Commissioner Donohoo announces changes to calendar

Commissioner Donohoo announces changes to calendar

To accommodate the new Commissioner panels, Commissioner Donohoo has changed several dates.  For details, go to http://www.iwcc.il.gov/news.htm#cal

2014 open house dates

At http://www.iwcc.il.gov/news.htm#open we have posted the Chicago open house dates for the first half of 2014:  March 19 and June 19.

The program will begin at 9:15 am.  After an overview of our court process, visitors will observe arbitration hearings and review-level oral arguments. After oral arguments end, there will be a question-and-answer period with commissioners. The program will end around 12 noon.

To register, email susan.piha@illinois.gov

For more information, go to http://www.iwcc.il.gov/news.htm

Send contracts to CURRENT arbitrators; Another felony conviction won against uninsured employer

Send contracts to CURRENT arbitrators

Please send settlement contracts and other documents to the currently assigned arbitrator.  If you send materials to the arbitrator who will take over the case in January, you will only slow down your case as materials are returned or forwarded.  Please help us spread the word!


Another felony conviction won against uninsured employer

Another uninsured employer has pled guilty to a Class 4 felony for refusing to obtain workers' compensation insurance. John Linek, individually and as President of SMS Logistics of Chicago, has been ordered to pay a $10,000 penalty for refusing to obtain workers compensation insurance. The IWCC's Insurance Compliance Unit had been requesting compliance with the Act from this trucking firm since 2010.

In August 2013, the Compliance Division obtained a felony conviction against Ahmed Ghosien, d/b/a Ghosien European Auto Werks in Hometown. Ghosien pled guilty to a Class 4 felony for failing to obtain workers' compensation insurance. The IWCC's Insurance Compliance Unit worked with the Cook County Sheriff's Office and the Cook County State's Attorney's Special Prosecutions Division to obtain the conviction. Again, the Insurance Compliance Unit had worked on the case since 2010.

Both of these individuals were given many opportunities to obtain insurance before charges were filed, but they persistently refused. Employers who fail to follow the law put their workers at risk, and they enjoy an unfair competitive advantage over law-abiding employers.


For more information go to http://www.iwcc.il.gov/news.htm

Arbitration calendars online; Downstate 19(b) cases will remain at site

2014 Arbitration calendars online; Downstate 19(b) cases will remain at site

The 2014 arbitration calendars are now online at http://www.iwcc.il.gov/calendars.htm

In January 2014, arbitrators will appear at the following sites:

Zone 1
Collinsville: Lindsay
Mt Vernon: Lee
Herrin: Zanotti

Zone 2
Springfield: Pulia
Quincy: Gallagher
Urbana: Dearing

Zone 3
Bloomington: Erbacci
Peoria: McCarthy
Rock Island: Dollison

Zone 4
 Geneva: O'Malley
 New Lenox: Granada
 Ottawa: Mathis

Zone 5
Rockford: Fratianni
Waukegan: Falcioni
Woodstock: Andros

Zone 6
Chicago: Luskin
Chicago: Cronin
Wheaton*: Doherty
*Arb. Luskin will appear in Wheaton in February. Arb. Cronin will appear in March.


Note that Downstate 19(b) cases will remain assigned to the Downstate site.

In Chicago, the Commission will redistribute cases to create new calls.  In 2014, Arbitrator Carlson will handle the call Arb. Cronin handled in 2013, and Arb. Luskin will take over Arb. O’Malley’s call.

Fee Schedule Updated

The Commission has updated its medical fee schedule to include maximum reimbursement rates for codes that had been previously listed as "POC53.2."  Section 8.2 of the Workers' Compensation Act authorizes the Commission to establish fee schedule reimbursements using provider non-discounted charge data, non-Medicare relative values, and conversion factors from established fee schedule amounts. 

The Workers' Compensation Medical Fee Advisory Board voted to approve the reimbursements for 16,000 codes on the Professional Services fee schedule, all of which had been paid at 53.2% of the billed amount. 

