093_HB2293

 
                                     LRB093 06092 LRD 06197 b

 1        AN ACT in relation to workplace injuries and diseases.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Workers' Compensation Act is amended by
 5    changing Sections 8, 16, and 16a and  adding  Section  8a  as
 6    follows:

 7        (820 ILCS 305/8) (from Ch. 48, par. 138.8)
 8        Sec.  8.   The amount of compensation which shall be paid
 9    to the employee for an accidental  injury  not  resulting  in
10    death is set forth in this  Section.:
11        (a)  The employer shall provide and pay the lesser of the
12    health  care  provider's  actual  charges  or  the  usual and
13    customary charges incurred for all the necessary  first  aid,
14    medical  and  surgical  services,  and all necessary medical,
15    surgical and hospital services thereafter incurred,  limited,
16    however,  to  that  which  is  reasonably required to cure or
17    relieve from the effects of the accidental injury. The  usual
18    and   customary   charges  under  this  Act  shall  be  those
19    established pursuant  to  paragraphs  (5)  and  (6)  of  this
20    subsection (a). Charges for procedures or services related to
21    a  claim  under  this  Act  shall not exceed charges to other
22    non-workers'  compensation  third  party  payors  for   those
23    procedures  or  services,  exclusive  of  charges pursuant to
24    negotiation,  contract,  or  federal   or   State   laws   or
25    regulations.  The  employer  shall  also  pay  for treatment,
26    instruction and training necessary for the  physical,  mental
27    and  vocational rehabilitation of the employee, including all
28    maintenance costs and expenses incidental thereto.  If  as  a
29    result   of   the   injury  the  employee  is  unable  to  be
30    self-sufficient the  employer  shall  further  pay  for  such
31    maintenance  or  institutional  care  as  shall  be required.
 
                            -2-      LRB093 06092 LRD 06197 b
 1    Nothing in this Section shall preclude employers  and  health
 2    care  providers  from  agreeing  to and utilizing alternative
 3    reimbursement  methods  or  schedules  agreeable   to   both,
 4    provided  that  any alternative reimbursement method shall be
 5    set forth in a written contract or  other  written  agreement
 6    signed by the parties.
 7             (1)  The  employee  may  at any time elect to secure
 8        his own physician, surgeon and hospital services  at  the
 9        employer's expense, or,
10             (2)  Upon  agreement  between  the  employer and the
11        employees, or the  employees'  exclusive  representative,
12        and subject to the approval of the Industrial Commission,
13        the  employer  shall maintain a list of physicians, to be
14        known as a Panel of Physicians, who are accessible to the
15        employees. The employer shall post this list in  a  place
16        or  places  easily  accessible  to  his  employees.   The
17        employee  shall  have  the  right  to make an alternative
18        choice  of  physician  from  such  Panel  if  he  is  not
19        satisfied with the physician first selected.  If, due  to
20        the  nature of the injury or its occurrence away from the
21        employer's place of business, the employee is  unable  to
22        make  a  selection  from the Panel, the selection process
23        from the Panel shall not apply.  The  physician  selected
24        from the Panel may arrange for any consultation, referral
25        or  other  specialized medical services outside the Panel
26        at the employer's expense. Provided that,  in  the  event
27        the  Commission  shall find that a doctor selected by the
28        employee is rendering improper or  inadequate  care,  the
29        Commission  may  order  the  employee  to  select another
30        doctor certified or qualified in the  medical  field  for
31        which  treatment is required.  If the employee refuses to
32        make such change the Commission may relieve the  employer
33        of  his  obligation  to pay the doctor's charges from the
34        date of refusal to the date of compliance.
 
                            -3-      LRB093 06092 LRD 06197 b
 1             (3)  The  Commission  shall  establish   rules   for
 2        processing  payments  to  health  care  providers  in  an
 3        expeditious  and  timely manner including designating the
 4        proper payor  to  be  billed  for  health  care  benefits
 5        related to a claim.
 6             Health   care   providers   may  seek  payment  from
 7        employees until the health care provider is  notified  in
 8        writing,  on  a  uniform  form  adopted  by  rule  by the
 9        Industrial Commission, by the employer  or  the  employee
10        that  the  services  concern  a claim under the Act. This
11        notification shall specifically  identify  the  party  to
12        whom  bills  for  services  must be submitted. The health
13        care  provider  must  then  within   60   days   resubmit
14        previously  submitted bills and then subsequent bills for
15        services exclusively to the  party  to  which  bills  for
16        services  must  be  submitted.  Nothing in this Act shall
17        prevent health care providers from notifying employees of
18        the bills for services consistent with the limitations of
19        this Section.
20                  (A)  Nondisputed health care payments:
21                       (i)  The employer shall make  payments  or
22                  cause  payments  to  be  made  to  health  care
23                  providers  within  30 days after the receipt by
24                  the employer of due  proof  of  loss.  For  the
25                  purpose  of  this  Section, "due proof of loss"
26                  consists of a receipt of an itemized bill  with
27                  a demand for payment and a complete copy of the
28                  patient  records related to the claim and those
29                  charges. The employer shall notify  the  health
30                  care   provider   of  any  failure  to  provide
31                  sufficient documentation for  a  due  proof  of
32                  loss  within 30 days after receipt of the claim
33                  for  health  services.  If  requested  by   the
34                  employer,  subsequent  billings  shall  provide
 
                            -4-      LRB093 06092 LRD 06197 b
 1                  updated  patient  records  from  the  date last
 2                  provided.
 3                       (ii)  If the employer fails, neglects,  or
 4                  refuses,  without  good  and just cause, to pay
 5                  the health  care  provider  charges  within  30
 6                  days,  the  employer  shall pay interest on the
 7                  unpaid balance of fees at a rate  of  7%.   The
 8                  interest  shall begin to accrue on the 31st day
 9                  following receipt of  due  proof  of  loss  and
10                  shall stop accruing on the day before tender of
11                  payment for the amount paid. The employer shall
12                  pay  any  required  interest  charges within 30
13                  days of payment of other health  care  provider
14                  charges.
15                  (B)  Disputed health care payments.
16                       (i)  Any disputes concerning an employer's
17                  neglect,  failure  or  refusal to pay the usual
18                  and customary charges of health care  providers
19                  services   under   subsection   8(a)  shall  be
20                  resolved in a separate proceeding  between  the
21                  employer  and  the  health  care provider. This
22                  separate proceeding may take place concurrently
23                  with any  proceeding  concerning  a  claim  for
24                  benefits  under  this  Act.  The arbitrator may
25                  bifurcate any proceeding, but resolution  of  a
26                  payment dispute shall not be decided prior to a
27                  determination  of  the  compensability  of  the
28                  claim.  The  employer  shall provide the health
29                  care provider and  the  employee  with  written
30                  notice  of the specific reasons for non-payment
31                  or  payment  of  less  than  submitted  charges
32                  within 60 days of receipt of due proof of loss.
33                  Any dispute shall  be  resolved  in  accordance
34                  with  the rules which shall include, but not be
 
                            -5-      LRB093 06092 LRD 06197 b
 1                  limited to, the employers obligation to provide
 2                  a written notice and the health care  providers
 3                  obligation  to provide a written explanation of
 4                  a  billing  and  an  affidavit  concerning  the
 5                  health  care   providers   charges   to   other
 6                  non-workers'     compensation    third    party
 7                  non-governmental  payors.  The  employee  shall
 8                  have a duty to  cooperate  in  any  process  or
 9                  proceeding.   The  provider  of  any  services,
10                  treatment,  care,  instruction,  training,   or
11                  appliances  or  other tangible things for which
12                  an employer is responsible  for  payment  under
13                  this  subsection  (a)  is  bound  by charges or
14                  payments ordered by the Industrial Commission.
15                       (ii)  In   addition   to   any    remedies
16                  available  to an employee under the Act, if the
17                  Commission   finds   that   an   employer   has
18                  neglected, failed or refused to pay or cause to
19                  be paid the usual and customary  charges  by  a
20                  health  care  provider,  under  subsection 8(a)
21                  without good and just cause, the employer shall
22                  pay interest pursuant to subsection  (3)(A)(ii)
23                  and  the  provider's  attorneys  fees and other
24                  costs related  to  the  proceeding  before  the
25                  Commission under this Section.
26                       (iii)  The    Commission    shall    adopt
27                  procedural  rules  for  these proceedings which
28                  are consistent with current practices under the
29                  Act  and   provide   for   minimal   delay   or
30                  inconvenience.
31                  (C)  The employee and any health care providers
32             may,  but are not required to, be represented by the
33             same attorney.
34                  (D)  Any  fees  for  undisputed   health   care
 
                            -6-      LRB093 06092 LRD 06197 b
 1             provider  services  shall  be  paid  directly to the
 2             health care provider. The employee shall not receive
 3             payments owed to health care providers. In the  case
 4             of  an award or settlement, in whole or in part, for
 5             disputed health care provider payments, payment  may
 6             be  made  to the health care provider or in cases in
 7             which the health care provider is represented by  an
 8             attorney, the payments shall be made to the attorney
 9             involved in the name of the attorney and health care
10             providers.  The attorney shall disburse the funds to
11             the health care  providers  involved  in  accordance
12             with the award or settlement.
13                  (E)  In  addition  to  compensation  for health
14             care  services,  health  care  providers  shall   be
15             separately  reimbursed  by  the requesting party for
16             requested records, reports, letters,  testimony,  or
17             depositions  for all reasonable expenses incurred in
18             connection  with  provision  of   this   information
19             pursuant to Section 16.
20                  (F)  Health  care provider service payments may
21             only be denied by the employer upon a finding that:
22                       (1)  the  service  or  procedure  was  not
23                  related to an accidental injury; or
24                       (2)  the  service  or  procedure  was  not
25                  necessary or reasonably  required  to  cure  or
26                  provide   relief   from   the  effects  of  the
27                  accidental injury.
28             A  finding  that  a  health  care  service  was  not
29        necessary or  reasonably  required  to  cure  or  provide
30        relief from the effects of the accidental injury shall be
31        based on clinical criteria which are:
32                       (1)  developed   with   the   input   from
33                  appropriate actively practicing physicians; and
34                       (2)  based  on  sound  clinical principles
 
