GEORGE KLAUKE, JR.

ALHOLM, MONAHAN, KLAUKE, HAY & OLDENBURG’S

ILLINOIS WC RULES OF THUMB AND LITTLE KNOWN FACTS

180 North Wacker Drive Chicago, IL 60606

312 704 8444 312 704 1352 fax illinois-law.com

DENYING CLAIM/CUTTING OFF TTD:

1. If you need more time to investigate accident/claim, you’re supposed to write petitioner and say why

2. If you want to cut off TTD (after having started it), you’re supposed to write and say why

3. You have responsibility to get medical information but employee has to execute authorizations on request

4. If you deny or want to dispute any part of a medical bill, you’re supposed to write and say why

IME (Independent medical exam):

1. You’re supposed to pay, in advance, mileage, meals and work hours lost to and from IME

2. If petitioner doesn’t attend, you can discontinue benefits until he/she does (write letter w/reason)

3. Illinois WC Act/rules do not place any limit on number of IME’s which you can request—the Commission might limit

4. Rules don’t mandate that you have to turn over IME’s ever—if not within 48 hours of hearing, doctor can’t testify

WC SUBPOENAS:

1. Be sure to distinguish WC subpoenas from common law subpoenas—rules/enforcement are very different

2. Unless you agree, WC subpoenas are trial subpoenas only—documents returnable only at hearing (not status call).

3. WC subpoenas require personal service on person in charge of records with appropriate witness fees as part of service—service by mail or registered mail not provided in WC Act or rules

4. If you subpoena records or documents, you do not have to copy opposing counsel on subpoena request

MILEAGE TO TREATING DOCTORS: Regardless of current cases, nothing in Rules requires payment of mileage to treating doctors (Prime example of how Illinois is a “Rules are for Fools”state; compare overtime/bonus)

CONTACTING REPRESENTED PETITIONERS: Nothing in Illinois WC Act or rules precludes employer/claims adjuster from contacting represented petitioner—ethical canons prevent lawyer from contacting represented client

19(B-1) RULES:

1. Petitioner must serve unfiled petition 15 days before filing on respondent

2. Once petitioner has filed petition, respondent has 15 days to respond either by motion to strike or written response

3. Motion to strike must be heard at 19(B-1) pretrial, if granted, petitioner has 5 days to correct, if denied, respondent has 5 days to file response

4. Failure to list witness name or document in 19(B-1) response precludes use in defense case—only real “discovery” in WC

5. Briefs on review/appeal must be filed within 15 days of filing appeal or waiver of orals

6. Properly filed 19(B-1) petition must be resolved by arbitrator within 90 days and by Commission within 90 days.

BOHANNON RULE (TOTAL & PERMANENT VS. WAGE DIFFERENTIAL): Always get petitioner back to some job as:

1. Total and permanent rate utilizes higher TTD rate/cap (higher minimum too) vs. wage differential at PPD rate/cap

2. Total and permanent ends at end of life span, wage loss ends at retirement from work

PENALTIES/FEES:

1. 19(k) awards 50% of benefits for refusal to pay compensation frivolously; new case says 19(k) applies to medical bills

2. 19(l) awards $10 a day with a cap of $2,500 for failure to pay TTD

3. 16 awards 20% attorney fee for unfairness or frivolous defenses; new case says 16 applies to medical bills

4. Always tender payment on statutory losses at MMI—for amputation, skull/vertebral fracture, eye enucleation, etc.

CAPS ON PETITIONER’S ATTORNEYS’ FEES:

1. Attorneys’ fees capped at $100 for statutory loss—amputation, skull/vertebral fracture

2. On nonstatutory loss, fees capped at 20% of 364 weeks of benefits

PPD RULES OF THUMB:

Simple fracture/simple surgery utilize a 15-25% rule; Soft tissue claims try to get 1 to 1 ratio on lost time to PPD paid