To view the new Professional Services fees, click the new button, "2013 Professional (10-11-13)" at https://iwcc.ingenix.com/IWCC.asp

Handbook, workplace notice now in Polish

We have translated the handbook and workplace notice into Polish, and created a web page in Polish in which we explain that the Commission will provide an interpreter to pro se claimants who are settling their cases. 

To view the handbook, go to  http://www.iwcc.il.gov/handbook013013inpolish.pdf
To view the workplace notice, go to  http://www.iwcc.il.gov/ICPNpFORM.pdf
To view the Polish web page, go to  http://www.iwcc.il.gov/polish.htm

IL Supreme Ct olds that the mailbox rule applies to Commission review cases; First felony conviction won against uninsured employer; NCCI files for 4.5% decrease in 2014 WC advisory insurance rates

Illinois Supreme Court holds that the mailbox rule applies to Commission review cases

In a lengthy and comprehensive analysis, the Illinois Supreme Court held that the mailbox-rule applies when a party appeals from a Commission decision to the Circuit Court.  In Gruszecza v. IWCC, a majority of the Supreme Court interpreted Section 19(f)(1) of the Act to dictate that the proceeding to appeal a Commission decision is commenced when the request for summons is placed in a mailbox.  Section 19(f) states: “A proceeding for review shall be commenced within 20 days of the receipt of notice of decision by the Commission.”  According to the holding in Gruszecza, the date that a summons is mailed, not received and file-stamped by the Clerk of the Circuit Court, will control when a party seeks judicial review of a Commission decision.

To read the decision, go to http://www.iwcc.il.gov/grusz.pdf


First felony conviction won against uninsured employer

For the first time, an uninsured employer has been convicted of a Class 4 felony for failing to obtain workers' compensation insurance. Class 4 felony penalties are 1-3 years in penitentiary and/or fines up to $25,000.

The IWCC's Insurance Compliance Unit worked for over one year with the Cook County Sheriff's Office and the Cook County State's Attorney's Special Prosecutions Division to bring about this result.

Ahmed Ghosien, d/b/a Ghosien European Auto Werks in Hometown, was first contacted in 2010 about his lack of insurance. He agreed to get insurance and pay a fine for noncompliance, but he never made payments and the insurance was cancelled for nonpayment. He was indicted in 2012, and the case was continued several times until he finally pled guilty on July 25. His sentencing date is in October.

Making sure that employers have insurance protects workers and other employers. Congratulations to the Insurance Compliance staff for their achievement!


NCCI files for 4.5% decrease in 2014 WC advisory insurance rates

The National Council on Compensation Insurance (NCCI) filed for an 4.5% decrease in voluntary advisory insurance rates, effective January 1, 2014, following the 3.8% decrease in 2013. These significant savings follow the enactment of House Bill 1698 on June 28, 2011.

Governor Quinn Appoints Three New Workers’ Compensation Arbitrators and One New Commissioner - Twelve Arbitrators Reappointed as Commission Sees Continued Success Following System Overhaul

CHICAGO - Governor Pat Quinn today announced the appointment of three new arbitrators to the Illinois Workers' Compensation Commission (IWCC) who perform the duty of enforcing the provision of the Workers' Compensation Act. These three arbitrators will join the 27 who are currently serving. In 2011, Governor Quinn championed and signed into law historic workers' compensation reform legislation to overhaul the system in Illinois. Today's announcement continues the Governor's commitment to making Illinois government more efficient, accountable and effective.

“These individuals have years of professional experience that will benefit the Illinois’ workers’ compensation program,” Governor Quinn said. “I am pleased to appoint these arbitrators and a commissioner who will work for the people of Illinois to resolve workers’ compensation cases in a manner which treats injured workers with respect and ensures that employers in Illinois receive a fair and efficient resolution to claims.”

The reforms signed into law by Governor Quinn in 2011 called on the Governor to appoint new arbitrators to the Commission, considering the recommendations made by the Workers’ Compensation Advisory Board, which is a body composed of six members representing the employer community and six members representing employees and working people in Illinois. Arbitrators at the Commission are responsible for ruling on claims filed by employees who suffer an injury at work.