                            -7-      LRB093 06092 LRD 06197 b
 1                  and processes.
 2             Any  such  finding  shall  be  accompanied  by   the
 3        clinical criteria used as the basis for such finding.
 4             (4)  Every  hospital,  physician,  surgeon  or other
 5        person rendering treatment or services in accordance with
 6        the provisions of this Section shall upon written request
 7        furnish full and complete reports thereof to, and  permit
 8        their records to be copied by, the employer, the employee
 9        or his dependents, as the case may be, or any other party
10        to any proceeding for compensation before the Commission,
11        or their attorneys.
12             (5)  Charges  of  health  care  providers  shall  be
13        compensated  at  actual  charges  not  to exceed the 85th
14        percentile  of  the  usual  and  customary   charges   as
15        determined by this Section.
16             The  Industrial Commission shall determine the usual
17        and customary charges of health  care  providers,  except
18        hospital  charges under paragraph (6), in each geographic
19        area  of  the  State  by  adopting  rules  designating  a
20        national database  that  includes  health  care  provider
21        charges,   except   hospital  charges,  information  from
22        Illinois with a minimum of 12,000,000 Illinois line  item
23        charges,   excluding  charges  which  are  discounted  by
24        contract, law,  or  regulation,  and  which  makes  these
25        charges  available  by  geozip  or any smaller geographic
26        unit in Illinois.  The usual and customary charges  shall
27        be as current as possible with no charge data being older
28        than  24  months  and  shall  be updated at least every 6
29        months. The data shall in no  way  identify  or  tend  to
30        identify  any patient, employer, or health care provider.
31        Usual  and  customary  charge  determinations  shall   be
32        available  electronically  to  the  Industrial Commission
33        every 6 months, and beginning July 1, 2004.
34             As used in this Section, "geozip" means a  group  of
 
                            -8-      LRB093 06092 LRD 06197 b
 1        one   or   more    three-digit   zip codes  based on data
 2        similarities, geographical similarities, and frequencies.
 3        A "geozip" does not cross state boundaries.  As  used  in
 4        this  Section,  "three-digit zip code" means a geographic
 5        area in which all zip codes have the same first 3 digits.
 6             Except as otherwise provided in this Section 8a,  no
 7        action  shall  be  commenced  or maintained in a court of
 8        this State by or on behalf of the above mentioned  health
 9        care  providers  nor  shall  those  health care providers
10        pursue the payment of a bill individually  or  through  a
11        collection  agency  or credit reporting bureau against an
12        employee for  the  collection  of  charges  for  services
13        incurred  for  a  claim  covered or alleged to be covered
14        under  this  Act  until  resolution  by  the   Industrial
15        Commission.  Health  care  providers may bill an employee
16        when a claim is not found to be covered under the Act.
17             (6)  On or after October  1,  2003,  the  Industrial
18        Commission   shall  determine  the  usual  and  customary
19        payments for Illinois hospitals  within  three-digit  zip
20        code  areas  by  adopting rules designating a database or
21        databases  and  establishing  the  usual  and   customary
22        payments pursuant to this paragraph (6).
23             The database or databases used to establish hospital
24        usual  and  customary  payments  shall  include  Illinois
25        hospital   inpatient   charge   data   reflecting   total
26        discharges   within   the  State  and  Illinois  hospital
27        outpatient charge  data  with  a  minimum  of  12,000,000
28        records.  The  database  or  databases shall exclude data
29        from   tertiary   teaching   hospitals,    rehabilitation
30        hospitals, psychiatric hospitals, and trauma centers. The
31        data  shall  exclude  charges  which  are  discounted  by
32        contract,  law,  or regulation, and shall be available by
33        three-digit  zip  code  areas.  The  data  shall  reflect
34        hospital line item charges. As  used  in  this  paragraph
 
                            -9-      LRB093 06092 LRD 06197 b
 1        (6), "line item charge" means the charge for each revenue
 2        code  submitted  by  hospitals  on  the  uniform hospital
 3        billing form required by  Section  4-2  of  the  Illinois
 4        Health  Finance  Reform  Act.  The  data  shall in no way
 5        identify or  tend  to  identify  any  patient,  employer,
 6        health  care  provider,  or  hospital  facility. Hospital
 7        charge data shall be as  current  as  possible,  with  no
 8        charge  data  being  older  than  24 months, and shall be
 9        updated every 6 months.
10             The  usual  and  customary  payment   for   hospital
11        procedures,  treatments, or services shall be established
12        for each line item  charge  at  the  85th  percentile  of
13        charges  for  hospitals  within  the same three-digit zip
14        code area. The charge data for inpatient  and  outpatient
15        services  shall  be  grouped  or  referenced by line item
16        charges or, where appropriate and available, by CPT code.
17        For  inpatient  services,  line  item  charges  shall  be
18        determined  per  patient  day,  as  appropriate.  Nothing
19        herein shall prohibit the payment of outpatient  services
20        by  CPT  code. Usual and customary payment determinations
21        for hospital inpatient and outpatient services  shall  be
22        published  electronically  by  the  Industrial Commission
23        every 6 months starting  July  1,  2004.  The  usual  and
24        customary  payment  limitations  under this Act shall not
25        apply to hospitals located in three-digit zip code  areas
26        that contain fewer than 20 hospitals. Nothing in this Act
27        shall  prohibit  a  hospital and employer or insurer from
28        negotiating and  agreeing  on  a  level  of  payment  for
29        individual  bills  or charges that differs from the usual
30        and  customary  payment  established  under   this   Act,
31        provided  that  such  agreement is documented in writing,
32        electronically, or by another mutually agreed method.
33             Hospitals designated by  the  Department  of  Public
34        Health  as  tertiary  teaching  hospitals, rehabilitation
 
                            -10-     LRB093 06092 LRD 06197 b
 1        hospitals, psychiatric hospitals, or trauma centers shall
 2        not  be  subject  to  the  usual  and  customary  payment
 3        limitations  under  this  Act;  provided,  however,  that
 4        charges for procedures or services  related  to  a  claim
 5        under  this  Act  rendered  by  such  hospitals shall not
 6        exceed their charges to non-workers'  compensation  third
 7        party payors for those procedures or services. Charges of
 8        tertiary  teaching  hospitals,  rehabilitation hospitals,
 9        psychiatric hospitals, and trauma centers  shall  not  be
10        included  in  the database or databases designated by the
11        Industrial Commission. Any hospital no longer  designated
12        a  tertiary  teaching  hospital, rehabilitation hospital,
13        psychiatric hospital, or a trauma center by the  Illinois
14        Department of Public Health shall be subject to the usual
15        and customary payment provisions under this Act within 30
16        days  of  receipt of notice of change of designation from
17        the Department of Public Health.
18             All   hospitals,   including    tertiary    teaching
19        hospitals,    rehabilitation    hospitals,    psychiatric
20        hospitals,  or  trauma centers, shall be fully subject to
21        the provisions of paragraph 8(a)(3)(F).
22             Except as  otherwise  provided  in  this  subsection
23        8(a),  no  action  shall  be commenced or maintained in a
24        court of this State by or on behalf  of  a  hospital  nor
25        shall   a   hospital   pursue   the  payment  of  a  bill
26        individually or through a  collection  agency  or  credit
27        reporting  bureau  against an employee for the collection
28        of charges for services incurred for a claim  covered  or
29        alleged  to be covered under this Act until resolution by
30        the Industrial Commission. Hospitals may bill an employee
31        when a claim is not found to be covered under the Act.
32             (7)(i)  No list of usual and  customary  charges  of
33        health  care  providers  pursuant  to paragraph (5) or of
34        hospitals pursuant to paragraph (6),  and  no  update  of
 
                            -11-     LRB093 06092 LRD 06197 b
 1        such  a  list, shall be established except by rule of the
 2        Commission.   Before  any  rule  establishing  usual  and
 3        customary charges becomes final, the Commission shall:
 4                  (a)  Comply  with all public notice and comment
 5             requirements   set    forth    in    the    Illinois
 6             Administrative Procedure Act;
 7                  (b)  Allow  members of the public to review the
 8             actual, underlying database upon which the  list  of
 9             usual  and customary charges in the proposed rule is
10             derived;
11                  (c)  Verify   the   validity,   accuracy,   and
12             timeliness of all usual and customary charges in the
13             proposed rule, and  make  available  to  the  public
14             written  explanation  of  why the charges are valid,
15             accurate, and timely.
16             For purposes of this paragraph, a "valid" usual  and
17        customary   charge   is   a   charge   that   takes  into
18        consideration only appropriate sources of data, and  that
19        complies  with  the  criteria  for  usual  and  customary
20        charges  for  health  care  providers  as  set  forth  in
21        paragraph (5) or for hospitals as set forth  in paragraph
22        (6)  with  respect  to  minimum  numbers  of  line items,
23        geographical  sources  and   coverage,   exclusions   and
24        exemptions,  and  confidentialities.  An "accurate" usual
25        and customary charge is a charge for which  the  compiled
26        data  have  been correctly interpreted in determining the
27        level of the  charge.  A  "timely"  usual  and  customary
28        charge  is  a charge that is as current as possible, with
29        no charge data being older than 24 months, and for  which
30        6 or fewer months have elapsed since the latest update of
31        data.
32             (ii)  The  requirements  of this paragraph (7) shall
33        apply  to  all  determinations  of  usual  and  customary
34        charges established by rule of the Commission as well  as
 
                            -12-     LRB093 06092 LRD 06197 b
 1        to all updates of those determinations.
 2             (iii)  The   Commission   shall   update  usual  and
 3        customary charges at least every 6  months  by  emergency
 4        rule.
 5             (iv)  The provisions of paragraphs (5) and (6) shall
 6        not  take  effect  unless  and  until  the Commission has
 7        complied with all of the requirements of  this  paragraph
 8        (7).
 9             (8)  The  payment of health care provider charges is
10        not compensation to extend the time for  filing  a  claim
11        under  this Act.  The payment of the health care provider
12        charges  by  an  employer  or  the  employer's  insurance
13        carrier,  shall  not  constitute  an  admission  of   the
14        employer's  liability  to  payment compensation or create
15        any obligation to pay health care provider charges.
16             (9)  Interest paid under this Section shall  not  be
17        an  admission  of liability to pay compensation or to pay
18        any health care provider charges.
19             (10)  The  Industrial  Commission  shall   implement
20        these  amendments  in the following manner: The physician
21        and health care provider database under paragraph (5) and
22        the hospital, in-patient and out-patient  database  under
23        paragraph  (6) and a precise methodology for use shall be
24        adopted by rule no later  than  October  1,  2003.    The
25        database  usual and customary determination shall then be
26        published electronically  by  the  Industrial  Commission
27        every 6 months beginning July 1, 2004.  The provisions of
28        paragraphs  (5)  and  (6)  shall become effective 30 days
29        after the  Commission  establishes  a  database  by  rule
30        pursuant to the requirement of paragraph (7).
31        (a-5)  Notwithstanding   the  foregoing,  the  employer's
32    liability to pay for such medical services  selected  by  the
33    employee shall be limited to:
34             (1)  all first aid and emergency treatment; plus
 
