(Hoffman, D-Belleville; Hastings, D-Tinley Park) amends the Workers Compensation Act to require an employer or insurer to provide written notification to a provider and employee (or a designee) an explanation of benefits that explains the basis for the denial of a work-related illness or injury or the insufficiency of the required data necessary to adjudicate a medical bill. On the House concurrence calendar after passing the Senate last week.
Claimant filed workers' compensation claim for June 2014 injury to his right arm while in the employ of electric company; and filed workers compensation claims for April 1, 2015 and April 3, 2015 injuries to his right shoulder while working for another company. Commission's conclusion, that the April 2015 accidents did not constitute intervening accidents sufficient to break the causal connection from the June 2014 accident, was not against manifest weight of evidence. Evidence supports finding that claimant had not completely recovered from his 1st surgery despite being released to return to work.(HOLDRIDGE, HOFFMAN, CAVANAGH, and BARBERIS, concurring.)
(Tracy, R-Quincy; Wheeler, R-North Aurora) creates authorization and requirements for using email as a method of service under this Act. Effective Jan. 1, 2019.
Court dismissed with prejudice claims of medical providers for breach of contract, violation of Section 8.2(d)(3) of Workers Compensation Act, and violation of Consumer Fraud and Deceptive Practices Act. Dismissal was proper as providers have no direct cause of action against workers compensation insurer for its delay in paying medical bills. (PUCINSKI and HYMAN, concurring.)
(Court opinion corrected 6/26/18.) Plaintiff filed negligence suit against her coworker and 2 other drivers for injuries she sustained in a 3-car collision when coworker was driving restaurant employees to work in a van their employer provided for their commute. Workers' compensation system is exclusive source of compensation from Plaintiff's employer and coemployee for injury that occurred during course of her employment. As van in which Plaintiff was a passenger was employer-controlled, Plaintiff was injured in a work-related accident. Plaintiff relinquished control over conditions of transportation when she boarded vehicle owned by employer and driven under employer's direction. Coemployee driver is immune from common-law negligence claim as he was acting within scope of employment at time of collision. (GORDON and ELLIS, concurring.)
Plaintiff was working as an employee of 3rd-party defendant on a construction project and was injured when he was unloading a window that his employer was going to install at the project. Plaintiff filed workers' compensation claim and received benefits. In negligence case Plaintiff filed against general contractor for project, 3rd-party defendant waived its limited liability status but not its statutory workers' compensation lien rights. Indemnification provision in subcontract agreement lacks any specific reference to lien or to any intention that lien be waived. A specific referent to the lien in a waiver provision is required before the lien can be deemed waived.(PIERCE and HARRIS, concurring.)
A workers' compensation lien, pursuant to Section 5(b) of the Workers' Compensation Act, cannot be subject to reduction or elimination due to conduct on the part of the insurer in its handling of the workers' compensation claim itself, in its cooperation with an investigation of 3rd-party causes of the injury, or in its negotiations with employee as to satisfaction of its lien. Under Section 5(b) of the Act, an employer's right to reimbursement of full amount of benefits paid or to be paid to worker is absolute. No basis in Illinois law to hold that alleged conduct on part of lienholder (workers' compensation insurer of employer) outweighs absolute right that it has to reimbursement of its lien. (WELCH and OVERSTREET, concurring.)
Health care providers which provided care to employee injured at work had to wait several years for payment from employer and its workers' compensation insurer; they filed suit and were awarded statutory interest under Section 8.2(d) of Workers' Compensation Act. No language in the Act expressly authorizes a private right of action. Health care providers, whose only basis for claiming interest was Section 8.2(d) of the Act, are not members of the class for whose benefit the Act was enacted. Thus, they failed to state a claim upon which relief could be granted, and court erred in awarding statutory interest. (ELLIS, concurring; GORDON, specially concurring.)
This case presents question as to whether trial court properly denied on res judicata grounds employee’s motion to intervene in plaintiff-employer’s subrogation action under Workers’ Compensation Act to recover from defendant any workers’ compensation benefits it paid to employee for injuries sustained by employee, where employee’s prior personal injury lawsuit against instant defendant had been dismissed on statute of limitations grounds. Appellate Court, in reversing trial court, found that dismissal of employee’s untimely filed lawsuit did not act as bar to employee’s attempt to intervene in plaintiff-employer’s timely filed case. In its petition for leave to appeal, defendant argued that any intervention by employee would conflict with holding in Sankey Brothers, Inc., 152 Ill.App.3d 393.
Registered nurse filed claim for workers' compensation benefits. Commission reversed arbitrator's decision, finding claimant failed to prove she sustained work-related accident to her right shoulder. Record contains sufficient support for Commission's decision. Commission resolved disputed facts, including finding that Claimant was not credible, and finding that medical experts of both parties mainly agreed that history and mechanism of injury was not a reasonable or likely cause of the right shoulder condition. (HOLDRIDGE, HOFFMAN, HUDSON, and BARBERIS, concurring.)