The law requires that all newly-appointed arbitrators must be attorneys and that both arbitrators and Commissioners are subject to the ethical rules and requirements followed by Illinois judges. Arbitrators and Commissioners must also take at least 20 hours of training every two years while in office regarding professional and ethical standards, detection of fraud, evidence-based medical treatment, and Coal Workers’ Pneumoconiosis.

Governor Quinn appointed the following new Arbitrators:

· Molly Dearing, J.D., Southern Illinois University School of Law; B.A., University of Illinois – Urbana/Champaign; Associate of Arts, Southeastern Illinois College

· Jeffrey Huebsch, J.D., Illinois Institute of Technology/Chicago-Kent Law School; B.A., North Central College

· Ketki Steffen, J.D., John Marshall Law School; B.A., University of Illinois – Urbana/Champaign

The Governor has appointed the following Commissioner:

· Michael Brennan, J.D., DePaul University College of Law; B.A., DePaul University

The Governor reappointed the following Arbitrators:

· William Gallagher, J.D., Southern Illinois University-Carbondale; B.A., Southern Illinois University-Edwardsville

· Carolyn Doherty, J.D., John Marshall Law School; B.A., Marquette University

· Joshua Luskin, J.D., University of Michigan; B.A., Macalester College
          
· Robert Williams J.D., Loyola Law School of Chicago; M.B.A. University of Illinois at Chicago;   B.S., Le Moyne-Owen College

· Barbara Flores, J.D., Chicago-Kent College of Law; B.S., University of Illinois

· Deborah Simpson, J.D., John Marshall Law School; B.A., DePaul University

· Brian Cronin, M.B.A., University of Chicago; B.B.A., University of Notre Dame

· Kurt Carlson, J.D., John Marshall Law School; B.A., University of Wisconsin-Madison

·  Gregory Dollison, Paralegal Certificate, Roosevelt University; B.S., Illinois Institute of Technology

·  Edward Lee, J.D., John Marshall Law School; B.A., Tulane University

· Molly Mason, J.D., Loyola University Law School; B.A., Harvard University

· Douglas McCarthy, J.D., Southern Illinois University Law School; M.A., Sangamon State; B.S., Illinois State University

No hearings nor settlements on September 11-12

All arbitrators and commissioners will be in training sessions on September 11-12. There will be no hearings nor review of settlements.   Please plan accordingly.

To subscribe or unsubscribe from this IWCC news email list, go to http://www.iwcc.il.gov/news.htm

WC PPP Form Revised

In HB1698  (820 ILCS 305/8(a) and 8.1 (a)), the Illinois Workers Compensation Commission (IWCC) was tasked with the responsibility of creating the mandatory Workers Compensation Preferred Provider Program  (WC PPP) notification documents that an employer must provide to the employee at the time of injury.  The mandatory form was published by the IWCC on 10/18/2011. 

In a notice published by the IWCC on 6/20/2013, an updated form has been created that replaces the original mandatory document.  The wording of the document has been modified and the requirement of an employee signature has been removed.   The notice states that the revision was made based on employer concerns.  The updated form has a revision date of 6/20/13

To view the new forms, go to http://www.iwcc.il.gov/forms.htm#other.  Forms are available in English and Spanish.

Workers' Compensation Legislation Sent to Governor Quinn

HB 3390 (Sims/Mulroe) passed out of the General Assembly on Friday on a concurrence motion by the House (118-0-0). Senate Amendments 2 and 3 became the bill. The Senate approved the amendments 58-0-0.  The bill makes four changes to the Workers’ Compensation Act and is effective upon signing by the Governor.

1.  Elimination of handbook requirement

The bill directs the Commission to post its informational handbook on its website and removes the mandate that the Commission send a copy of the handbook to each injured worker who is the subject of an accident report.  This change represents an elimination of a $62,500 line item in the Commission’s FY14 budget.