                            -13-     LRB093 06092 LRD 06197 b
 1             (2)  all  medical,  surgical  and  hospital services
 2        provided by the physician, surgeon or hospital  initially
 3        chosen  by  the  employee  or  by  any  other  physician,
 4        consultant,  expert,  institution  or  other  provider of
 5        services recommended by said initial service provider  or
 6        any  subsequent provider of medical services in the chain
 7        of referrals from said initial service provider; plus
 8             (3)  all medical,  surgical  and  hospital  services
 9        provided  by  any  second  physician, surgeon or hospital
10        subsequently chosen by  the  employee  or  by  any  other
11        physician,   consultant,  expert,  institution  or  other
12        provider of services recommended by said  second  service
13        provider  or  any subsequent provider of medical services
14        in the  chain  of  referrals  from  said  second  service
15        provider.  Thereafter  the  employer shall select and pay
16        for  all  necessary  medical,   surgical   and   hospital
17        treatment  and  the employee may not select a provider of
18        medical services at the  employer's  expense  unless  the
19        employer  agrees  to  such  selection.  At  any  time the
20        employee may obtain any medical treatment he  desires  at
21        his own expense. This paragraph shall not affect the duty
22        to pay for rehabilitation referred to above.
23        When  an  employer  and  employee  so  agree  in writing,
24    nothing in this Act prevents  an  employee  whose  injury  or
25    disability  has been established under this Act, from relying
26    in good faith, on treatment  by  prayer  or  spiritual  means
27    alone,  in  accordance  with  the  tenets  and  practice of a
28    recognized  church  or  religious  denomination,  by  a  duly
29    accredited practitioner thereof, and having nursing  services
30    appropriate  therewith,  without suffering loss or diminution
31    of the compensation benefits under  this  Act.  However,  the
32    employee  shall  submit to all physical examinations required
33    by this Act.  The cost of such  treatment  and  nursing  care
34    shall  be  paid by the employee unless the employer agrees to
 
                            -14-     LRB093 06092 LRD 06197 b
 1    make such payment.
 2        Where the accidental injury results in the amputation  of
 3    an  arm,  hand, leg or foot, or the enucleation of an eye, or
 4    the loss of any of the  natural  teeth,  the  employer  shall
 5    furnish  an artificial of any such members lost or damaged in
 6    accidental injury  arising  out  of  and  in  the  course  of
 7    employment,  and  shall  also furnish the necessary braces in
 8    all proper and necessary cases.  In cases of the  loss  of  a
 9    member or members by amputation, the employer shall, whenever
10    necessary,  maintain  in  good  repair,  refit or replace the
11    artificial limbs during the lifetime of the employee.   Where
12    the  accidental injury accompanied by physical injury results
13    in damage to a denture, eye glasses or contact eye lenses, or
14    where  the  accidental  injury  results  in  damage   to   an
15    artificial  member, the employer shall replace or repair such
16    denture, glasses, lenses, or artificial member.
17        The furnishing by the employer of any  such  services  or
18    appliances  is  not  an admission of liability on the part of
19    the employer to pay compensation.
20        The furnishing of any such services or appliances or  the
21    servicing  thereof  by  the  employer  is  not the payment of
22    compensation.
23        (b)  If the period of temporary total incapacity for work
24    lasts more  than  3  working  days,  weekly  compensation  as
25    hereinafter  provided  shall be paid beginning on the 4th day
26    of such temporary total incapacity and continuing as long  as
27    the  total  temporary  incapacity  lasts.  In cases where the
28    temporary total incapacity for work continues for a period of
29    14 days or more from the day  of  the  accident  compensation
30    shall commence on the day after the accident.
31             1.  The   compensation   rate  for  temporary  total
32        incapacity under this paragraph (b) of this Section shall
33        be equal to 66 2/3% of the employee's average weekly wage
34        computed in accordance with Section 10, provided that  it
 
                            -15-     LRB093 06092 LRD 06197 b
 1        shall  be  not  less  than  the  following amounts in the
 2        following cases:
 3                  $100.90 in case of a single person;
 4                  $105.50 in case of a  married  person  with  no
 5             children;
 6                  $108.30 in case of one child;
 7                  $113.40 in case of 2 children;
 8                  $117.40 in case of 3 children;
 9                  $124.30 in case of 4 or more children;
10        nor exceed the employee's average weekly wage computed in
11        accordance  with  the provisions of Section 10, whichever
12        is less.
13             2.  The compensation rate in all  cases  other  than
14        for  temporary total disability under this paragraph (b),
15        and other than for serious  and  permanent  disfigurement
16        under  paragraph (c) and other than for permanent partial
17        disability under subparagraph (2)  of  paragraph  (d)  or
18        under paragraph (e), of this Section shall be equal to 66
19        2/3%  of  the  employee's average weekly wage computed in
20        accordance with the provisions of  Section  10,  provided
21        that  it  shall be not less than the following amounts in
22        the following cases:
23                  $80.90 in case of a single person;
24                  $83.20 in case of  a  married  person  with  no
25             children;
26                  $86.10 in case of one child;
27                  $88.90 in case of 2 children;
28                  $91.80 in case of 3 children;
29                  $96.90 in case of 4 or more children;
30        nor exceed the employee's average weekly wage computed in
31        accordance  with  the provisions of Section 10, whichever
32        is less.
33             2.1.  The compensation rate in all cases of  serious
34        and  permanent  disfigurement  under paragraph (c) and of
 
                            -16-     LRB093 06092 LRD 06197 b
 1        permanent partial disability under  subparagraph  (2)  of
 2        paragraph  (d)  or  under  paragraph  (e) of this Section
 3        shall be equal to 60% of the  employee's  average  weekly
 4        wage  computed  in  accordance  with  the  provisions  of
 5        Section  10,  provided that it shall be not less than the
 6        following amounts in the following cases:
 7                  $80.90 in case of a single person;
 8                  $83.20 in case of  a  married  person  with  no
 9             children;
10                  $86.10 in case of one child;
11                  $88.90 in case of 2 children;
12                  $91.80 in case of 3 children;
13                  $96.90 in case of 4 or more children;
14        nor exceed the employee's average weekly wage computed in
15        accordance  with  the provisions of Section 10, whichever
16        is less.
17             3.  As used in this Section the term "child" means a
18        child of the employee including any child legally adopted
19        before the accident or whom at the time of  the  accident
20        the  employee was under legal obligation to support or to
21        whom the employee stood in loco parentis, and who at  the
22        time  of  the  accident was under 18 years of age and not
23        emancipated.  The term "children"  means  the  plural  of
24        "child".
25             4.  All  weekly  compensation  rates  provided under
26        subparagraphs 1, 2 and 2.1 of this paragraph (b) of  this
27        Section shall be subject to the following limitations:
28             The  maximum  weekly  compensation rate from July 1,
29        1975, except as hereinafter provided, shall  be  100%  of
30        the  State's  average  weekly  wage in covered industries
31        under the Unemployment Insurance Act, that being the wage
32        that most closely approximates the State's average weekly
33        wage.
34             The maximum weekly compensation rate, for the period
 
                            -17-     LRB093 06092 LRD 06197 b
 1        July  1,  1984,  through  June  30,   1987,   except   as
 2        hereinafter provided, shall be $293.61. Effective July 1,
 3        1987  and  on  July 1 of each year thereafter the maximum
 4        weekly compensation rate, except as hereinafter provided,
 5        shall be determined as follows: if during  the  preceding
 6        12  month period there shall have been an increase in the
 7        State's average weekly wage in covered  industries  under
 8        the  Unemployment  Insurance Act, the weekly compensation
 9        rate shall  be  proportionately  increased  by  the  same
10        percentage  as  the percentage of increase in the State's
11        average weekly  wage  in  covered  industries  under  the
12        Unemployment Insurance Act during such period.
13             The maximum weekly compensation rate, for the period
14        January  1,  1981  through  December  31, 1983, except as
15        hereinafter  provided,  shall  be  100%  of  the  State's
16        average weekly  wage  in  covered  industries  under  the
17        Unemployment  Insurance Act in effect on January 1, 1981.
18        Effective January 1, 1984 and on January 1, of each  year
19        thereafter  the  maximum weekly compensation rate, except
20        as hereinafter provided, shall be determined as  follows:
21        if  during the preceding 12 month period there shall have
22        been an increase in the State's average  weekly  wage  in
23        covered  industries under the Unemployment Insurance Act,
24        the weekly compensation  rate  shall  be  proportionately
25        increased  by  the  same  percentage as the percentage of
26        increase in the State's average weekly  wage  in  covered
27        industries  under  the  Unemployment Insurance Act during
28        such period.
29             From July 1, 1977 and thereafter such maximum weekly
30        compensation rate in death cases  under  Section  7,  and
31        permanent  total  disability cases under paragraph (f) or
32        subparagraph 18 of paragraph (3) of this Section and  for
33        temporary  total  disability  under paragraph (b) of this
34        Section and for amputation of a member or enucleation  of
 
                            -18-     LRB093 06092 LRD 06197 b
 1        an  eye  under  paragraph  (e)  of  this Section shall be
 2        increased to 133-1/3% of the State's average weekly  wage
 3        in  covered  industries  under the Unemployment Insurance
 4        Act.
 5             4.1.  Any   provision   herein   to   the   contrary
 6        notwithstanding,  the  weekly   compensation   rate   for
 7        compensation  payments under subparagraph 18 of paragraph
 8        (e) of this Section  and  under  paragraph  (f)  of  this
 9        Section and under paragraph (a) of Section 7, shall in no
10        event be less than 50% of the State's average weekly wage
11        in  covered  industries  under the Unemployment Insurance
12        Act.
13             4.2.  Any provision to the contrary notwithstanding,
14        the total compensation payable under Section 7 shall  not
15        exceed the greater of $250,000 or 20 years.
16             5.  For  the  purpose  of  this Section this State's
17        average weekly  wage  in  covered  industries  under  the
18        Unemployment  Insurance  Act  on  July  1, 1975 is hereby
19        fixed  at  $228.16  per  week  and  the  computation   of
20        compensation  rates  shall  be  based  on  the  aforesaid
21        average   weekly   wage  until  modified  as  hereinafter
22        provided.
23             6.  The Department of  Employment  Security  of  the
24        State shall on or before the first day of December, 1977,
25        and  on or before the first day of June, 1978, and on the
26        first  day  of  each  December  and  June  of  each  year
27        thereafter, publish the State's average  weekly  wage  in
28        covered  industries  under the Unemployment Insurance Act
29        and the Industrial Commission shall on the  15th  day  of
30        January,  1978  and  on the 15th day of July, 1978 and on
31        the 15th day of  each  January  and  July  of  each  year
32        thereafter,  post  and publish the State's average weekly
33        wage  in  covered  industries  under   the   Unemployment
34        Insurance  Act  as  last  determined and published by the
 
