093_HB3006

 
                                     LRB093 09501 WGH 09736 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 09501 WGH 09736 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 09501 WGH 09736 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  60 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 60 days after receipt of the claim
33                  for health services. Subsequent billings  shall
34                  provide  updated  patient records from the date
 
                            -4-      LRB093 09501 WGH 09736 b
 1                  last  provided.  Nothing  in  this  Act   shall
 2                  prohibit   the   employer   from   waiving  the
 3                  requirement that patient record  updates  shall
 4                  accompany billings.
 5                       (ii)  If  the employer fails, neglects, or
 6                  refuses, without good and just  cause,  to  pay
 7                  the  health  care  provider  charges  within 60
 8                  days, the employer shall pay  interest  on  the
 9                  unpaid  balance  of  fees at a rate of 7%.  The
10                  interest shall begin to accrue on the 61st  day
11                  following  receipt  of  due  proof  of loss and
12                  shall stop accruing on the day before tender of
13                  payment for the amount paid. The employer shall
14                  pay any required  interest  charges  within  30
15                  days  of  payment of other health care provider
16                  charges.
17                  (B)  Disputed health care payments.
18                       (i)  Any disputes concerning an employer's
19                  neglect, failure or refusal to  pay  the  usual
20                  and  customary charges of health care providers
21                  services  under  subsection   8(a)   shall   be
22                  resolved  in  a separate proceeding between the
23                  employer and the  health  care  provider.  This
24                  separate proceeding may take place concurrently
25                  with  any  proceeding  concerning  a  claim for
26                  benefits under this  Act.  The  arbitrator  may
27                  bifurcate  any  proceeding, but resolution of a
28                  payment dispute shall not be decided prior to a
29                  determination  of  the  compensability  of  the
30                  claim. The employer shall  provide  the  health
31                  care  provider  and  the  employee with written
32                  notice of the specific reasons for  non-payment
33                  or  payment  of  less  than  submitted  charges
34                  within 60 days of receipt of due proof of loss.
 
                            -5-      LRB093 09501 WGH 09736 b
 1                  Any  dispute  shall  be  resolved in accordance
 2                  with the rules which shall include, but not  be
 3                  limited to, the employers obligation to provide
 4                  a  written notice and the health care providers
 5                  obligation to provide a written explanation  of
 6                  a  billing  and  an  affidavit  concerning  the
 7                  health   care   providers   charges   to  other
 8                  non-workers'    compensation    third     party
 9                  non-governmental  payors.  The  employee  shall
10                  have  a  duty  to  cooperate  in any process or
11                  proceeding.  The  provider  of  any   services,
12                  treatment,   care,  instruction,  training,  or
13                  appliances or other tangible things  for  which
14                  an  employer  is  responsible for payment under
15                  this subsection (a)  is  bound  by  charges  or
16                  payments ordered by the Industrial Commission.
17                       (ii)  In    addition   to   any   remedies
18                  available to an employee under the Act, if  the
19                  Commission   finds   that   an   employer   has
20                  neglected, failed or refused to pay or cause to
21                  be  paid  the  usual and customary charges by a
22                  health care  provider,  under  subsection  8(a)
23                  without good and just cause, the employer shall
24                  pay  interest pursuant to subsection (3)(A)(ii)
25                  and the provider's  attorneys  fees  and  other
26                  costs  related  to  the  proceeding  before the
27                  Commission under this Section.
28                       (iii)  The    Commission    shall    adopt
29                  procedural rules for  these  proceedings  which
30                  are consistent with current practices under the
31                  Act   and   provide   for   minimal   delay  or
32                  inconvenience.
33                  (C)  The employee and any health care providers
34             may, but are not required to, be represented by  the
 
                            -6-      LRB093 09501 WGH 09736 b
 1             same attorney.
 2                  (D)  Any   fees   for  undisputed  health  care
 3             provider services shall  be  paid  directly  to  the
 4             health care provider. The employee shall not receive
 5             payments  owed to health care providers. In the case
 6             of an award or settlement, in whole or in part,  for
 7             disputed  health care provider payments, payment may
 8             be made to the health care provider or in  cases  in
 9             which  the health care provider is represented by an
10             attorney, the payments shall be made to the attorney
11             involved in the name of the attorney and health care
12             providers. The attorney shall disburse the funds  to
13             the  health  care  providers  involved in accordance
14             with the award or settlement.
15                  (E)  In addition  to  compensation  for  health
16             care   services,  health  care  providers  shall  be
17             separately reimbursed by the  requesting  party  for
18             requested  records,  reports, letters, testimony, or
19             depositions for all reasonable expenses incurred  in
20             connection   with   provision  of  this  information
21             pursuant to Section 16.
22                  (F)  Health care provider service payments  may
23             only be denied by the employer upon a finding that:
24                       (1)  the  service  or  procedure  was  not
25                  related to an accidental injury; or
26                       (2)  the  service  or  procedure  was  not
27                  necessary  or  reasonably  required  to cure or
28                  provide  relief  from  the   effects   of   the
29                  accidental injury.
30             A  finding  that  a  health  care  service  was  not
31        necessary  or  reasonably  required  to  cure  or provide
32        relief from the effects of the accidental injury shall be
33        based on clinical criteria which are:
34                       (1)  developed   with   the   input   from
 
                            -7-      LRB093 09501 WGH 09736 b
 1                  appropriate actively practicing physicians; and
 2                       (2)  based on  sound  clinical  principles
 3                  and processes.
 4             Any   such  finding  shall  be  accompanied  by  the
 5        clinical criteria used as the basis for such finding.
 6             (4)  Every hospital,  physician,  surgeon  or  other
 7        person rendering treatment or services in accordance with
 8        the provisions of this Section shall upon written request
 9        furnish  full and complete reports thereof to, and permit
10        their records to be copied by, the employer, the employee
11        or his dependents, as the case may be, or any other party
12        to any proceeding for compensation before the Commission,
13        or their attorneys.
14             (5)  Charges  of  health  care  providers  shall  be
15        compensated at actual charges  not  to  exceed  the  85th
16        percentile   of   the  usual  and  customary  charges  as
17        determined by this Section.
18             The Industrial Commission shall determine the  usual
19        and  customary  charges  of health care providers, except
20        hospital charges under paragraph (6), in each  geographic
21        area  of  the  State  by  adopting  rules  designating  a
22        national  database  that  includes  health  care provider
23        charges,  except  hospital  charges,   information   from
24        Illinois  with a minimum of 12,000,000 Illinois line item
25        charges,  excluding  charges  which  are  discounted   by
26        contract,  law,  or  regulation,  and  which  makes these
27        charges available by geozip  or  any  smaller  geographic
28        unit  in Illinois.  The usual and customary charges shall
29        be as current as possible with no charge data being older
30        than 24 months and shall be  updated  at  least  every  6
31        months.  The  data  shall  in  no way identify or tend to
32        identify any patient, employer, or health care  provider.
33        Usual   and  customary  charge  determinations  shall  be
34        available electronically  to  the  Industrial  Commission
 
                            -8-      LRB093 09501 WGH 09736 b
 1        every 6 months, and beginning July 1, 2005.
 2             As  used  in this Section, "geozip" means a group of
 3        one  or  more  three-digit   zip  codes   based  on  data
 4        similarities, geographical similarities, and frequencies.
 5        A  "geozip"  does not cross state boundaries.  As used in
 6        this Section, "three-digit zip code" means  a  geographic
 7        area in which all zip codes have the same first 3 digits.
 8             Except  as otherwise provided in this Section 8a, no
 9        action shall be commenced or maintained  in  a  court  of
10        this  State by or on behalf of the above mentioned health
11        care providers nor  shall  those  health  care  providers
12        pursue  the  payment  of a bill individually or through a
13        collection agency or credit reporting bureau  against  an
14        employee  for  the  collection  of  charges  for services
15        incurred for a claim covered or  alleged  to  be  covered
16        under   this  Act  until  resolution  by  the  Industrial
17        Commission. Health care providers may  bill  an  employee
18        when a claim is not found to be covered under the Act.
19             (6)  On  or  after  October  1, 2004, the Industrial
20        Commission  shall  determine  the  usual  and   customary
21        payments  for  Illinois  hospitals within three-digit zip
22        code areas by adopting rules designating  a  database  or
23        databases   and  establishing  the  usual  and  customary
24        payments pursuant to this paragraph (6).
25             The database or databases used to establish hospital
26        usual  and  customary  payments  shall  include  Illinois
27        hospital   inpatient   charge   data   reflecting   total
28        discharges  within  the  State  and   Illinois   hospital
29        outpatient  charge  data  with  a  minimum  of 12,000,000
30        records. The database or  databases  shall  exclude  data
31        from    tertiary   teaching   hospitals,   rehabilitation
32        hospitals, psychiatric hospitals, and trauma centers. The
33        data  shall  exclude  charges  which  are  discounted  by
34        contract, law, or regulation, and shall be  available  by
 
                            -9-      LRB093 09501 WGH 09736 b
 1        three-digit  zip  code  areas.  The  data  shall  reflect
 2        hospital  line  item  charges.  As used in this paragraph
 3        (6), "line item charge" means the charge for each revenue
 4        code submitted  by  hospitals  on  the  uniform  hospital
 5        billing  form  required  by  Section  4-2 of the Illinois
 6        Health Finance Reform Act.  The  data  shall  in  no  way
 7        identify  or  tend  to  identify  any  patient, employer,
 8        health care  provider,  or  hospital  facility.  Hospital
 9        charge  data  shall  be  as  current as possible, with no
10        charge data being older than  24  months,  and  shall  be
11        updated every 6 months.
12             The   usual   and  customary  payment  for  hospital
13        procedures, treatments, or services shall be  established
14        for  each  line  item  charge  at  the 85th percentile of
15        charges for hospitals within  the  same  three-digit  zip
16        code  area.  The charge data for inpatient and outpatient
17        services shall be grouped  or  referenced  by  line  item
18        charges or, where appropriate and available, by CPT code.
19        For  inpatient  services,  line  item  charges  shall  be
20        determined  per  patient  day,  as  appropriate.  Nothing
21        herein  shall prohibit the payment of outpatient services
22        by CPT code. Usual and customary  payment  determinations
23        for  hospital  inpatient and outpatient services shall be
24        published electronically  by  the  Industrial  Commission
25        every  6  months  starting  July  1,  2005. The usual and
26        customary payment limitations under this  Act  shall  not
27        apply  to hospitals located in three-digit zip code areas
28        that contain fewer than 20 hospitals. Nothing in this Act
29        shall prohibit a hospital and employer  or  insurer  from
30        negotiating  and  agreeing  on  a  level  of  payment for
31        individual bills or charges that differs from  the  usual
32        and   customary   payment  established  under  this  Act,
33        provided that such agreement is  documented  in  writing,
34        electronically, or by another mutually agreed method.
 
