Production Bonuses and Overtime Wages Included in Average Weekly Wage

Arcelor Mittal Steel vs. IWCC No. No. 1-10-2180WC The claimant, Robert Common, a union member, injured his right arm at work.  He testified that he worked a regular eight-hour shift Monday through Friday.  Each Thursday the next week’s schedule was posted: “2” on the schedule indicated that the individual would be assigned a 12-hour shift

TTD Awarded Despite Refusal to Accept Light Duty Work

Otto Baum Company, Inc. v. IWCC and Tim Hilton No. 4-10-0959WC Tim Hilton was injured while working for Otto Baum Company on August 6, 2008, after which he was taken off work.  After diagnostic workup, he was cleared for sedentary work.  Otto Baum offered a temporary position within his restrictions.  Hilton reported for work but

Personnel and Procedural Changes at IWCC

The Illinois Workers’ Compensation Commission has announced personnel and procedural changes impacting the practice statewide.  As to the former, Governor Quinn has made a number of Commission appointments that include the hiring of eight new arbitrators.  The following is the information released by the Commission. The calls of former arbitrators will be handled as follows:


As a refresher to our July 2011 newsletter, there is no statutory or regulatory authority requiring CMS approval of a workers’ compensation Medicare set‑aside arrangement (WCMSA).  A series of CMS policy memos clearly implied a “requirement” over the past several years, but in May 2011 CMS issued another policy memo which confirmed: There are no

New CMS Memorandum Addresses Liability Medicare Set Aside Arrangements

On September 29, 2011, the Centers for Medicare & Medicaid Services issued its newest memorandum.  The memorandum, a copy of which follows this Alert, provides insight into the issue of when a Liability Medicare-Set Aside proposal should be submitted to CMS.  While CMS has provided fairly clear work-level review thresholds in the workers’ compensation arena,

Appellate Court Upholds Sanctity of Section 5b

Loryann Johnson vs. Ayalnesh A. Tikuye and Amigo Driving School No. No. 1-10-0114 Loryann Johnson was employed by the Secretary of State as a license examiner.  She was injured while working, administering a driving test to Ayalnesh Tikuye. She collected workers’ compensationbenefits for her injuries, which included medical payments, lost wages and a lump sum

Commission Has Jurisdiction to Adjudicate Fraud in Pending Cases

Country Insurance & Financial Services vs. Timothy B. Roberts No. No. 1-10-3402 The Appellate Court, First District, has weighed in on the subject of fraud in workers’ compensation cases, this time in a case pending before the Commission.  Roberts filed an application alleging work-related injuries on January 16, 2007, following which Country Insurance paid temporary

Congress and the MSP

In last month’s Newsletter, we shared information on Congressional attention being paid to the MSP. On July 25, 2011, members of the Subcommittee on Oversight and Investigations sent a letter to the Secretary of Health and Human Services and the Center for Medicare and Medicaid Services Administrator outlining its position on the current state of

New WCMSA Review Contractor

CMS has awarded the contract to review Workers’ Compensation Medicare Set-Aside submissions to a new vendor (Provider Resources, Inc.).  The new contract runs through June 30, 2012.  CMS mandated that the new contractor achieve significant decreases in the time it takes to complete the WCMSA submission process.  CMS’ Request for Proposal (RFP) included provisions that

Web Based Submission Portal

As the Workers’ Compensation Medicare Set-Aside (WCMSA) submission process is currently implemented, CMS only accepts WCMSA proposals via regular mail.  All necessary materials must be scanned into PDF format, put onto a compact disc, and mailed to the Workers’ Compensation Review Contractor.  Once the contractor receives the WCMSA proposal, it must upload the information into