2.  Elimination of $35 transcript fee paid by employers and employees to appeal cases

The bill eliminates the $35 fee paid by parties who appeal decisions from the Commission to the Circuit Court. Instead, parties who wish to appeal a Commission decision must file with the Commission a notice of the intent to appeal a decision to the Circuit Court. This change applies to all decisions by the Commission entered after the effective date of the bill.  It also ends an archaic and time-consuming cost calculation for the preparation of records. Remaining monies in the Transcript Deposit Fund will be transferred to the Injured Workers’ Benefit Fund, which is a fund dedicated to providing benefits to employees who have been injured at a workplace without workers’ compensation insurance.

3.  Requirement for Commission to obtain interpreters when necessary for settlement contracts

The bill requires the Commission to furnish language interpreters for petitioners who do not speak English, do not have an attorney, do not have their own interpreter, and are signing settlement contracts. 

4. Requirement for Arbitrators to demonstrate workers’ compensation expertise

Finally, the bill provides that all persons appointed to be Arbitrators must demonstrate their knowledge and experience with the Workers’ Compensation Act in writing.  It also eliminates erroneous references to the Personnel Code.  Pursuant to Public Act 97-719, all Arbitrators are appointed by the Governor with the advice and consent of the Senate.

To view the bill, go to: http://www.ilga.gov/legislation/billstatus.asp?DocNum=3390&GAID=12&GA=98&DocTypeID=HB&LegID=75259&SessionID=85

Illinois Workers' Compensation Preferred Provider Program – WCPPP Update

HFN has been approved as a Workers' Compensation Preferred Provider Program Administrator (WCPPPA) by the Illinois Department of Insurance.

The HFN WCPPP Solution
Employers now have, for the first time, the ability to direct their injured workers into a “Workers' Compensation Preferred Provider Program” for their medical treatment. HFN is uniquely positioned and ready to help you realize the benefits and savings associated with utilizing a WCPPP. The final rules have been published and became effective March 4, 2013. HFN is ready to assist you in understanding these regulations and how they can benefit your organization.   

We are available to discuss designating HFN as your WCPPP. HFN is ready to provide comprehensive or customized solutions that can lower your workers’ compensation costs, improve employee health, reduce indemnity and increase productivity for your entire workforce. To augment our WCPPP HFN has the largest Coordinated Occupational Health Network in Illinois (COP®) with 24 hour coverage and Return to Work initiatives to partner with your healthy workforce goals.

For more information about HFN’s WCPPP, Work Comp Direct and other workers comp services  please contact Guy Swanson at (630) 990-8609 or SwansonG@hfninc.com. Additional information is also available at HFN’s WC blog: http://ilwcreformguide.blogspot.com/

IWCC Posts Updated Repricing Instructions

On January 24, the Illinois Workers' Compensation Commission posted its Instructions and Guidelines for Treatment On or After 9/1/11 to its website.  These instructions include all of the changes implemented in HB 1698/PA 97-18 and the subsequent rulemakings approved through the JCAR process.  

Previously, the Rules section on the IWCC website was updated with many of the updates and changes, but the Instructions and Guidelines section was pending.

The IWCC maintains all of these documents under the Medical Fee Schedule/FAQs section of its website.

1/23/2012 IWCC Board meetings

Both the Illinois Workers' Compensation Commission's Workers' Compensation Advisory Board and Commission Review Board meet on Wednesday, January 21, 2013.

The Workers' Compensation Advisory Board meets at 1PM in the 8th Floor Chairman's Conference room at the James R. Thompson Center in Chicago.  The agenda includes Commission and Legislative updates, Commission appointments, and a discussion on a possible pro se assistance program.  Friday's post included the IWCC's publication of its regulatory agenda update.

The Commission Review Board will also meet Wednesday in the Thompson Center's 8th Floor Chairman's Conference room at 10AM.  The current agenda includes a report by Carolyn Parks regarding communications involving IWCC Arbitrators.



