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WCLA MCLE 2-25-15 Legislative Update Wednesday February 25, 2015 12:00 pm to 1:00 pm James R. Thompson Center, Chicago, IL 1 Hour General MCLE Credit.

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Presentation on theme: "WCLA MCLE 2-25-15 Legislative Update Wednesday February 25, 2015 12:00 pm to 1:00 pm James R. Thompson Center, Chicago, IL 1 Hour General MCLE Credit."— Presentation transcript:

1 WCLA MCLE 2-25-15 Legislative Update Wednesday February 25, 2015 12:00 pm to 1:00 pm James R. Thompson Center, Chicago, IL 1 Hour General MCLE Credit

2 HB2418 Kay/SB0770 McCarter Traveling Employee & Causation Amends the Workers' Compensation Act. Provides that an employee who is required to travel in connection with his or her employment and who suffers an injury while in travel status shall be eligible for benefits only if the injury arises out of and in the course of employment while he or she is actively engaged in the duties of employment. Defines "accident" and "injury". Provides that "injury" includes the aggravation of a pre-existing condition by an accident arising out of and in the course of the employment, but only for so long as the aggravation of the pre-existing condition continues to be the major contributing cause of the disability. Provides that an injury resulting directly or indirectly from idiopathic causes is not compensable. Effective immediately. 2/17/2015 House Referred to Rules CommitteeRules Committee 2/11/2015 Senate Assigned to LaborLabor

3 HB2418 Kay/SB0770 McCarter Traveling Employee & Causation Section 1(d) To obtain compensation under this Act, an employee bears the burden of showing, by a preponderance of the evidence, that he or she has sustained accidental injuries arising out of and in the course of the employment. An employee who is required to travel in connection with his or her employment and who suffers an injury while in travel status shall be eligible for benefits only if the injury arises out of and in the course of employment while he or she is actively engaged in the duties of employment. This subsection (d)applies to travel necessarily incident to the performance of the employee's job responsibility if: (i) the employer furnishes the transportation or the employee receives reimbursement from the employer for costs of travel, gas, oil, or lodging as a part of the employee's benefits or employment agreement and the travel is necessitated by and on behalf of the employer as an integral part or condition of the employment; or (ii) the travel is required by the employer as part of the employee's job duties. Arising out of and in the course of the employment does not include travel to and from work. Arising out of and in the course of employment does not include when an employee is on a paid or unpaid break and is not performing any specific tasks for the employer during the break.

4 HB2418 Kay/SB0770 McCarter Traveling Employee & Causation New Section 1 (e) The term "accident" as used in this Act means an occurrence arising out of the employment, resulting from a risk incidental to the employment, and in the course of the employment at a time and place and under circumstances reasonably required by the employment.

5 HB2418 Kay/SB0770 McCarter Traveling Employee & Causation New Section 1 (f) The term "injury" as used in this Act means a medical condition or impairment that arises out of and in the course of employment. An injury, its occupational cause, and any resulting manifestations or disability must be established to a reasonable degree of medical certainty, based on objective relevant medical findings, and the accidental compensable injury must be the major contributing cause of any resulting injuries. For the purposes of this Section, "major contributing cause" means the cause which is more than 50% responsible for the injury as compared to all other causes combined for which treatment or benefits are sought. "Injury" includes the aggravation of a pre-existing condition by an accident arising out of and in the course of the employment, but only for so long as the aggravation of the pre-existing condition continues to be the major contributing cause of the disability.

6 HB2418 Kay/SB0770 McCarter Traveling Employee & Causation New Section 1(f) continued: An injury is deemed to arise out of and in the course of the employment only if:(1) it is reasonably apparent, upon consideration of all circumstances, that the accident is the major contributing cause of the injury; and(2) it does not come from a hazard or risk unrelated to the employment to which employees would have been equally exposed outside of the employment. An injury resulting directly or indirectly from idiopathic causes is not compensable.