                            -19-     LRB093 06092 LRD 06197 b
 1        Department of Employment Security.  The  amount  when  so
 2        posted  and  published  shall  be conclusive and shall be
 3        applicable as the basis of  computation  of  compensation
 4        rates   until   the   next  posting  and  publication  as
 5        aforesaid.
 6             7.  The payment of compensation by  an  employer  or
 7        his  insurance  carrier  to an injured employee shall not
 8        constitute an admission of the  employer's  liability  to
 9        pay compensation.
10        (c)  For  any  serious and permanent disfigurement to the
11    hand, head, face, neck, arm, leg below the knee or the  chest
12    above   the  axillary  line,  the  employee  is  entitled  to
13    compensation for such disfigurement, the amount determined by
14    agreement at any time or by arbitration under this Act, at  a
15    hearing  not  less  than  6  months  after  the  date  of the
16    accidental injury, which amount shall not exceed 150 weeks at
17    the applicable rate provided in subparagraph 2.1 of paragraph
18    (b) of this Section.
19        No compensation is payable  under  this  paragraph  where
20    compensation  is  payable under paragraphs (d), (e) or (f) of
21    this Section.
22        A duly appointed member of a fire department in  a  city,
23    the population of which exceeds 200,000 according to the last
24    federal  or  State census, is eligible for compensation under
25    this  paragraph  only  where  such  serious   and   permanent
26    disfigurement results from burns.
27        (d) 1.  If,   after   the   accidental  injury  has  been
28    sustained, the employee as a result thereof becomes partially
29    incapacitated from pursuing his usual and customary  line  of
30    employment,  he  shall, except in cases compensated under the
31    specific schedule set forth in paragraph (e) of this Section,
32    receive compensation for  the  duration  of  his  disability,
33    subject  to  the  limitations  as to maximum amounts fixed in
34    paragraph (b) of  this  Section,  equal  to  66-2/3%  of  the
 
                            -20-     LRB093 06092 LRD 06197 b
 1    difference  between the average amount which he would be able
 2    to earn  in  the  full  performance  of  his  duties  in  the
 3    occupation  in  which  he  was  engaged  at  the  time of the
 4    accident and the average amount which he  is  earning  or  is
 5    able  to  earn  in some suitable employment or business after
 6    the accident.
 7        2.  If,  as  a  result  of  the  accident,  the  employee
 8    sustains  serious  and  permanent  injuries  not  covered  by
 9    paragraphs (c) and (e) of this Section  or  having  sustained
10    injuries  covered by the aforesaid paragraphs (c) and (e), he
11    shall have sustained in addition thereto other injuries which
12    injuries do not incapacitate him from pursuing the duties  of
13    his  employment  but  which  would  disable him from pursuing
14    other suitable occupations, or which have otherwise  resulted
15    in   physical  impairment;  or  if  such  injuries  partially
16    incapacitate him from pursuing the duties of  his  usual  and
17    customary  line  of  employment  but  do  not  result  in  an
18    impairment  of  earning  capacity,  or  having resulted in an
19    impairment of earning capacity, the employee elects to  waive
20    his  right  to  recover under the foregoing subparagraph 1 of
21    paragraph (d) of this Section then in any  of  the  foregoing
22    events,  he  shall  receive  in  addition to compensation for
23    temporary  total  disability  under  paragraph  (b)  of  this
24    Section, compensation at the rate  provided  in  subparagraph
25    2.1  of  paragraph (b) of this Section for that percentage of
26    500 weeks that the  partial  disability  resulting  from  the
27    injuries covered by this paragraph bears to total disability.
28    If  the  employee  shall  have sustained a fracture of one or
29    more vertebra  or  fracture  of  the  skull,  the  amount  of
30    compensation  allowed  under  this  Section shall be not less
31    than 6 weeks for a fractured  skull  and  6  weeks  for  each
32    fractured  vertebra, and in the event the employee shall have
33    sustained a fracture of any of the  following  facial  bones:
34    nasal,   lachrymal,   vomer,  zygoma,  maxilla,  palatine  or
 
                            -21-     LRB093 06092 LRD 06197 b
 1    mandible, the  amount  of  compensation  allowed  under  this
 2    Section  shall  be  not  less  than  2  weeks  for  each such
 3    fractured bone, and for a fracture of each transverse process
 4    not less than 3 weeks.  In  the  event  such  injuries  shall
 5    result in the loss of a kidney, spleen or lung, the amount of
 6    compensation  allowed  under  this  Section shall be not less
 7    than 10 weeks for  each  such  organ.   Compensation  awarded
 8    under  this  subparagraph 2 shall not take into consideration
 9    injuries covered under paragraphs (c) and (e) of this Section
10    and the compensation provided in  this  paragraph  shall  not
11    affect  the  employee's  right  to compensation payable under
12    paragraphs  (b),  (c)  and  (e)  of  this  Section  for   the
13    disabilities therein covered.
14        (e)  For  accidental  injuries in the following schedule,
15    the employee shall receive compensation  for  the  period  of
16    temporary  total  incapacity  for  work  resulting  from such
17    accidental injury, under subparagraph 1 of paragraph  (b)  of
18    this   Section,   and   shall  receive  in  addition  thereto
19    compensation for a  further  period  for  the  specific  loss
20    herein  mentioned,  but  shall  not  receive any compensation
21    under any other  provisions  of  this  Act.    The  following
22    listed  amounts  apply to either the loss of or the permanent
23    and complete loss  of  use  of  the  member  specified,  such
24    compensation for the length of time as follows:
25             1.  Thumb-70 weeks.
26             2.  First, or index finger-40 weeks.
27             3.  Second, or middle finger-35 weeks.
28             4.  Third, or ring finger-25 weeks.
29             5.  Fourth, or little finger-20 weeks.
30             6.  Great toe-35 weeks.
31             7.  Each toe other than great toe-12 weeks.
32             8.  The  loss  of the first or distal phalanx of the
33        thumb or of any finger or toe shall be considered  to  be
34        equal  to  the  loss of one-half of such thumb, finger or
 
                            -22-     LRB093 06092 LRD 06197 b
 1        toe and the compensation payable shall be one-half of the
 2        amount above  specified.   The  loss  of  more  than  one
 3        phalanx  shall  be  considered  as the loss of the entire
 4        thumb, finger or  toe.   In  no  case  shall  the  amount
 5        received  for  more  than  one  finger  exceed the amount
 6        provided in this schedule for the loss of a hand.
 7             9.  Hand-190 weeks.  The loss of 2 or  more  digits,
 8        or  one  or more phalanges of 2 or more digits, of a hand
 9        may be compensated on the basis of partial loss of use of
10        a hand, provided, further, that the loss of 4 digits,  or
11        the  loss  of  use  of  4  digits, in the same hand shall
12        constitute the  complete loss of a hand.
13             10.  Arm-235  weeks.   Where  an  accidental  injury
14        results in the amputation of an arm below the elbow, such
15        injury shall be compensated as a loss of an  arm.   Where
16        an  accidental injury results in the amputation of an arm
17        above the elbow, compensation for an additional 15  weeks
18        shall be paid, except where the accidental injury results
19        in  the amputation of an arm at the shoulder joint, or so
20        close to shoulder joint that an artificial arm cannot  be
21        used,  or results in the disarticulation of an arm at the
22        shoulder  joint,  in  which  case  compensation  for   an
23        additional 65 weeks shall be paid.
24             11.  Foot-155 weeks.
25             12.  Leg-200  weeks.   Where  an  accidental  injury
26        results  in  the amputation of a leg below the knee, such
27        injury shall be compensated as loss of a  leg.  Where  an
28        accidental  injury  results  in  the  amputation of a leg
29        above the knee, compensation for an additional  25  weeks
30        shall be paid, except where the accidental injury results
31        in  the amputation of a leg at the hip joint, or so close
32        to the hip joint that an artificial leg cannot  be  used,
33        or  results  in  the  disarticulation of a leg at the hip
34        joint, in which case compensation for  an  additional  75
 
                            -23-     LRB093 06092 LRD 06197 b
 1        weeks shall be paid.
 2             13.  Eye-150  weeks.   Where  an  accidental  injury
 3        results in the enucleation of an eye, compensation for an
 4        additional 10 weeks shall be paid.
 5             14.  Loss  of hearing of one ear-50 weeks; total and
 6        permanent loss of hearing of both ears-200 weeks.
 7             15.  Testicle-50 weeks; both testicles-150 weeks.
 8             16.  For the permanent partial  loss  of  use  of  a
 9        member  or  sight  of  an  eye,  or  hearing  of  an ear,
10        compensation during that  proportion  of  the  number  of
11        weeks  in the foregoing schedule provided for the loss of
12        such member or sight of an eye, or  hearing  of  an  ear,
13        which  the partial loss of use thereof bears to the total
14        loss of use of such member, or sight of eye,  or  hearing
15        of an ear.
16                  (a)  Loss  of hearing for compensation purposes
17             shall be confined to the frequencies of 1,000, 2,000
18             and 3,000 cycles per second. Loss of hearing ability
19             for frequency tones above 3,000  cycles  per  second
20             are  not to be considered as constituting disability
21             for hearing.
22                  (b)  The percent of hearing loss, for  purposes
23             of  the  determination  of  compensation  claims for
24             occupational deafness, shall be  calculated  as  the
25             average  in  decibels  for the thresholds of hearing
26             for the frequencies of 1,000, 2,000 and 3,000 cycles
27             per second. Pure  tone  air  conduction  audiometric
28             instruments,   approved   by  nationally  recognized
29             authorities  in  this  field,  shall  be  used   for
30             measuring  hearing  loss.  If  the losses of hearing
31             average 30 decibels or less in  the  3  frequencies,
32             such losses of hearing shall not then constitute any
33             compensable  hearing  disability.  If  the losses of
34             hearing  average  85  decibels  or  more  in  the  3
 
                            -24-     LRB093 06092 LRD 06197 b
 1             frequencies, then the same shall constitute  and  be
 2             total or 100% compensable hearing loss.
 3                  (c)  In   measuring   hearing  impairment,  the
 4             lowest measured losses in each of the 3  frequencies
 5             shall   be  added  together  and  divided  by  3  to
 6             determine  the  average  decibel  loss.  For   every
 7             decibel  of  loss exceeding 30 decibels an allowance
 8             of 1.82% shall be made up to  the  maximum  of  100%
 9             which is reached at 85 decibels.
10                  (d)  If  a  hearing loss is established to have
11             existed on July 1, 1975 by audiometric  testing  the
12             employer  shall  not be liable for the previous loss
13             so established nor shall he be liable for  any  loss
14             for which compensation has been paid or awarded.
15                  (e)  No  consideration  shall  be  given to the
16             question  of  whether  or  not  the  ability  of  an
17             employee to understand speech is improved by the use
18             of a hearing aid.
19                  (f)  No  claim  for  loss  of  hearing  due  to
20             industrial  noise  shall  be  brought   against   an
21             employer  or  allowed  unless  the employee has been
22             exposed for a period of  time  sufficient  to  cause
23             permanent  impairment  to  noise levels in excess of
24             the following:
25                  Sound Level DBA
26                   Slow Response              Hours Per Day
27                        90                          8
28                        92                          6
29                        95                          4
30                        97                          3
31                        100                         2
32                        102                       1-1/2
33                        105                         1
34                        110                        1/2
 
