IL Comp Update: Failure to authorize care CANNOT result in the assessment of penalties

ILLINOIS WORKERS COMP UPDATE

Both Arbitrators and the Illinois Workers Comp Commission have increased the assessment of penalties and attorneys’ fees against Employers and Insurance Carriers. However, the Court of Appeals has again ruled that penalties CANNOT be assessed against an Employer/Carrier for failure to authorize care.

In February, the Illinois Court of Appeals ( click HERE for O’Neil v. IWCC) held:

“Nevertheless, as we observed (in a prior decision), neither section 8(a) nor any other provision of the Act allows the Commission to assess penalties against an employer based on a failure or delay in authorizing medical treatment.”

WHEN CAN PENALTIES BE ASSESSED?

Under multiple sections of the IL Act, penalties and attorneys’ fees can be assessed against an IL Employer or carrier in situations where there is a delay or refusal to pay for medical care AFTER the care has been provided:

“where there has been any unreasonable or vexatious delay of payment or intentional underpayment of compensation…, then the Commission may award compensation additional to that otherwise payable under this Act equal to 50% of the amount payable at the time of such award.”

So, remember that penalties can be assessed for failure to pay medical bills after the care has been provided, but the Commission cannot asses penalties and/or attorneys’ fees based upon a failure or refusal to authorize care before that care is provided.

If you want to discuss this further, or if you have any current cases where this is an issue, just let me know.

– Brad