                            -10-     LRB093 09501 WGH 09736 b
 1             Hospitals  designated  by  the  Department of Public
 2        Health as  tertiary  teaching  hospitals,  rehabilitation
 3        hospitals, psychiatric hospitals, or trauma centers shall
 4        not  be  subject  to  the  usual  and  customary  payment
 5        limitations  under  this  Act;  provided,  however,  that
 6        charges  for  procedures  or  services related to a claim
 7        under this Act  rendered  by  such  hospitals  shall  not
 8        exceed  their  charges to non-workers' compensation third
 9        party payors for those procedures or services. Charges of
10        tertiary teaching  hospitals,  rehabilitation  hospitals,
11        psychiatric  hospitals,  and  trauma centers shall not be
12        included in the database or databases designated  by  the
13        Industrial  Commission. Any hospital no longer designated
14        a tertiary teaching  hospital,  rehabilitation  hospital,
15        psychiatric  hospital, or a trauma center by the Illinois
16        Department of Public Health shall be subject to the usual
17        and customary payment provisions under this Act within 30
18        days of receipt of notice of change of  designation  from
19        the Department of Public Health.
20             All    hospitals,    including   tertiary   teaching
21        hospitals,    rehabilitation    hospitals,    psychiatric
22        hospitals, or trauma centers, shall be fully  subject  to
23        the provisions of paragraph 8(a)(3)(F).
24             Except  as  otherwise  provided  in  this subsection
25        8(a), no action shall be commenced  or  maintained  in  a
26        court  of  this  State  by or on behalf of a hospital nor
27        shall  a  hospital  pursue  the   payment   of   a   bill
28        individually  or  through  a  collection agency or credit
29        reporting bureau against an employee for  the  collection
30        of  charges  for services incurred for a claim covered or
31        alleged to be covered under this Act until resolution  by
32        the Industrial Commission. Hospitals may bill an employee
33        when a claim is not found to be covered under the Act.
34             (7)(i)  No  list  of  usual and customary charges of
 
                            -11-     LRB093 09501 WGH 09736 b
 1        health care providers pursuant to  paragraph  (5)  or  of
 2        hospitals  pursuant  to  paragraph  (6), and no update of
 3        such a list, shall be established except by rule  of  the
 4        Commission.    Before  any  rule  establishing  usual and
 5        customary charges becomes final, the Commission shall:
 6                  (a)  Comply with all public notice and  comment
 7             requirements    set    forth    in    the   Illinois
 8             Administrative Procedure Act;
 9                  (b)  Allow members of the public to review  the
10             actual,  underlying  database upon which the list of
11             usual and customary charges in the proposed rule  is
12             derived;
13                  (c)  Verify   the   validity,   accuracy,   and
14             timeliness of all usual and customary charges in the
15             proposed  rule,  and  make  available  to the public
16             written explanation of why the  charges  are  valid,
17             accurate, and timely.
18             For  purposes of this paragraph, a "valid" usual and
19        customary  charge   is   a   charge   that   takes   into
20        consideration  only appropriate sources of data, and that
21        complies  with  the  criteria  for  usual  and  customary
22        charges  for  health  care  providers  as  set  forth  in
23        paragraph (5) or for hospitals as set forth  in paragraph
24        (6) with  respect  to  minimum  numbers  of  line  items,
25        geographical   sources   and   coverage,  exclusions  and
26        exemptions, and confidentialities.  An  "accurate"  usual
27        and  customary  charge is a charge for which the compiled
28        data have been correctly interpreted in  determining  the
29        level  of  the  charge.  A  "timely"  usual and customary
30        charge is a charge that is as current as  possible,  with
31        no  charge data being older than 24 months, and for which
32        6 or fewer months have elapsed since the latest update of
33        data.
34             (ii)  The requirements of this paragraph  (7)  shall
 
                            -12-     LRB093 09501 WGH 09736 b
 1        apply  to  all  determinations  of  usual  and  customary
 2        charges  established by rule of the Commission as well as
 3        to all updates of those determinations.
 4             (iii)  The  Commission  shall   update   usual   and
 5        customary  charges  at  least every 6 months by emergency
 6        rule.
 7             (iv)  The provisions of paragraphs (5) and (6) shall
 8        not take effect  unless  and  until  the  Commission  has
 9        complied  with  all of the requirements of this paragraph
10        (7).
11             (8)  The payment of health care provider charges  is
12        not  compensation  to  extend the time for filing a claim
13        under this Act.  The payment of the health care  provider
14        charges  by  an  employer  or  the  employer's  insurance
15        carrier,   shall  not  constitute  an  admission  of  the
16        employer's liability to payment  compensation  or  create
17        any obligation to pay health care provider charges.
18             (9)  Interest  paid  under this Section shall not be
19        an admission of liability to pay compensation or  to  pay
20        any health care provider charges.
21             (10)  The   Industrial  Commission  shall  implement
22        these amendments in the following manner:  The  physician
23        and health care provider database under paragraph (5) and
24        the  hospital,  in-patient and out-patient database under
25        paragraph (6) and a precise methodology for use shall  be
26        adopted  by  rule  no  later  than  October 1, 2004.  The
27        database usual and customary determination shall then  be
28        published  electronically  by  the  Industrial Commission
29        every 6 months beginning July 1, 2005.  The provisions of
30        paragraphs (5) and (6)  shall become  effective  30  days
31        after  the  Commission  establishes  a  database  by rule
32        pursuant to the requirement of paragraph (7).
33        (a-5)  Notwithstanding  the  foregoing,  the   employer's
34    liability  to  pay  for such medical services selected by the
 
                            -13-     LRB093 09501 WGH 09736 b
 1    employee shall be limited to:
 2             (1)  all first aid and emergency treatment; plus
 3             (2)  all medical,  surgical  and  hospital  services
 4        provided  by the physician, surgeon or hospital initially
 5        chosen  by  the  employee  or  by  any  other  physician,
 6        consultant, expert,  institution  or  other  provider  of
 7        services  recommended by said initial service provider or
 8        any subsequent provider of medical services in the  chain
 9        of referrals from said initial service provider; plus
10             (3)  all  medical,  surgical  and  hospital services
11        provided by any second  physician,  surgeon  or  hospital
12        subsequently  chosen  by  the  employee  or  by any other
13        physician,  consultant,  expert,  institution  or   other
14        provider  of  services recommended by said second service
15        provider or any subsequent provider of  medical  services
16        in  the  chain  of  referrals  from  said  second service
17        provider. Thereafter the employer shall  select  and  pay
18        for   all   necessary   medical,  surgical  and  hospital
19        treatment and the employee may not select a  provider  of
20        medical  services  at  the  employer's expense unless the
21        employer agrees  to  such  selection.  At  any  time  the
22        employee  may  obtain any medical treatment he desires at
23        his own expense. This paragraph shall not affect the duty
24        to pay for rehabilitation referred to above.
25        When an  employer  and  employee  so  agree  in  writing,
26    nothing  in  this  Act  prevents  an employee whose injury or
27    disability has been established under this Act, from  relying
28    in  good  faith,  on  treatment  by prayer or spiritual means
29    alone, in accordance  with  the  tenets  and  practice  of  a
30    recognized  church  or  religious  denomination,  by  a  duly
31    accredited  practitioner thereof, and having nursing services
32    appropriate therewith, without suffering loss  or  diminution
33    of  the  compensation  benefits  under this Act. However, the
34    employee shall submit to all physical  examinations  required
 
                            -14-     LRB093 09501 WGH 09736 b
 1    by  this  Act.   The  cost of such treatment and nursing care
 2    shall be paid by the employee unless the employer  agrees  to
 3    make such payment.
 4        Where  the accidental injury results in the amputation of
 5    an arm, hand, leg or foot, or the enucleation of an  eye,  or
 6    the  loss  of  any  of  the natural teeth, the employer shall
 7    furnish an artificial of any such members lost or damaged  in
 8    accidental  injury  arising  out  of  and  in  the  course of
 9    employment, and shall also furnish the  necessary  braces  in
10    all  proper  and  necessary cases.  In cases of the loss of a
11    member or members by amputation, the employer shall, whenever
12    necessary, maintain in good  repair,  refit  or  replace  the
13    artificial  limbs during the lifetime of the employee.  Where
14    the accidental injury accompanied by physical injury  results
15    in damage to a denture, eye glasses or contact eye lenses, or
16    where   the   accidental  injury  results  in  damage  to  an
17    artificial member, the employer shall replace or repair  such
18    denture, glasses, lenses, or artificial member.
19        The  furnishing  by  the employer of any such services or
20    appliances is not an admission of liability on  the  part  of
21    the employer to pay compensation.
22        The  furnishing of any such services or appliances or the
23    servicing thereof by the  employer  is  not  the  payment  of
24    compensation.
25        (b)  If the period of temporary total incapacity for work
26    lasts  more  than  3  working  days,  weekly  compensation as
27    hereinafter provided shall be paid beginning on the  4th  day
28    of  such temporary total incapacity and continuing as long as
29    the total temporary incapacity lasts.   In  cases  where  the
30    temporary total incapacity for work continues for a period of
31    14  days  or  more  from the day of the accident compensation
32    shall commence on the day after the accident.
33             1.  The  compensation  rate  for   temporary   total
34        incapacity under this paragraph (b) of this Section shall
 