                            -25-     LRB093 06092 LRD 06197 b
 1                        115                        1/4
 2             This subparagraph (f) shall not be applied in  cases
 3        of hearing loss resulting from trauma or explosion.
 4             17.  In computing the compensation to be paid to any
 5        employee  who,  before  the  accident for which he claims
 6        compensation, had before that time  sustained  an  injury
 7        resulting  in  the  loss by amputation or partial loss by
 8        amputation of any member, including hand, arm,  thumb  or
 9        fingers, leg, foot or any toes, such loss or partial loss
10        of  any such member shall be deducted from any award made
11        for the subsequent injury.  For the permanent loss of use
12        or the permanent partial loss of use of any  such  member
13        or  the  partial  loss  of  sight  of  an  eye, for which
14        compensation has been paid, then such loss shall be taken
15        into consideration and deducted from any  award  for  the
16        subsequent injury.
17             18.  The  specific  case of loss of both hands, both
18        arms, or both feet, or both legs, or both eyes, or of any
19        two thereof, or the permanent and complete  loss  of  the
20        use  thereof, constitutes total and permanent disability,
21        to be compensated according to the compensation fixed  by
22        paragraph  (f)  of this Section.  These specific cases of
23        total and  permanent  disability  do  not  exclude  other
24        cases.
25             Any employee who has previously suffered the loss or
26        permanent  and  complete  loss  of the use of any of such
27        members, and in a subsequent independent  accident  loses
28        another or suffers the permanent and complete loss of the
29        use  of any one of such members the employer for whom the
30        injured employee is working  at  the  time  of  the  last
31        independent  accident  is liable to pay compensation only
32        for the loss or permanent and complete loss of the use of
33        the member occasioned by the last independent accident.
34             19.  In a case of specific loss and  the  subsequent
 
                            -26-     LRB093 06092 LRD 06197 b
 1        death  of  such  injured  employee from other causes than
 2        such injury leaving  a  widow,  widower,  or   dependents
 3        surviving  before  payment  or  payment  in full for such
 4        injury, then the amount due for such injury is payable to
 5        the widow or  widower  and,  if  there  be  no  widow  or
 6        widower, then to such dependents, in the proportion which
 7        such dependency bears to total dependency.
 8        Beginning  July  1,  1980, and every 6 months thereafter,
 9    the Commission shall examine the Second Injury Fund and when,
10    after deducting all advances or loans made to such Fund,  the
11    amount  therein  is  $500,000  then the amount required to be
12    paid by employers pursuant to  paragraph  (f)  of  Section  7
13    shall  be  reduced  by  one-half. When the Second Injury Fund
14    reaches the sum of $600,000 then  the  payments  shall  cease
15    entirely.    However,  when  the  Second Injury Fund has been
16    reduced to $400,000,  payment  of  one-half  of  the  amounts
17    required  by  paragraph (f) of Section 7 shall be resumed, in
18    the manner herein provided, and when the Second  Injury  Fund
19    has  been  reduced  to  $300,000, payment of the full amounts
20    required by paragraph (f) of Section 7 shall be  resumed,  in
21    the  manner  herein  provided.  The Commission shall make the
22    changes in  payment  effective  by  general  order,  and  the
23    changes in payment become immediately effective for all cases
24    coming  before the Commission thereafter either by settlement
25    agreement or final order, irrespective of  the  date  of  the
26    accidental injury.
27        On  August 1, 1996 and on February 1 and August 1 of each
28    subsequent year, the Commission  shall  examine  the  special
29    fund designated as the "Rate Adjustment Fund" and when, after
30    deducting all advances or loans made to said fund, the amount
31    therein  is  $4,000,000,  the  amount  required to be paid by
32    employers pursuant to paragraph (f) of  Section  7  shall  be
33    reduced  by  one-half.  When the Rate Adjustment Fund reaches
34    the  sum  of  $5,000,000  the  payment  therein  shall  cease
 
                            -27-     LRB093 06092 LRD 06197 b
 1    entirely.  However, when said Rate Adjustment Fund  has  been
 2    reduced  to  $3,000,000 the amounts required by paragraph (f)
 3    of Section 7 shall be resumed in the manner herein provided.
 4        (f)  In case of complete disability,  which  renders  the
 5    employee  wholly and permanently incapable of work, or in the
 6    specific case of total and permanent disability  as  provided
 7    in   subparagraph  18  of  paragraph  (e)  of  this  Section,
 8    compensation  shall  be  payable  at  the  rate  provided  in
 9    subparagraph 2 of paragraph (b) of this Section for life.
10        An employee entitled to benefits under paragraph  (f)  of
11    this  Section shall also be entitled to receive from the Rate
12    Adjustment Fund provided in paragraph (f) of Section 7 of the
13    supplementary benefits provided  in  paragraph  (g)  of  this
14    Section 8.
15        If   any  employee  who  receives  an  award  under  this
16    paragraph afterwards returns to work or is able to do so, and
17    earns or is able to earn as  much  as  before  the  accident,
18    payments  under  such  award  shall  cease.  If such employee
19    returns to work, or is able to do so, and earns or is able to
20    earn part but not as much as before the accident, such  award
21    shall  be  modified  so  as  to  conform  to  an  award under
22    paragraph (d) of this Section.  If such award  is  terminated
23    or  reduced  under  the  provisions  of  this paragraph, such
24    employees have the right at any time within 30  months  after
25    the  date  of  such termination or reduction to file petition
26    with the Commission for the purpose  of  determining  whether
27    any  disability exists as a result of the original accidental
28    injury and the extent thereof.
29        Disability as enumerated in subdivision 18, paragraph (e)
30    of this Section is considered complete disability.
31        If an employee who had previously incurred  loss  or  the
32    permanent and complete loss of use of one member, through the
33    loss  or  the  permanent  and complete loss of the use of one
34    hand, one  arm,  one  foot,  one  leg,  or  one  eye,  incurs
 
                            -28-     LRB093 06092 LRD 06197 b
 1    permanent  and  complete  disability  through the loss or the
 2    permanent and complete loss of the use of another member,  he
 3    shall receive, in addition to the compensation payable by the
 4    employer  and after such payments have ceased, an amount from
 5    the Second Injury Fund  provided  for  in  paragraph  (f)  of
 6    Section 7, which, together with the compensation payable from
 7    the  employer in whose employ he was when the last accidental
 8    injury was  incurred,  will  equal  the  amount  payable  for
 9    permanent   and  complete  disability  as  provided  in  this
10    paragraph of this Section.
11        The custodian of the Second Injury Fund provided  for  in
12    paragraph  (f) of Section 7 shall be joined with the employer
13    as a party respondent in the application  for  adjustment  of
14    claim.   The  application for adjustment of claim shall state
15    briefly and in general terms the approximate time  and  place
16    and manner of the loss of the first member.
17        In  its  award  the  Commission  or  the Arbitrator shall
18    specifically find the amount the injured  employee  shall  be
19    weekly  paid, the number of weeks compensation which shall be
20    paid by the employer, the date upon which payments begin  out
21    of  the  Second  Injury Fund provided for in paragraph (f) of
22    Section 7 of this Act, the length of time the weekly payments
23    continue, the date upon which the pension  payments  commence
24    and  the monthly amount of the payments. The Commission shall
25    30 days after the date upon which payments out of the  Second
26    Injury  Fund  have  begun as provided in the award, and every
27    month thereafter, prepare and submit to the State Comptroller
28    a voucher for payment for all compensation  accrued  to  that
29    date  at  the  rate  fixed  by  the  Commission.   The  State
30    Comptroller  shall  draw  a  warrant  to the injured employee
31    along with a receipt to be executed by the  injured  employee
32    and  returned  to  the  Commission.  The endorsed warrant and
33    receipt is a full and complete acquittance to the  Commission
34    for  the  payment  out  of  the Second Injury Fund.  No other
 
                            -29-     LRB093 06092 LRD 06197 b
 1    appropriation or warrant is necessary for payment out of  the
 2    Second  Injury  Fund.  The Second Injury Fund is appropriated
 3    for the purpose of making payments according to the terms  of
 4    the awards.
 5        As  of  July  1, 1980 to July 1, 1982, all claims against
 6    and obligations of the Second Injury Fund shall become claims
 7    against and obligations of the Rate Adjustment  Fund  to  the
 8    extent  there is insufficient money in the Second Injury Fund
 9    to pay such  claims  and  obligations.   In  that  case,  all
10    references to "Second Injury Fund" in this Section shall also
11    include the Rate Adjustment Fund.
12        (g)  Every  award  for permanent total disability entered
13    by the Commission on and after   July  1,  1965  under  which
14    compensation  payments shall become due and payable after the
15    effective date of this amendatory Act, and  every  award  for
16    death  benefits  or permanent total disability entered by the
17    Commission on and after the effective date of this amendatory
18    Act shall be subject to annual adjustments as to  the  amount
19    of  the  compensation rate therein provided. Such adjustments
20    shall first be made on July 15, 1977, and all awards made and
21    entered prior to July 1, 1975 and on July  15  of  each  year
22    thereafter.  In all other cases such adjustment shall be made
23    on  July 15 of the second year next following the date of the
24    entry of the award and shall  further  be  made  on  July  15
25    annually  thereafter.   If during the intervening period from
26    the date of the entry of the  award,  or  the  last  periodic
27    adjustment,  there shall have been an increase in the State's
28    average  weekly  wage  in  covered   industries   under   the
29    Unemployment  Insurance  Act,  the  weekly  compensation rate
30    shall be proportionately increased by the same percentage  as
31    the percentage of increase in the State's average weekly wage
32    in  covered  industries under the Unemployment Insurance Act.
33    The increase in the compensation rate  under  this  paragraph
34    shall  in  no  event  bring the total compensation rate to an
 
