers' liabilities | ||
arising under the Workers' Compensation Act or Workers' | ||
Occupational Diseases Act as reported in each company's annual | ||
statement filed for the previous year as required by Section | ||
136. The Illinois Workers' Compensation Commission Operations | ||
Fund Surcharge shall be collected by companies subject to | ||
subsection (a) of this Section as a separately stated | ||
surcharge on insured employers at the rate of 1.092% 1.01% of | ||
direct written premium for the surcharge due in 2024 and each |
year thereafter . The Illinois Workers' Compensation Commission | ||
Operations Fund Surcharge shall not be collected by companies | ||
subject to subsection (a) of this Section from any employer | ||
that self-insures its liabilities arising under the Workers' | ||
Compensation Act or Workers' Occupational Diseases Act, | ||
provided that the employer has paid the Illinois Workers' | ||
Compensation Commission Operations Fund Fee pursuant to | ||
Section 4d of the Workers' Compensation Act. All sums | ||
collected by the Department of Insurance under the provisions | ||
of this Section shall be paid promptly after the receipt of the | ||
same, accompanied by a detailed statement thereof, into the | ||
Illinois Workers' Compensation Commission Operations Fund in | ||
the State treasury. | ||
(b)(2) (Blank). The surcharge due pursuant to Public Act | ||
93-840 shall be collected instead of the surcharge due on July | ||
1, 2004 under Public Act 93-32. Payment of the surcharge due | ||
under Public Act 93-840 shall discharge the employer's | ||
obligations due on July 1, 2004. | ||
(c) In addition to the authority specifically granted | ||
under Article XXV of this Code, the Director shall have such | ||
authority to adopt rules or establish forms as may be | ||
reasonably necessary for purposes of enforcing this Section. | ||
The Director shall also have authority to defer, waive, or | ||
abate the surcharge or any penalties imposed by this Section | ||
if in the Director's opinion the company's solvency and | ||
ability to meet its insured obligations would be immediately |
threatened by payment of the surcharge due. | ||
(d) When a company fails to pay the full amount of any | ||
annual Illinois Workers' Compensation Commission Operations | ||
Fund Surcharge of $100 or more due under this Section, there | ||
shall be added to the amount due as a penalty an amount equal | ||
to 10% of the deficiency for each month or part of a month that | ||
the deficiency remains unpaid. | ||
(e) The Department of Insurance may enforce the collection | ||
of any delinquent payment, penalty, or portion thereof by | ||
legal action or in any other manner by which the collection of | ||
debts due the State of Illinois may be enforced under the laws | ||
of this State. | ||
(f) Whenever it appears to the satisfaction of the | ||
Director that a company has paid pursuant to this Act an | ||
Illinois Workers' Compensation Commission Operations Fund | ||
Surcharge in an amount in excess of the amount legally | ||
collectable from the company, the Director shall issue a | ||
credit memorandum for an amount equal to the amount of such | ||
overpayment. A credit memorandum may be applied for the 2-year | ||
period from the date of issuance, against the payment of any | ||
amount due during that period under the surcharge imposed by | ||
this Section or, subject to reasonable rule of the Department | ||
of Insurance including requirement of notification, may be | ||
assigned to any other company subject to regulation under this | ||
Act. Any application of credit memoranda after the period | ||
provided for in this Section is void. |
(g) Annually, the Governor may direct a transfer of up to | ||
2% of all moneys collected under this Section to the Insurance | ||
Financial Regulation Fund. | ||
(Source: P.A. 102-775, eff. 5-13-22.) | ||
Section 10. The Workers' Compensation Act is amended by | ||
changing Sections 4, 4a-5, 4d, 7, 19, and 25.5 as follows: | ||
(820 ILCS 305/4) (from Ch. 48, par. 138.4) | ||
(Text of Section from P.A. 101-40 and 102-37) | ||
Sec. 4. (a) Any employer, including but not limited to | ||
general contractors and their subcontractors, who shall come | ||
within the provisions of Section 3 of this Act, and any other | ||
employer who shall elect to provide and pay the compensation | ||
provided for in this Act shall: | ||
(1) File with the Commission annually an application | ||
for approval as a self-insurer which shall include a | ||
current financial statement, and annually, thereafter, an | ||
application for renewal of self-insurance, which shall | ||
include a current financial statement. Said application | ||
and financial statement shall be signed and sworn to by | ||
the president or vice president and secretary or assistant | ||
secretary of the employer if it be a corporation, or by all | ||
of the partners, if it be a copartnership, or by the owner | ||
if it be neither a copartnership nor a corporation. All | ||
initial applications and all applications for renewal of |
self-insurance must be submitted at least 60 days prior to | ||
the requested effective date of self-insurance. An | ||
employer may elect to provide and pay compensation as | ||
provided for in this Act as a member of a group workers' | ||
compensation pool under Article V 3/4 of the Illinois | ||
Insurance Code. If an employer becomes a member of a group | ||
workers' compensation pool, the employer shall not be | ||
relieved of any obligations imposed by this Act. | ||
If the sworn application and financial statement of | ||
any such employer does not satisfy the Commission of the | ||
financial ability of the employer who has filed it, the | ||
Commission shall require such employer to, | ||
(2) Furnish security, indemnity or a bond guaranteeing | ||
the payment by the employer of the compensation provided | ||
for in this Act, provided that any such employer whose | ||
application and financial statement shall not have | ||
satisfied the commission of his or her financial ability | ||
and who shall have secured his liability in part by excess | ||
liability insurance shall be required to furnish to the | ||
Commission security, indemnity or bond guaranteeing his or | ||
her payment up to the effective limits of the excess | ||
coverage, or | ||
(3) Insure his entire liability to pay such | ||
compensation in some insurance carrier authorized, | ||
licensed, or permitted to do such insurance business in | ||
this State. Every policy of an insurance carrier, insuring |
the payment of compensation under this Act shall cover all | ||
the employees and the entire compensation liability of the | ||
insured: Provided, however, that any employer may insure | ||
his or her compensation liability with 2 or more insurance | ||
carriers or may insure a part and qualify under subsection | ||
1, 2, or 4 for the remainder of his or her liability to pay | ||
such compensation, subject to the following two | ||
provisions: | ||
Firstly, the entire compensation liability of the | ||
employer to employees working at or from one location | ||
shall be insured in one such insurance carrier or | ||
shall be self-insured, and | ||
Secondly, the employer shall submit evidence | ||
satisfactorily to the Commission that his or her | ||
entire liability for the compensation provided for in | ||
this Act will be secured. Any provisions in any | ||
policy, or in any endorsement attached thereto, | ||
attempting to limit or modify in any way, the | ||
liability of the insurance carriers issuing the same | ||
except as otherwise provided herein shall be wholly | ||
void. | ||
Nothing herein contained shall apply to policies of | ||
excess liability carriage secured by employers who have | ||
been approved by the Commission as self-insurers, or | ||
(4) Make some other provision, satisfactory to the | ||
Commission, for the securing of the payment of |
compensation provided for in this Act, and | ||
(5) Upon becoming subject to this Act and thereafter | ||
as often as the Commission may in writing demand, file | ||
with the Commission in form prescribed by it evidence of | ||
his or her compliance with the provision of this Section. | ||
(a-1) Regardless of its state of domicile or its principal | ||
place of business, an employer shall make payments to its | ||
insurance carrier or group self-insurance fund, where | ||
applicable, based upon the premium rates of the situs where | ||
the work or project is located in Illinois if: | ||
(A) the employer is engaged primarily in the building | ||
and construction industry; and | ||
(B) subdivision (a)(3) of this Section applies to the | ||
employer or the employer is a member of a group | ||
self-insurance plan as defined in subsection (1) of | ||
Section 4a. | ||
The Illinois Workers' Compensation Commission shall impose | ||
a penalty upon an employer for violation of this subsection | ||
(a-1) if: | ||
(i) the employer is given an opportunity at a hearing | ||
to present evidence of its compliance with this subsection | ||
(a-1); and | ||
(ii) after the hearing, the Commission finds that the | ||
employer failed to make payments upon the premium rates of | ||
the situs where the work or project is located in | ||
Illinois. |
The penalty shall not exceed $1,000 for each day of work | ||
for which the employer failed to make payments upon the | ||
premium rates of the situs where the work or project is located | ||
in Illinois, but the total penalty shall not exceed $50,000 | ||
for each project or each contract under which the work was | ||
performed. | ||
Any penalty under this subsection (a-1) must be imposed | ||
not later than one year after the expiration of the applicable | ||
limitation period specified in subsection (d) of Section 6 of | ||
this Act. Penalties imposed under this subsection (a-1) shall | ||
be deposited into the Illinois Workers' Compensation | ||
Commission Operations Fund, a special fund that is created in | ||
the State treasury. Subject to appropriation, moneys in the | ||
Fund shall be used solely for the operations of the Illinois | ||
Workers' Compensation Commission, the salaries and benefits of | ||
the Self-Insurers Advisory Board employees, the operating | ||
costs of the Self-Insurers Advisory Board, and by the | ||
Department of Insurance for the purposes authorized in | ||
subsection (c) of Section 25.5 of this Act. | ||
(a-2) Every Employee Leasing Company (ELC), as defined in | ||
Section 15 of the Employee Leasing Company Act, shall at a | ||
minimum provide the following information to the Commission or | ||
any entity designated by the Commission regarding each | ||
workers' compensation insurance policy issued to the ELC: | ||
(1) Any client company of the ELC listed as an | ||
additional named insured. |
(2) Any informational schedule attached to the master | ||
policy that identifies any individual client company's | ||
name, FEIN, and job location. | ||
(3) Any certificate of insurance coverage document | ||
issued to a client company specifying its rights and | ||
obligations under the master policy that establishes both | ||
the identity and status of the client, as well as the dates | ||
of inception and termination of coverage, if applicable. | ||
(b) The sworn application and financial statement, or | ||
security, indemnity or bond, or amount of insurance, or other | ||
provisions, filed, furnished, carried, or made by the | ||
employer, as the case may be, shall be subject to the approval | ||
of the Commission. | ||
Deposits under escrow agreements shall be cash, negotiable | ||
United States government bonds or negotiable general | ||
obligation bonds of the State of Illinois. Such cash or bonds | ||
shall be deposited in escrow with any State or National Bank or | ||
Trust Company having trust authority in the State of Illinois. | ||
Upon the approval of the sworn application and financial | ||
statement, security, indemnity or bond or amount of insurance, | ||
filed, furnished or carried, as the case may be, the | ||
Commission shall send to the employer written notice of its | ||
approval thereof. The certificate of compliance by the | ||
employer with the provisions of subparagraphs (2) and (3) of | ||
paragraph (a) of this Section shall be delivered by the | ||
insurance carrier to the Illinois Workers' Compensation |
Commission within five days after the effective date of the | ||
policy so certified. The insurance so certified shall cover | ||
all compensation liability occurring during the time that the | ||
insurance is in effect and no further certificate need be | ||
filed in case such insurance is renewed, extended or otherwise | ||
continued by such carrier. The insurance so certified shall | ||
not be cancelled or in the event that such insurance is not | ||
renewed, extended or otherwise continued, such insurance shall | ||
not be terminated until at least 10 days after receipt by the | ||
Illinois Workers' Compensation Commission of notice of the | ||
cancellation or termination of said insurance; provided, | ||
however, that if the employer has secured insurance from | ||
another insurance carrier, or has otherwise secured the | ||
payment of compensation in accordance with this Section, and | ||
such insurance or other security becomes effective prior to | ||
the expiration of the 10 days, cancellation or termination | ||
may, at the option of the insurance carrier indicated in such | ||
notice, be effective as of the effective date of such other | ||
insurance or security. | ||
(c) Whenever the Commission shall find that any | ||
corporation, company, association, aggregation of individuals, | ||
reciprocal or interinsurers exchange, or other insurer | ||
effecting workers' compensation insurance in this State shall | ||
be insolvent, financially unsound, or unable to fully meet all | ||
payments and liabilities assumed or to be assumed for | ||
compensation insurance in this State, or shall practice a |
policy of delay or unfairness toward employees in the | ||
adjustment, settlement, or payment of benefits due such | ||
employees, the Commission may after reasonable notice and | ||
hearing order and direct that such corporation, company, | ||
association, aggregation of individuals, reciprocal or | ||
interinsurers exchange, or insurer, shall from and after a | ||
date fixed in such order discontinue the writing of any such | ||
workers' compensation insurance in this State. Subject to such | ||
modification of the order as the Commission may later make on | ||
review of the order, as herein provided, it shall thereupon be | ||
unlawful for any such corporation, company, association, | ||
aggregation of individuals, reciprocal or interinsurers | ||
