5-28-2018; Illinois WC Required Forms and Notices; Top Ten Things everyone should know about Illinois Work Comp Law and Claims Practice and more

Synopsis: Illinois Work Comp Required Forms and Notices That You Need to Use.

Editor’s comment: I recommend all IL employers print and post the following notices, both in English and Spanish in a conspicuous location frequented by employees such as the break room, lunch room or time clock. If you have multiple business locations be sure to post the notices at each location.

·        Workers’ Compensation Insurance Notice  (English and Spanish).

·        Anti-WC Fraud Notice (English and Spanish).

I also recommend all IL employers/carriers, print and review the following forms and information:

·         IC45 First Report of Injury (FROI). Section 6(b) of the Workers’ Compensation Act requires that employers or insurers acting on your behalf send paper or electronic reports to the Illinois Workers’ Compensation Commission on all covered accidents involving more than three lost work days. 
 
As soon as you have been notified of a work-related injury or illness, fill out this form and submit it to the Illinois Workers’ Compensation Commission and your carrier. This form must be completed within five days from notice of an accident.

Workplace Fatalities must be reported within two days of the death. The Illinois Workers’ Compensation Commission also accepts the International Association of Industrial Accident Boards and Commissions (IAIABC) first report of injury form: IA-1 IAIABC W.C. First Report of Injury.

·         IC85 Employers Supplementary of Injury (FROI). This is a supplemental form you can ignore. The Illinois Workers’ Compensation Commission does monitor filing of the form IC45). To my understanding, they don’t monitor compliance with filing of this form. If that should change, we will advise.

·         IL WC PPP Form or PPP Preferred Provider Program Mandatory Notice (6/13) [Word]. If you have an IL WC PPP, you need to use this notice. I am happy to consult at no charge if you need it for starting a WC PPP for this State. All you will do by starting one is save a LOT of money.

·         Use and implement an Incident/Accident Investigation Form—If you need one or aren’t comfortable with yours, send a reply. Don’t use the IC45 (the IL WC State Form) as your incident/accident investigation form—it doesn’t work well. Our basic incident/accident form is completed by employee and the employee’s supervisor/manager as soon after the accident as possible. Once completed, please send the report to your carrier and save a copy to your file.

·         HIPAA/GINA Compliant Medical Release—every employer in the U.S. should have a HIPAA/GINA Compliant Release and ask your employee sign it when they report any workplace accident or disease. By doing so, you will have open and crucial access to medical records and bills. I can send you a free copy of our release—just send a reply.

In addition to providing workers’ compensation benefits, Illinois employers are obligated to:

·        Post a notice in each workplace explaining workers’ compensation rights and providing the name, policy number, and contact information of the employer’s insurance carrier. If you need this notice, send a reply.

·        Maintain records of work-related injuries and report injuries involving more than 3 lost work days to the IWCC.

·        Refrain from harassing, discharging, refusing to rehire or in any way discriminating against an employee who exercises his or her rights under the law. This follows the IL Supreme Court ruling in Kelsay v. Motorola.

·        Refrain from charging employees for any part of the workers’ compensation insurance premiums or benefits.

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Synopsis: Top Ten Things everyone should know about Illinois Work Comp Law and Claims Practice.

Editor’s comment: I consider this some critical common sense thoughts about the WC Legal Battlefield in which we are all deployed.

1.      It’s a no fault law. Unless your injured worker is drunk or reckless (e.g. the worker jumps off a roof for fun instead of using an employer-provided ladder), their fault doesn’t matter if you get hurt at work.  The employee doesn’t have to prove the company was negligent and the employer isn’t off the hook if the worker is careless.

2.      IL WC Plaintiff/Petitioner Lawyer fees are 20% and don’t exceed that amount without special and truly extraordinary circumstances.

3.      100% of reasonable, necessary and related medical bills should be paid for any treatment directly related to an accepted and related job injury or disease.  IL WC has no co-pays, no out of pocket medical expenses or other costs.

4.      Without a signed HIPAA-GINA compliant release, an WC insurance company and the employer may not talk directly to the injured worker’s doctor. Again, without a signed HIPAA-GINA compliant release, employer/insurance carrier reps should not be in WC medical appointments. This includes any nurse case managers. If you want my form, send a reply. Happy to analyze any questions and concerns about this with all you curious medical care managers.

5.      You can and should tell your injured workers, any lawyer who tells them what their case is “worth” right after they’ve been hurt is probably full of it and telling them that just to try and get them to sign up. There is no accurate way to tell an injured worker for certain what the case is worth until they are finished with medical care and at maximum medical improvement and back to work.

6.      The value of any WC case is determined in part based on the severity of the injury, how it will affect the worker in the future, the medical care they have, how much money they were earning when hurt, their age, the job they can return to, whether or not they have any permanent work restrictions and the need for future medical care.

7.      Work comp isn’t truly a “law suit.” Workers’ compensation cases in Illinois are not lawsuits, but instead are claims for benefits like any other insurance claim. There is no Judge or lawsuit—everything is determined by a state agency, not a judge in a courtroom.

8.      Any IL employer can drug test an injured worker after an accident.  If they test positive it creates a “rebuttable presumption” that the drugs caused the accident. The worker can overcome this presumption based on the facts of how they got injured, medical records and witness testimony.

9.      Any injured worker needs to provide notice to their employer within 45 days of when they knew or should have known their injury or disease was work related.

10. An injured worker can switch attorneys if the first one isn’t doing the job and it won’t cost the worker anything. Lots of case law confirms Plaintiff/Petitioner lawyer fees can’t exceed 20%. The new firm and old firm will have to work it out to split the 20% or the Arbitrator will decide.

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