                            -30-     LRB093 06092 LRD 06197 b
 1    amount  greater  than  the  prevailing  maximum  rate.   Such
 2    increase shall be paid in the same manner as herein  provided
 3    for  payments  under  the  Second  Injury Fund to the injured
 4    employee, or his dependents, as the case may be, out  of  the
 5    Rate  Adjustment  Fund provided in paragraph (f) of Section 7
 6    of this Act.  Payments shall be made at the same intervals as
 7    provided in the award or, at the option  of  the  Commission,
 8    may  be made in quarterly payment on the 15th day of January,
 9    April, July and October of each year.   In  the  event  of  a
10    decrease in such average weekly wage there shall be no change
11    in the then existing compensation rate.  The within paragraph
12    shall  not  apply  to cases where there is disputed liability
13    and in which a compromise lump  sum  settlement  between  the
14    employer  and the injured employee, or his dependents, as the
15    case may  be,  has  been  duly  approved  by  the  Industrial
16    Commission.
17        Provided,   that  in  cases  of  awards  entered  by  the
18    Commission for injuries occurring before July  1,  1975,  the
19    increases   in  the  compensation  rate  adjusted  under  the
20    foregoing provision of this paragraph (g) shall be limited to
21    increases in the  State's  average  weekly  wage  in  covered
22    industries  under  the  Unemployment  Insurance Act occurring
23    after July 1, 1975.
24        (h)  In case death occurs from any cause before the total
25    compensation to which the employee would have  been  entitled
26    has  been  paid,  then in case the employee leaves any widow,
27    widower, child, parent (or  any  grandchild,  grandparent  or
28    other  lineal  heir  or  any collateral heir dependent at the
29    time of the accident upon the earnings of the employee to the
30    extent of 50% or more of total dependency) such  compensation
31    shall  be  paid to the beneficiaries of the deceased employee
32    and distributed as provided in paragraph (g) of Section 7.
33        (h-1)  In  case  an  injured  employee  is  under   legal
34    disability at the time when any right or privilege accrues to
 
                            -31-     LRB093 06092 LRD 06197 b
 1    him  or  her  under  this  Act,  a  guardian may be appointed
 2    pursuant to law, and may, on  behalf  of  such  person  under
 3    legal  disability,  claim  and  exercise  any  such  right or
 4    privilege with the same effect as if the employee himself  or
 5    herself  had claimed or exercised the right or privilege.  No
 6    limitations of time provided by this Act run so long  as  the
 7    employee   who   is  under  legal  disability  is  without  a
 8    conservator or guardian.
 9        (i)  In case the injured employee is under  16  years  of
10    age  at  the  time of the accident and is illegally employed,
11    the amount of compensation payable under paragraphs (b), (c),
12    (d), (e) and (f) of this Section is increased 50%.
13        However, where an employer  has  on  file  an  employment
14    certificate  issued  pursuant  to the Child Labor Law or work
15    permit issued pursuant to the Federal  Fair  Labor  Standards
16    Act,  as  amended,  or  a birth certificate properly and duly
17    issued, such certificate,  permit  or  birth  certificate  is
18    conclusive  evidence  as  to  the  age  of  the injured minor
19    employee for the purposes of this Section.
20        Nothing herein contained repeals or amends the provisions
21    of the Child Labor Law relating to the employment  of  minors
22    under the age of 16 years.
23        (j) 1.  In   the  event  the  injured  employee  receives
24    benefits, including medical, surgical  or  hospital  benefits
25    under  any  group plan covering non-occupational disabilities
26    contributed to wholly or partially  by  the  employer,  which
27    benefits  should  not  have  been  payable  if  any rights of
28    recovery existed under this Act, then such amounts so paid to
29    the employee from any such group plan as shall be  consistent
30    with,  and  limited to, the provisions of paragraph 2 hereof,
31    shall be credited to or against any compensation payment  for
32    temporary  total incapacity for work or any medical, surgical
33    or hospital benefits made or to be made under  this  Act.  In
34    such   event,  the  period  of  time  for  giving  notice  of
 
                            -32-     LRB093 06092 LRD 06197 b
 1    accidental injury and filing application  for  adjustment  of
 2    claim  does not commence to run until the termination of such
 3    payments.  This paragraph does not  apply  to  payments  made
 4    under   any   group   plan  which  would  have  been  payable
 5    irrespective of an accidental injury  under  this  Act.   Any
 6    employer  receiving such credit shall keep such employee safe
 7    and harmless from any and all claims or liabilities that  may
 8    be  made  against  him  by  reason  of  having  received such
 9    payments only to the extent of such credit.
10        Any excess benefits paid to  or  on  behalf  of  a  State
11    employee  by  the  State  Employees'  Retirement System under
12    Article 14 of the Illinois Pension Code on a death  claim  or
13    disputed  disability  claim  shall  be  credited  against any
14    payments made or to be made by the State of Illinois to or on
15    behalf of such employee under this Act, except  for  payments
16    for  medical expenses which have already been incurred at the
17    time of the award.  The  State  of  Illinois  shall  directly
18    reimburse  the  State  Employees'  Retirement  System  to the
19    extent of such credit.
20        2.  Nothing contained in this Act shall be  construed  to
21    give  the  employer  or  the  insurance  carrier the right to
22    credit for any benefits or payments received by the  employee
23    other  than  compensation  payments provided by this Act, and
24    where the employee receives payments other than  compensation
25    payments,  whether as full or partial salary, group insurance
26    benefits, bonuses,  annuities  or  any  other  payments,  the
27    employer  or  insurance carrier shall receive credit for each
28    such payment only to the  extent  of  the  compensation  that
29    would  have  been  payable  during the period covered by such
30    payment.
31        3.  The  extension  of  time  for  the   filing   of   an
32    Application  for Adjustment of Claim as provided in paragraph
33    1 above shall not apply to those cases  where  the  time  for
34    such  filing  had expired prior to the date on which payments
 
                            -33-     LRB093 06092 LRD 06197 b
 1    or benefits enumerated herein have been initiated or resumed.
 2    Provided however that this paragraph 3 shall  apply  only  to
 3    cases wherein the payments or benefits hereinabove enumerated
 4    shall be received after July 1, 1969.
 5    (Source: P.A. 89-470, eff. 6-13-96.)

 6        (820 ILCS 305/8a new)
 7        Sec.  8a. Reports. The Industrial Commission shall report
 8    in writing to the Governor and the Illinois General  Assembly
 9    on  the  31st  day  of December, annually, beginning one year
10    after the effective date of this amendatory Act of  the  93rd
11    General  Assembly,  the details and results of implementation
12    of  this  amendatory  Act  of  the  93rd   General   Assembly
13    sufficient  to determine its effectiveness in maintaining the
14    availability of quality  health  care  services  for  injured
15    employees and at a reasonable cost to employers.

16        (820 ILCS 305/16) (from Ch. 48, par. 138.16)
17        Sec.   16.    The   Commission  shall  make  and  publish
18    procedural rules and  orders  for  carrying  out  the  duties
19    imposed  upon  it  by  law  and for determining the extent of
20    disability sustained, which rules and orders shall be  deemed
21    prima facie reasonable and valid.
22        The  process and procedure before the Commission shall be
23    as simple and summary as reasonably may be.
24        The Commission upon application of either party may issue
25    dedimus potestatem directed to a commissioner, notary public,
26    justice of the peace or any other officer authorized  by  law
27    to  administer oaths, to take the depositions of such witness
28    or witnesses as may be necessary  in  the  judgment  of  such
29    applicant.   Such  dedimus potestatem may issue to any of the
30    officers aforesaid in any state or territory  of  the  United
31    States.   When  the  deposition  of any witness resident of a
32    foreign country is desired to be taken, the dedimus shall  be
 
                            -34-     LRB093 06092 LRD 06197 b
 1    directed  to  and  the deposition taken before a consul, vice
 2    consul or other authorized representative of  the  government
 3    of  the  United  States  of  America, whose station is in the
 4    country where the witness whose deposition  is  to  be  taken
 5    resides.   In  countries  where  the government of the United
 6    States has no consul or other diplomatic representative, then
 7    depositions  in  such  case  shall  be  taken   through   the
 8    appropriate  judicial  authority  of  that  country; or where
 9    treaties provide for other  methods  of  taking  depositions,
10    then  the same may be taken as in such treaties provided. The
11    Commission shall have the power to adopt necessary  rules  to
12    govern the issue of such dedimus potestatem.
13        The  Commission, or any member thereof, or any Arbitrator
14    designated  by  the  Commission  shall  have  the  power   to
15    administer  oaths,  subpoena  and examine witnesses; to issue
16    subpoenas duces  tecum,  requiring  the  production  of  such
17    books,  papers,  records  and documents as may be evidence of
18    any matter under inquiry and to examine and inspect the  same
19    and  such places or premises as may relate to the question in
20    dispute. The  Commission,  or  any  member  thereof,  or  any
21    Arbitrator  designated  by  the  Commission, shall on written
22    request of either party to the dispute, issue  subpoenas  for
23    the  attendance  of  such  witnesses  and  production of such
24    books, papers, records and documents as shall  be  designated
25    in  the  applications,  and  the  parties  applying  for such
26    subpoena shall advance the officer and witness fees  provided
27    for in civil actions pending in circuit courts of this State,
28    except  as  otherwise  provided  by  Section  20 of this Act.
29    Service of such subpoena shall be  made  by  any  sheriff  or
30    other  person.   In case any person refuses to comply with an
31    order of the Commission or subpoenas issued by it or  by  any
32    member   thereof,   or   any  Arbitrator  designated  by  the
33    Commission or to permit an inspection of places or  premises,
34    or to produce any books, papers, records or documents, or any
 
                            -35-     LRB093 06092 LRD 06197 b
 1    witness  refuses to testify to any matters regarding which he
 2    or she may be lawfully interrogated, the Circuit Court of the
 3    county  in  which  the  hearing  or  matter  is  pending,  on
 4    application of any member of the Commission or any Arbitrator
 5    designated by  the  Commission,  shall  compel  obedience  by
 6    attachment  proceedings,  as  for  contempt,  as in a case of
 7    disobedience of the requirements  of  a  subpoena  from  such
 8    court on a refusal to testify therein.
 9        The  records kept by a hospital, certified to as true and
10    correct by the superintendent or  other  officer  in  charge,
11    showing  the  medical and surgical treatment given an injured
12    employee in such hospital, shall be  admissible  without  any
13    further proof as evidence of the medical and surgical matters
14    stated  therein,  but  shall  not be conclusive proof of such
15    matters.
16        The Commission at its expense shall provide  an  official
17    court   reporter   to   take  the  testimony  and  record  of
18    proceedings at the  hearings  before  an  Arbitrator  or  the
19    Commission,  who shall furnish a transcript of such testimony
20    or proceedings to either party requesting  it,  upon  payment
21    therefor  at  the rate of $1.00 per page for the original and
22    35 cents per page for each copy of such transcript.   Payment
23    for  photostatic  copies  of exhibits shall be extra.  If the
24    Commission has determined, as provided in Section 20 of  this
25    Act, that the employee is a poor person, a transcript of such
26    testimony  and  proceedings,  including photostatic copies of
27    exhibits,  shall  be  furnished  to  such  employee  at   the
28    Commission's expense.
29        In  accordance  with  the provisions of subsection (a) of
30    Section 8 of this Act and subdivision (a)(3) of Section 8  of
31    this  Act,  the  Commission shall have the power to determine
32    the  reasonableness  and  fix  the  amount  of  any  fee   of
33    compensation  charged  by  any  person,  including attorneys,
34    physicians, surgeons and hospitals, for any service performed
 
                            -36-     LRB093 06092 LRD 06197 b
 1    in connection with this Act, or for which payment  is  to  be
 2    made  under  this Act or rendered in securing any right under
 3    this Act.
 4        Whenever the Commission shall find that the employer, his
 5    or her agent, service company or insurance carrier  has  been
 6    guilty  of  delay  or  unfairness  towards an employee in the
 7    adjustment,  settlement  or  payment  of  benefits  due  such
 8    employee within the purview of the  provisions  of  paragraph
 9    (c)  of  Section  4  of  this  Act;  or  has  been  guilty of
10    unreasonable or vexatious delay, intentional under-payment of
11    compensation benefits, or has engaged in  frivolous  defenses
12    which  do  not present a real controversy, within the purview
13    of the provisions of paragraph (k) of Section 19 of this Act,
14    the Commission may assess all or any part of  the  attorney's
15    fees and costs against such employer and his or her insurance
16    carrier.
17    (Source: P.A. 86-998.)