exchange, or insurer to effect any workers' compensation | ||
insurance in this State. A copy of the order shall be served | ||
upon the Director of Insurance by registered mail. Whenever | ||
the Commission finds that any service or adjustment company | ||
used or employed by a self-insured employer or by an insurance | ||
carrier to process, adjust, investigate, compromise or | ||
otherwise handle claims under this Act, has practiced or is | ||
practicing a policy of delay or unfairness toward employees in | ||
the adjustment, settlement or payment of benefits due such | ||
employees, the Commission may after reasonable notice and | ||
hearing order and direct that such service or adjustment | ||
company shall from and after a date fixed in such order be | ||
prohibited from processing, adjusting, investigating, | ||
compromising or otherwise handling claims under this Act. |
Whenever the Commission finds that any self-insured | ||
employer has practiced or is practicing delay or unfairness | ||
toward employees in the adjustment, settlement or payment of | ||
benefits due such employees, the Commission may, after | ||
reasonable notice and hearing, order and direct that after a | ||
date fixed in the order such self-insured employer shall be | ||
disqualified to operate as a self-insurer and shall be | ||
required to insure his entire liability to pay compensation in | ||
some insurance carrier authorized, licensed and permitted to | ||
do such insurance business in this State, as provided in | ||
subparagraph 3 of paragraph (a) of this Section. | ||
All orders made by the Commission under this Section shall | ||
be subject to review by the courts, said review to be taken in | ||
the same manner and within the same time as provided by Section | ||
19 of this Act for review of awards and decisions of the | ||
Commission, upon the party seeking the review filing with the | ||
clerk of the court to which said review is taken a bond in an | ||
amount to be fixed and approved by the court to which the | ||
review is taken, conditioned upon the payment of all | ||
compensation awarded against the person taking said review | ||
pending a decision thereof and further conditioned upon such | ||
other obligations as the court may impose. Upon the review the | ||
Circuit Court shall have power to review all questions of fact | ||
as well as of law. The penalty hereinafter provided for in this | ||
paragraph shall not attach and shall not begin to run until the | ||
final determination of the order of the Commission. |
(d) Whenever a Commissioner, with due process and after a | ||
hearing, determines an employer has knowingly failed to | ||
provide coverage as required by paragraph (a) of this Section, | ||
the failure shall be deemed an immediate serious danger to | ||
public health, safety, and welfare sufficient to justify | ||
service by the Commission of a work-stop order on such | ||
employer, requiring the cessation of all business operations | ||
of such employer at the place of employment or job site. If a | ||
business is declared to be extra hazardous, as defined in | ||
Section 3, a Commissioner may issue an emergency work-stop | ||
order on such an employer ex parte, prior to holding a hearing, | ||
requiring the cessation of all business operations of such | ||
employer at the place of employment or job site while awaiting | ||
the ruling of the Commission. Whenever a Commissioner issues | ||
an emergency work-stop order, the Commission shall issue a | ||
notice of emergency work-stop hearing to be posted at the | ||
employer's places of employment and job sites. Any law | ||
enforcement agency in the State shall, at the request of the | ||
Commission, render any assistance necessary to carry out the | ||
provisions of this Section, including, but not limited to, | ||
preventing any employee of such employer from remaining at a | ||
place of employment or job site after a work-stop order has | ||
taken effect. Any work-stop order shall be lifted upon proof | ||
of insurance as required by this Act. Any orders under this | ||
Section are appealable under Section 19(f) to the Circuit | ||
Court. |
Any individual employer, corporate officer or director of | ||
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who knowingly | ||
fails to provide coverage as required by paragraph (a) of this | ||
Section is guilty of a Class 4 felony. This provision shall not | ||
apply to any corporate officer or director of any | ||
publicly-owned corporation. Each day's violation constitutes a | ||
separate offense. The State's Attorney of the county in which | ||
the violation occurred, or the Attorney General, shall bring | ||
such actions in the name of the People of the State of | ||
Illinois, or may, in addition to other remedies provided in | ||
this Section, bring an action for an injunction to restrain | ||
the violation or to enjoin the operation of any such employer. | ||
Any individual employer, corporate officer or director of | ||
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who | ||
negligently fails to provide coverage as required by paragraph | ||
(a) of this Section is guilty of a Class A misdemeanor. This | ||
provision shall not apply to any corporate officer or director | ||
of any publicly-owned corporation. Each day's violation | ||
constitutes a separate offense. The State's Attorney of the | ||
county in which the violation occurred, or the Attorney | ||
General, shall bring such actions in the name of the People of | ||
the State of Illinois. | ||
The criminal penalties in this subsection (d) shall not | ||
apply where there exists a good faith dispute as to the |
existence of an employment relationship. Evidence of good | ||
faith shall include, but not be limited to, compliance with | ||
the definition of employee as used by the Internal Revenue | ||
Service. | ||
All investigative actions must be acted upon within 90 | ||
days of the issuance of the complaint. Employers who are | ||
subject to and who knowingly fail to comply with this Section | ||
shall not be entitled to the benefits of this Act during the | ||
period of noncompliance, but shall be liable in an action | ||
under any other applicable law of this State. In the action, | ||
such employer shall not avail himself or herself of the | ||
defenses of assumption of risk or negligence or that the | ||
injury was due to a co-employee. In the action, proof of the | ||
injury shall constitute prima facie evidence of negligence on | ||
the part of such employer and the burden shall be on such | ||
employer to show freedom of negligence resulting in the | ||
injury. The employer shall not join any other defendant in any | ||
such civil action. Nothing in this amendatory Act of the 94th | ||
General Assembly shall affect the employee's rights under | ||
subdivision (a)3 of Section 1 of this Act. Any employer or | ||
carrier who makes payments under subdivision (a)3 of Section 1 | ||
of this Act shall have a right of reimbursement from the | ||
proceeds of any recovery under this Section. | ||
An employee of an uninsured employer, or the employee's | ||
dependents in case death ensued, may, instead of proceeding | ||
against the employer in a civil action in court, file an |
application for adjustment of claim with the Commission in | ||
accordance with the provisions of this Act and the Commission | ||
shall hear and determine the application for adjustment of | ||
claim in the manner in which other claims are heard and | ||
determined before the Commission. | ||
All proceedings under this subsection (d) shall be | ||
reported on an annual basis to the Workers' Compensation | ||
Advisory Board. | ||
An investigator with the Department of Insurance may issue | ||
a citation to any employer that is not in compliance with its | ||
obligation to have workers' compensation insurance under this | ||
Act. The amount of the fine shall be based on the period of | ||
time the employer was in non-compliance, but shall be no less | ||
than $500, and shall not exceed $10,000. An employer that has | ||
been issued a citation shall pay the fine to the Department of | ||
Insurance and provide to the Department of Insurance proof | ||
that it obtained the required workers' compensation insurance | ||
within 10 days after the citation was issued. This Section | ||
does not affect any other obligations this Act imposes on | ||
employers. | ||
Upon a finding by the Commission, after reasonable notice | ||
and hearing, of the knowing and willful failure or refusal of | ||
an employer to comply with any of the provisions of paragraph | ||
(a) of this Section, the failure or refusal of an employer, | ||
service or adjustment company, or an insurance carrier to | ||
comply with any order of the Illinois Workers' Compensation |
Commission pursuant to paragraph (c) of this Section | ||
disqualifying him or her to operate as a self insurer and | ||
requiring him or her to insure his or her liability, or the | ||
knowing and willful failure of an employer to comply with a | ||
citation issued by an investigator with the Department of | ||
Insurance, the Commission may assess a civil penalty of up to | ||
$500 per day for each day of such failure or refusal after the | ||
effective date of this amendatory Act of 1989. The minimum | ||
penalty under this Section shall be the sum of $10,000. Each | ||
day of such failure or refusal shall constitute a separate | ||
offense. The Commission may assess the civil penalty | ||
personally and individually against the corporate officers and | ||
directors of a corporate employer, the partners of an employer | ||
partnership, and the members of an employer limited liability | ||
company, after a finding of a knowing and willful refusal or | ||
failure of each such named corporate officer, director, | ||
partner, or member to comply with this Section. The liability | ||
for the assessed penalty shall be against the named employer | ||
first, and if the named employer fails or refuses to pay the | ||
penalty to the Commission within 30 days after the final order | ||
of the Commission, then the named corporate officers, | ||
directors, partners, or members who have been found to have | ||
knowingly and willfully refused or failed to comply with this | ||
Section shall be liable for the unpaid penalty or any unpaid | ||
portion of the penalty. Upon investigation by the Department | ||
of Insurance, the Attorney General shall have the authority to |
prosecute all proceedings to enforce the civil and | ||
administrative provisions of this Section before the | ||
Commission. The Commission and the Department of Insurance | ||
shall promulgate procedural rules for enforcing this Section | ||
relating to their respective duties prescribed herein. | ||
If an employer is found to be in non-compliance with any | ||
provisions of paragraph (a) of this Section more than once, | ||
all minimum penalties will double. Therefore, upon the failure | ||
or refusal of an employer, service or adjustment company, or | ||
insurance carrier to comply with any order of the Commission | ||
pursuant to paragraph (c) of this Section disqualifying him or | ||
her to operate as a self-insurer and requiring him or her to | ||
insure his or her liability, or the knowing and willful | ||
failure of an employer to comply with a citation issued by an | ||
investigator with the Department of Insurance, the Commission | ||
may assess a civil penalty of up to $1,000 per day for each day | ||
of such failure or refusal after the effective date of this | ||
amendatory Act of the 101st General Assembly. The minimum | ||
penalty under this Section shall be the sum of $20,000. In | ||
addition, employers with 2 or more violations of any | ||
provisions of paragraph (a) of this Section may not | ||
self-insure for one year or until all penalties are paid. | ||
A Commission decision imposing penalties under this | ||
Section may be judicially reviewed only as described in | ||
Section 19(f). After expiration of the period for seeking | ||
judicial review, the Commission's final decision imposing |
penalties may be enforced in the same manner as a judgment | ||
entered by a court of competent jurisdiction. The Commission's | ||
final decision imposing penalties is a debt due and owing to | ||
the State and can be enforced to the same extent as a judgment | ||
entered by a circuit court. The Attorney General shall | ||
represent the Commission and the Department of Insurance in | ||
any action challenging the final decision in circuit court. If | ||
the court affirms the Commission's decision, the court shall | ||
enter judgment against the employer in the amount of the fines | ||
assessed by the Commission. The Attorney General shall make | ||
reasonable efforts to collect the amounts due under the | ||
Commission's decision. | ||
Upon the failure or refusal of any employer, service or | ||
adjustment company or insurance carrier to comply with the | ||
provisions of this Section and with the orders of the | ||
Commission under this Section, or the order of the court on | ||
review after final adjudication, the Commission may bring a | ||
civil action to recover the amount of the penalty in Cook | ||
County or in Sangamon County in which litigation the | ||
Commission shall be represented by the Attorney General. The | ||
Commission shall send notice of its finding of non-compliance | ||
and assessment of the civil penalty to the Attorney General. | ||
It shall be the duty of the Attorney General within 30 days | ||
after receipt of the notice, to institute prosecutions and | ||
promptly prosecute all reported violations of this Section. | ||
Any individual employer, corporate officer or director of |
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who, with the | ||
intent to avoid payment of compensation under this Act to an | ||
injured employee or the employee's dependents, knowingly | ||
transfers, sells, encumbers, assigns, or in any manner | ||
disposes of, conceals, secretes, or destroys any property | ||
belonging to the employer, officer, director, partner, or | ||
member is guilty of a Class 4 felony. | ||
Penalties and fines collected pursuant to this paragraph | ||
(d) shall be deposited upon receipt into a special fund which | ||
shall be designated the Injured Workers' Benefit Fund, of | ||
which the State Treasurer is ex-officio custodian, such | ||
special fund to be held and disbursed in accordance with this | ||
paragraph (d) for the purposes hereinafter stated in this | ||
paragraph (d), upon the final order of the Commission. The | ||
Injured Workers' Benefit Fund shall be deposited the same as | ||
are State funds and any interest accruing thereon shall be | ||
added thereto every 6 months. The Injured Workers' Benefit | ||
