State Legislation

Illinois

CorVel is a national provider of industry-leading workers’ compensation solutions to Illinois payors. Incidents and injuries are reported to Advocacy 24/7 for immediate intervention. We are the only partner that offers integrated claims management and managed care services via one platform. Our services are provided by CorVel employees all working together in real time. No silos, no delays. More access, more action. This means you have more control of your program, facilitating faster and better decision making.

Our comprehensive return to work program ensures collaboration and communication with all interested parties including the injured worker, employer, human resources, medical and safety teams, and healthcare providers. We use technology, compassionate case management for employees and cost containment measures, to give Illinois employers a superior program.

Illinois Regulatory Updates 02/17/2025

HB 1253 – Workers Comp-Causation Amends the Workers’ Compensation Act. Provides That an Injury Arises Out of and In the Course of Employment Only If the Accident Significantly Caused or Contributed to Both the Resulting Condition and the Disability. Provides That an Injury Does Not Arise Out of and In the Course of Employment If (1) the Hazard or Risk Was Not Incidental to Employment and Was a Hazard or Risk to Which the General Public Is Also Exposed, (2) the Injury Did Not Occur at a Time and Place and Under Circumstances Reasonably Required By the Employment, or (3) the Disability Resulted from a Personal Risk. Limits Conditions Under Which Repetitive or Cumulative Trauma Is Compensable. Provides That Gradual Deterioration or Progressive Degeneration of the Body Caused By Aging Is Not Compensable As Repetitive or Cumulative Trauma. Effective Immediately.

Issues: Workers’ Compensation, Workers’ Compensation (General)

Summary For 01/15/2025

Accidental injuries are deemed work-related only if the accident significantly caused or contributed to both the condition and the resulting disability.

This measure outlines when accidental injuries are not considered to have been caused by employment.

This measure takes effect upon becoming law.

Most Recent Update:

01/10/2025 – Introduced

HB 1254 – Workers Comp-Benefit Rates Amends the Workers’ Compensation Act. Makes Changes to the Compensation Periods For Accidental Injuries Resulting In the Loss of or the Permanent and Complete Loss of Use of the Thumb, Fingers, or Toes; the Amputation of an Arm, Foot, or Leg; the Enucleation of an Eye; and Other Injuries to Reduce the Compensation to the Amounts In Effect For Injuries Occurring Before February 1, 2006. Effective Immediately.

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary For 01/15/2025

This measure amends the Workers’ Compensation Act. This measure makes changes to the compensation periods for accidental injuries resulting in the loss of or the permanent and complete loss of use of the thumb, fingers, or toes; the amputation of an arm, foot, or leg; the enucleation of an eye; and other injuries to reduce the compensation to the amounts in effect for injuries occurring before February 1, 2006. This measure takes effect immediately.

Most Recent Update:

01/10/2025 – Introduced

HB 1255 – Workers Comp-Prior Injury Amends the Workers’ Compensation Act. Provides That, In Computing the Compensation to Be Paid to an Employee Who, Before the Accident For Which the Employee Claims Compensation, Had Before That Time Sustained an Injury Resulting In a Permanency Award or Settlement, the Award or Settlement Shall Be Deducted from any Award Made For the Subsequent Injury. Provides That, If an Employee Received an Award or Settlement For a Shoulder Injury Between 2012 and the Effective Date of the Amendatory Act, Then the Award or Settlement Shall Be Converted to the Appropriate Number of Weeks For an Arm and the Credit Taken Against any Award or Settlement Shall Be Taken on the Arm. Effective Immediately.

Issues: Workers’ Compensation, Workers’ Compensation (General)

Summary For 01/15/2025:

When calculating compensation for an employee who was previously awarded or settled for a permanent injury, that prior award will be deducted from any compensation granted for a new injury resulting in a permanent award or settlement. This applies to injuries that are a loss or partial loss of a body part. If a shoulder injury resulted in an award or settlement between 2012 and the enactment of this law, it will be converted to an equivalent number of weeks for an arm, and the deduction will be applied accordingly. This measure takes effect upon becoming law.

Most Recent Update:

01/10/2025 – Introduced

HB 1257 – Workers Comp Employee Travel Amends the Workers’ Compensation Act Concerning Injuries Sustained By Employees During Travel. Provides That Accidental Injuries Sustained While Traveling to or from Work Do Not Arise Out of and In the Course of Employment, Except Under Specified Circumstances. Provides That the Injury May Arise Out of and In the Course of Employment If, at the Time of the Injury, the Employee Was Performing Acts the Employer Instructed the Employee to Perform, Acts That the Employee Had a Common Law or Statutory Duty to Perform While Performing Duties For His or Her Employer, or Acts That the Employee Might Be Reasonably Expected to Perform Incident to His or Her Assigned Duties. Effective Immediately.

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary For 01/14/2025

This measure clarifies that accidental injuries sustained while traveling to or from work do not arise out of and in the course of employment.
This measure outlines the criteria to be considered an accidental injury arising out of work when traveling away from employer as part of the individuals occupation.
This measure takes effect upon becoming law.

Most Recent Update:

01/10/2025 – Introduced

HB 1258 – Workers Comp-Shoulder-Hip Amends the Workers’ Compensation Act. Provides That, For Purposes of Awarding Compensation For Injuries, an Injury to the Shoulder Shall Be Considered an Injury to a Part of the Arm and an Injury to the Hip Shall Be Considered an Injury to a Part of the Leg. Effective Immediately.

