Claims Kit

In the Covid World, the Commission has been constantly pivoting to make certain that we keep operating. As the Bar is aware, the Commission has faced great difficulty in the receipt and redistribution of mail.

The USPS has not always been able to deliver mail on a consistent basis.To alleviate some of the mail issues, Arbitrators will consider all Motions and Petitions that are received by them, by e-mail, at least two business days prior to the Monthly Status Call.This has been posted on our website for the last several weeks.

Because of Covid, and in accord with our Rules, we have temporarily abandoned the requirement that a purple ink Commission stamp be affixed to all Motions and Petitions. Section 9015 of our Rules allows the Chairman to set procedures that provide for the electronic filing of documents with the Commission. We believe that this action is consistent with our Rules and that it will alleviate difficulties with the USPS.

Please also remember that all of this presupposes that your opponent has been properly served with any documents in accord with our Rules. This only applies to the requirement of Notice to the Commission.

Michael J. Brennan
Chairman

The WCIO has updated the Injury Description Tables that are used by the IAIABC to reflect specific coding in response to COVID-19.

A new Cause of Injury Code (DN0037) - 83 for “Pandemic” and a new Nature of Injury Code (DN0035) - 83 for “COVID-19” were approved. The codes are anticipated to be used for the reporting for any claim effective December 2019 or later. The new Injury Description Tables may be found on the WCIO website, Injury Description Table page below.

https://www.wcio.org/Document%20Library/InjuryDescriptionTablePage.aspx

The IWCC has updated its EDI reporting system to recognize these new codes. Please send any questions regarding this announcement to our dedicated EDI e-mail address, IWCC-EDICoordinator@ebix.com.

Posting Requirements 305/6

All employers must post a notice in each workplace that explains workers' rights under the Workers' Compensation Act and lists the insurance carrier, policy number, contact information, etc. The employer must post in a conspicuous place in the place of employment, a printed or typewritten notice stating whether he is insured or whether he has qualified and is operating as a self-insured employer.

Workplace Notice Poster

Compensacion A Los Trabajadores

Physician Selection 305/8

Generally, the employee may choose the provider where he or she seeks treatment. The employee's choice of provider will be limited to a selected network of providers if an employer has established what is called a Preferred Provider Program or "PPP." If there is a PPP, the employee has a choice of two physicians from the network within the PPP.

If an employer does not have a PPP, then the employee has a choice of any two providers. This does not include referrals from those two providers. If the injured worker wants to see or be treated by a third doctor, they will be responsible for any medical expenses incurred, unless approved by the Workers' Compensation insurance company.

The employee may decline participation in the PPP at any time by sending the employer a written statement. If the employee declines participation, it counts as one of the two choices of medical providers.

If the employee declines participation in the PPP, the employee may choose any doctor or hospital, and go to any doctor to whom the employee is referred by that provider. If the employee wishes to see another chain of providers, however, the employer must approve.

First aid and emergency care are not considered to be one of the employee's two choices. Non emergency care obtained before the employee reports the injury to the employer does not count as one of the two choices.

A worker may, without penalty, refuse or limit the involvement of nurses or case managers hired by the employer. The employee is obligated to provide medical records that are relevant to the case, but otherwise a worker's medical care is confidential.

Reporting of Claim by Employer  820 ILCS 305-6

The Workers' Compensation Act requires employers (or insurers acting on their behalf) to send reports to the Commission on all accidents involving more than three lost work days. First reports on fatal accidents are due within two work days after the death. In all other cases such report shall be made between the 15th and 25th of each month unless required to be made sooner by rule of the Commission.

A supplementary or subsequent report should be made if it is determined that a permanent disability is involved.

There are two versions of each report. The Commission will accept either version. The IC45 and IC85 forms were created by the Commission; the IA1 and IA2 forms were created by the International Association of Industrial Accident Boards and Commissions, and are used in several states. It may be more convenient for multi-state employers to use the IAIABC forms.