Fund is subject to audit the same as State funds and accounts | ||
and is protected by the general bond given by the State | ||
Treasurer. The Injured Workers' Benefit Fund is considered | ||
always appropriated for the purposes of disbursements as | ||
provided in this paragraph, and shall be paid out and | ||
disbursed as herein provided and shall not at any time be | ||
appropriated or diverted to any other use or purpose. Moneys | ||
in the Injured Workers' Benefit Fund shall be used only for |
payment of workers' compensation benefits for injured | ||
employees when the employer has failed to provide coverage as | ||
determined under this paragraph (d) and has failed to pay the | ||
benefits due to the injured employee. The employer shall | ||
reimburse the Injured Workers' Benefit Fund for any amounts | ||
paid to an employee on account of the compensation awarded by | ||
the Commission. The Attorney General shall make reasonable | ||
efforts to obtain reimbursement for the Injured Workers' | ||
Benefit Fund. | ||
The Commission shall have the right to obtain | ||
reimbursement from the employer for compensation obligations | ||
paid by the Injured Workers' Benefit Fund. Any such amounts | ||
obtained shall be deposited by the Commission into the Injured | ||
Workers' Benefit Fund. If an injured employee or his or her | ||
personal representative receives payment from the Injured | ||
Workers' Benefit Fund, the State of Illinois has the same | ||
rights under paragraph (b) of Section 5 that the employer who | ||
failed to pay the benefits due to the injured employee would | ||
have had if the employer had paid those benefits, and any | ||
moneys recovered by the State as a result of the State's | ||
exercise of its rights under paragraph (b) of Section 5 shall | ||
be deposited into the Injured Workers' Benefit Fund. The | ||
custodian of the Injured Workers' Benefit Fund shall be joined | ||
with the employer as a party respondent in the application for | ||
adjustment of claim. After July 1, 2006, the Commission shall | ||
make disbursements from the Fund once each year to each |
eligible claimant. An eligible claimant is an injured worker | ||
who has within the previous fiscal year obtained a final award | ||
for benefits from the Commission against the employer and the | ||
Injured Workers' Benefit Fund and has notified the Commission | ||
within 90 days of receipt of such award. Within a reasonable | ||
time after the end of each fiscal year, the Commission shall | ||
make a disbursement to each eligible claimant. At the time of | ||
disbursement, if there are insufficient moneys in the Fund to | ||
pay all claims, each eligible claimant shall receive a | ||
pro-rata share, as determined by the Commission, of the | ||
available moneys in the Fund for that year. Payment from the | ||
Injured Workers' Benefit Fund to an eligible claimant pursuant | ||
to this provision shall discharge the obligations of the | ||
Injured Workers' Benefit Fund regarding the award entered by | ||
the Commission. | ||
(e) This Act shall not affect or disturb the continuance | ||
of any existing insurance, mutual aid, benefit, or relief | ||
association or department, whether maintained in whole or in | ||
part by the employer or whether maintained by the employees, | ||
the payment of benefits of such association or department | ||
being guaranteed by the employer or by some person, firm or | ||
corporation for him or her: Provided, the employer contributes | ||
to such association or department an amount not less than the | ||
full compensation herein provided, exclusive of the cost of | ||
the maintenance of such association or department and without | ||
any expense to the employee. This Act shall not prevent the |
organization and maintaining under the insurance laws of this | ||
State of any benefit or insurance company for the purpose of | ||
insuring against the compensation provided for in this Act, | ||
the expense of which is maintained by the employer. This Act | ||
shall not prevent the organization or maintaining under the | ||
insurance laws of this State of any voluntary mutual aid, | ||
benefit or relief association among employees for the payment | ||
of additional accident or sick benefits. | ||
(f) No existing insurance, mutual aid, benefit or relief | ||
association or department shall, by reason of anything herein | ||
contained, be authorized to discontinue its operation without | ||
first discharging its obligations to any and all persons | ||
carrying insurance in the same or entitled to relief or | ||
benefits therein. | ||
(g) Any contract, oral, written or implied, of employment | ||
providing for relief benefit, or insurance or any other device | ||
whereby the employee is required to pay any premium or | ||
premiums for insurance against the compensation provided for | ||
in this Act shall be null and void. Any employer withholding | ||
from the wages of any employee any amount for the purpose of | ||
paying any such premium shall be guilty of a Class B | ||
misdemeanor. | ||
In the event the employer does not pay the compensation | ||
for which he or she is liable, then an insurance company, | ||
association or insurer which may have insured such employer | ||
against such liability shall become primarily liable to pay to |
the employee, his or her personal representative or | ||
beneficiary the compensation required by the provisions of | ||
this Act to be paid by such employer. The insurance carrier may | ||
be made a party to the proceedings in which the employer is a | ||
party and an award may be entered jointly against the employer | ||
and the insurance carrier. | ||
(h) It shall be unlawful for any employer, insurance | ||
company or service or adjustment company to interfere with, | ||
restrain or coerce an employee in any manner whatsoever in the | ||
exercise of the rights or remedies granted to him or her by | ||
this Act or to discriminate, attempt to discriminate, or | ||
threaten to discriminate against an employee in any way | ||
because of his or her exercise of the rights or remedies | ||
granted to him or her by this Act. | ||
It shall be unlawful for any employer, individually or | ||
through any insurance company or service or adjustment | ||
company, to discharge or to threaten to discharge, or to | ||
refuse to rehire or recall to active service in a suitable | ||
capacity an employee because of the exercise of his or her | ||
rights or remedies granted to him or her by this Act. | ||
(i) If an employer elects to obtain a life insurance | ||
policy on his employees, he may also elect to apply such | ||
benefits in satisfaction of all or a portion of the death | ||
benefits payable under this Act, in which case, the employer's | ||
compensation premium shall be reduced accordingly. | ||
(j) Within 45 days of receipt of an initial application or |
application to renew self-insurance privileges the | ||
Self-Insurers Advisory Board shall review and submit for | ||
approval by the Chairman of the Commission recommendations of | ||
disposition of all initial applications to self-insure and all | ||
applications to renew self-insurance privileges filed by | ||
private self-insurers pursuant to the provisions of this | ||
Section and Section 4a-9 of this Act. Each private | ||
self-insurer shall submit with its initial and renewal | ||
applications the application fee required by Section 4a-4 of | ||
this Act. | ||
The Chairman of the Commission shall promptly act upon all | ||
initial applications and applications for renewal in full | ||
accordance with the recommendations of the Board or, should | ||
the Chairman disagree with any recommendation of disposition | ||
of the Self-Insurer's Advisory Board, he shall within 30 days | ||
of receipt of such recommendation provide to the Board in | ||
writing the reasons supporting his decision. The Chairman | ||
shall also promptly notify the employer of his decision within | ||
15 days of receipt of the recommendation of the Board. | ||
If an employer is denied a renewal of self-insurance | ||
privileges pursuant to application it shall retain said | ||
privilege for 120 days after receipt of a notice of | ||
cancellation of the privilege from the Chairman of the | ||
Commission. | ||
All orders made by the Chairman under this Section shall | ||
be subject to review by the courts, such review to be taken in |
the same manner and within the same time as provided by | ||
subsection (f) of Section 19 of this Act for review of awards | ||
and decisions of the Commission, upon the party seeking the | ||
review filing with the clerk of the court to which such review | ||
is taken a bond in an amount to be fixed and approved by the | ||
court to which the review is taken, conditioned upon the | ||
payment of all compensation awarded against the person taking | ||
such review pending a decision thereof and further conditioned | ||
upon such other obligations as the court may impose. Upon the | ||
review the Circuit Court shall have power to review all | ||
questions of fact as well as of law. | ||
(Source: P.A. 101-40, eff. 1-1-20; 102-37, eff. 7-1-21.) | ||
(Text of Section from P.A. 101-384 and 102-37) | ||
Sec. 4. (a) Any employer, including but not limited to | ||
general contractors and their subcontractors, who shall come | ||
within the provisions of Section 3 of this Act, and any other | ||
employer who shall elect to provide and pay the compensation | ||
provided for in this Act shall: | ||
(1) File with the Commission annually an application | ||
for approval as a self-insurer which shall include a | ||
current financial statement, and annually, thereafter, an | ||
application for renewal of self-insurance, which shall | ||
include a current financial statement. Said application | ||
and financial statement shall be signed and sworn to by | ||
the president or vice president and secretary or assistant |
secretary of the employer if it be a corporation, or by all | ||
of the partners, if it be a copartnership, or by the owner | ||
if it be neither a copartnership nor a corporation. All | ||
initial applications and all applications for renewal of | ||
self-insurance must be submitted at least 60 days prior to | ||
the requested effective date of self-insurance. An | ||
employer may elect to provide and pay compensation as | ||
provided for in this Act as a member of a group workers' | ||
compensation pool under Article V 3/4 of the Illinois | ||
Insurance Code. If an employer becomes a member of a group | ||
workers' compensation pool, the employer shall not be | ||
relieved of any obligations imposed by this Act. | ||
If the sworn application and financial statement of | ||
any such employer does not satisfy the Commission of the | ||
financial ability of the employer who has filed it, the | ||
Commission shall require such employer to, | ||
(2) Furnish security, indemnity or a bond guaranteeing | ||
the payment by the employer of the compensation provided | ||
for in this Act, provided that any such employer whose | ||
application and financial statement shall not have | ||
satisfied the commission of his or her financial ability | ||
and who shall have secured his liability in part by excess | ||
liability insurance shall be required to furnish to the | ||
Commission security, indemnity or bond guaranteeing his or | ||
her payment up to the effective limits of the excess | ||
coverage, or |
(3) Insure his entire liability to pay such | ||
compensation in some insurance carrier authorized, | ||
licensed, or permitted to do such insurance business in | ||
this State. Every policy of an insurance carrier, insuring | ||
the payment of compensation under this Act shall cover all | ||
the employees and the entire compensation liability of the | ||
insured: Provided, however, that any employer may insure | ||
his or her compensation liability with 2 or more insurance | ||
carriers or may insure a part and qualify under subsection | ||
1, 2, or 4 for the remainder of his or her liability to pay | ||
such compensation, subject to the following two | ||
provisions: | ||
Firstly, the entire compensation liability of the | ||
employer to employees working at or from one location | ||
shall be insured in one such insurance carrier or | ||
shall be self-insured, and | ||
Secondly, the employer shall submit evidence | ||
satisfactorily to the Commission that his or her | ||
entire liability for the compensation provided for in | ||
this Act will be secured. Any provisions in any | ||
policy, or in any endorsement attached thereto, | ||
attempting to limit or modify in any way, the | ||
liability of the insurance carriers issuing the same | ||
except as otherwise provided herein shall be wholly | ||
void. | ||
Nothing herein contained shall apply to policies of |
excess liability carriage secured by employers who have | ||
been approved by the Commission as self-insurers, or | ||
(4) Make some other provision, satisfactory to the | ||
Commission, for the securing of the payment of | ||
compensation provided for in this Act, and | ||
(5) Upon becoming subject to this Act and thereafter | ||
as often as the Commission may in writing demand, file | ||
with the Commission in form prescribed by it evidence of | ||
his or her compliance with the provision of this Section. | ||
(a-1) Regardless of its state of domicile or its principal | ||
place of business, an employer shall make payments to its | ||
insurance carrier or group self-insurance fund, where | ||
applicable, based upon the premium rates of the situs where | ||
the work or project is located in Illinois if: | ||
(A) the employer is engaged primarily in the building | ||
and construction industry; and | ||
(B) subdivision (a)(3) of this Section applies to the | ||
employer or the employer is a member of a group | ||
self-insurance plan as defined in subsection (1) of | ||
Section 4a. | ||
The Illinois Workers' Compensation Commission shall impose | ||
a penalty upon an employer for violation of this subsection | ||
(a-1) if: | ||
(i) the employer is given an opportunity at a hearing | ||
to present evidence of its compliance with this subsection | ||
(a-1); and |
(ii) after the hearing, the Commission finds that the | ||
employer failed to make payments upon the premium rates of | ||
the situs where the work or project is located in | ||
Illinois. | ||
The penalty shall not exceed $1,000 for each day of work | ||
for which the employer failed to make payments upon the | ||
premium rates of the situs where the work or project is located | ||
in Illinois, but the total penalty shall not exceed $50,000 | ||
for each project or each contract under which the work was | ||
performed. | ||