18        (820 ILCS 305/16a) (from Ch. 48, par. 138.16a)
19        Sec.  16a.   (A)  In  the  establishment  or  approval of
20    attorney's fees in relation to claims brought under this Act,
21    the Commission shall be guided  by  the  provisions  of  this
22    Section  and  by  the legislative intent, hereby declared, to
23    encourage settlement and prompt administrative   handling  of
24    such  claims  and  thereby  reduce  expenses to claimants for
25    compensation under this Act.
26        (B)  With  respect  to  any  and   all   proceedings   in
27    connection with any initial or original claim under this Act,
28    no  claim of any attorney for services rendered in connection
29    with the securing of compensation  for  an  employee  or  his
30    dependents  and  also  resolving  any  disputed  health  care
31    provider  charges  and  medical  expenses, whether secured by
32    agreement, order, award or a  judgment  in  any  court  shall
33    exceed  20% of the amount of compensation recovered and paid,
 
                            -37-     LRB093 06092 LRD 06197 b
 1    unless further fees shall be allowed to the attorney  upon  a
 2    hearing  by  the  Commission  fixing fees, and subject to the
 3    other  provisions  of  this  Section.   However,  except   as
 4    hereinafter  provided  in this Section, in death cases, total
 5    disability cases and partial disability cases, the amount  of
 6    an  attorney's  fees  shall  not  exceed 20% of the sum which
 7    would be due under this Act for 364 weeks of permanent  total
 8    disability  based  upon  the  employee's average gross weekly
 9    wage prior to the date of the accident  and  subject  to  the
10    maximum  weekly  benefits provided in this Act unless further
11    fees shall be allowed to the attorney upon a hearing  by  the
12    Commission fixing fees.
13        (B-5)   With  respect  to  any  and  all  proceedings  in
14    connection with any disputed health care provider charges and
15    medical expenses associated  with  any  initial  or  original
16    claim  under  this Act, no claim of any attorney for services
17    rendered in connection with the securing of compensation  for
18    any  health  care  provider,  whether  secured  by agreement,
19    order, award, or a judgment in any court, shall exceed 20% of
20    the amount of compensation recovered and paid to  any  health
21    care  provider.  These  fees  shall  be  fixed  pursuant to a
22    written contract in accordance with subsection  (C)  of  this
23    Section.
24        In   any   proceeding   including  disputed  health  care
25    payments, in whole or in  part,  all  health  care  providers
26    shall  be given 30 calendar days notice by the employer prior
27    to a hearing to effect any award or settlement to submit  all
28    outstanding  bills.  Any  award  or settlement payments for a
29    contested claim shall be made to the attorney involved in the
30    name of the attorney and health care providers. The  attorney
31    shall  disburse  the  funds  to  the  health  care  providers
32    involved  in  accordance  with  the  award or settlement. The
33    amount of health care provider payments shall  be  the  usual
34    and  customary charges under subsection 8(a), except when the
 
                            -38-     LRB093 06092 LRD 06197 b
 1    amount of the award or settlement of  a  contested  claim  is
 2    insufficient  to  compensate  all health care providers usual
 3    and customary charges. In  these  situations,  all  physician
 4    payments shall not exceed 30% of the award or settlement, all
 5    hospital  payments  (in-patient  and  out-patient)  shall not
 6    exceed 30% of the award or settlement, and all  other  health
 7    care  providers payments shall not exceed 20% of the award or
 8    settlement.   All   health   care   providers   shall   share
 9    proportionate  amounts  within  their  respective   statutory
10    limitations  as  full  and final payment for all sums due and
11    owing. In addition, usual  and  customary  charges  shall  be
12    satisfied  to  extent  possible for all health care providers
13    from amount unused within  the  statutory  limitations  on  a
14    proportionate basis.
15        (C)  All  attorneys'  fees in connection with the initial
16    or original claim for compensation shall be fixed pursuant to
17    a written contract on  forms  prescribed  by  the  Commission
18    between  the attorney and the employee or his dependents, and
19    every attorney, whether the disposition of the original claim
20    is by agreement, settlement, award,  judgment  or  otherwise,
21    shall  file  his contract with the Chairman of the Commission
22    who shall approve the contract only if it  is  in  accordance
23    with all provisions of this Section.
24        (D)  No  attorneys' fees shall be charged with respect to
25    compensation for undisputed medical expenses.
26        (E)  No attorneys' fees shall be  charged  in  connection
27    with  any  temporary total disability compensation unless the
28    payment of such compensation in a timely  manner  or  in  the
29    proper  amount  is  refused,  or  unless such compensation is
30    terminated  by  the  employer  and  the   payment   of   such
31    compensation  is obtained or reinstated by the efforts of the
32    attorney,  whether  by  agreement,   settlement,   award   or
33    judgment.
34        (F)  In  the following cases in which there is no dispute
 
                            -39-     LRB093 06092 LRD 06197 b
 1    between the parties as to the liability of the respondent  to
 2    pay  compensation  in a timely manner or in the proper amount
 3    and there is no dispute that the accident has resulted in:
 4        (1)  the death of the employee; or
 5        (2)  a statutory permanent disability; or
 6        (3)  the amputation of a finger, toe, or member; or
 7        (4)  the removal of a testicle; or
 8        (5)  the enucleation of or 100% loss of vision of an eye;
 9    the legal fees, if any, for services rendered are to be fixed
10    by  the  Industrial  Commission  at  a  nominal  amount,  not
11    exceeding $100.
12        (G)  In the following cases in which there is no  dispute
13    between  the parties as to the liability of the respondent to
14    pay compensation and there is no dispute  that  the  accident
15    has resulted in:
16        (1)  a fracture of one or more vertebrae; or
17        (2)  a skull fracture; or
18        (3)  a  fracture  of  one  or  more spinous or transverse
19    processes; or
20        (4)  a fracture of one or more facial bones; or
21        (5)  the removal of a kidney, spleen or lung;
22    the legal fees, if any, for services rendered are to be fixed
23    by  the  Industrial  Commission  at  a  nominal  amount,  not
24    exceeding $100, provided that the  employee  is  awarded  the
25    minimum amount for the above injuries as specified in Section
26    8(d)2.
27        (H)  With regard to any claim where the amount to be paid
28    for  compensation  does  not exceed the written offer made to
29    the claimant or claimants by the employer or his agent  prior
30    to  representation  by  an attorney, no fees shall be paid to
31    any such attorney.
32        (I)  All  attorneys'  fees  for  representation   of   an
33    employee  or  his  dependents  shall be only recoverable from
34    compensation actually paid to such employee or dependents.
 
                            -40-     LRB093 06092 LRD 06197 b
 1        (J)  Any and  all  disputes  regarding  attorneys'  fees,
 2    whether  such  disputes relate to which one or more attorneys
 3    represents the claimant or claimants or is  entitled  to  the
 4    attorneys'  fees,  or a division of attorneys' fees where the
 5    claimant or claimants are or have been  represented  by  more
 6    than   one   attorney,   or  any  other  disputes  concerning
 7    attorneys' fees or contracts for attorneys'  fees,  shall  be
 8    heard  and  determined  by  the  Commission  after reasonable
 9    notice to all interested parties and attorneys.
10        (K)  After  reasonable  notice  and  hearing  before  the
11    Commission, any attorney found to  be  in  violation  of  any
12    provision   of   this  Section  shall  be  required  to  make
13    restitution of any excess fees charged  plus  interest  at  a
14    reasonable rate as determined by the Commission.
15    (Source: P.A. 84-1438.)

16        Section  15.   The  Workers' Occupational Diseases Act is
17    amended by changing Sections 16 and 16a  and  adding  Section
18    16b as follows:

19        (820 ILCS 310/16) (from Ch. 48, par. 172.51)
20        Sec. 16. The Commission shall make and publish procedural
21    rules  and orders for carrying out the duties imposed upon it
22    by law, which rules and orders shall be  deemed  prima  facie
23    reasonable and valid.
24        The  process and procedure before the Commission shall be
25    as simple and summary as reasonably may be.
26        The Commission upon application of either party may issue
27    a dedimus  potestatem  directed  to  a  commissioner,  notary
28    public, magistrate, justice of the peace or any other officer
29    authorized   by   law   to  administer  oaths,  to  take  the
30    depositions of such witness or witnesses as may be  necessary
31    in  the  judgment of such applicant.  Such dedimus potestatem
32    may issue to any of the officers aforesaid in  any  state  or
 