7 HB2419 Kay/SB0769 McCarter Average Weekly Wage Amends the Workers' Compensation Act. Provides for the computation of compensation when there are multiple employers and when there is less than full-time work. Effective immediately. 2/17/2015 House Referred to Rules CommitteeRules Committee 2/11/2015 Senate Assigned to LaborLabor

8 HB2419 Kay/SB0769 McCarter Average Weekly Wage Sec. 10. The basis for computing the compensation provided for in Sections 7 and 8 of the Act shall be as follows: (1) The compensation shall be computed on the basis of the "Average weekly wage" which shall mean the actual earnings of the employee in the employment in which he was working at the time of the injury during the period of 52 weeks ending with the last day of the employee's last full pay period immediately preceding the date of injury, illness or disablement excluding overtime, and bonus divided by 52; but if the injured employee lost 5 or more calendar days during such period, whether or not in the same week, then the earnings for the remainder of such52 weeks shall be divided by the number of weeks and parts thereof remaining after the time so lost has been deducted.

9 HB2419 Kay/SB0769 McCarter Average Weekly Wage (2) Where the employment prior to the injury extended over a period of less than 52 weeks, or the employment is noncontinuous or less than full-time, or the employee lost one or more calendar days during that period, the earnings earned during that period shall be divided by the number of weeks during which the employee worked, regardless of the number of hours worked during that week the method of dividing the earnings during that period by the number of weeks and parts thereof during which the employee actually earned wages shall be followed.

10 HB2419 Kay/SB0769 McCarter Average Weekly Wage (3) When the employee is working concurrently with 2 or more employers and the respondent employer has knowledge of such additional employment prior to the injury, the employee's wages from all such employers shall be considered as if earned from the employer liable for compensation. (4) Each week during which the employee earned wages counts as one week for purposes of computation under subdivisions (1), (2), and (3), regardless of the number of hours worked during that week.

11 HB2419 Kay/SB0769 McCarter Average Weekly Wage (5) Where by reason of the shortness of the time during which the employee has been in the employment of his employer or of the casual nature or terms of the employment, it is impractical to compute the average weekly wages as above defined, regard shall be had to the average weekly amount which during the 52 weeks previous to the injury, illness or disablement was being or would have been earned by a person in the same grade employed at the same work for each of such 52weeks for the same number of hours per week by the same employer. In the case of volunteer firemen, police and civil defense members or trainees, the income benefits shall be based on the average weekly wage in their regular employment. When the employee is working concurrently with two or more employers and the respondent employer has knowledge of such employment prior to the injury, his wages from all such employers shall be considered as if earned from the employer liable for compensation.

12 HB2420 Kay/SB0771 McCarter Interstate Scaffolding Amends the Workers' Compensation Act. Provides that no employer shall be required to pay temporary partial disability benefits to an employee who has been discharged for cause. Provides that, following a hearing, the Illinois Workers' Compensation Commission may reinstate the temporary partial benefits and retroactively restore any benefits the employer should have paid if it finds the employer's discharge of the employee was not for cause. Makes technical changes. Effective immediately. 2/17/2015 House Referred to Rules CommitteeRules Committee 2/11/2015 Senate Assigned to LaborLabor

13 HB2420 Kay/SB0771 McCarter Interstate Scaffolding Added to Section 8(a): No employer shall be required to pay temporary partial disability or maintenance benefits to an employee who has been discharged for cause. Prior to suspension of temporary partial disability or maintenance benefits, the employer shall provide notice to the employee who has been discharged for cause. Following a hearing, the Commission may reinstate the temporary partial benefits and retroactively restore any benefits the employer should have paid if it finds the employer's discharge of the employee was not for cause. "Discharge for cause" means a discharge resulting from the employee's voluntary violation of a rule or policy of the employer not caused by the employee's disability.

14 HB2421 Kay/SB0772 McCarter Causation Amends the Workers' Compensation Act. Defines the terms "accident" and "injury". Provides that "injury" includes the aggravation of a pre-existing condition by an accident arising out of and in the course of the employment, but only for so long as the aggravation of the pre-existing condition continues to be the major contributing cause of the disability. Provides that an injury resulting directly or indirectly from idiopathic causes is not compensable. 2/17/2015 House Referred to Rules CommitteeRules Committee 2/11/2015 Senate Assigned to LaborLabor

15 HB2421 Kay/SB0772 McCarter Causation New Section 1 (e) The term "accident" as used in this Act means an occurrence arising out of the employment, resulting from a risk incidental to the employment, and in the course of the employment at a time and place and under circumstances reasonably required by the employment. (f) The term "injury" as used in this Act means a medical condition or impairment that arises out of and in the course of employment. An injury, its occupational cause, and any resulting manifestations or disability must be established to a reasonable degree of medical certainty, based on objective relevant medical findings, and the accidental compensable injury must be the major contributing cause of any resulting injuries. For the purposes of this Section, "major contributing cause" means the cause which is more than 50% responsible for the injury as compared to all other causes combined for which treatment or benefits are sought. "Injury" includes the aggravation of a pre-existing condition by an accident arising out of and in the course of the employment, but only for so long as the aggravation of the pre-existing condition continues to be the major contributing cause of the disability.