                            -15-     LRB093 09501 WGH 09736 b
 1        be equal to 66 2/3% of the employee's average weekly wage
 2        computed  in accordance with Section 10, provided that it
 3        shall be not less  than  the  following  amounts  in  the
 4        following cases:
 5                  $100.90 in case of a single person;
 6                  $105.50  in  case  of  a married person with no
 7             children;
 8                  $108.30 in case of one child;
 9                  $113.40 in case of 2 children;
10                  $117.40 in case of 3 children;
11                  $124.30 in case of 4 or more children;
12        nor exceed the employee's average weekly wage computed in
13        accordance with the provisions of Section  10,  whichever
14        is less.
15             2.  The  compensation  rate  in all cases other than
16        for temporary total disability under this paragraph  (b),
17        and  other  than  for serious and permanent disfigurement
18        under paragraph (c) and other than for permanent  partial
19        disability  under  subparagraph  (2)  of paragraph (d) or
20        under paragraph (e), of this Section shall be equal to 66
21        2/3% of the employee's average weekly  wage  computed  in
22        accordance  with  the  provisions of Section 10, provided
23        that it shall be not less than the following  amounts  in
24        the following cases:
25                  $80.90 in case of a single person;
26                  $83.20  in  case  of  a  married person with no
27             children;
28                  $86.10 in case of one child;
29                  $88.90 in case of 2 children;
30                  $91.80 in case of 3 children;
31                  $96.90 in case of 4 or more children;
32        nor exceed the employee's average weekly wage computed in
33        accordance with the provisions of Section  10,  whichever
34        is less.
 
                            -16-     LRB093 09501 WGH 09736 b
 1             2.1.  The  compensation rate in all cases of serious
 2        and permanent disfigurement under paragraph  (c)  and  of
 3        permanent  partial  disability  under subparagraph (2) of
 4        paragraph (d) or under  paragraph  (e)  of  this  Section
 5        shall  be  equal  to 60% of the employee's average weekly
 6        wage  computed  in  accordance  with  the  provisions  of
 7        Section 10, provided that it shall be not less  than  the
 8        following amounts in the following cases:
 9                  $80.90 in case of a single person;
10                  $83.20  in  case  of  a  married person with no
11             children;
12                  $86.10 in case of one child;
13                  $88.90 in case of 2 children;
14                  $91.80 in case of 3 children;
15                  $96.90 in case of 4 or more children;
16        nor exceed the employee's average weekly wage computed in
17        accordance with the provisions of Section  10,  whichever
18        is less.
19             3.  As used in this Section the term "child" means a
20        child of the employee including any child legally adopted
21        before  the  accident or whom at the time of the accident
22        the employee was under legal obligation to support or  to
23        whom  the employee stood in loco parentis, and who at the
24        time of the accident was under 18 years of  age  and  not
25        emancipated.   The  term  "children"  means the plural of
26        "child".
27             4.  All weekly  compensation  rates  provided  under
28        subparagraphs  1, 2 and 2.1 of this paragraph (b) of this
29        Section shall be subject to the following limitations:
30             The maximum weekly compensation rate  from  July  1,
31        1975,  except  as  hereinafter provided, shall be 100% of
32        the State's average weekly  wage  in  covered  industries
33        under the Unemployment Insurance Act, that being the wage
34        that most closely approximates the State's average weekly
 
                            -17-     LRB093 09501 WGH 09736 b
 1        wage.
 2             The maximum weekly compensation rate, for the period
 3        July   1,   1984,   through  June  30,  1987,  except  as
 4        hereinafter provided, shall be $293.61. Effective July 1,
 5        1987 and on July 1 of each year  thereafter  the  maximum
 6        weekly compensation rate, except as hereinafter provided,
 7        shall  be  determined as follows: if during the preceding
 8        12 month period there shall have been an increase in  the
 9        State's  average  weekly wage in covered industries under
10        the Unemployment Insurance Act, the  weekly  compensation
11        rate  shall  be  proportionately  increased  by  the same
12        percentage as the percentage of increase in  the  State's
13        average  weekly  wage  in  covered  industries  under the
14        Unemployment Insurance Act during such period.
15             The maximum weekly compensation rate, for the period
16        January 1, 1981 through  December  31,  1983,  except  as
17        hereinafter  provided,  shall  be  100%  of  the  State's
18        average  weekly  wage  in  covered  industries  under the
19        Unemployment Insurance Act in effect on January 1,  1981.
20        Effective  January 1, 1984 and on January 1, of each year
21        thereafter the maximum weekly compensation  rate,  except
22        as  hereinafter provided, shall be determined as follows:
23        if during the preceding 12 month period there shall  have
24        been  an  increase  in the State's average weekly wage in
25        covered industries under the Unemployment Insurance  Act,
26        the  weekly  compensation  rate  shall be proportionately
27        increased by the same percentage  as  the  percentage  of
28        increase  in  the  State's average weekly wage in covered
29        industries under the Unemployment  Insurance  Act  during
30        such period.
31             From July 1, 1977 and thereafter such maximum weekly
32        compensation  rate  in  death  cases under Section 7, and
33        permanent total disability cases under paragraph  (f)  or
34        subparagraph  18 of paragraph (3) of this Section and for
 
                            -18-     LRB093 09501 WGH 09736 b
 1        temporary total disability under paragraph  (b)  of  this
 2        Section  and for amputation of a member or enucleation of
 3        an eye under paragraph  (e)  of  this  Section  shall  be
 4        increased  to 133-1/3% of the State's average weekly wage
 5        in covered industries under  the  Unemployment  Insurance
 6        Act.
 7             4.1.  Any   provision   herein   to   the   contrary
 8        notwithstanding,   the   weekly   compensation  rate  for
 9        compensation payments under subparagraph 18 of  paragraph
10        (e)  of  this  Section  and  under  paragraph (f) of this
11        Section and under paragraph (a) of Section 7, shall in no
12        event be less than 50% of the State's average weekly wage
13        in covered industries under  the  Unemployment  Insurance
14        Act.
15             4.2.  Any provision to the contrary notwithstanding,
16        the  total compensation payable under Section 7 shall not
17        exceed the greater of $250,000 or 20 years.
18             5.  For the purpose of  this  Section  this  State's
19        average  weekly  wage  in  covered  industries  under the
20        Unemployment Insurance Act on  July  1,  1975  is  hereby
21        fixed   at  $228.16  per  week  and  the  computation  of
22        compensation  rates  shall  be  based  on  the  aforesaid
23        average  weekly  wage  until  modified   as   hereinafter
24        provided.
25             6.  The  Department  of  Employment  Security of the
26        State shall on or before the first day of December, 1977,
27        and on or before the first day of June, 1978, and on  the
28        first  day  of  each  December  and  June  of  each  year
29        thereafter,  publish  the  State's average weekly wage in
30        covered industries under the Unemployment  Insurance  Act
31        and  the  Industrial  Commission shall on the 15th day of
32        January, 1978 and on the 15th day of July,  1978  and  on
33        the  15th  day  of  each  January  and  July of each year
34        thereafter, post and publish the State's  average  weekly
 
                            -19-     LRB093 09501 WGH 09736 b
 1        wage   in   covered  industries  under  the  Unemployment
 2        Insurance Act as last determined  and  published  by  the
 3        Department  of  Employment  Security.  The amount when so
 4        posted and published shall be  conclusive  and  shall  be
 5        applicable  as  the  basis of computation of compensation
 6        rates  until  the  next  posting   and   publication   as
 7        aforesaid.
 8             7.  The  payment  of  compensation by an employer or
 9        his insurance carrier to an injured  employee  shall  not
10        constitute  an  admission  of the employer's liability to
11        pay compensation.
12        (c)  For any serious and permanent disfigurement  to  the
13    hand,  head, face, neck, arm, leg below the knee or the chest
14    above  the  axillary  line,  the  employee  is  entitled   to
15    compensation for such disfigurement, the amount determined by
16    agreement  at any time or by arbitration under this Act, at a
17    hearing not  less  than  6  months  after  the  date  of  the
18    accidental injury, which amount shall not exceed 150 weeks at
19    the applicable rate provided in subparagraph 2.1 of paragraph
20    (b) of this Section.
21        No  compensation  is  payable  under this paragraph where
22    compensation is payable under paragraphs (d), (e) or  (f)  of
23    this Section.
24        A  duly  appointed member of a fire department in a city,
25    the population of which exceeds 200,000 according to the last
26    federal or State census, is eligible for  compensation  under
27    this   paragraph   only  where  such  serious  and  permanent
28    disfigurement results from burns.
29        (d) 1.  If,  after  the  accidental   injury   has   been
30    sustained, the employee as a result thereof becomes partially
31    incapacitated  from  pursuing his usual and customary line of
32    employment, he shall, except in cases compensated  under  the
33    specific schedule set forth in paragraph (e) of this Section,
34    receive  compensation  for  the  duration  of his disability,
 