 

IWCC 2013 Regulatory Agenda

In this morning's Illinois Register, the IWCC filed a regulatory agenda update for the Illinois
Insurance Regulations (50 Ill. Adm. Code 7100).

On Page 630 (PDF page 156) of the Illinois Register, the IWCC gives a general overview of its intentions to update both Sections 7100.100 and 7100.70 of the Insurance Regulations.  The IWCC notification lists the anticipated JCAR First Notice submission date as "undetermined."

Description: The Commission anticipates changes to two Sections of Part 7100 of its rules. Section 7100.100 sets forth the procedure for the enforcement of the insurance compliance provisions of Section 4 of the Workers' Compensation Act. This rule has not been updated since 1990 and there have been several significant amendments to Section 4 since that time, including the ability of the Commission to issue a work-stop order for an employer who has knowingly failed to provide workers' compensation insurance. In addition, Section 7100.100 does not include the minimum $10,000 fine for the knowing and willful failure or refusal to obtain workers' compensation insurance set forth in Section 4(d) of the Workers' Compensation Act and the applicability of such fine to corporate officers and directors, which is also set forth in Section 4(d) of the Act. Section 7100.70 sets forth the qualifications required to be approved as a self-insurer in Illinois, as well as the procedural aspects of the application process. This rule has not been updated since 1996. The rule will be updated in order ensure the integrity of the self-insurance program.

 

IWCC Arbitration Site Changes

The Illinois Workers' Compensation Commission sent out two reminders regarding arbitration site changes.  Effective in 2013, the Kewanee arbitration hearing site call moved to Rock Island, and the Geneva hearing site is moving back to the Kane County Courthouse effective 1/7/2013.

Rock Island (formerly Kewanee)

City Hall - Council Chambers
1528 Third Avenue
Rock Island, IL 61201

Geneva (effective 1/7/2013)

Kane County Courthouse
100 South Third Street
Geneva, Illinois 60134


The IWCC maintains the current list of all IWCC arbitration hearing sites on its website.  

IWCC Employer Insurance Coverage Form

The IWCC announced a new Request for Information on Employer's Insurance Coverage form is available.  This new form (Form IC46) is used when an individual needs information regarding an employer's workers' compensation insurance coverage.  The new form replaces Form IC42 (with the same name).

The IWCC announcement does differentiate between requesting employer insurance information and requesting an investigation into an uninsured employer.

Send the Request for Information (IC46) to Yvonna Castronova, Supervisor of the Information Unit. Upon receipt, the Information staff will research the available resources and send you a report on what was found.

If you wish to ask the Insurance Compliance Staff to investigate an employer you believe to be uninsured, contact Robert Ruiz, Manager of the Insurance Compliance Division. Please understand that if an investigation is launched, we cannot share information about an investigation with you.

IWCC Medical Fee Schedule Re-Posted

As of this morning, the Illinois Workers' Compensation Commission's website has the 2013 Medical Fee Schedule re-posted on its fee schedule page.  The following link will take you the website lookup (choose Treatment Year 2013 for the new rates): Medical Fee Schedule/FAQ  

The original link was retracted by the IWCC contractor, Optuminsight, due to data integrity issues. 

Unless there are any further announcements from the IWCC, the 2013 fee schedule is effective January 1, 2013.

2013 Medical Fee Schedule: Status Update

As announced previously at its December Medical Fee Advisory Board meeting, the IWCC posted the 2013 medical fee schedule on its website; however, it pulled the schedule shortly after due to issues identified by the vendor.

The IWCC announcement:

The 2013 fee schedule was posted, but some problems were identified, and the vendor, Optuminsight, took it down to work on it. Optuminsight is working on adding code descriptions and posting the correct surgical codes to the Hospital Outpatient and ASTC fee schedules, so please view the schedule with caution. We will announce when this work has been completed.  

In the meantime, if you identify any issues with the 2013 schedule, please let us know.

The 2013 medical fee schedule is effective on January 1, 2013.  We will post additional updates when the IWCC website rereleases the schedule or Optuminsight announces any additional changes.