Any penalty under this subsection (a-1) must be imposed | ||
not later than one year after the expiration of the applicable | ||
limitation period specified in subsection (d) of Section 6 of | ||
this Act. Penalties imposed under this subsection (a-1) shall | ||
be deposited into the Illinois Workers' Compensation | ||
Commission Operations Fund, a special fund that is created in | ||
the State treasury. Subject to appropriation, moneys in the | ||
Fund shall be used solely for the operations of the Illinois | ||
Workers' Compensation Commission and by the Department of | ||
Insurance for the purposes authorized in subsection (c) of | ||
Section 25.5 of this Act. | ||
(a-2) Every Employee Leasing Company (ELC), as defined in | ||
Section 15 of the Employee Leasing Company Act, shall at a | ||
minimum provide the following information to the Commission or | ||
any entity designated by the Commission regarding each | ||
workers' compensation insurance policy issued to the ELC: |
(1) Any client company of the ELC listed as an | ||
additional named insured. | ||
(2) Any informational schedule attached to the master | ||
policy that identifies any individual client company's | ||
name, FEIN, and job location. | ||
(3) Any certificate of insurance coverage document | ||
issued to a client company specifying its rights and | ||
obligations under the master policy that establishes both | ||
the identity and status of the client, as well as the dates | ||
of inception and termination of coverage, if applicable. | ||
(b) The sworn application and financial statement, or | ||
security, indemnity or bond, or amount of insurance, or other | ||
provisions, filed, furnished, carried, or made by the | ||
employer, as the case may be, shall be subject to the approval | ||
of the Commission. | ||
Deposits under escrow agreements shall be cash, negotiable | ||
United States government bonds or negotiable general | ||
obligation bonds of the State of Illinois. Such cash or bonds | ||
shall be deposited in escrow with any State or National Bank or | ||
Trust Company having trust authority in the State of Illinois. | ||
Upon the approval of the sworn application and financial | ||
statement, security, indemnity or bond or amount of insurance, | ||
filed, furnished or carried, as the case may be, the | ||
Commission shall send to the employer written notice of its | ||
approval thereof. The certificate of compliance by the | ||
employer with the provisions of subparagraphs (2) and (3) of |
paragraph (a) of this Section shall be delivered by the | ||
insurance carrier to the Illinois Workers' Compensation | ||
Commission within five days after the effective date of the | ||
policy so certified. The insurance so certified shall cover | ||
all compensation liability occurring during the time that the | ||
insurance is in effect and no further certificate need be | ||
filed in case such insurance is renewed, extended or otherwise | ||
continued by such carrier. The insurance so certified shall | ||
not be cancelled or in the event that such insurance is not | ||
renewed, extended or otherwise continued, such insurance shall | ||
not be terminated until at least 10 days after receipt by the | ||
Illinois Workers' Compensation Commission of notice of the | ||
cancellation or termination of said insurance; provided, | ||
however, that if the employer has secured insurance from | ||
another insurance carrier, or has otherwise secured the | ||
payment of compensation in accordance with this Section, and | ||
such insurance or other security becomes effective prior to | ||
the expiration of the 10 days, cancellation or termination | ||
may, at the option of the insurance carrier indicated in such | ||
notice, be effective as of the effective date of such other | ||
insurance or security. | ||
(c) Whenever the Commission shall find that any | ||
corporation, company, association, aggregation of individuals, | ||
reciprocal or interinsurers exchange, or other insurer | ||
effecting workers' compensation insurance in this State shall | ||
be insolvent, financially unsound, or unable to fully meet all |
payments and liabilities assumed or to be assumed for | ||
compensation insurance in this State, or shall practice a | ||
policy of delay or unfairness toward employees in the | ||
adjustment, settlement, or payment of benefits due such | ||
employees, the Commission may after reasonable notice and | ||
hearing order and direct that such corporation, company, | ||
association, aggregation of individuals, reciprocal or | ||
interinsurers exchange, or insurer, shall from and after a | ||
date fixed in such order discontinue the writing of any such | ||
workers' compensation insurance in this State. Subject to such | ||
modification of the order as the Commission may later make on | ||
review of the order, as herein provided, it shall thereupon be | ||
unlawful for any such corporation, company, association, | ||
aggregation of individuals, reciprocal or interinsurers | ||
exchange, or insurer to effect any workers' compensation | ||
insurance in this State. A copy of the order shall be served | ||
upon the Director of Insurance by registered mail. Whenever | ||
the Commission finds that any service or adjustment company | ||
used or employed by a self-insured employer or by an insurance | ||
carrier to process, adjust, investigate, compromise or | ||
otherwise handle claims under this Act, has practiced or is | ||
practicing a policy of delay or unfairness toward employees in | ||
the adjustment, settlement or payment of benefits due such | ||
employees, the Commission may after reasonable notice and | ||
hearing order and direct that such service or adjustment | ||
company shall from and after a date fixed in such order be |
prohibited from processing, adjusting, investigating, | ||
compromising or otherwise handling claims under this Act. | ||
Whenever the Commission finds that any self-insured | ||
employer has practiced or is practicing delay or unfairness | ||
toward employees in the adjustment, settlement or payment of | ||
benefits due such employees, the Commission may, after | ||
reasonable notice and hearing, order and direct that after a | ||
date fixed in the order such self-insured employer shall be | ||
disqualified to operate as a self-insurer and shall be | ||
required to insure his entire liability to pay compensation in | ||
some insurance carrier authorized, licensed and permitted to | ||
do such insurance business in this State, as provided in | ||
subparagraph 3 of paragraph (a) of this Section. | ||
All orders made by the Commission under this Section shall | ||
be subject to review by the courts, said review to be taken in | ||
the same manner and within the same time as provided by Section | ||
19 of this Act for review of awards and decisions of the | ||
Commission, upon the party seeking the review filing with the | ||
clerk of the court to which said review is taken a bond in an | ||
amount to be fixed and approved by the court to which the | ||
review is taken, conditioned upon the payment of all | ||
compensation awarded against the person taking said review | ||
pending a decision thereof and further conditioned upon such | ||
other obligations as the court may impose. Upon the review the | ||
Circuit Court shall have power to review all questions of fact | ||
as well as of law. The penalty hereinafter provided for in this |
paragraph shall not attach and shall not begin to run until the | ||
final determination of the order of the Commission. | ||
(d) Whenever a panel of 3 Commissioners comprised of one | ||
member of the employing class, one representative of a labor | ||
organization recognized under the National Labor Relations Act | ||
or an attorney who has represented labor organizations or has | ||
represented employees in workers' compensation cases, and one | ||
member not identified with either the employing class or a | ||
labor organization, with due process and after a hearing, | ||
determines an employer has knowingly failed to provide | ||
coverage as required by paragraph (a) of this Section, the | ||
failure shall be deemed an immediate serious danger to public | ||
health, safety, and welfare sufficient to justify service by | ||
the Commission of a work-stop order on such employer, | ||
requiring the cessation of all business operations of such | ||
employer at the place of employment or job site. Any law | ||
enforcement agency in the State shall, at the request of the | ||
Commission, render any assistance necessary to carry out the | ||
provisions of this Section, including, but not limited to, | ||
preventing any employee of such employer from remaining at a | ||
place of employment or job site after a work-stop order has | ||
taken effect. Any work-stop order shall be lifted upon proof | ||
of insurance as required by this Act. Any orders under this | ||
Section are appealable under Section 19(f) to the Circuit | ||
Court. | ||
Any individual employer, corporate officer or director of |
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who knowingly | ||
fails to provide coverage as required by paragraph (a) of this | ||
Section is guilty of a Class 4 felony. This provision shall not | ||
apply to any corporate officer or director of any | ||
publicly-owned corporation. Each day's violation constitutes a | ||
separate offense. The State's Attorney of the county in which | ||
the violation occurred, or the Attorney General, shall bring | ||
such actions in the name of the People of the State of | ||
Illinois, or may, in addition to other remedies provided in | ||
this Section, bring an action for an injunction to restrain | ||
the violation or to enjoin the operation of any such employer. | ||
Any individual employer, corporate officer or director of | ||
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who | ||
negligently fails to provide coverage as required by paragraph | ||
(a) of this Section is guilty of a Class A misdemeanor. This | ||
provision shall not apply to any corporate officer or director | ||
of any publicly-owned corporation. Each day's violation | ||
constitutes a separate offense. The State's Attorney of the | ||
county in which the violation occurred, or the Attorney | ||
General, shall bring such actions in the name of the People of | ||
the State of Illinois. | ||
The criminal penalties in this subsection (d) shall not | ||
apply where there exists a good faith dispute as to the | ||
existence of an employment relationship. Evidence of good |
faith shall include, but not be limited to, compliance with | ||
the definition of employee as used by the Internal Revenue | ||
Service. | ||
Employers who are subject to and who knowingly fail to | ||
comply with this Section shall not be entitled to the benefits | ||
of this Act during the period of noncompliance, but shall be | ||
liable in an action under any other applicable law of this | ||
State. In the action, such employer shall not avail himself or | ||
herself of the defenses of assumption of risk or negligence or | ||
that the injury was due to a co-employee. In the action, proof | ||
of the injury shall constitute prima facie evidence of | ||
negligence on the part of such employer and the burden shall be | ||
on such employer to show freedom of negligence resulting in | ||
the injury. The employer shall not join any other defendant in | ||
any such civil action. Nothing in this amendatory Act of the | ||
94th General Assembly shall affect the employee's rights under | ||
subdivision (a)3 of Section 1 of this Act. Any employer or | ||
carrier who makes payments under subdivision (a)3 of Section 1 | ||
of this Act shall have a right of reimbursement from the | ||
proceeds of any recovery under this Section. | ||
An employee of an uninsured employer, or the employee's | ||
dependents in case death ensued, may, instead of proceeding | ||
against the employer in a civil action in court, file an | ||
application for adjustment of claim with the Commission in | ||
accordance with the provisions of this Act and the Commission | ||
shall hear and determine the application for adjustment of |
claim in the manner in which other claims are heard and | ||
determined before the Commission. | ||
All proceedings under this subsection (d) shall be | ||
reported on an annual basis to the Workers' Compensation | ||
Advisory Board. | ||
An investigator with the Department of Insurance may issue | ||
a citation to any employer that is not in compliance with its | ||
obligation to have workers' compensation insurance under this | ||
Act. The amount of the fine shall be based on the period of | ||
time the employer was in non-compliance, but shall be no less | ||
than $500, and shall not exceed $2,500. An employer that has | ||
been issued a citation shall pay the fine to the Department of | ||
Insurance and provide to the Department of Insurance proof | ||
that it obtained the required workers' compensation insurance | ||
within 10 days after the citation was issued. This Section | ||
does not affect any other obligations this Act imposes on | ||
employers. | ||
Upon a finding by the Commission, after reasonable notice | ||
and hearing, of the knowing and wilful failure or refusal of an | ||
employer to comply with any of the provisions of paragraph (a) | ||
of this Section, the failure or refusal of an employer, | ||
service or adjustment company, or an insurance carrier to | ||
comply with any order of the Illinois Workers' Compensation | ||
Commission pursuant to paragraph (c) of this Section | ||
disqualifying him or her to operate as a self insurer and | ||
requiring him or her to insure his or her liability, or the |
knowing and willful failure of an employer to comply with a | ||
citation issued by an investigator with the Department of | ||
Insurance, the Commission may assess a civil penalty of up to | ||
$500 per day for each day of such failure or refusal after the | ||
effective date of this amendatory Act of 1989. The minimum | ||
penalty under this Section shall be the sum of $10,000. Each | ||
day of such failure or refusal shall constitute a separate | ||
offense. The Commission may assess the civil penalty | ||
personally and individually against the corporate officers and | ||
directors of a corporate employer, the partners of an employer | ||
partnership, and the members of an employer limited liability | ||
company, after a finding of a knowing and willful refusal or | ||
failure of each such named corporate officer, director, | ||
partner, or member to comply with this Section. The liability | ||
for the assessed penalty shall be against the named employer | ||
first, and if the named employer fails or refuses to pay the | ||
penalty to the Commission within 30 days after the final order | ||
