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Workers’ Compensation Agreed Bill

BACKGROUND: A workers’ compensation agreed bill has been negotiated by organized labor and business interests. The Illinois workers’ compensation system was designed as a no-fault system to settle disputes in the unfortunate situation where a workplace injury occurs. Currently workers and employers lose money due to the occurrence of a workplace injury. The legislation will improve the delivery and level of benefits to those injured on the job and reduce the total amount paid by employers for the system. We urge you to support this compromise.

The legislation achieves the following: BENEFIT DELIVERY

Ensures prompt payment for medical providers who treat injured workers by allowing 1% interest per month after 60 days on unpaid medical bills.

Prohibits a medical provider from billing an injured worker for the balance of charges not paid by an insurance company while the workers’ compensation claim is pending. Under this legislation, Illinois will become the last state in the nation to adopt a balanced billing prohibition.

Creates a 3rd Workers’ Compensation Commission panel to expedite resolution of disputed claims and also expands and expedites emergency hearings to resolve cases within 180 days, which will allow injured workers to receive quicker treatment and an earlier return to work.

Simplifies procedures for introduction of injured workers certified medical records into evidence before the Workers’ Compensation Commission, allowing for faster and less costly resolution of disputes.

Requires the Workers’ Compensation Commission to certify vocational rehabilitation counselors who provide rehabilitation services to injured workers. Also defines maintenance and temporary partial disability benefits to encourage an earlier return to work.

Ensures the Rate Adjustment Fund is made solvent and phased-out over the next 10 years.

Enhances penalties, for the unreasonable delay of workers’ compensation benefits, from $10 per day to $30 per day and from 52,500 per claim to $10,000 per claim and defines the Commission’s authority in assessing penalties under Section 19(k).

Provides for timely and accurate collection of claims paid data by the State Division of Insurance to allow both business and labor to track worker compensation injuries and costs.

BENEFIT STRUCTURE

Increases the minimum benefit for a worker killed on the job to the greater of $500,000 or 25 years (was

approximately $400,000 for 20 years).

Increases the burial benefits to $8,000 for fatally injured workers from $4,200.

Protects low-wage workers and ties the minimum temporary total disability (TTD) and permanent partial disability (PPD) rates to the Illinois Minimum Wage for a 40-hour week. These rates have not been increased for more than 20 years.

Sets the minimum rates for Amputations at 50% of the Statewide Average Weekly Wage (SAWW). Increases the number of weeks by 7’/2% for loss of use of scheduled body parts and disfigurement.

Sets the maximum wage differential rate at 100% of the Statewide Average Weekly Wage (SAWW) for workers who qualify and extends the reopening of the claim to 60 months.

COST CONTAINMENT

Creates cost containment in workers’ compensation by joining 44 other states in creating a medical fee schedule indexed to the Consumer Price Index (CPI). The fee schedule allows for providers treating injured workers to charge up to 90% of the 80* Percentile utilizing Illinois medical databases. This medical fee schedule will save Illinois businesses millions of dollars annually.

Helps contain workers’ compensation costs for Illinois business owners, and the bill provides for Utilization Review of proposed or provided medical treatment to ensure the treatment is reasonable and necessary for injured workers using nationally recognized medical standards.

Reconstitutes the Workers’ Compensation Advisory Board composed of business and labor interests to consult with the members of the Workers’ Compensation Commission and make recommendations on appointments to the Commission.

FRAUD

Creates a workers’ compensation fraud statute and investigation unit within the Division of Insurance of the Department of Financial and Professional Regulation to investigate charges of workers’ compensation fraud including uninsured employers and allows for reporting of fraudulent claims by employees.

Enhances penalties and fines and creates a work-stop order for failure by employers to obtain workers’ compensation insurance. Further provides civil liabilities for persons who knowingly and fraudulently attempt to obtain workers’ compensation benefits.

August 1, 2005

PROPONENTS

Illinois AFL-C1O

Illinois Manufacturers’ Association Illinois Retail Merchants Association National Federation of Independent Business Illinois Chamber of Commerce Illinois Construction Coalition Chicagoland Chamber of Commerce Associated Firefighters of Illinois United Food and Commercial Workers Illinois Petroleum Marketers Association Illinois Association of Convenience Stores Illinois Food Retailers Association

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