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15
Oct 2019

Injurious Practices & The Illinois Workers’ Compensation Act

By Deidre Christenson     

  When can an employer deny benefits to an employee who has engaged in unhealthy behavior that has impacted his recovery? Section 19(d) of the Illinois Workers’ Compensation Act provides that: If any employee shall persist in insanitary or injurious practices which tend to either imperil or retard his recovery or shall refuse to submit
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09
Oct 2019

The “Eggshell Skull Rule” and Co-Morbidities

By Padraig McCoid     

  The “Eggshell Skull Rule” is a longstanding principle in workers’ compensation law.  Under the rule, you take an injured worker as you find him.  In other words, even if an accident would not have injured an average person, the employer may still be liable.  This is true with any co-morbidity an injured worker might
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06
Oct 2019

CMS To Grant Access to Open Debt Reports and Introduce New WCMSA Electronic Attestation Feature on the WCMSAP

By Paul Pasche     

  The Centers for Medicare and Medicaid Services (CMS) made two welcome announcements today that impact the Medicare Secondary Payer compliance community. Beginning on October 7, 2019, CMS will offer new access to Open Debt Reports through the CMS web portal designated for disputing and resolving Medicare conditional payments claims. An Open Debt Report will
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02
Oct 2019

Changes to the “Workers’ Compensation Electronic and Standardized Billing” Regulations

By William Lowry, Jr.     

  The Illinois’ Department of Insurance (the Department) recently enacted changes to the “Workers’ Compensation Electronic and Standardized Paper Billing” regulations in order to implement Public Act 100-1117, which amended Sections 8.2 and 8.2(a) of the Illinois Workers’ Compensation Act (the Act). The amendments to both the Act and corresponding regulation have created several pertinent
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17
Sep 2019

IWCC Publishes Proposed Rules Defining “Explanation of Benefits”

By Joseph Gregorio     

  On September 13, 2019, Illinois Workers’ Compensation Commission published proposed rule changes in the Illinois Register.  The proposed rule changes implement the rulemaking required by Public Act 100-1117, defining what documents qualify as an explanation of benefits, and what information must be included to properly deny a medical bill. The proposed rule changes are
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