                            -20-     LRB093 09501 WGH 09736 b
 1    subject to the limitations as to  maximum  amounts  fixed  in
 2    paragraph  (b)  of  this  Section,  equal  to  66-2/3% of the
 3    difference between the average amount which he would be  able
 4    to  earn  in  the  full  performance  of  his  duties  in the
 5    occupation in which  he  was  engaged  at  the  time  of  the
 6    accident  and  the  average  amount which he is earning or is
 7    able to earn in some suitable employment  or  business  after
 8    the accident.
 9        2.  If,  as  a  result  of  the  accident,  the  employee
10    sustains  serious  and  permanent  injuries  not  covered  by
11    paragraphs  (c)  and  (e) of this Section or having sustained
12    injuries covered by the aforesaid paragraphs (c) and (e),  he
13    shall have sustained in addition thereto other injuries which
14    injuries  do not incapacitate him from pursuing the duties of
15    his employment but which  would  disable  him  from  pursuing
16    other  suitable occupations, or which have otherwise resulted
17    in  physical  impairment;  or  if  such  injuries   partially
18    incapacitate  him  from  pursuing the duties of his usual and
19    customary  line  of  employment  but  do  not  result  in  an
20    impairment of earning capacity,  or  having  resulted  in  an
21    impairment  of earning capacity, the employee elects to waive
22    his right to recover under the foregoing  subparagraph  1  of
23    paragraph  (d)  of  this Section then in any of the foregoing
24    events, he shall receive  in  addition  to  compensation  for
25    temporary  total  disability  under  paragraph  (b)  of  this
26    Section,  compensation  at  the rate provided in subparagraph
27    2.1 of paragraph (b) of this Section for that  percentage  of
28    500  weeks  that  the  partial  disability resulting from the
29    injuries covered by this paragraph bears to total disability.
30    If the employee shall have sustained a  fracture  of  one  or
31    more  vertebra  or  fracture  of  the  skull,  the  amount of
32    compensation allowed under this Section  shall  be  not  less
33    than  6  weeks  for  a  fractured  skull and 6 weeks for each
34    fractured vertebra, and in the event the employee shall  have
 
                            -21-     LRB093 09501 WGH 09736 b
 1    sustained  a  fracture  of any of the following facial bones:
 2    nasal,  lachrymal,  vomer,  zygoma,  maxilla,   palatine   or
 3    mandible,  the  amount  of  compensation  allowed  under this
 4    Section shall  be  not  less  than  2  weeks  for  each  such
 5    fractured bone, and for a fracture of each transverse process
 6    not  less  than  3  weeks.   In the event such injuries shall
 7    result in the loss of a kidney, spleen or lung, the amount of
 8    compensation allowed under this Section  shall  be  not  less
 9    than  10  weeks  for  each  such organ.  Compensation awarded
10    under this subparagraph 2 shall not take  into  consideration
11    injuries covered under paragraphs (c) and (e) of this Section
12    and  the  compensation  provided  in this paragraph shall not
13    affect the employee's right  to  compensation  payable  under
14    paragraphs   (b),  (c)  and  (e)  of  this  Section  for  the
15    disabilities therein covered.
16        (e)  For accidental injuries in the  following  schedule,
17    the  employee  shall  receive  compensation for the period of
18    temporary total  incapacity  for  work  resulting  from  such
19    accidental  injury,  under subparagraph 1 of paragraph (b) of
20    this  Section,  and  shall  receive   in   addition   thereto
21    compensation  for  a  further  period  for  the specific loss
22    herein mentioned, but  shall  not  receive  any  compensation
23    under  any  other  provisions  of  this  Act.   The following
24    listed amounts apply to either the loss of or  the  permanent
25    and  complete  loss  of  use  of  the  member specified, such
26    compensation for the length of time as follows:
27             1.  Thumb-70 weeks.
28             2.  First, or index finger-40 weeks.
29             3.  Second, or middle finger-35 weeks.
30             4.  Third, or ring finger-25 weeks.
31             5.  Fourth, or little finger-20 weeks.
32             6.  Great toe-35 weeks.
33             7.  Each toe other than great toe-12 weeks.
34             8.  The loss of the first or distal phalanx  of  the
 
                            -22-     LRB093 09501 WGH 09736 b
 1        thumb  or  of any finger or toe shall be considered to be
 2        equal to the loss of one-half of such  thumb,  finger  or
 3        toe and the compensation payable shall be one-half of the
 4        amount  above  specified.   The  loss  of  more  than one
 5        phalanx shall be considered as the  loss  of  the  entire
 6        thumb,  finger  or  toe.   In  no  case  shall the amount
 7        received for more  than  one  finger  exceed  the  amount
 8        provided in this schedule for the loss of a hand.
 9             9.  Hand-190  weeks.   The loss of 2 or more digits,
10        or one or more phalanges of 2 or more digits, of  a  hand
11        may be compensated on the basis of partial loss of use of
12        a  hand, provided, further, that the loss of 4 digits, or
13        the loss of use of 4  digits,  in  the  same  hand  shall
14        constitute the  complete loss of a hand.
15             10.  Arm-235  weeks.   Where  an  accidental  injury
16        results in the amputation of an arm below the elbow, such
17        injury  shall  be compensated as a loss of an arm.  Where
18        an accidental injury results in the amputation of an  arm
19        above  the elbow, compensation for an additional 15 weeks
20        shall be paid, except where the accidental injury results
21        in the amputation of an arm at the shoulder joint, or  so
22        close  to shoulder joint that an artificial arm cannot be
23        used, or results in the disarticulation of an arm at  the
24        shoulder   joint,  in  which  case  compensation  for  an
25        additional 65 weeks shall be paid.
26             11.  Foot-155 weeks.
27             12.  Leg-200  weeks.   Where  an  accidental  injury
28        results in the amputation of a leg below the  knee,  such
29        injury  shall  be  compensated as loss of a leg. Where an
30        accidental injury results in  the  amputation  of  a  leg
31        above  the  knee, compensation for an additional 25 weeks
32        shall be paid, except where the accidental injury results
33        in the amputation of a leg at the hip joint, or so  close
34        to  the  hip joint that an artificial leg cannot be used,
 
                            -23-     LRB093 09501 WGH 09736 b
 1        or results in the disarticulation of a  leg  at  the  hip
 2        joint,  in  which  case compensation for an additional 75
 3        weeks shall be paid.
 4             13.  Eye-150  weeks.   Where  an  accidental  injury
 5        results in the enucleation of an eye, compensation for an
 6        additional 10 weeks shall be paid.
 7             14.  Loss of hearing of one ear-50 weeks; total  and
 8        permanent loss of hearing of both ears-200 weeks.
 9             15.  Testicle-50 weeks; both testicles-150 weeks.
10             16.  For  the  permanent  partial  loss  of use of a
11        member or  sight  of  an  eye,  or  hearing  of  an  ear,
12        compensation  during  that  proportion  of  the number of
13        weeks in the foregoing schedule provided for the loss  of
14        such  member  or  sight  of an eye, or hearing of an ear,
15        which the partial loss of use thereof bears to the  total
16        loss  of  use of such member, or sight of eye, or hearing
17        of an ear.
18                  (a)  Loss of hearing for compensation  purposes
19             shall be confined to the frequencies of 1,000, 2,000
20             and 3,000 cycles per second. Loss of hearing ability
21             for  frequency  tones  above 3,000 cycles per second
22             are not to be considered as constituting  disability
23             for hearing.
24                  (b)  The  percent of hearing loss, for purposes
25             of the  determination  of  compensation  claims  for
26             occupational  deafness,  shall  be calculated as the
27             average in decibels for the  thresholds  of  hearing
28             for the frequencies of 1,000, 2,000 and 3,000 cycles
29             per  second.  Pure  tone  air conduction audiometric
30             instruments,  approved  by   nationally   recognized
31             authorities   in  this  field,  shall  be  used  for
32             measuring hearing loss. If  the  losses  of  hearing
33             average  30  decibels  or less in the 3 frequencies,
34             such losses of hearing shall not then constitute any
 
                            -24-     LRB093 09501 WGH 09736 b
 1             compensable hearing disability.  If  the  losses  of
 2             hearing  average  85  decibels  or  more  in  the  3
 3             frequencies,  then  the same shall constitute and be
 4             total or 100% compensable hearing loss.
 5                  (c)  In  measuring  hearing   impairment,   the
 6             lowest  measured losses in each of the 3 frequencies
 7             shall  be  added  together  and  divided  by  3   to
 8             determine   the  average  decibel  loss.  For  every
 9             decibel of loss exceeding 30 decibels  an  allowance
10             of  1.82%  shall  be  made up to the maximum of 100%
11             which is reached at 85 decibels.
12                  (d)  If a hearing loss is established  to  have
13             existed  on  July 1, 1975 by audiometric testing the
14             employer shall not be liable for the  previous  loss
15             so  established  nor shall he be liable for any loss
16             for which compensation has been paid or awarded.
17                  (e)  No consideration shall  be  given  to  the
18             question  of  whether  or  not  the  ability  of  an
19             employee to understand speech is improved by the use
20             of a hearing aid.
21                  (f)  No  claim  for  loss  of  hearing  due  to
22             industrial   noise   shall  be  brought  against  an
23             employer or allowed unless  the  employee  has  been
24             exposed  for  a  period  of time sufficient to cause
25             permanent impairment to noise levels  in  excess  of
26             the following:
27                  Sound Level DBA
28                   Slow Response              Hours Per Day
29                        90                          8
30                        92                          6
31                        95                          4
32                        97                          3
33                        100                         2
34                        102                       1-1/2
 