Issues: Workers’ Compensation, Workers’ Compensation (General)

Summary For 01/14/2025:

When awarding worker’s compensation for injuries, an injury to the shoulder will be considered an injury to the arm and an injury to the hip will be considered an injury to the leg. This measure goes into effect upon becoming law.

Most Recent Update:

01/10/2025 – Introduced

HB 1259 – Workers Comp-Spinal Injury Amends the Workers’ Compensation Act. Provides That For Purposes of Computing Compensation For an Employee Who Had a Prior Compensated Injury to the Spine, the Prior Compensation Shall Be Deducted from Compensation Awarded For a Subsequent Injury to the Same Part of the Spine. Effective Immediately.

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary For 01/15/2025

This measure provides that compensation for an employee who had a prior compensated injury to the spine, the prior compensation will be deducted from compensation awarded for a subsequent injury to the same part of the spine. This measure goes into effect upon becoming law.

Most Recent Update:

01/10/2025 – Introduced

SB 35 – Work Comp-Sole Proprietors Amends the Workers’ Compensation Act. Provides That the Provisions of the Act Shall Apply Automatically and Without Election to All Employers and All Their Employees, Including, But Not Limited To, Sole Proprietors and General Contractors and Their Subcontractors (Currently, All Employers and All Their Employees), Engaged In any Department Enterprises or Businesses Which Are Declared to Be Extra Hazardous. Removes a Provision That the Act Shall Not Be Construed to Apply to any Sole Proprietor or Partner or Member of a Limited Liability Company Who Elects Not to Provide and Pay Compensation For Accidental Injuries Sustained By Himself, Arising Out of and In the Course of the Employment According to the Provisions of the Act. Provides That the Definition of “Corporate Officer” Does Not Include a Sole Proprietor.

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary For 01/16/2025

This measure includes sole proprietors, general contractors, and their subcontractors as employees. The term “corporate officer” does not include a sole proprietor.
If this measure passes the legislature prior to June 1, it takes effect January 1. If it passes the legislature after May 31, this measure takes effect June 1 of the following year.

Most Recent Update:

01/22/2025 -This measure has been referred to the Senate Judiciary Committee, chaired by Michael E. Hastings. This measure is eligible for consideration in the committee of referral.

Illinois Regulatory Updates 06/07/2023

HB 4079 – Workers Comp-Various

Issues: Workers’ Compensation, Workers’ Compensation (General)

Summary:

This measure establishes geographic regions for workers’ compensation fee schedules. It establishes 4 regions for non-hospital fees and 14 regions for hospital fees. It sets the fees according to CPT and DRG code relative to percentages of the Medicare fee schedule, though allows for petitioning by providers if the fee is insufficient. Fees are to be set administratively within bands relative to the Medicare rate. This takes effect September 1, 2024.
It also requires development of an evidence-based workers’ compensation formulary. It allows custom compound medications for no more than 7 days unless the compound meets certain qualifications, including no commercial equivalent and a demonstration of clinical appropriateness. It bases reimbursement for these compounds on national average wholesale price, according to proportion of the component within the compound. This section takes effect September 1, 2023.

Most Recent Update:

05/10/2023 – Introduced

HB 4087 – Workers Comp-Compound Drugs Amends the Workers’ Compensation Act. Provides That the Illinois Workers’ Compensation Commission, Upon Consultation With the Workers’ Compensation Medical Fee Advisory Board, Shall Adopt an Evidence-Based Drug Formulary. Requires Prescriptions In Workers’ Compensation Cases to Be Limited to the Drugs on the Formulary. Provides That By September 1, 2023, the Commission, In Consultation With the Workers’ Compensation Medical Fee Advisory Board, Shall Adopt By Rule an Evidence-Based Drug Formulary and any Rules Necessary For Its Administration. Provides That Prescriptions Prescribed For Workers’ Compensation Cases Shall Be Limited to the Prescription Drugs and Doses on the Closed Formulary. Provides That a Custom Compound Medication For Longer Than the One Time 7-Day Supply Shall Be Approved For Payment Only If the Compound Meets Specified Standards. Provides For Charges For Custom Compound Medications. Effective Immediately.

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure requires administrative development of an evidence-based drug formulary under the workers’ compensation system. It also sets limits on compounded drugs. It allows custom compounds in excess of 7-day amounts only if there is no readily available commercial equivalent and the components are all approved for use and have a National Drug Code number. It also outlines allowable cost, according to proportion of components within the compound. Finally, it allows dispensing fees based on actual cost. It takes effect upon enactment.

Most Recent Update:

05/11/2023 – Introduced

CorVel is approved as a Workers’ Compensation Preferred Provider Program (WCPPP) for the state of Illinois. Additional information can be found on the state website and the JCAR Final Rules.

We are here to help.
Learn more about CorVel’s workers’ compensation solutions, or contact a local representative for additional information.

The Illinois Workers’ Compensation Act updated the state mandated fee schedule, causation, employer directed care (Preferred Provider Program), use of American Medical Association (AMA) guidelines and utilization review. Additional information can be found in the House Bill 1698 bulletin. These requirements are mandatory for all Illinois employers.

We are here to help.
CorVel is a licensed Third Party Claims Administrator in the state of Illinois and we are a state certified Utilization Review Organization that is compliant with the Illinois Workers’ Compensation Act. We are URAC accredited and follow URAC standards. CorVel’s proprietary provider network is approved by the state of Illinois as a Preferred Provider Administrator.

Learn more about CorVel’s workers’ compensation solutions or contact a local representative for additional information.