                            -41-     LRB093 06092 LRD 06197 b
 1    territory  of  the United States.  When the deposition of any
 2    witness resident of a foreign country is desired to be taken,
 3    the dedimus shall be directed to  and  the  deposition  taken
 4    before   a   consul,   vice   consul   or   other  authorized
 5    representative of the government  of  the  United  States  of
 6    America,  whose  station  is in the country where the witness
 7    whose deposition is to be taken resides.  In countries  where
 8    the  government  of  the United States has no consul or other
 9    diplomatic representative,  then  depositions  in  such  case
10    shall  be taken through the appropriate judicial authority of
11    that country; or where treaties provide for other methods  of
12    taking  depositions,  then  the  same may be taken as in such
13    treaties provided.  The Commission shall have  the  power  to
14    adopt  necessary  rules  to  govern the issue of such dedimus
15    potestatem.
16        The Commission, or any member thereof, or any  Arbitrator
17    designated  by  said  Commission  shall  have  the  power  to
18    administer  oaths,  subpoena  and examine witnesses; to issue
19    subpoenas duces  tecum,  requiring  the  production  of  such
20    books,  papers,  records  and documents as may be evidence of
21    any matter under inquiry and to examine and inspect the  same
22    and  such places or premises as may relate to the question in
23    dispute. Said  Commission  or  any  member  thereof,  or  any
24    Arbitrator  designated  by  said Commission, shall on written
25    request of either party to the dispute, issue  subpoenas  for
26    the  attendance  of  such  witnesses  and  production of such
27    books, papers, records and documents as shall  be  designated
28    in  said  applications,  providing  however, that the parties
29    applying for such subpoena  shall  advance  the  officer  and
30    witness  fees  provided  for  in suits pending in the Circuit
31    Court.  Service of such subpoena shall be made by any sheriff
32    or other person.  In case any person refuses to  comply  with
33    an  order  of  the Commission or subpoenas issued by it or by
34    any member thereof, or  any  Arbitrator  designated  by  said
 
                            -42-     LRB093 06092 LRD 06197 b
 1    Commission  or to permit an inspection of places or premises,
 2    or to produce any books, papers, records or documents, or any
 3    witness refuses to testify to any matters regarding which  he
 4    may  be  lawfully  interrogated,  the  Circuit  Court for the
 5    county in  which  said  hearing  or  matter  is  pending,  on
 6    application of any member of the Commission or any Arbitrator
 7    designated  by  the  Commission,  shall  compel  obedience by
 8    attachment proceedings, as for contempt,  as  in  a  case  of
 9    disobedience  of  the  requirements  of  a subpoena from such
10    court on a refusal to testify therein.
11        The records kept by a hospital, certified to as true  and
12    correct  by  the  superintendent  or other officer in charge,
13    showing the medical and surgical treatment given  an  injured
14    employee  in  such  hospital, shall be admissible without any
15    further proof as evidence of the medical and surgical matters
16    stated therein, but shall not be  conclusive  proof  of  such
17    matters.
18        The  Commission  at its expense shall provide an official
19    court  reporter  to  take  the  testimony   and   record   of
20    proceedings  at  the  hearings  before  an  Arbitrator or the
21    Commission, who shall furnish a transcript of such  testimony
22    or proceedings to either party requesting it, upon payment to
23    him  therefor  at the rate of $1.00 per page for the original
24    and 35 cents per page  for  each  copy  of  such  transcript.
25    Payment  for  photostatic  copies of exhibits shall be extra.
26    If the Commission has determined, as provided in Section 19.5
27    of this Act, that the employee is a poor person, a transcript
28    of such  testimony  and  proceedings,  including  photostatic
29    copies  of  exhibits,  shall be furnished to such employee at
30    the Commission's expense.
31        In accordance with subsection (a) of  Section  8  of  the
32    Workers' Compensation Act and subdivision (a)(3) of Section 8
33    of  the  Workers' Compensation Act, the Commission shall have
34    the power to determine the reasonableness and fix the  amount
 
                            -43-     LRB093 06092 LRD 06197 b
 1    of  any  fee of compensation charged by any person, including
 2    attorneys,  physicians,  surgeons  and  hospitals,  for   any
 3    service  performed  in connection with this Act, or for which
 4    payment is to be made under this Act or rendered in  securing
 5    any right under this Act.
 6        Whenever the Commission shall find that the employer, his
 7    agent,  service  company or insurance carrier has been guilty
 8    of delay or unfairness towards an employee in the adjustment,
 9    settlement or payment of benefits due such  employee  or  has
10    been  guilty  of unreasonable or vexatious delay, intentional
11    under-payment of compensation benefits,  or  has  engaged  in
12    frivolous  defenses  which do not present a real controversy,
13    the Commission may assess all or any part of  the  attorney's
14    fees  and  costs  against  such  employer  and  his insurance
15    carrier.
16    (Source: P.A. 86-998; 87-895.)

17        (820 ILCS 310/16a) (from Ch. 48, par. 172.51a)
18        Sec.  16a.  (A)  In  the  establishment  or  approval  of
19    attorney's fees in relation to claims brought under this Act,
20    the Commission shall be guided  by  the  provisions  of  this
21    Section  and  by  the legislative intent, hereby declared, to
22    encourage settlement and prompt administrative   handling  of
23    such  claims  and  thereby  reduce  expenses to claimants for
24    compensation under this Act.
25        (B)  With  respect  to  any  and   all   proceedings   in
26    connection with any initial or original claim under this Act,
27    no  claim of any attorney for services rendered in connection
28    with the securing of compensation  for  an  employee  or  his
29    dependents  and  also  resolving  any  disputed  health  care
30    provider  charges  and  medical  expenses, whether secured by
31    agreement, order, award or a  judgment  in  any  court  shall
32    exceed  20% of the amount of compensation recovered and paid,
33    unless further fees shall be allowed to the attorney  upon  a
 
                            -44-     LRB093 06092 LRD 06197 b
 1    hearing  by  the  Commission  fixing  fees and subject to the
 2    other  provisions  of  this  Section.   However,  except   as
 3    hereinafter  provided  in this Section, in death cases, total
 4    disability cases and partial disability cases, the amount  of
 5    an  attorney's  fees  shall  not  exceed 20% of the sum which
 6    would be due under the  Workers'  Compensation  Act  for  364
 7    weeks of permanent total disability based upon the employee's
 8    average  gross  weekly wage prior to the date of the accident
 9    and subject to the maximum weekly benefits provided  in  this
10    Act unless further fees shall be allowed to the attorney upon
11    a hearing by the Commission fixing fees.
12        (B-5)  With   respect  to  any  and  all  proceedings  in
13    connection with any disputed health care provider charges and
14    medical expenses associated  with  any  initial  or  original
15    claim  under  this Act, no claim of any attorney for services
16    rendered in connection with the securing of compensation  for
17    any  health  care  provider,  whether  secured  by agreement,
18    order, award, or a judgment in any court, shall exceed 20% of
19    the amount of compensation recovered and paid to  any  health
20    care  provider. These fees shall be fixed pursuant to written
21    contract in accordance with subsection (C) of this Section.
22        In  any  proceeding  including   disputed   health   care
23    payments,  in  whole  or  in  part, all health care providers
24    shall be given 30 calendar days notice by the employer  prior
25    to  a hearing to effect any award or settlement to submit all
26    outstanding bills. Any award or  settlement  payments  for  a
27    contested claim shall be made to the attorney involved in the
28    name  of the attorney and health care providers. The attorney
29    shall  disburse  the  funds  to  the  health  care  providers
30    involved in accordance with  the  award  or  settlement.  The
31    amount  of  health  care provider payments shall be the usual
32    and customary charges under subsection 8(a), except when  the
33    amount  of  the  award  or settlement of a contested claim is
34    insufficient to compensate all health  care  providers  usual
 
                            -45-     LRB093 06092 LRD 06197 b
 1    and  customary  charges.  In  these situations, all physician
 2    payments shall not exceed 30% of the award or settlement, all
 3    hospital payments  (in-patient  and  out-patient)  shall  not
 4    exceed  30%  of the award or settlement, and all other health
 5    care providers payments shall not exceed 20% of the award  or
 6    settlement.   All   health   care   providers   shall   share
 7    proportionate   amounts  within  their  respective  statutory
 8    limitations as full and final payment for all  sums  due  and
 9    owing.  In  addition,  usual  and  customary charges shall be
10    satisfied to extent possible for all  health  care  providers
11    from  amount  unused  within  the  statutory limitations on a
12    proportionate basis.
13        (C)  All attorneys' fees in connection with  the  initial
14    or original claim for compensation shall be fixed pursuant to
15    a  written  contract  on  forms  prescribed by the Commission
16    between the attorney and the employee or his dependents,  and
17    every attorney, whether the disposition of the original claim
18    is  by  agreement,  settlement, award, judgment or otherwise,
19    shall file his contract with the Chairman of  the  Commission
20    who  shall  approve  the contract only if it is in accordance
21    with all provisions of this Section.
22        (D)  No attorneys' fees shall be charged with respect  to
23    compensation for undisputed medical expenses.
24        (E)  No  attorneys'  fees  shall be charged in connection
25    with any temporary total disability compensation  unless  the
26    payment  of  such  compensation  in a timely manner or in the
27    proper amount is refused,  or  unless  such  compensation  is
28    terminated   by   the   employer  and  the  payment  of  such
29    compensation is obtained or reinstated by the efforts of  the
30    attorney,   whether   by   agreement,  settlement,  award  or
31    judgment.
32        (F)  With regard to any claim where the amount to be paid
33    for compensation does not exceed the written  offer  made  to
34    the  claimant or claimants by the employer or his agent prior
 
                            -46-     LRB093 06092 LRD 06197 b
 1    to representation by an attorney, no fees shall  be  paid  to
 2    any such attorney.
 3        (G)  All   attorneys'   fees  for  representation  of  an
 4    employee or his dependents shall  be  only  recoverable  from
 5    compensation actually paid to such employee or dependents.
 6        (H)  Any  and  all  disputes  regarding  attorneys' fees,
 7    whether such disputes relate to which one or  more  attorneys
 8    represents  the  claimant  or claimants or is entitled to the
 9    attorneys' fees, or a division of attorneys' fees  where  the
10    claimant  or  claimants  are or have been represented by more
11    than  one  attorney,  or  any   other   disputes   concerning
12    attorneys'  fees  or  contracts for attorneys' fees, shall be
13    heard and  determined  by  the  Commission  after  reasonable
14    notice to all interested parties and attorneys.
15        (I)  After  reasonable  notice  and  hearing  before  the
16    Commission,  any  attorney  found  to  be in violation of any
17    provision  of  this  Section  shall  be  required   to   make
18    restitution  of  any  excess fees charged, plus interest at a
19    reasonable rate as determined by the Commission.
20    (Source: P.A. 81-1482.)

21        (820 ILCS 310/16b new)
22        Sec. 16b. Reports. The Industrial Commission shall report
23    in writing to the Governor and the Illinois General  Assembly
24    on  the  31st  day  of December, annually, beginning one year
25    after the effective date of this amendatory Act of  the  93rd
26    General  Assembly,  the details and results of implementation
27    of  this  amendatory  Act  of  the  93rd   General   Assembly
28    sufficient  to determine its effectiveness in maintaining the
29    availability of quality  health  care  services  for  injured
30    employees and at a reasonable cost to employers.

31        Section 95. Severability.  The provisions of this Act are
32    severable under Section 1.31 of the Statute on Statutes.
 
                            -47-     LRB093 06092 LRD 06197 b
 1        Section  99.  Effective date.  This Act takes effect upon
 2    becoming law.