                            -25-     LRB093 09501 WGH 09736 b
 1                        105                         1
 2                        110                        1/2
 3                        115                        1/4
 4             This  subparagraph (f) shall not be applied in cases
 5        of hearing loss resulting from trauma or explosion.
 6             17.  In computing the compensation to be paid to any
 7        employee who, before the accident  for  which  he  claims
 8        compensation,  had  before  that time sustained an injury
 9        resulting in the loss by amputation or  partial  loss  by
10        amputation  of  any member, including hand, arm, thumb or
11        fingers, leg, foot or any toes, such loss or partial loss
12        of any such member shall be deducted from any award  made
13        for the subsequent injury.  For the permanent loss of use
14        or  the  permanent partial loss of use of any such member
15        or the partial  loss  of  sight  of  an  eye,  for  which
16        compensation has been paid, then such loss shall be taken
17        into  consideration  and  deducted from any award for the
18        subsequent injury.
19             18.  The specific case of loss of both  hands,  both
20        arms, or both feet, or both legs, or both eyes, or of any
21        two  thereof,  or  the permanent and complete loss of the
22        use thereof, constitutes total and permanent  disability,
23        to  be compensated according to the compensation fixed by
24        paragraph (f) of this Section.  These specific  cases  of
25        total  and  permanent  disability  do  not  exclude other
26        cases.
27             Any employee who has previously suffered the loss or
28        permanent and complete loss of the use  of  any  of  such
29        members,  and  in a subsequent independent accident loses
30        another or suffers the permanent and complete loss of the
31        use of any one of such members the employer for whom  the
32        injured  employee  is  working  at  the  time of the last
33        independent accident is liable to pay  compensation  only
34        for the loss or permanent and complete loss of the use of
 
                            -26-     LRB093 09501 WGH 09736 b
 1        the member occasioned by the last independent accident.
 2             19.  In  a  case of specific loss and the subsequent
 3        death of such injured employee  from  other  causes  than
 4        such  injury  leaving  a  widow,  widower, or  dependents
 5        surviving before payment or  payment  in  full  for  such
 6        injury, then the amount due for such injury is payable to
 7        the  widow  or  widower  and,  if  there  be  no widow or
 8        widower, then to such dependents, in the proportion which
 9        such dependency bears to total dependency.
10        Beginning July 1, 1980, and every  6  months  thereafter,
11    the Commission shall examine the Second Injury Fund and when,
12    after  deducting all advances or loans made to such Fund, the
13    amount therein is $500,000 then the  amount  required  to  be
14    paid  by  employers  pursuant  to  paragraph (f) of Section 7
15    shall be reduced by one-half. When  the  Second  Injury  Fund
16    reaches  the  sum  of  $600,000 then the payments shall cease
17    entirely.  However, when the  Second  Injury  Fund  has  been
18    reduced  to  $400,000,  payment  of  one-half  of the amounts
19    required by paragraph (f) of Section 7 shall be  resumed,  in
20    the  manner  herein provided, and when the Second Injury Fund
21    has been reduced to $300,000, payment  of  the  full  amounts
22    required  by  paragraph (f) of Section 7 shall be resumed, in
23    the manner herein provided. The  Commission  shall  make  the
24    changes  in  payment  effective  by  general  order,  and the
25    changes in payment become immediately effective for all cases
26    coming before the Commission thereafter either by  settlement
27    agreement  or  final  order,  irrespective of the date of the
28    accidental injury.
29        On August 1, 1996 and on February 1 and August 1 of  each
30    subsequent  year,  the  Commission  shall examine the special
31    fund designated as the "Rate Adjustment Fund" and when, after
32    deducting all advances or loans made to said fund, the amount
33    therein is $4,000,000, the amount  required  to  be  paid  by
34    employers  pursuant  to  paragraph  (f) of Section 7 shall be
 
                            -27-     LRB093 09501 WGH 09736 b
 1    reduced by one-half.  When the Rate Adjustment  Fund  reaches
 2    the  sum  of  $5,000,000  the  payment  therein  shall  cease
 3    entirely.   However,  when said Rate Adjustment Fund has been
 4    reduced to $3,000,000 the amounts required by  paragraph  (f)
 5    of Section 7 shall be resumed in the manner herein provided.
 6        (f)  In  case  of  complete disability, which renders the
 7    employee wholly and permanently incapable of work, or in  the
 8    specific  case  of total and permanent disability as provided
 9    in  subparagraph  18  of  paragraph  (e)  of  this   Section,
10    compensation  shall  be  payable  at  the  rate  provided  in
11    subparagraph 2 of paragraph (b) of this Section for life.
12        An  employee  entitled to benefits under paragraph (f) of
13    this Section shall also be entitled to receive from the  Rate
14    Adjustment Fund provided in paragraph (f) of Section 7 of the
15    supplementary  benefits  provided  in  paragraph  (g) of this
16    Section 8.
17        If  any  employee  who  receives  an  award  under   this
18    paragraph afterwards returns to work or is able to do so, and
19    earns  or  is  able  to  earn as much as before the accident,
20    payments under such award  shall  cease.   If  such  employee
21    returns to work, or is able to do so, and earns or is able to
22    earn  part but not as much as before the accident, such award
23    shall be  modified  so  as  to  conform  to  an  award  under
24    paragraph  (d)  of this Section.  If such award is terminated
25    or reduced under  the  provisions  of  this  paragraph,  such
26    employees  have  the right at any time within 30 months after
27    the date of such termination or reduction  to  file  petition
28    with  the  Commission  for the purpose of determining whether
29    any disability exists as a result of the original  accidental
30    injury and the extent thereof.
31        Disability as enumerated in subdivision 18, paragraph (e)
32    of this Section is considered complete disability.
33        If  an  employee  who had previously incurred loss or the
34    permanent and complete loss of use of one member, through the
 
                            -28-     LRB093 09501 WGH 09736 b
 1    loss or the permanent and complete loss of  the  use  of  one
 2    hand,  one  arm,  one  foot,  one  leg,  or  one  eye, incurs
 3    permanent and complete disability through  the  loss  or  the
 4    permanent  and complete loss of the use of another member, he
 5    shall receive, in addition to the compensation payable by the
 6    employer and after such payments have ceased, an amount  from
 7    the  Second  Injury  Fund  provided  for  in paragraph (f) of
 8    Section 7, which, together with the compensation payable from
 9    the employer in whose employ he was when the last  accidental
10    injury  was  incurred,  will  equal  the  amount  payable for
11    permanent  and  complete  disability  as  provided  in   this
12    paragraph of this Section.
13        The  custodian  of the Second Injury Fund provided for in
14    paragraph (f) of Section 7 shall be joined with the  employer
15    as  a  party  respondent in the application for adjustment of
16    claim.  The application for adjustment of claim  shall  state
17    briefly  and  in general terms the approximate time and place
18    and manner of the loss of the first member.
19        In its award  the  Commission  or  the  Arbitrator  shall
20    specifically  find  the  amount the injured employee shall be
21    weekly paid, the number of weeks compensation which shall  be
22    paid  by the employer, the date upon which payments begin out
23    of the Second Injury Fund provided for in  paragraph  (f)  of
24    Section 7 of this Act, the length of time the weekly payments
25    continue,  the  date upon which the pension payments commence
26    and the monthly amount of the payments. The Commission  shall
27    30  days after the date upon which payments out of the Second
28    Injury Fund have begun as provided in the  award,  and  every
29    month thereafter, prepare and submit to the State Comptroller
30    a  voucher  for  payment for all compensation accrued to that
31    date  at  the  rate  fixed  by  the  Commission.   The  State
32    Comptroller shall draw a  warrant  to  the  injured  employee
33    along  with  a receipt to be executed by the injured employee
34    and returned to the  Commission.  The  endorsed  warrant  and
 
                            -29-     LRB093 09501 WGH 09736 b
 1    receipt  is a full and complete acquittance to the Commission
 2    for the payment out of the  Second  Injury  Fund.   No  other
 3    appropriation  or warrant is necessary for payment out of the
 4    Second Injury Fund.  The Second Injury Fund  is  appropriated
 5    for  the purpose of making payments according to the terms of
 6    the awards.
 7        As of July 1, 1980 to July 1, 1982,  all  claims  against
 8    and obligations of the Second Injury Fund shall become claims
 9    against  and  obligations  of the Rate Adjustment Fund to the
10    extent there is insufficient money in the Second Injury  Fund
11    to  pay  such  claims  and  obligations.   In  that case, all
12    references to "Second Injury Fund" in this Section shall also
13    include the Rate Adjustment Fund.
14        (g)  Every award for permanent total  disability  entered
15    by  the  Commission  on  and  after  July 1, 1965 under which
16    compensation payments shall become due and payable after  the
17    effective  date  of  this amendatory Act, and every award for
18    death benefits or permanent total disability entered  by  the
19    Commission on and after the effective date of this amendatory
20    Act  shall  be subject to annual adjustments as to the amount
21    of the compensation rate therein provided.  Such  adjustments
22    shall first be made on July 15, 1977, and all awards made and
23    entered  prior  to  July  1, 1975 and on July 15 of each year
24    thereafter.  In all other cases such adjustment shall be made
25    on July 15 of the second year next following the date of  the
26    entry  of  the  award  and  shall  further be made on July 15
27    annually thereafter.  If during the intervening  period  from
28    the  date  of  the  entry  of the award, or the last periodic
29    adjustment, there shall have been an increase in the  State's
30    average   weekly   wage   in  covered  industries  under  the
31    Unemployment Insurance  Act,  the  weekly  compensation  rate
32    shall  be proportionately increased by the same percentage as
33    the percentage of increase in the State's average weekly wage
34    in covered industries under the Unemployment  Insurance  Act.
 