of the Commission, then the named corporate officers, | ||
directors, partners, or members who have been found to have | ||
knowingly and willfully refused or failed to comply with this | ||
Section shall be liable for the unpaid penalty or any unpaid | ||
portion of the penalty. Upon investigation by the Department | ||
of Insurance, the Attorney General shall have the authority to | ||
prosecute all proceedings to enforce the civil and | ||
administrative provisions of this Section before the | ||
Commission. The Commission and the Department of Insurance |
shall promulgate procedural rules for enforcing this Section | ||
relating to their respective duties prescribed herein. | ||
A Commission decision imposing penalties under this | ||
Section may be judicially reviewed only as described in | ||
Section 19(f). After expiration of the period for seeking | ||
judicial review, the Commission's final decision imposing | ||
penalties may be enforced in the same manner as a judgment | ||
entered by a court of competent jurisdiction. The Commission's | ||
final decision imposing penalties is a debt due and owing to | ||
the State and can be enforced to the same extent as a judgment | ||
entered by a circuit court. The Attorney General shall | ||
represent the Commission and the Department of Insurance in | ||
any action challenging the final decision in circuit court. If | ||
the court affirms the Commission's decision, the court shall | ||
enter judgment against the employer in the amount of the fines | ||
assessed by the Commission. The Attorney General shall make | ||
reasonable efforts to collect the amounts due under the | ||
Commission's decision. | ||
Upon the failure or refusal of any employer, service or | ||
adjustment company or insurance carrier to comply with the | ||
provisions of this Section and with the orders of the | ||
Commission under this Section, or the order of the court on | ||
review after final adjudication, the Commission may bring a | ||
civil action to recover the amount of the penalty in Cook | ||
County or in Sangamon County in which litigation the | ||
Commission shall be represented by the Attorney General. The |
Commission shall send notice of its finding of non-compliance | ||
and assessment of the civil penalty to the Attorney General. | ||
It shall be the duty of the Attorney General within 30 days | ||
after receipt of the notice, to institute prosecutions and | ||
promptly prosecute all reported violations of this Section. | ||
Any individual employer, corporate officer or director of | ||
a corporate employer, partner of an employer partnership, or | ||
member of an employer limited liability company who, with the | ||
intent to avoid payment of compensation under this Act to an | ||
injured employee or the employee's dependents, knowingly | ||
transfers, sells, encumbers, assigns, or in any manner | ||
disposes of, conceals, secretes, or destroys any property | ||
belonging to the employer, officer, director, partner, or | ||
member is guilty of a Class 4 felony. | ||
Penalties and fines collected pursuant to this paragraph | ||
(d) shall be deposited upon receipt into a special fund which | ||
shall be designated the Injured Workers' Benefit Fund, of | ||
which the State Treasurer is ex-officio custodian, such | ||
special fund to be held and disbursed in accordance with this | ||
paragraph (d) for the purposes hereinafter stated in this | ||
paragraph (d), upon the final order of the Commission. The | ||
Injured Workers' Benefit Fund shall be deposited the same as | ||
are State funds and any interest accruing thereon shall be | ||
added thereto every 6 months. The Injured Workers' Benefit | ||
Fund is subject to audit the same as State funds and accounts | ||
and is protected by the general bond given by the State |
Treasurer. The Injured Workers' Benefit Fund is considered | ||
always appropriated for the purposes of disbursements as | ||
provided in this paragraph, and shall be paid out and | ||
disbursed as herein provided and shall not at any time be | ||
appropriated or diverted to any other use or purpose. Moneys | ||
in the Injured Workers' Benefit Fund shall be used only for | ||
payment of workers' compensation benefits for injured | ||
employees when the employer has failed to provide coverage as | ||
determined under this paragraph (d) and has failed to pay the | ||
benefits due to the injured employee. The employer shall | ||
reimburse the Injured Workers' Benefit Fund for any amounts | ||
paid to an employee on account of the compensation awarded by | ||
the Commission. The Attorney General shall make reasonable | ||
efforts to obtain reimbursement for the Injured Workers' | ||
Benefit Fund. | ||
The Commission shall have the right to obtain | ||
reimbursement from the employer for compensation obligations | ||
paid by the Injured Workers' Benefit Fund. Any such amounts | ||
obtained shall be deposited by the Commission into the Injured | ||
Workers' Benefit Fund. If an injured employee or his or her | ||
personal representative receives payment from the Injured | ||
Workers' Benefit Fund, the State of Illinois has the same | ||
rights under paragraph (b) of Section 5 that the employer who | ||
failed to pay the benefits due to the injured employee would | ||
have had if the employer had paid those benefits, and any | ||
moneys recovered by the State as a result of the State's |
exercise of its rights under paragraph (b) of Section 5 shall | ||
be deposited into the Injured Workers' Benefit Fund. The | ||
custodian of the Injured Workers' Benefit Fund shall be joined | ||
with the employer as a party respondent in the application for | ||
adjustment of claim. After July 1, 2006, the Commission shall | ||
make disbursements from the Fund once each year to each | ||
eligible claimant. An eligible claimant is an injured worker | ||
who has within the previous fiscal year obtained a final award | ||
for benefits from the Commission against the employer and the | ||
Injured Workers' Benefit Fund and has notified the Commission | ||
within 90 days of receipt of such award. Within a reasonable | ||
time after the end of each fiscal year, the Commission shall | ||
make a disbursement to each eligible claimant. At the time of | ||
disbursement, if there are insufficient moneys in the Fund to | ||
pay all claims, each eligible claimant shall receive a | ||
pro-rata share, as determined by the Commission, of the | ||
available moneys in the Fund for that year. Payment from the | ||
Injured Workers' Benefit Fund to an eligible claimant pursuant | ||
to this provision shall discharge the obligations of the | ||
Injured Workers' Benefit Fund regarding the award entered by | ||
the Commission. | ||
(e) This Act shall not affect or disturb the continuance | ||
of any existing insurance, mutual aid, benefit, or relief | ||
association or department, whether maintained in whole or in | ||
part by the employer or whether maintained by the employees, | ||
the payment of benefits of such association or department |
being guaranteed by the employer or by some person, firm or | ||
corporation for him or her: Provided, the employer contributes | ||
to such association or department an amount not less than the | ||
full compensation herein provided, exclusive of the cost of | ||
the maintenance of such association or department and without | ||
any expense to the employee. This Act shall not prevent the | ||
organization and maintaining under the insurance laws of this | ||
State of any benefit or insurance company for the purpose of | ||
insuring against the compensation provided for in this Act, | ||
the expense of which is maintained by the employer. This Act | ||
shall not prevent the organization or maintaining under the | ||
insurance laws of this State of any voluntary mutual aid, | ||
benefit or relief association among employees for the payment | ||
of additional accident or sick benefits. | ||
(f) No existing insurance, mutual aid, benefit or relief | ||
association or department shall, by reason of anything herein | ||
contained, be authorized to discontinue its operation without | ||
first discharging its obligations to any and all persons | ||
carrying insurance in the same or entitled to relief or | ||
benefits therein. | ||
(g) Any contract, oral, written or implied, of employment | ||
providing for relief benefit, or insurance or any other device | ||
whereby the employee is required to pay any premium or | ||
premiums for insurance against the compensation provided for | ||
in this Act shall be null and void. Any employer withholding | ||
from the wages of any employee any amount for the purpose of |
paying any such premium shall be guilty of a Class B | ||
misdemeanor. | ||
In the event the employer does not pay the compensation | ||
for which he or she is liable, then an insurance company, | ||
association or insurer which may have insured such employer | ||
against such liability shall become primarily liable to pay to | ||
the employee, his or her personal representative or | ||
beneficiary the compensation required by the provisions of | ||
this Act to be paid by such employer. The insurance carrier may | ||
be made a party to the proceedings in which the employer is a | ||
party and an award may be entered jointly against the employer | ||
and the insurance carrier. | ||
(h) It shall be unlawful for any employer, insurance | ||
company or service or adjustment company to interfere with, | ||
restrain or coerce an employee in any manner whatsoever in the | ||
exercise of the rights or remedies granted to him or her by | ||
this Act or to discriminate, attempt to discriminate, or | ||
threaten to discriminate against an employee in any way | ||
because of his or her exercise of the rights or remedies | ||
granted to him or her by this Act. | ||
It shall be unlawful for any employer, individually or | ||
through any insurance company or service or adjustment | ||
company, to discharge or to threaten to discharge, or to | ||
refuse to rehire or recall to active service in a suitable | ||
capacity an employee because of the exercise of his or her | ||
rights or remedies granted to him or her by this Act. |
(i) If an employer elects to obtain a life insurance | ||
policy on his employees, he may also elect to apply such | ||
benefits in satisfaction of all or a portion of the death | ||
benefits payable under this Act, in which case, the employer's | ||
compensation premium shall be reduced accordingly. | ||
(j) Within 45 days of receipt of an initial application or | ||
application to renew self-insurance privileges the | ||
Self-Insurers Advisory Board shall review and submit for | ||
approval by the Chairman of the Commission recommendations of | ||
disposition of all initial applications to self-insure and all | ||
applications to renew self-insurance privileges filed by | ||
private self-insurers pursuant to the provisions of this | ||
Section and Section 4a-9 of this Act. Each private | ||
self-insurer shall submit with its initial and renewal | ||
applications the application fee required by Section 4a-4 of | ||
this Act. | ||
The Chairman of the Commission shall promptly act upon all | ||
initial applications and applications for renewal in full | ||
accordance with the recommendations of the Board or, should | ||
the Chairman disagree with any recommendation of disposition | ||
of the Self-Insurer's Advisory Board, he shall within 30 days | ||
of receipt of such recommendation provide to the Board in | ||
writing the reasons supporting his decision. The Chairman | ||
shall also promptly notify the employer of his decision within | ||
15 days of receipt of the recommendation of the Board. | ||
If an employer is denied a renewal of self-insurance |
privileges pursuant to application it shall retain said | ||
privilege for 120 days after receipt of a notice of | ||
cancellation of the privilege from the Chairman of the | ||
Commission. | ||
All orders made by the Chairman under this Section shall | ||
be subject to review by the courts, such review to be taken in | ||
the same manner and within the same time as provided by | ||
subsection (f) of Section 19 of this Act for review of awards | ||
and decisions of the Commission, upon the party seeking the | ||
review filing with the clerk of the court to which such review | ||
is taken a bond in an amount to be fixed and approved by the | ||
court to which the review is taken, conditioned upon the | ||
payment of all compensation awarded against the person taking | ||
such review pending a decision thereof and further conditioned | ||
upon such other obligations as the court may impose. Upon the | ||
review the Circuit Court shall have power to review all | ||
questions of fact as well as of law. | ||
(Source: P.A. 101-384, eff. 1-1-20 ; 102-37, eff. 7-1-21.) | ||
(820 ILCS 305/4a-5) (from Ch. 48, par. 138.4a-5) | ||
Sec. 4a-5. There is hereby created a Self-Insurers | ||
Security Fund. The State Treasurer shall be the ex officio | ||
custodian of the Self-Insurers Security Fund. Moneys in the | ||
Fund shall be deposited in a separate account in the same | ||
manner as are State Funds and any interest accruing thereon | ||
shall be added thereto every 6 months. It shall be subject to |
audit the same as State funds and accounts and shall be | ||
protected by the general bond given by the State Treasurer. | ||
The funds in the Self-Insurers Security Fund shall not be | ||
subject to appropriation and shall be made available for the | ||
purposes of compensating employees who are eligible to receive | ||
benefits from their employers pursuant to the provisions of | ||
the Workers' Compensation Act or Workers' Occupational | ||
Diseases Act, when, pursuant to this Section, the Board has | ||
determined that a private self-insurer has become an insolvent | ||
self-insurer and is unable to pay compensation benefits due to | ||
financial insolvency. Moneys in the Fund may be used to | ||
compensate any type of injury or occupational disease which is | ||
compensable under either Act , and for all claims for related | ||
administrative fees, operating costs of the Board, attorney's | ||
fees, and other costs reasonably incurred by the Board. Moneys | ||
in the Self-Insurers Security Fund may also be used for paying | ||
the salaries and benefits of the Self-Insurers Advisory Board | ||
employees and the operating costs of the Board. The Chairman, | ||
with the advice of the Board, may direct the State Comptroller | ||
and the State Treasurer to transfer up to $2,000,000 in any | ||
fiscal year from the Self-Insurers Security Fund to the | ||
Illinois Workers' Compensation Commission Operations Fund, to | ||
the extent that there are insufficient funds in the Illinois | ||