16 HB2421 Kay/SB0772 McCarter Causation (1) An injury is deemed to arise out of and in the course of the employment only if: (A) it is reasonably apparent, upon consideration of all circumstances, that the accident is the major contributing cause of the injury; and(B) it does not come from a hazard or risk unrelated to the employment to which employees would have been equally exposed outside of the employment. (2) An injury resulting directly or indirectly fromidiopathic causes is not compensable.

17 HB2422 Kay MAW Credit & Will County Forest Preserve Amends the Workers' Compensation Act. Provides that, with respect to the computation of compensation to be paid to an employee who had previously sustained an injury resulting in payment of compensation for partial disability for injuries not involving serious and permanent disfigurement and injuries for which the Act provides a schedule of benefits, the amount of the prior award for the partial disability with respect to the same portion of the body shall be deducted. Limits cumulative awards for partial disability to 500 weeks, which shall constitute a complete loss of use of the body as a whole. Provides that injuries to the shoulder are deemed to be injuries to the arm and injuries to the hip are deemed to be injuries to the leg. Effective immediately. 2/17/2015 House Referred to Rules CommitteeRules Committee

18 HB2422 Kay MAW Credit & Will County Forest Preserve In computing the compensation to be paid to any employee who, before the accident for which he or she claims compensation, had previously sustained an injury resulting in the payment of compensation for a percentage of partial disability under this subparagraph 2, such percentage of partial disability shall be deducted from any award made under this subparagraph 2 for a subsequent injury to the same portion of the body as was involved in the prior injury for which compensation was paid; provided, however, nothing herein contained shall permit cumulative awards for compensation for partial disability under this subparagraph 2 to exceed 500 weeks, which shall constitute complete loss of use of the body as a whole.

19 HB2422 Kay MAW Credit & Will County Forest Preserve For purposes of awards under this subdivision (e), injuries to the shoulder shall be considered to be injuries to part of the arm. This amendatory Act of the 99th General Assembly is declarative of existing law and is not a new enactment. For purposes of awards under this subdivision (e), injuries to the hip shall be considered to be injuries to part of the leg. This amendatory Act of the 99th General Assembly is declarative of existing law and is not a new enactment.

20 SB0846 Righter Omnibus Bill Amends the Workers' Compensation Act. Provides that an employee who is required to travel in connection with his or her employment and who suffers an injury while in travel status shall be eligible for benefits only if the injury arises out of and in the course of employment while he or she is actively engaged in the duties of employment. Defines "accident" and "injury". Provides that "injury" does not include the aggravation of a pre-existing condition by an accident unless it can be shown to a reasonable degree of medical certainty that the aggravation arose primarily out of and in the course of the employment. Provides that an injury resulting directly or indirectly from idiopathic causes is not compensable. Further provides that, with respect to the computation of compensation to be paid to an employee who had previously sustained an injury resulting in payment of compensation for partial disability for injuries not involving serious and permanent disfigurement and injuries for which the Act provides a schedule of benefits, the amount of the prior award for the partial disability with respect to the same portion of the body shall be deducted. Limits cumulative awards for partial disability to 500 weeks, which shall constitute a complete loss of use of the body as a whole. Provides that no employer shall be required to pay temporary partial disability benefits to an employee who has been discharged for cause. Provides that injuries to the shoulder are deemed to be injuries to the arm and injuries to the hip are deemed to be injuries to the leg. Effective immediately. 2/17/2015 Senate Assigned to LaborLabor

21 SB0846 Righter Omnibus Bill (iii) An injury causes death, disablement, or the need for medical treatment only if it has been shown to a reasonable degree of medical certainty that the employment contributed more than 50% in causing the death, disablement, or need for medical treatment, considering all causes; (iv) "Shown to a reasonable degree of medical certainty" means that, in the opinion of a physician, it is more likely than not considering all causes, as opposed to peculation or possibility; (v) If the injured worker selects a preferred provider from the employer's Preferred Provider Program (PPP), the opinion of the treating physician shall be rebuttably presumed correct on the issue of causation.