                            -30-     LRB093 09501 WGH 09736 b
 1    The  increase  in  the compensation rate under this paragraph
 2    shall in no event bring the total  compensation  rate  to  an
 3    amount  greater  than  the  prevailing  maximum  rate.   Such
 4    increase  shall be paid in the same manner as herein provided
 5    for payments under the Second  Injury  Fund  to  the  injured
 6    employee,  or  his dependents, as the case may be, out of the
 7    Rate Adjustment Fund provided in paragraph (f) of  Section  7
 8    of this Act.  Payments shall be made at the same intervals as
 9    provided  in  the  award or, at the option of the Commission,
10    may be made in quarterly payment on the 15th day of  January,
11    April,  July  and  October  of  each year.  In the event of a
12    decrease in such average weekly wage there shall be no change
13    in the then existing compensation rate.  The within paragraph
14    shall not apply to cases where there  is  disputed  liability
15    and  in  which  a  compromise lump sum settlement between the
16    employer and the injured employee, or his dependents, as  the
17    case  may  be,  has  been  duly  approved  by  the Industrial
18    Commission.
19        Provided,  that  in  cases  of  awards  entered  by   the
20    Commission  for  injuries  occurring before July 1, 1975, the
21    increases  in  the  compensation  rate  adjusted  under   the
22    foregoing provision of this paragraph (g) shall be limited to
23    increases  in  the  State's  average  weekly  wage in covered
24    industries under the  Unemployment  Insurance  Act  occurring
25    after July 1, 1975.
26        (h)  In case death occurs from any cause before the total
27    compensation  to  which the employee would have been entitled
28    has been paid, then in case the employee  leaves  any  widow,
29    widower,  child,  parent  (or  any grandchild, grandparent or
30    other lineal heir or any collateral  heir  dependent  at  the
31    time of the accident upon the earnings of the employee to the
32    extent  of 50% or more of total dependency) such compensation
33    shall be paid to the beneficiaries of the  deceased  employee
34    and distributed as provided in paragraph (g) of Section 7.
 
                            -31-     LRB093 09501 WGH 09736 b
 1        (h-1)  In   case  an  injured  employee  is  under  legal
 2    disability at the time when any right or privilege accrues to
 3    him or her under  this  Act,  a  guardian  may  be  appointed
 4    pursuant  to  law,  and  may,  on behalf of such person under
 5    legal disability,  claim  and  exercise  any  such  right  or
 6    privilege  with the same effect as if the employee himself or
 7    herself had claimed or exercised the right or privilege.   No
 8    limitations  of  time provided by this Act run so long as the
 9    employee  who  is  under  legal  disability  is   without   a
10    conservator or guardian.
11        (i)  In  case  the  injured employee is under 16 years of
12    age at the time of the accident and  is  illegally  employed,
13    the amount of compensation payable under paragraphs (b), (c),
14    (d), (e) and (f) of this Section is increased 50%.
15        However,  where  an  employer  has  on file an employment
16    certificate issued pursuant to the Child Labor  Law  or  work
17    permit  issued  pursuant  to the Federal Fair Labor Standards
18    Act, as amended, or a birth  certificate  properly  and  duly
19    issued,  such  certificate,  permit  or  birth certificate is
20    conclusive evidence as  to  the  age  of  the  injured  minor
21    employee for the purposes of this Section.
22        Nothing herein contained repeals or amends the provisions
23    of  the  Child Labor Law relating to the employment of minors
24    under the age of 16 years.
25        (j) 1.  In  the  event  the  injured  employee   receives
26    benefits,  including  medical,  surgical or hospital benefits
27    under any group plan covering  non-occupational  disabilities
28    contributed  to  wholly  or  partially by the employer, which
29    benefits should not  have  been  payable  if  any  rights  of
30    recovery existed under this Act, then such amounts so paid to
31    the  employee from any such group plan as shall be consistent
32    with, and limited to, the provisions of paragraph  2  hereof,
33    shall  be credited to or against any compensation payment for
34    temporary total incapacity for work or any medical,  surgical
 
                            -32-     LRB093 09501 WGH 09736 b
 1    or  hospital  benefits  made or to be made under this Act. In
 2    such  event,  the  period  of  time  for  giving  notice   of
 3    accidental  injury  and  filing application for adjustment of
 4    claim does not commence to run until the termination of  such
 5    payments.   This  paragraph  does  not apply to payments made
 6    under  any  group  plan  which  would   have   been   payable
 7    irrespective  of  an  accidental  injury under this Act.  Any
 8    employer receiving such credit shall keep such employee  safe
 9    and  harmless from any and all claims or liabilities that may
10    be made  against  him  by  reason  of  having  received  such
11    payments only to the extent of such credit.
12        Any  excess  benefits  paid  to  or  on behalf of a State
13    employee by the  State  Employees'  Retirement  System  under
14    Article  14  of the Illinois Pension Code on a death claim or
15    disputed disability  claim  shall  be  credited  against  any
16    payments made or to be made by the State of Illinois to or on
17    behalf  of  such employee under this Act, except for payments
18    for medical expenses which have already been incurred at  the
19    time  of  the  award.   The  State of Illinois shall directly
20    reimburse the  State  Employees'  Retirement  System  to  the
21    extent of such credit.
22        2.  Nothing  contained  in this Act shall be construed to
23    give the employer or  the  insurance  carrier  the  right  to
24    credit  for any benefits or payments received by the employee
25    other than compensation payments provided by  this  Act,  and
26    where  the employee receives payments other than compensation
27    payments, whether as full or partial salary, group  insurance
28    benefits,  bonuses,  annuities  or  any  other  payments, the
29    employer or insurance carrier shall receive credit  for  each
30    such  payment  only  to  the  extent of the compensation that
31    would have been payable during the  period  covered  by  such
32    payment.
33        3.  The   extension   of   time  for  the  filing  of  an
34    Application for Adjustment of Claim as provided in  paragraph
 
                            -33-     LRB093 09501 WGH 09736 b
 1    1  above  shall  not  apply to those cases where the time for
 2    such filing had expired prior to the date on  which  payments
 3    or benefits enumerated herein have been initiated or resumed.
 4    Provided  however  that  this paragraph 3 shall apply only to
 5    cases wherein the payments or benefits hereinabove enumerated
 6    shall be received after July 1, 1969.
 7    (Source: P.A. 89-470, eff. 6-13-96.)

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

18        (820 ILCS 305/16) (from Ch. 48, par. 138.16)
19        Sec.  16.   The  Commission  shall   make   and   publish
20    procedural  rules  and  orders  for  carrying  out the duties
21    imposed upon it by law and  for  determining  the  extent  of
22    disability  sustained, which rules and orders shall be deemed
23    prima facie 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    dedimus potestatem directed to a commissioner, notary public,
28    justice  of  the peace or any other officer authorized by law
29    to administer oaths, to take the depositions of such  witness
30    or  witnesses  as  may  be  necessary in the judgment of such
31    applicant.  Such dedimus potestatem may issue to any  of  the
32    officers  aforesaid  in  any state or territory of the United
 
                            -34-     LRB093 09501 WGH 09736 b
 1    States.  When the deposition of any  witness  resident  of  a
 2    foreign  country is desired to be taken, the dedimus shall be
 3    directed to and the deposition taken before  a  consul,  vice
 4    consul  or  other authorized representative of the government
 5    of the United States of America,  whose  station  is  in  the
 6    country  where  the  witness  whose deposition is to be taken
 7    resides.  In countries where the  government  of  the  United
 8    States has no consul or other diplomatic representative, then
 9    depositions   in   such  case  shall  be  taken  through  the
10    appropriate judicial authority  of  that  country;  or  where
11    treaties  provide  for  other  methods of taking depositions,
12    then the same may be taken as in such treaties provided.  The
13    Commission  shall  have the power to adopt necessary rules to
14    govern the issue of such dedimus potestatem.
15        The Commission, or any member thereof, or any  Arbitrator
16    designated   by  the  Commission  shall  have  the  power  to
17    administer oaths, subpoena and examine  witnesses;  to  issue
18    subpoenas  duces  tecum,  requiring  the  production  of such
19    books, papers, records and documents as may  be  evidence  of
20    any  matter under inquiry and to examine and inspect the same
21    and such places or premises as may relate to the question  in
22    dispute.  The  Commission,  or  any  member  thereof,  or any
23    Arbitrator designated by the  Commission,  shall  on  written
24    request  of  either party to the dispute, issue subpoenas for
25    the attendance of  such  witnesses  and  production  of  such
26    books,  papers,  records and documents as shall be designated
27    in the  applications,  and  the  parties  applying  for  such
28    subpoena  shall advance the officer and witness fees provided
29    for in civil actions pending in circuit courts of this State,
30    except as otherwise provided  by  Section  20  of  this  Act.
31    Service  of  such  subpoena  shall  be made by any sheriff or
32    other person.  In case any person refuses to comply  with  an
33    order  of  the Commission or subpoenas issued by it or by any
34    member  thereof,  or  any  Arbitrator   designated   by   the
 