Workers' Compensation Commission Operations Fund to pay the | ||
operating costs of the Illinois Workers' Compensation | ||
Commission or the salaries and benefits of employees of the |
Illinois Workers' Compensation Commission. No later than | ||
October 31 of the fiscal year following any transfer from the | ||
Self-Insurers Security Fund to the Illinois Workers' | ||
Compensation Commission Operations Fund, the Chairman, with | ||
the advice of the Board, shall direct the State Comptroller | ||
and the State Treasurer to transfer from the Illinois Workers' | ||
Compensation Commission Operations Fund to the Self-Insurers | ||
Security Fund an amount equivalent to the sum of all amounts | ||
transferred from the Self-Insurers Security Fund to the | ||
Illinois Workers' Compensation Commission Operations Fund in | ||
the prior fiscal year with interest at the rate earned by | ||
moneys on deposit in the Self-Insurers Security Fund. Upon | ||
receipt of funds from any transfer between the Self-Insurers | ||
Security Fund and the Illinois Workers' Compensation | ||
Commission Operations Fund, the Chairman shall submit notice, | ||
including the date and amount of the transfer, to the Governor | ||
and the General Assembly. Payment from the Self-Insurers | ||
Security Fund shall be made by the Comptroller only upon the | ||
authorization of the Chairman as evidenced by properly | ||
certified vouchers of the Commission, upon the direction of | ||
the Board. | ||
(Source: P.A. 101-40, eff. 1-1-20; 102-558, eff. 8-20-21; | ||
102-910, eff. 5-27-22.) | ||
(820 ILCS 305/4d) | ||
Sec. 4d. Illinois Workers' Compensation Commission |
Operations Fund Fee. | ||
(a) As of the effective date of this amendatory Act of the | ||
93rd General Assembly, each employer that self-insures its | ||
liabilities arising under this Act or Workers' Occupational | ||
Diseases Act shall pay a fee measured by the annual actual | ||
wages paid in this State of such an employer in the manner | ||
provided in this Section. Such proceeds shall be deposited in | ||
the Illinois Workers' Compensation Commission Operations Fund. | ||
If an employer survives or was formed by a merger, | ||
consolidation, reorganization, or reincorporation, the actual | ||
wages paid in this State of all employers party to the merger, | ||
consolidation, reorganization, or reincorporation shall, for | ||
purposes of determining the amount of the fee imposed by this | ||
Section, be regarded as those of the surviving or new | ||
employer. | ||
(b) Beginning on July 30, 2004 (the effective date of | ||
Public Act 93-840) and on July 1 of each year thereafter | ||
through 2023 , the Chairman shall charge and collect an annual | ||
Illinois Workers' Compensation Commission Operations Fund Fee | ||
from every employer subject to subsection (a) of this Section | ||
equal to 0.0075% of its annual actual wages paid in this State | ||
as reported in each employer's annual self-insurance renewal | ||
filed for the previous year as required by Section 4 of this | ||
Act and Section 4 of the Workers' Occupational Diseases Act. | ||
Beginning on July 1, 2024 and on July 1 of each year | ||
thereafter, the Chairman shall charge and collect an annual |
Illinois Workers' Compensation Commission Operations Fund Fee | ||
from every employer subject to subsection (a) of this Section | ||
equal to 0.0081% of its annual actual wages paid in this State | ||
as reported in each employer's annual self-insurance renewal | ||
filed for the previous year as required by Section 4 of this | ||
Act and Section 4 of the Workers' Occupational Diseases Act. | ||
All sums collected by the Commission under the provisions of | ||
this Section shall be paid promptly after the receipt of the | ||
same, accompanied by a detailed statement thereof, into the | ||
Illinois Workers' Compensation Commission Operations Fund. The | ||
fee due pursuant to Public Act 93-840 shall be collected | ||
instead of the fee due on July 1, 2004 under Public Act 93-32. | ||
Payment of the fee due under Public Act 93-840 shall discharge | ||
the employer's obligations due on July 1, 2004. | ||
(c) In addition to the authority specifically granted | ||
under Section 16, the Chairman shall have such authority to | ||
adopt rules or establish forms as may be reasonably necessary | ||
for purposes of enforcing this Section. The Commission shall | ||
have authority to defer, waive, or abate the fee or any | ||
penalties imposed by this Section if in the Commission's | ||
opinion the employer's solvency and ability to meet its | ||
obligations to pay workers' compensation benefits would be | ||
immediately threatened by payment of the fee due. | ||
(d) When an employer fails to pay the full amount of any | ||
annual Illinois Workers' Compensation Commission Operations | ||
Fund Fee of $100 or more due under this Section, there shall be |
added to the amount due as a penalty the greater of $1,000 or | ||
an amount equal to 5% of the deficiency for each month or part | ||
of a month that the deficiency remains unpaid. | ||
(e) The Commission may enforce the collection of any | ||
delinquent payment, penalty or portion thereof by legal action | ||
or in any other manner by which the collection of debts due the | ||
State of Illinois may be enforced under the laws of this State. | ||
(f) Whenever it appears to the satisfaction of the | ||
Chairman that an employer has paid pursuant to this Act an | ||
Illinois Workers' Compensation Commission Operations Fund Fee | ||
in an amount in excess of the amount legally collectable from | ||
the employer, the Chairman shall issue a credit memorandum for | ||
an amount equal to the amount of such overpayment. A credit | ||
memorandum may be applied for the 2-year period from the date | ||
of issuance against the payment of any amount due during that | ||
period under the fee imposed by this Section or, subject to | ||
reasonable rule of the Commission including requirement of | ||
notification, may be assigned to any other employer subject to | ||
regulation under this Act. Any application of credit memoranda | ||
after the period provided for in this Section is void. | ||
(Source: P.A. 95-331, eff. 8-21-07.) | ||
(820 ILCS 305/7) (from Ch. 48, par. 138.7) | ||
Sec. 7. The amount of compensation which shall be paid for | ||
an accidental injury to the employee resulting in death is: | ||
(a) If the employee leaves surviving a widow, widower, |
child or children, the applicable weekly compensation rate | ||
computed in accordance with subparagraph 2 of paragraph (b) of | ||
Section 8, shall be payable during the life of the widow or | ||
widower and if any surviving child or children shall not be | ||
physically or mentally incapacitated then until the death of | ||
the widow or widower or until the youngest child shall reach | ||
the age of 18, whichever shall come later; provided that if | ||
such child or children shall be enrolled as a full time student | ||
in any accredited educational institution, the payments shall | ||
continue until such child has attained the age of 25. In the | ||
event any surviving child or children shall be physically or | ||
mentally incapacitated, the payments shall continue for the | ||
duration of such incapacity. | ||
The term "child" means a child whom the deceased employee | ||
left surviving, including a posthumous child, a child legally | ||
adopted, a child whom the deceased employee was legally | ||
obligated to support or a child to whom the deceased employee | ||
stood in loco parentis. The term "children" means the plural | ||
of "child". | ||
The term "physically or mentally incapacitated child or | ||
children" means a child or children incapable of engaging in | ||
regular and substantial gainful employment. | ||
In the event of the remarriage of a widow or widower, where | ||
the decedent did not leave surviving any child or children | ||
who, at the time of such remarriage, are entitled to | ||
compensation benefits under this Act, the surviving spouse |
shall be paid a lump sum equal to 2 years compensation benefits | ||
and all further rights of such widow or widower shall be | ||
extinguished. | ||
If the employee leaves surviving any child or children | ||
under 18 years of age who at the time of death shall be | ||
entitled to compensation under this paragraph (a) of this | ||
Section, the weekly compensation payments herein provided for | ||
such child or children shall in any event continue for a period | ||
of not less than 6 years. | ||
Any beneficiary entitled to compensation under this | ||
paragraph (a) of this Section shall receive from the special | ||
fund provided in paragraph (f) of this Section, in addition to | ||
the compensation herein provided, supplemental benefits in | ||
accordance with paragraph (g) of Section 8. | ||
(b) If no compensation is payable under paragraph (a) of | ||
this Section and the employee leaves surviving a parent or | ||
parents who at the time of the accident were totally dependent | ||
upon the earnings of the employee then weekly payments equal | ||
to the compensation rate payable in the case where the | ||
employee leaves surviving a widow or widower, shall be paid to | ||
such parent or parents for the duration of their lives, and in | ||
the event of the death of either, for the life of the survivor. | ||
(c) If no compensation is payable under paragraphs (a) or | ||
(b) of this Section and the employee leaves surviving any | ||
child or children who are not entitled to compensation under | ||
the foregoing paragraph (a) but who at the time of the accident |
were nevertheless in any manner dependent upon the earnings of | ||
the employee, or leaves surviving a parent or parents who at | ||
the time of the accident were partially dependent upon the | ||
earnings of the employee, then there shall be paid to such | ||
dependent or dependents for a period of 8 years weekly | ||
compensation payments at such proportion of the applicable | ||
rate if the employee had left surviving a widow or widower as | ||
such dependency bears to total dependency. In the event of the | ||
death of any such beneficiary the share of such beneficiary | ||
shall be divided equally among the surviving beneficiaries and | ||
in the event of the death of the last such beneficiary all the | ||
rights under this paragraph shall be extinguished. | ||
(d) If no compensation is payable under paragraphs (a), | ||
(b) or (c) of this Section and the employee leaves surviving | ||
any grandparent, grandparents, grandchild or grandchildren or | ||
collateral heirs dependent upon the employee's earnings to the | ||
extent of 50% or more of total dependency, then there shall be | ||
paid to such dependent or dependents for a period of 5 years | ||
weekly compensation payments at such proportion of the | ||
applicable rate if the employee had left surviving a widow or | ||
widower as such dependency bears to total dependency. In the | ||
event of the death of any such beneficiary the share of such | ||
beneficiary shall be divided equally among the surviving | ||
beneficiaries and in the event of the death of the last such | ||
beneficiary all rights hereunder shall be extinguished. | ||
(e) The compensation to be paid for accidental injury |
which results in death, as provided in this Section, shall be | ||
paid to the persons who form the basis for determining the | ||
amount of compensation to be paid by the employer, the | ||
respective shares to be in the proportion of their respective | ||
dependency at the time of the accident on the earnings of the | ||
deceased. The Commission or an Arbitrator thereof may, in its | ||
or his discretion, order or award the payment to the parent or | ||
grandparent of a child for the latter's support the amount of | ||
compensation which but for such order or award would have been | ||
paid to such child as its share of the compensation payable, | ||
which order or award may be modified from time to time by the | ||
Commission in its discretion with respect to the person to | ||
whom shall be paid the amount of the order or award remaining | ||
unpaid at the time of the modification. | ||
The payments of compensation by the employer in accordance | ||
with the order or award of the Commission discharges such | ||
employer from all further obligation as to such compensation. | ||
(f) The sum of $8,000 for burial expenses shall be paid by | ||
the employer to the widow or widower, other dependent, next of | ||
kin or to the person or persons incurring the expense of | ||
burial. | ||
In the event the employer failed to provide necessary | ||
first aid, medical, surgical or hospital service, he shall pay | ||
the cost thereof to the person or persons entitled to | ||
compensation under paragraphs (a), (b), (c) or (d) of this | ||
Section, or to the person or persons incurring the obligation |
therefore, or providing the same. | ||
On January 15 and July 15, 1981, and on January 15 and July | ||
15 of each year thereafter the employer shall within 60 days | ||
pay a sum equal to 1/8 of 1% of all compensation payments made | ||
by him after July 1, 1980, either under this Act or the | ||
Workers' Occupational Diseases Act, whether by lump sum | ||
settlement or weekly compensation payments, but not including | ||
hospital, surgical or rehabilitation payments, made during the | ||
first 6 months and during the second 6 months respectively of | ||
the fiscal year next preceding the date of the payments, into a | ||
special fund which shall be designated the "Second Injury | ||
Fund", of which the State Treasurer is ex-officio custodian, | ||
such special fund to be held and disbursed for the purposes | ||
hereinafter stated in paragraphs (f) and (g) of Section 8, | ||
either upon the order of the Commission or of a competent | ||
court. Said special fund shall be deposited the same as are | ||
State funds and any interest accruing thereon shall be added | ||
thereto every 6 months. It is subject to audit the same as | ||
State funds and accounts and is protected by the General bond | ||
given by the State Treasurer. It is considered always | ||
appropriated for the purposes of disbursements as provided in | ||
Section 8, paragraph (f), of this Act, and shall be paid out | ||
and disbursed as therein provided and shall not at any time be | ||
appropriated or diverted to any other use or purpose. | ||
On January 15, 1991, the employer shall further pay a sum | ||
equal to one half of 1% of all compensation payments made by |
him from January 1, 1990 through June 30, 1990 either under | ||
this Act or under the Workers' Occupational Diseases Act, | ||
whether by lump sum settlement or weekly compensation | ||
payments, but not including hospital, surgical or | ||