22 SB 1328 McCarter Appellate Court Amends the Workers' Compensation Act. Provides that any petition for leave to appeal from a judgment of the 5-judge panel of the Appellate Court designated to hear and decide cases involving review of Illinois Workers' Compensation Commission orders shall not require certification by the Appellate Court and shall be filed within the time allowed for filing a petition for rehearing in accordance with Supreme Court Rule 315(b). 2/18/2015 Senate Referred to AssignmentsAssignments

23 SB 1328 McCarter Appellate Court Any petition for leave to appeal from a judgment of the 5-judge panel of the Appellate Court designated to hear and decide cases involving review of Commission orders shall not require certification by the Appellate Court and shall be filed within the time allowed for filing a petition for rehearing in accordance with Supreme Court Rule 315(b). Appeals shall be taken from the Appellate Court to theSupreme Court in accordance with Supreme Court Rule 315.

24 Other Measures Strict AMA: “Strengthen AMA standards” Strict UR: “Reduce or stop doctor shopping” Restrictions in Choice of Medical: “Reduce or stop doctor shopping” Medical Fee Schedule: “(T)he medical fee schedule should also be reviewed. About 40 states use a fee schedule…even after Illinois cut the fee schedule by 30 percent in 2011, the state only went from having the second-highest fee schedule to the third-highest.” Springfield State Journal Register, 1/24/2015.

25 Other “Other” Measures WC Resolution (HR0172 Hoffman): “RESOLVED, That injured employees, who have provided their labor and made sacrifices for the betterment of the State and its economy, should not be threatened or confronted with additional benefit reductions through further changes to the Illinois Workers' Compensation Act.” Insurance Premium Task Force (SR 150/SJR14 Raoul): “(T)he Task Force shall study NCCI’s recommendations for workers' compensation premium rates and the extent to which Illinois employers' actual premiums reflect these recommended rates”

26 Other “Other” Measures State Fund (HB2552 Fine): Amends the Illinois Insurance Code. In the provision concerning the Illinois Workers' Compensation Commission Operations Fund surcharge, provides that after the effective date of the amendatory Act, the Director of Insurance shall make one or more loans to the Illinois Employers Mutual Insurance Company (the Company) in an amount not to exceed an aggregate amount of $10,000,000 from the Illinois Workers' Compensation Commission Operations Fund for the start-up funding and initial capitalization of the Company. Creates the Illinois Employers Mutual Insurance Company Article in the Code and establishes the Company as a nonprofit, independent public corporation. Provides that the Company (1) shall be operated as a domestic mutual insurance company, subject to all applicable provisions of the Code, (2) shall issue insurance for workers' compensation and occupational disease and shall not provide any other type of insurance, (3) shall not be considered a State agency or instrumentality of the State for any purpose, and (4) shall not receive any State appropriations or funds, except for an initial loan or loans. Sets forth provisions concerning a board of directors, ratemaking, the Illinois Insurance Guaranty Fund, a chief executive officer, liability, a workplace safety plan, investments, dividends, the sale of policies, auditing requirements, and an annual report. Effective immediately.

27 Other “Other” Measures No Exclusive Remedy for Client Companies of Staffing Agencies (SB1812 Martinez): Amends the Workers' Compensation Act. Provides that a borrowing employer that has entered into an agreement with a loaning employer may not avail itself of the exclusive remedy protection under the Act. Provides that any agreement between a loaning employer and a borrowing employer by which the loaning employer is entitled to receive certain reimbursements relating to fees and costs in hearings before the Illinois Workers' Compensation Commission is prohibited, is against public policy, and shall be wholly void. “Hours Worked” Premium Basis (SB1499 Manar): Amends the Illinois Insurance Code. Provides that with respect to employers correctly classified within the construction industry, the amount charged to the insured for workers' compensation and employers' liability insurance shall be based upon hours worked by employees in specific job categories or classifications, not the wages or salaries paid to the employees. Makes technical and grammatical changes.

28 Other “Other” Measures Strengthen WC Cost Reporting for Self-Insureds Safety & RTW Incentives Fund Deficit in IWBF


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