                            -35-     LRB093 09501 WGH 09736 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    or she may be lawfully interrogated, the Circuit Court of the
 5    county  in  which  the  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
23    therefor at the rate of $1.00 per page for the  original  and
24    35  cents per page for each copy of such transcript.  Payment
25    for photostatic copies of exhibits shall be extra.    If  the
26    Commission  has determined, as provided in Section 20 of this
27    Act, that the employee is a poor person, a transcript of such
28    testimony and proceedings, including  photostatic  copies  of
29    exhibits,   shall  be  furnished  to  such  employee  at  the
30    Commission's expense.
31        In accordance with the provisions of  subsection  (a)  of
32    Section  8 of this Act and subdivision (a)(3) of Section 8 of
33    this Act, the Commission shall have the  power  to  determine
34    the   reasonableness  and  fix  the  amount  of  any  fee  of
 
                            -36-     LRB093 09501 WGH 09736 b
 1    compensation charged  by  any  person,  including  attorneys,
 2    physicians, surgeons and hospitals, for any service performed
 3    in  connection  with  this Act, or for which payment is to be
 4    made under this Act or rendered in securing any  right  under
 5    this Act.
 6        Whenever the Commission shall find that the employer, his
 7    or  her  agent, service company or insurance carrier has been
 8    guilty of delay or unfairness  towards  an  employee  in  the
 9    adjustment,  settlement  or  payment  of  benefits  due  such
10    employee  within  the  purview of the provisions of paragraph
11    (c) of  Section  4  of  this  Act;  or  has  been  guilty  of
12    unreasonable or vexatious delay, intentional under-payment of
13    compensation  benefits,  or has engaged in frivolous defenses
14    which do not present a real controversy, within  the  purview
15    of the provisions of paragraph (k) of Section 19 of this Act,
16    the  Commission  may assess all or any part of the attorney's
17    fees and costs against such employer and his or her insurance
18    carrier.
19    (Source: P.A. 86-998.)

20        (820 ILCS 305/16a) (from Ch. 48, par. 138.16a)
21        Sec. 16a.   (A)  In  the  establishment  or  approval  of
22    attorney's fees in relation to claims brought under this Act,
23    the  Commission  shall  be  guided  by the provisions of this
24    Section and by the legislative intent,  hereby  declared,  to
25    encourage  settlement  and prompt administrative  handling of
26    such claims and thereby  reduce  expenses  to  claimants  for
27    compensation under this Act.
28        (B)  With   respect   to   any  and  all  proceedings  in
29    connection with any initial or original claim under this Act,
30    no claim of any attorney for services rendered in  connection
31    with  the  securing  of  compensation  for an employee or his
32    dependents  and  also  resolving  any  disputed  health  care
33    provider charges and medical  expenses,  whether  secured  by
 
                            -37-     LRB093 09501 WGH 09736 b
 1    agreement,  order,  award  or  a  judgment in any court shall
 2    exceed 20% of the amount of compensation recovered and  paid,
 3    unless  further  fees shall be allowed to the attorney upon a
 4    hearing by the Commission fixing fees,  and  subject  to  the
 5    other   provisions  of  this  Section.   However,  except  as
 6    hereinafter provided in this Section, in death  cases,  total
 7    disability  cases and partial disability cases, the amount of
 8    an attorney's fees shall not exceed  20%  of  the  sum  which
 9    would  be due under this Act for 364 weeks of permanent total
10    disability based upon the  employee's  average  gross  weekly
11    wage  prior  to  the  date of the accident and subject to the
12    maximum weekly benefits provided in this Act  unless  further
13    fees  shall  be allowed to the attorney upon a hearing by the
14    Commission fixing fees.
15        (B-5)  With  respect  to  any  and  all  proceedings   in
16    connection with any disputed health care provider charges and
17    medical  expenses  associated  with  any  initial or original
18    claim under this Act, no claim of any attorney  for  services
19    rendered  in connection with the securing of compensation for
20    any health  care  provider,  whether  secured  by  agreement,
21    order, award, or a judgment in any court, shall exceed 20% of
22    the  amount  of compensation recovered and paid to any health
23    care provider. These  fees  shall  be  fixed  pursuant  to  a
24    written  contract  in  accordance with subsection (C) of this
25    Section.
26        In  any  proceeding  including   disputed   health   care
27    payments,  in  whole  or  in  part, all health care providers
28    shall be given 30 calendar days notice by the employer  prior
29    to  a hearing to effect any award or settlement to submit all
30    outstanding bills. Any award or  settlement  payments  for  a
31    contested claim shall be made to the attorney involved in the
32    name  of the attorney and health care providers. The attorney
33    shall  disburse  the  funds  to  the  health  care  providers
34    involved in accordance with  the  award  or  settlement.  The
 
                            -38-     LRB093 09501 WGH 09736 b
 1    amount  of  health  care provider payments shall be the usual
 2    and customary charges under subsection 8(a), except when  the
 3    amount  of  the  award  or settlement of a contested claim is
 4    insufficient to compensate all health  care  providers  usual
 5    and  customary  charges.  In  these situations, all physician
 6    payments shall not exceed 30% of the award or settlement, all
 7    hospital payments  (in-patient  and  out-patient)  shall  not
 8    exceed  30%  of the award or settlement, and all other health
 9    care providers payments shall not exceed 20% of the award  or
10    settlement.   All   health   care   providers   shall   share
11    proportionate   amounts  within  their  respective  statutory
12    limitations as full and final payment for all  sums  due  and
13    owing.  In  addition,  usual  and  customary charges shall be
14    satisfied to extent possible for all  health  care  providers
15    from  amount  unused  within  the  statutory limitations on a
16    proportionate basis.
17        (C)  All attorneys' fees in connection with  the  initial
18    or original claim for compensation shall be fixed pursuant to
19    a  written  contract  on  forms  prescribed by the Commission
20    between the attorney and the employee or his dependents,  and
21    every attorney, whether the disposition of the original claim
22    is  by  agreement,  settlement, award, judgment or otherwise,
23    shall file his contract with the Chairman of  the  Commission
24    who  shall  approve  the contract only if it is in accordance
25    with all provisions of this Section.
26        (D)  No attorneys' fees shall be charged with respect  to
27    compensation for undisputed medical expenses.
28        (E)  No  attorneys'  fees  shall be charged in connection
29    with any temporary total disability compensation  unless  the
30    payment  of  such  compensation  in a timely manner or in the
31    proper amount is refused,  or  unless  such  compensation  is
32    terminated   by   the   employer  and  the  payment  of  such
33    compensation is obtained or reinstated by the efforts of  the
34    attorney,   whether   by   agreement,  settlement,  award  or
 
                            -39-     LRB093 09501 WGH 09736 b
 1    judgment.
 2        (F)  In the following cases in which there is no  dispute
 3    between  the parties as to the liability of the respondent to
 4    pay compensation in a timely manner or in the  proper  amount
 5    and there is no dispute that the accident has resulted in:
 6        (1)  the death of the employee; or
 7        (2)  a statutory permanent disability; or
 8        (3)  the amputation of a finger, toe, or member; or
 9        (4)  the removal of a testicle; or
10        (5)  the enucleation of or 100% loss of vision of an eye;
11    the legal fees, if any, for services rendered are to be fixed
12    by  the  Industrial  Commission  at  a  nominal  amount,  not
13    exceeding $100.
14        (G)  In  the following cases in which there is no dispute
15    between the parties as to the liability of the respondent  to
16    pay  compensation  and  there is no dispute that the accident
17    has resulted in:
18        (1)  a fracture of one or more vertebrae; or
19        (2)  a skull fracture; or
20        (3)  a fracture of one  or  more  spinous  or  transverse
21    processes; or
22        (4)  a fracture of one or more facial bones; or
23        (5)  the removal of a kidney, spleen or lung;
24    the legal fees, if any, for services rendered are to be fixed
25    by  the  Industrial  Commission  at  a  nominal  amount,  not
26    exceeding  $100,  provided  that  the employee is awarded the
27    minimum amount for the above injuries as specified in Section
28    8(d)2.
29        (H)  With regard to any claim where the amount to be paid
30    for compensation does not exceed the written  offer  made  to
31    the  claimant or claimants by the employer or his agent prior
32    to representation by an attorney, no fees shall  be  paid  to
33    any such attorney.
34        (I)  All   attorneys'   fees  for  representation  of  an
 
                            -40-     LRB093 09501 WGH 09736 b
 1    employee or his dependents shall  be  only  recoverable  from
 2    compensation actually paid to such employee or dependents.
 3        (J)  Any  and  all  disputes  regarding  attorneys' fees,
 4    whether such disputes relate to which one or  more  attorneys
 5    represents  the  claimant  or claimants or is entitled to the
 6    attorneys' fees, or a division of attorneys' fees  where  the
 7    claimant  or  claimants  are or have been represented by more
 8    than  one  attorney,  or  any   other   disputes   concerning
 9    attorneys'  fees  or  contracts for attorneys' fees, shall be
10    heard and  determined  by  the  Commission  after  reasonable
11    notice to all interested parties and attorneys.
12        (K)  After  reasonable  notice  and  hearing  before  the
13    Commission,  any  attorney  found  to  be in violation of any
14    provision  of  this  Section  shall  be  required   to   make
15    restitution  of  any  excess  fees charged plus interest at a
16    reasonable rate as determined by the Commission.
17    (Source: P.A. 84-1438.)