rehabilitation payments, into an additional Special Fund which | ||
shall be designated as the "Rate Adjustment Fund". On March | ||
15, 1991, the employer shall pay into the Rate Adjustment Fund | ||
a sum equal to one half of 1% of all such compensation payments | ||
made from July 1, 1990 through December 31, 1990. Within 60 | ||
days after July 15, 1991, the employer shall pay into the Rate | ||
Adjustment Fund a sum equal to one half of 1% of all such | ||
compensation payments made from January 1, 1991 through June | ||
30, 1991. Within 60 days after January 15 of 1992 and each | ||
subsequent year through 1996, the employer shall pay into the | ||
Rate Adjustment Fund a sum equal to one half of 1% of all such | ||
compensation payments made in the last 6 months of the | ||
preceding calendar year. Within 60 days after July 15 of 1992 | ||
and each subsequent year through 1995, the employer shall pay | ||
into the Rate Adjustment Fund a sum equal to one half of 1% of | ||
all such compensation payments made in the first 6 months of | ||
the same calendar year. Within 60 days after January 15 of 1997 | ||
and each subsequent year through 2005, the employer shall pay | ||
into the Rate Adjustment Fund a sum equal to three-fourths of | ||
1% of all such compensation payments made in the last 6 months | ||
of the preceding calendar year. Within 60 days after July 15 of | ||
1996 and each subsequent year through 2004, the employer shall |
pay into the Rate Adjustment Fund a sum equal to three-fourths | ||
of 1% of all such compensation payments made in the first 6 | ||
months of the same calendar year. Within 60 days after July 15 | ||
of 2005, the employer shall pay into the Rate Adjustment Fund a | ||
sum equal to 1% of such compensation payments made in the first | ||
6 months of the same calendar year. Within 60 days after | ||
January 15 of 2006 and each subsequent year through 2024 , the | ||
employer shall pay into the Rate Adjustment Fund a sum equal to | ||
1.25% of such compensation payments made in the last 6 months | ||
of the preceding calendar year. Within 60 days after July 15 of | ||
2006 and each subsequent year through 2023 , the employer shall | ||
pay into the Rate Adjustment Fund a sum equal to 1.25% of such | ||
compensation payments made in the first 6 months of the same | ||
calendar year. Within 60 days after July 15 of 2024 and each | ||
subsequent year thereafter, the employer shall pay into the | ||
Rate Adjustment Fund a sum equal to 1.375% of such | ||
compensation payments made in the first 6 months of the same | ||
calendar year. Within 60 days after January 15 of 2025 and each | ||
subsequent year thereafter, the employer shall pay into the | ||
Rate Adjustment Fund a sum equal to 1.375% of such | ||
compensation payments made in the last 6 months of the | ||
preceding calendar year. The administrative costs of | ||
collecting assessments from employers for the Rate Adjustment | ||
Fund shall be paid from the Rate Adjustment Fund. The cost of | ||
an actuarial audit of the Fund shall be paid from the Rate | ||
Adjustment Fund. The State Treasurer is ex officio custodian |
of such Special Fund and the same shall be held and disbursed | ||
for the purposes hereinafter stated in paragraphs (f) and (g) | ||
of Section 8 upon the order of the Commission or of a competent | ||
court. The Rate Adjustment Fund shall be deposited the same as | ||
are State funds and any interest accruing thereon shall be | ||
added thereto every 6 months. It shall be subject to audit the | ||
same as State funds and accounts and shall be protected by the | ||
general bond given by the State Treasurer. It is considered | ||
always appropriated for the purposes of disbursements as | ||
provided in paragraphs (f) and (g) of Section 8 of this Act and | ||
shall be paid out and disbursed as therein provided and shall | ||
not at any time be appropriated or diverted to any other use or | ||
purpose. Within 5 days after the effective date of this | ||
amendatory Act of 1990, the Comptroller and the State | ||
Treasurer shall transfer $1,000,000 from the General Revenue | ||
Fund to the Rate Adjustment Fund. By February 15, 1991, the | ||
Comptroller and the State Treasurer shall transfer $1,000,000 | ||
from the Rate Adjustment Fund to the General Revenue Fund. The | ||
Comptroller and Treasurer are authorized to make transfers at | ||
the request of the Chairman up to a total of $19,000,000 from | ||
the Second Injury Fund, the General Revenue Fund, and the | ||
Workers' Compensation Benefit Trust Fund to the Rate | ||
Adjustment Fund to the extent that there is insufficient money | ||
in the Rate Adjustment Fund to pay claims and obligations. | ||
Amounts may be transferred from the General Revenue Fund only | ||
if the funds in the Second Injury Fund or the Workers' |
Compensation Benefit Trust Fund are insufficient to pay claims | ||
and obligations of the Rate Adjustment Fund. All amounts | ||
transferred from the Second Injury Fund, the General Revenue | ||
Fund, and the Workers' Compensation Benefit Trust Fund shall | ||
be repaid from the Rate Adjustment Fund within 270 days of a | ||
transfer, together with interest at the rate earned by moneys | ||
on deposit in the Fund or Funds from which the moneys were | ||
transferred. | ||
Upon a finding by the Commission, after reasonable notice | ||
and hearing, that any employer has willfully and knowingly | ||
failed to pay the proper amounts into the Second Injury Fund or | ||
the Rate Adjustment Fund required by this Section or if such | ||
payments are not made within the time periods prescribed by | ||
this Section, the employer shall, in addition to such | ||
payments, pay a penalty of 20% of the amount required to be | ||
paid or $2,500, whichever is greater, for each year or part | ||
thereof of such failure to pay. This penalty shall only apply | ||
to obligations of an employer to the Second Injury Fund or the | ||
Rate Adjustment Fund accruing after the effective date of this | ||
amendatory Act of 1989. All or part of such a penalty may be | ||
waived by the Commission for good cause shown. | ||
Any obligations of an employer to the Second Injury Fund | ||
and Rate Adjustment Fund accruing prior to the effective date | ||
of this amendatory Act of 1989 shall be paid in full by such | ||
employer within 5 years of the effective date of this | ||
amendatory Act of 1989, with at least one-fifth of such |
obligation to be paid during each year following the effective | ||
date of this amendatory Act of 1989. If the Commission finds, | ||
following reasonable notice and hearing, that an employer has | ||
failed to make timely payment of any obligation accruing under | ||
the preceding sentence, the employer shall, in addition to all | ||
other payments required by this Section, be liable for a | ||
penalty equal to 20% of the overdue obligation or $2,500, | ||
whichever is greater, for each year or part thereof that | ||
obligation is overdue. All or part of such a penalty may be | ||
waived by the Commission for good cause shown. | ||
The Chairman of the Illinois Workers' Compensation | ||
Commission shall, annually, furnish to the Director of the | ||
Department of Insurance a list of the amounts paid into the | ||
Second Injury Fund and the Rate Adjustment Fund by each | ||
insurance company on behalf of their insured employers. The | ||
Director shall verify to the Chairman that the amounts paid by | ||
each insurance company are accurate as best as the Director | ||
can determine from the records available to the Director. The | ||
Chairman shall verify that the amounts paid by each | ||
self-insurer are accurate as best as the Chairman can | ||
determine from records available to the Chairman. The Chairman | ||
may require each self-insurer to provide information | ||
concerning the total compensation payments made upon which | ||
contributions to the Second Injury Fund and the Rate | ||
Adjustment Fund are predicated and any additional information | ||
establishing that such payments have been made into these |
funds. Any deficiencies in payments noted by the Director or | ||
Chairman shall be subject to the penalty provisions of this | ||
Act. | ||
The State Treasurer, or his duly authorized | ||
representative, shall be named as a party to all proceedings | ||
in all cases involving claim for the loss of, or the permanent | ||
and complete loss of the use of one eye, one foot, one leg, one | ||
arm or one hand. | ||
The State Treasurer or his duly authorized agent shall | ||
have the same rights as any other party to the proceeding, | ||
including the right to petition for review of any award. The | ||
reasonable expenses of litigation, such as medical | ||
examinations, testimony, and transcript of evidence, incurred | ||
by the State Treasurer or his duly authorized representative, | ||
shall be borne by the Second Injury Fund. | ||
If the award is not paid within 30 days after the date the | ||
award has become final, the Commission shall proceed to take | ||
judgment thereon in its own name as is provided for other | ||
awards by paragraph (g) of Section 19 of this Act and take the | ||
necessary steps to collect the award. | ||
Any person, corporation or organization who has paid or | ||
become liable for the payment of burial expenses of the | ||
deceased employee may in his or its own name institute | ||
proceedings before the Commission for the collection thereof. | ||
For the purpose of administration, receipts and | ||
disbursements, the Special Fund provided for in paragraph (f) |
of this Section shall be administered jointly with the Special | ||
Fund provided for in Section 7, paragraph (f) of the Workers' | ||
Occupational Diseases Act. | ||
(g) All compensation, except for burial expenses provided | ||
in this Section to be paid in case accident results in death, | ||
shall be paid in installments equal to the percentage of the | ||
average earnings as provided for in Section 8, paragraph (b) | ||
of this Act, at the same intervals at which the wages or | ||
earnings of the employees were paid. If this is not feasible, | ||
then the installments shall be paid weekly. Such compensation | ||
may be paid in a lump sum upon petition as provided in Section | ||
9 of this Act. However, in addition to the benefits provided by | ||
Section 9 of this Act where compensation for death is payable | ||
to the deceased's widow, widower or to the deceased's widow, | ||
widower and one or more children, and where a partial lump sum | ||
is applied for by such beneficiary or beneficiaries within 18 | ||
months after the deceased's death, the Commission may, in its | ||
discretion, grant a partial lump sum of not to exceed 100 weeks | ||
of the compensation capitalized at their present value upon | ||
the basis of interest calculated at 3% per annum with annual | ||
rests, upon a showing that such partial lump sum is for the | ||
best interest of such beneficiary or beneficiaries. | ||
(h) 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 (a), (b), (c), | ||
(d) and (f) of this Section shall be increased 50%. |
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. | ||
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 only. | ||
(i) Whenever the dependents of a deceased employee are | ||
noncitizens not residing in the United States, Mexico or | ||
Canada, the amount of compensation payable is limited to the | ||
beneficiaries described in paragraphs (a), (b) and (c) of this | ||
Section and is 50% of the compensation provided in paragraphs | ||
(a), (b) and (c) of this Section, except as otherwise provided | ||
by treaty. | ||
In a case where any of the persons who would be entitled to | ||
compensation is living at any place outside of the United | ||
States, then payment shall be made to the personal | ||
representative of the deceased employee. The distribution by | ||
such personal representative to the persons entitled shall be | ||
made to such persons and in such manner as the Commission | ||
orders. | ||
(Source: P.A. 102-1030, eff. 5-27-22.) |
(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 | ||
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 | ||
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 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 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 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. | ||
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 | ||
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; | ||
(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 | ||
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 | ||
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 | ||
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 | ||
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 | ||
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 from a labor | ||
organization recognized under the National Labor Relations Act | ||
or an attorney who has represented labor organizations or has | ||
represented employees in workers' compensation cases, 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 |
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 | ||
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 | ||
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 (d) of | ||
Section 4 and 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 other than those claims under Section 18.1, 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 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 file with the | ||
Commission notice of intent to file for review in Circuit | ||
Court. It shall be the duty of the Commission upon such | ||
filing of notice of intent to file for review in the | ||
Circuit Court to prepare a true and correct 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. The changes made to this | ||
subdivision (f)(1) by this amendatory Act of the 98th | ||
General Assembly apply to any Commission decision entered | ||
after the effective date of this amendatory Act of the | ||
98th General Assembly. | ||
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 filing with the Commission of | ||
the notice of the intent to file for review in the Circuit | ||
Court or an affidavit of the attorney setting forth that | ||
notice of intent to file for review in the Circuit Court | ||
has been given in writing to the Secretary or Assistant | ||
Secretary of the Commission. | ||
(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. | ||
The following 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: | ||
(1) the State Treasurer, for a fund administered | ||
by the State Treasurer ex officio against whom the |
Commission shall have rendered an award for the | ||