New IWCC Arbitration and Commission Review Board Rules

The December 21 edition of the Illinois Register includes two adopted amendment rulemakings from the Illinois Workers' Compensation Commission.  Both rulemakings, effective December 4, deal with complaints and review procedures of IWCC Arbitrators and Commissioners.
 
The IWCC put out an announcement regarding these two updated rules, and included in that announcement was a new form to submit complaints to the Commission Review Board:  IWCC Commission Review Board Complaint Form

New/Update Rules Overview

Arbitration (PDF document page 285)

• 50 Ill Adm Code 7030
• Proposed 8/17/2012
• Effective 12/4/2012 

Differences between Proposal and Final Version: In subsections (f)(1)(B) and (f)(2)(B),  the Final Version specifies that the assignment of a petition to disqualify either an  Arbitrator or Commissioner shall be made randomly by the Commission. The Final Version adds a new subsection (f)(3), which specifies that a petition for substitution may be made to the Commission if reasonable notice of the application has been given to the adverse party or his or her attorney.

Summary and Purpose of Rulemaking: The amendment addresses an audit finding set forth by Auditor General William Holland in the audit directed pursuant to House Resolution 131 of the 97th General Assembly. Specifically, the audit found that the current version of Section 7030.30 conflicts with the changes of Public Act 97-18. Public Act 97-18 provided that the Canons of Judicial Conduct as adopted by the Illinois Supreme Court apply to the hearing and non-hearing conduct of the Arbitrators and Commissioner. Thus, these changes to Section 7030.30 align the bases for disqualification and also the remittal of a disqualification by and Arbitrator or Commissioner with the provisions of Canon 3 of the Canons of Judicial Conduct.  

In addition, the amendment creates a formalized process for the filing of a Petition for Substitution of an Arbitrator or Commissioner. There is one published Appellate Court opinion that calls on the Commission to promulgate such a rule, Preston v. Industrial Comm'n, 332 Ill. App. 3d 708 (3rd Dist. 2002). In that case, a Commissioner who was subject to a petition to disqualify sat on the panel that ruled on the petition. While the majority found no error in the hearing process, the Court recommended that the Commission promulgate a rule to address the procedural handling of petitions to disqualify Commissioners.

Department of Insurance Payment Compliance Bulletin

The Illinois Department of Insurance released a compliance bulletin reminder to all companies licensed/approved to provide workers' compensation coverage in Illinois.  The bulletin covers provider notification and payment requirements included in Sections 8.2(d)(2) & (3) of HB 1698/PA 97-18.

Section 8.2(d)(2) 

If the claim does not contain substantially all the required data elements necessary to adjudicate the bill, or the claim is denied for any other reason, in whole or in part, the employer or insurer shall provide written notification, explaining the basis for the denial and describing any additional necessary data elements, to the provider within 30 days of receipt of the bill.

 

Section 8.2(d)(3) 

In the case of nonpayment to a provider within 30 days of receipt of the bill which contained substantially all of the required data elements necessary to adjudicate the bill or nonpayment to a provider of a portion of such a bill up to the lesser of the actual charge or the payment level set by the Commission in the fee schedule established in this Section, the bill, or portion of the bill, shall incur interest at a rate of 1% per month payable to the provider. Any required interest payment shall be made within 30 days after payment.
 

The Illinois Workers' Compensation Commission also released a notice regarding this IDOI bulletin. 

IWCC Ottawa Trial Date Cancellation

The Illinois Workers' Compensation Commission announced a change to its Ottawa, IL arbitration schedule.  The 12/28/2012 trial date (located at the LaSalle County Courthouse, 119 W. Madison Street, Ottawa, IL) is cancelled due to a scheduling conflict.

Due to a scheduling conflict, we have eliminated the last day of the December call in Ottawa. Arbitrator Falcioni will conduct the call as scheduled on Dec. 24, and trials will be conducted on Dec. 26 and 27. He will not appear on Dec. 28. We apologize for any inconvenience.