18        Section 15.  The Workers' Occupational  Diseases  Act  is
19    amended  by  changing  Sections 16 and 16a and adding Section
20    16b as follows:

21        (820 ILCS 310/16) (from Ch. 48, par. 172.51)
22        Sec. 16. The Commission shall make and publish procedural
23    rules and orders for carrying out the duties imposed upon  it
24    by  law,  which  rules and orders shall be deemed prima facie
25    reasonable and valid.
26        The process and procedure before the Commission shall  be
27    as simple and summary as reasonably may be.
28        The Commission upon application of either party may issue
29    a  dedimus  potestatem  directed  to  a  commissioner, notary
30    public, magistrate, justice of the peace or any other officer
31    authorized  by  law  to  administer  oaths,   to   take   the
32    depositions  of such witness or witnesses as may be necessary
 
                            -41-     LRB093 09501 WGH 09736 b
 1    in the judgment of such applicant.  Such  dedimus  potestatem
 2    may  issue  to  any of the officers aforesaid in any state or
 3    territory of the United States.  When the deposition  of  any
 4    witness resident of a foreign country is desired to be taken,
 5    the  dedimus  shall  be  directed to and the deposition taken
 6    before  a   consul,   vice   consul   or   other   authorized
 7    representative  of  the  government  of  the United States of
 8    America, whose station is in the country  where  the  witness
 9    whose  deposition is to be taken resides.  In countries where
10    the government of the United States has no  consul  or  other
11    diplomatic  representative,  then  depositions  in  such case
12    shall be taken through the appropriate judicial authority  of
13    that  country; or where treaties provide for other methods of
14    taking depositions, then the same may be  taken  as  in  such
15    treaties  provided.   The  Commission shall have the power to
16    adopt necessary rules to govern the  issue  of  such  dedimus
17    potestatem.
18        The  Commission, or any member thereof, or any Arbitrator
19    designated  by  said  Commission  shall  have  the  power  to
20    administer oaths, subpoena and examine  witnesses;  to  issue
21    subpoenas  duces  tecum,  requiring  the  production  of such
22    books, papers, records and documents as may  be  evidence  of
23    any  matter under inquiry and to examine and inspect the same
24    and such places or premises as may relate to the question  in
25    dispute.  Said  Commission  or  any  member  thereof,  or any
26    Arbitrator designated by said Commission,  shall  on  written
27    request  of  either party to the dispute, issue subpoenas for
28    the attendance of  such  witnesses  and  production  of  such
29    books,  papers,  records and documents as shall be designated
30    in said applications, providing  however,  that  the  parties
31    applying  for  such  subpoena  shall  advance the officer and
32    witness fees provided for in suits  pending  in  the  Circuit
33    Court.  Service of such subpoena shall be made by any sheriff
34    or  other  person.  In case any person refuses to comply with
 
                            -42-     LRB093 09501 WGH 09736 b
 1    an order of the Commission or subpoenas issued by  it  or  by
 2    any  member  thereof,  or  any  Arbitrator designated by said
 3    Commission or to permit an inspection of places or  premises,
 4    or to produce any books, papers, records or documents, or any
 5    witness  refuses to testify to any matters regarding which he
 6    may be lawfully  interrogated,  the  Circuit  Court  for  the
 7    county  in  which  said  hearing  or  matter  is  pending, on
 8    application of any member of the Commission or any Arbitrator
 9    designated by  the  Commission,  shall  compel  obedience  by
10    attachment  proceedings,  as  for  contempt,  as in a case of
11    disobedience of the requirements  of  a  subpoena  from  such
12    court on a refusal to testify therein.
13        The  records kept by a hospital, certified to as true and
14    correct by the superintendent or  other  officer  in  charge,
15    showing  the  medical and surgical treatment given an injured
16    employee in such hospital, shall be  admissible  without  any
17    further proof as evidence of the medical and surgical matters
18    stated  therein,  but  shall  not be conclusive proof of such
19    matters.
20        The Commission at its expense shall provide  an  official
21    court   reporter   to   take  the  testimony  and  record  of
22    proceedings at the  hearings  before  an  Arbitrator  or  the
23    Commission,  who shall furnish a transcript of such testimony
24    or proceedings to either party requesting it, upon payment to
25    him therefor at the rate of $1.00 per page for  the  original
26    and  35  cents  per  page  for  each copy of such transcript.
27    Payment for photostatic copies of exhibits  shall  be  extra.
28    If the Commission has determined, as provided in Section 19.5
29    of this Act, that the employee is a poor person, a transcript
30    of  such  testimony  and  proceedings,  including photostatic
31    copies of exhibits, shall be furnished to  such  employee  at
32    the Commission's expense.
33        In  accordance  with  subsection  (a) of Section 8 of the
34    Workers' Compensation Act and subdivision (a)(3) of Section 8
 
                            -43-     LRB093 09501 WGH 09736 b
 1    of the Workers' Compensation Act, the Commission  shall  have
 2    the  power to determine the reasonableness and fix the amount
 3    of any fee of compensation charged by any  person,  including
 4    attorneys,   physicians,  surgeons  and  hospitals,  for  any
 5    service performed in connection with this Act, or  for  which
 6    payment  is to be made under this Act or rendered in securing
 7    any right under this Act.
 8        Whenever the Commission shall find that the employer, his
 9    agent, service company or insurance carrier has  been  guilty
10    of delay or unfairness towards an employee in the adjustment,
11    settlement  or  payment  of benefits due such employee or has
12    been guilty of unreasonable or vexatious  delay,  intentional
13    under-payment  of  compensation  benefits,  or has engaged in
14    frivolous defenses which do not present a  real  controversy,
15    the  Commission  may assess all or any part of the attorney's
16    fees and  costs  against  such  employer  and  his  insurance
17    carrier.
18    (Source: P.A. 86-998; 87-895.)

19        (820 ILCS 310/16a) (from Ch. 48, par. 172.51a)
20        Sec.  16a.  (A)  In  the  establishment  or  approval  of
21    attorney's fees in relation to claims brought under this Act,
22    the  Commission  shall  be  guided  by the provisions of this
23    Section and by the legislative intent,  hereby  declared,  to
24    encourage  settlement  and prompt administrative  handling of
25    such claims and thereby  reduce  expenses  to  claimants  for
26    compensation under this Act.
27        (B)  With   respect   to   any  and  all  proceedings  in
28    connection with any initial or original claim under this Act,
29    no claim of any attorney for services rendered in  connection
30    with  the  securing  of  compensation  for an employee or his
31    dependents  and  also  resolving  any  disputed  health  care
32    provider charges and medical  expenses,  whether  secured  by
33    agreement,  order,  award  or  a  judgment in any court shall
 
                            -44-     LRB093 09501 WGH 09736 b
 1    exceed 20% of the amount of compensation recovered and  paid,
 2    unless  further  fees shall be allowed to the attorney upon a
 3    hearing by the Commission fixing  fees  and  subject  to  the
 4    other   provisions  of  this  Section.   However,  except  as
 5    hereinafter provided in this Section, in death  cases,  total
 6    disability  cases and partial disability cases, the amount of
 7    an attorney's fees shall not exceed  20%  of  the  sum  which
 8    would  be  due  under  the  Workers' Compensation Act for 364
 9    weeks of permanent total disability based upon the employee's
10    average gross weekly wage prior to the date of  the  accident
11    and  subject  to the maximum weekly benefits provided in this
12    Act unless further fees shall be allowed to the attorney upon
13    a hearing by the Commission fixing fees.
14        (B-5)  With  respect  to  any  and  all  proceedings   in
15    connection with any disputed health care provider charges and
16    medical  expenses  associated  with  any  initial or original
17    claim under this Act, no claim of any attorney  for  services
18    rendered  in connection with the securing of compensation for
19    any health  care  provider,  whether  secured  by  agreement,
20    order, award, or a judgment in any court, shall exceed 20% of
21    the  amount  of compensation recovered and paid to any health
22    care provider. These fees shall be fixed pursuant to  written
23    contract in accordance with subsection (C) of this 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
 
                            -45-     LRB093 09501 WGH 09736 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)  With regard to any claim where the amount to be paid
 
                            -46-     LRB093 09501 WGH 09736 b
 1    for  compensation  does  not exceed the written offer made to
 2    the claimant or claimants by the employer or his agent  prior
 3    to  representation  by  an attorney, no fees shall be paid to
 4    any such attorney.
 5        (G)  All  attorneys'  fees  for  representation   of   an
 6    employee  or  his  dependents  shall be only recoverable from
 7    compensation actually paid to such employee or dependents.
 8        (H)  Any and  all  disputes  regarding  attorneys'  fees,
 9    whether  such  disputes relate to which one or more attorneys
10    represents the claimant or claimants or is  entitled  to  the
11    attorneys'  fees,  or a division of attorneys' fees where the
12    claimant or claimants are or have been  represented  by  more
13    than   one   attorney,   or  any  other  disputes  concerning
14    attorneys' fees or contracts for attorneys'  fees,  shall  be
15    heard  and  determined  by  the  Commission  after reasonable
16    notice to all interested parties and attorneys.
17        (I)  After  reasonable  notice  and  hearing  before  the
18    Commission, any attorney found to  be  in  violation  of  any
19    provision   of   this  Section  shall  be  required  to  make
20    restitution of any excess fees charged, plus  interest  at  a
21    reasonable rate as determined by the Commission.
22    (Source: P.A. 81-1482.)

23        (820 ILCS 310/16b new)
24        Sec. 16b. Reports. The Industrial Commission shall report
25    in  writing to the Governor and the Illinois General Assembly
26    on the 31st day of December,  annually,  beginning  one  year
27    after  the  effective date of this amendatory Act of the 93rd
28    General Assembly, the details and results  of  implementation
29    of   this   amendatory  Act  of  the  93rd  General  Assembly
30    sufficient to determine its effectiveness in maintaining  the
31    availability  of  quality  health  care  services for injured
32    employees and at a reasonable cost to employers.
 
                            -47-     LRB093 09501 WGH 09736 b
 1        Section 97. Severability.  The provisions of this Act are
 2    severable under Section 1.31 of the Statute on Statutes.

 3        Section 99.  Effective date.  This Act takes effect  upon
 4    becoming law.