payment of money; and | ||
(2) a 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. | ||
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. If the court affirms the | ||
Commission's decision imposing fines on the employer under | ||
subsection (d) of Section 4, the court shall enter | ||
judgment against the employer in the amount of the fines | ||
assessed by the Commission. 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 | ||
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 | ||
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 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 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 30 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 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 or the Occupational Safety and Health 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. 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 | ||
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 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. 101-384, eff. 1-1-20; 102-775, eff. 5-13-22.) | ||
(820 ILCS 305/25.5) | ||
Sec. 25.5. Unlawful acts; penalties. | ||
(a) It is unlawful for any person, company, corporation, | ||
insurance carrier, healthcare provider, or other entity to: | ||
(1) Intentionally present or cause to be presented any | ||
false or fraudulent claim for the payment of any workers' | ||
compensation benefit. | ||
(2) Intentionally make or cause to be made any false | ||
or fraudulent material statement or material | ||
representation for the purpose of obtaining or denying any | ||
workers' compensation benefit. | ||
(3) Intentionally make or cause to be made any false | ||
or fraudulent statements with regard to entitlement to | ||
workers' compensation benefits with the intent to prevent | ||
an injured worker from making a legitimate claim for any | ||
workers' compensation benefits. | ||
(4) Intentionally prepare or provide an invalid, | ||
false, or counterfeit certificate of insurance as proof of | ||
workers' compensation insurance. |
(5) Intentionally make or cause to be made any false | ||
or fraudulent material statement or material | ||
representation for the purpose of obtaining workers' | ||
compensation insurance at less than the proper amount for | ||
that insurance. | ||
(6) Intentionally make or cause to be made any false | ||
or fraudulent material statement or material | ||
representation on an initial or renewal self-insurance | ||
application or accompanying financial statement for the | ||
purpose of obtaining self-insurance status or reducing the | ||
amount of security that may be required to be furnished | ||
pursuant to Section 4 of this Act. | ||
(7) Intentionally make or cause to be made any false | ||
or fraudulent material statement to the Department of | ||
Insurance's fraud and insurance non-compliance unit in the | ||
course of an investigation of fraud or insurance | ||
non-compliance. | ||
(8) Intentionally assist, abet, solicit, or conspire | ||
with any person, company, or other entity to commit any of | ||
the acts in paragraph (1), (2), (3), (4), (5), (6), or (7) | ||
of this subsection (a). | ||
(8.5) Intentionally assist, abet, solicit, or conspire | ||
with any person, company, or other entity to commit any of | ||
the acts in paragraph (4) of this subsection (a). | ||
(9) Intentionally present a bill or statement for the | ||
payment for medical services that were not provided. |
For the purposes of paragraphs (2), (3), (5), (6), (7), | ||
and (9), the term "statement" includes any writing, notice, | ||
proof of injury, bill for services, hospital or doctor records | ||
and reports, or X-ray and test results. | ||
(b) Sentences for violations of paragraphs (1), (2), (3), | ||
(5), (6), (7), (8), and (9) of subsection (a) are as follows: | ||
(1) A violation in which the value of the property | ||
obtained or attempted to be obtained is $300 or less is a | ||
Class A misdemeanor. | ||
(2) A violation in which the value of the property | ||
obtained or attempted to be obtained is more than $300 but | ||
not more than $10,000 is a Class 3 felony. | ||
(3) A violation in which the value of the property | ||
obtained or attempted to be obtained is more than $10,000 | ||
but not more than $100,000 is a Class 2 felony. | ||
(4) A violation in which the value of the property | ||
obtained or attempted to be obtained is more than $100,000 | ||
is a Class 1 felony. | ||
(5) A person convicted under this subsection Section | ||
shall be ordered to pay monetary restitution to the | ||
injured worker, insurance company , or self-insured entity , | ||
or any other person for any financial loss sustained as a | ||
result of a violation of this Section , including any court | ||
costs and attorney fees . An order of restitution also | ||
includes expenses incurred and paid by the State of | ||
Illinois , or an insurance company , a or self-insured |
entity , an injured worker, or any other person in | ||
connection with any medical evaluation or treatment | ||
services. For the purposes of this subsection, "person" | ||
includes any legal entity created under Section 535 of the | ||
Illinois Insurance Code. | ||
For the purposes of this subsection Section , where the | ||
exact value of property obtained or attempted to be obtained | ||
is either not alleged or is not specifically set by the terms | ||
of a policy of insurance, the value of the property shall be | ||
the fair market replacement value of the property claimed to | ||
be lost, the reasonable costs of reimbursing a vendor or other | ||
claimant for services to be rendered, or both. Notwithstanding | ||
the foregoing, an injured worker, an insurance company, | ||
self-insured entity, or any other person suffering financial | ||
loss sustained as a result of violation of this Section may | ||
seek restitution, including court costs and attorney's fees in | ||
a civil action in a court of competent jurisdiction. | ||
(b-5) Sentences for violations of paragraphs (4) and (8.5) | ||
of | ||
subsection (a) are as follows: | ||
(1) A violation in which the value of the property | ||
obtained or attempted to be obtained is $10,000 or less, | ||
is a Class 3 felony and a civil penalty of up to $10,000 | ||
per violation, payable to the Injured Workers' Benefit | ||
Fund, shall be assessed. | ||
(2) A violation in which the value of the property | ||
obtained or attempted to be obtained is more than $10,000, |
but not more than $100,000, is a Class 2 felony and a civil | ||
penalty of up to $10,000 per violation, payable to the | ||
Injured Workers' Benefit Fund, shall be assessed. | ||
(3) A violation in which the value of the property | ||
obtained or attempted to be obtained is more than $100,000 | ||
is a Class 1 felony and a civil penalty of up to $10,000 | ||
per violation, payable to the Injured Workers' Benefit | ||
Fund, shall be assessed. | ||
(4) A person convicted under this subsection shall be | ||
ordered to pay monetary restitution to the injured worker, | ||
insurance company, self-insured entity, or any other | ||
person for any financial loss sustained as a result of a | ||
violation of this Section. An order of restitution also | ||
includes expenses incurred and paid by the State of | ||
Illinois, an insurance company, a self-insured entity, an | ||
injured person, or any other person in connection with any | ||
medical evaluation or treatment services. | ||
For the purposes of this subsection, the value of the | ||
property obtained or attempted to be obtained shall be the | ||
amount of premiums saved by use of the invalid, false, or | ||
counterfeit certificate of insurance, the value of any | ||
payments under any contract obtained by reliance on the | ||
invalid, false, or counterfeit certificate of insurance, or | ||
both. Notwithstanding the foregoing, an injured worker, | ||
insurance company, self-insured entity, or any other person | ||
suffering financial loss sustained as a result of violation of |
this subsection may seek restitution, including court costs | ||
and attorney's fees in a civil action in a court of competent | ||
jurisdiction. | ||
(c) The Department of Insurance shall establish a fraud | ||
and insurance non-compliance unit responsible for | ||
investigating incidences of fraud and insurance non-compliance | ||
pursuant to this Section. The size of the staff of the unit | ||
shall be subject to appropriation by the General Assembly. It | ||
shall be the duty of the fraud and insurance non-compliance | ||
unit to determine the identity of insurance carriers, | ||
employers, employees, or other persons or entities who have | ||
violated the fraud and insurance non-compliance provisions of | ||
this Section. The fraud and insurance non-compliance unit | ||
shall report violations of the fraud and insurance | ||
non-compliance provisions of this Section to the Special | ||
Prosecutions Bureau of the Criminal Division of the Office of | ||
the Attorney General or to the State's Attorney of the county | ||
in which the offense allegedly occurred, either of whom has | ||
the authority to prosecute violations under this Section. | ||
With respect to the subject of any investigation being | ||
conducted, the fraud and insurance non-compliance unit shall | ||
have the general power of subpoena of the Department of | ||
Insurance, including the authority to issue a subpoena to a | ||
medical provider, pursuant to Section 8-802 of the Code of | ||
Civil Procedure. | ||
(d) Any person may report allegations of insurance |
non-compliance and fraud pursuant to this Section to the | ||
Department of Insurance's fraud and insurance non-compliance | ||
unit whose duty it shall be to investigate the report. The unit | ||
shall notify the Commission of reports of insurance | ||
non-compliance. Any person reporting an allegation of | ||
insurance non-compliance or fraud against either an employee | ||
or employer under this Section must identify himself. Except | ||
as provided in this subsection and in subsection (e), all | ||
reports shall remain confidential except to refer an | ||
investigation to the Attorney General or State's Attorney for | ||
prosecution or if the fraud and insurance non-compliance | ||
unit's investigation reveals that the conduct reported may be | ||
in violation of other laws or regulations of the State of | ||
Illinois, the unit may report such conduct to the appropriate | ||
governmental agency charged with administering such laws and | ||
regulations. Any person who intentionally makes a false report | ||
under this Section to the fraud and insurance non-compliance | ||
unit is guilty of a Class A misdemeanor. | ||
(e) In order for the fraud and insurance non-compliance | ||
unit to investigate a report of fraud related to an employee's | ||
claim, (i) the employee must have filed with the Commission an | ||
Application for Adjustment of Claim and the employee must have | ||
either received or attempted to receive benefits under this | ||
Act that are related to the reported fraud or (ii) the employee | ||
must have made a written demand for the payment of benefits | ||
that are related to the reported fraud. There shall be no |
immunity, under this Act or otherwise, for any person who | ||
files a false report or who files a report without good and | ||
just cause. Confidentiality of medical information shall be | ||
strictly maintained. Investigations that are not referred for | ||
prosecution shall be destroyed upon the expiration of the | ||
statute of limitations for the acts under investigation and | ||
shall not be disclosed except that the person making the | ||
report shall be notified that the investigation is being | ||
closed. It is unlawful for any employer, insurance carrier, | ||
service adjustment company, third party administrator, | ||
self-insured, or similar entity to file or threaten to file a | ||
report of fraud against an employee because of the exercise by | ||
the employee of the rights and remedies granted to the | ||
employee by this Act. | ||
(e-5) (Blank). | ||
(f) Any person convicted of fraud related to workers' | ||
compensation pursuant to this Section shall be subject to the | ||
penalties prescribed in the Criminal Code of 2012 and shall be | ||
ineligible to receive or retain any compensation, disability, | ||
or medical benefits as defined in this Act if the | ||
compensation, disability, or medical benefits were owed or | ||
received as a result of fraud for which the recipient of the | ||
compensation, disability, or medical benefit was convicted. | ||
This subsection applies to accidental injuries or diseases | ||
that occur on or after the effective date of this amendatory | ||
Act of the 94th General Assembly. |
(g) Civil liability. Any person convicted of fraud who | ||
knowingly obtains, attempts to obtain, or causes to be | ||
obtained any benefits under this Act by the making of a false | ||
claim or who knowingly misrepresents any material fact shall | ||
be civilly liable to the payor of benefits or the insurer or | ||
the payor's or insurer's subrogee or assignee in an amount | ||
equal to 3 times the value of the benefits or insurance | ||
coverage wrongfully obtained or twice the value of the | ||
benefits or insurance coverage attempted to be obtained, plus | ||
reasonable attorney's fees and expenses incurred by the payor | ||
or the payor's subrogee or assignee who successfully brings a | ||
claim under this subsection. This subsection applies to | ||
accidental injuries or diseases that occur on or after the | ||
effective date of this amendatory Act of the 94th General | ||
Assembly. | ||
(h) The fraud and insurance non-compliance unit shall | ||
submit a written report on an annual basis to the Chairman of | ||
the Commission, the Workers' Compensation Advisory Board, the | ||
General Assembly, the Governor, and the Attorney General by | ||
January 1 and July 1 of each year. This report shall include, | ||
at the minimum, the following information: | ||
(1) The number of allegations of insurance | ||
non-compliance and fraud reported to the fraud and | ||
insurance non-compliance unit. | ||
(2) The source of the reported allegations | ||
(individual, employer, or other). |
(3) The number of allegations investigated by the | ||
fraud and insurance non-compliance unit. | ||
(4) The number of criminal referrals made in | ||
accordance with this Section and the entity to which the | ||
referral was made. | ||
(5) All proceedings under this Section. | ||
(6) Recommendations regarding opportunities for | ||
additional fraud detection. | ||
(Source: P.A. 102-37, eff. 7-1-21.) | ||
Section 99. Effective date. This Act takes effect upon | ||
becoming law. |