Arbitration Decision Order Paragraphs

ILLINOIS WORKERS' COMPENSATON COMMISSION ARBITRATION DECISION ORDER PARAGRAPHS 9/19/14 Instructions This document is not protected. You do not need to enter the "iwcc" password. These templates address the most common scenarios. Cut and paste the text you need. Modify the language as necessary. Use only sentences that apply. For example, if no TTD is awarded, don't use the sentence awarding TTD. Do not include the TTD sentence with zeroes in the fields. Similarly, if there are no children in a fatal case, don't use the sentence, "Respondent shall make payments for not less than six years to any eligible child..." Credits Respondent shall be given a credit of $ benefits, for a total credit of $ . for TTD, $ for TPD, and $ for maintenance Respondent shall be given a credit of $ for medical benefits that have been paid, and Respondent shall hold petitioner harmless from any claims by any providers of the services for which Respondent is receiving this credit, as provided in Section 8(j) of the Act. Respondent shall be given credit for $ Denial of benefits This sentence should indicate the basis for the denials, e.g., "Because an employee-employer relationship did not exist, benefits are denied." Maintenance Respondent shall pay Petitioner maintenance benefits of $ through , as provided in Section 8(a) of the Act. Medical benefits Respondent shall pay reasonable and necessary medical services of $ Act. , as provided in Section 8(a) of the /week for weeks, commencing for benefits paid under Section of the Act. Respondent shall pay reasonable and necessary medical services, pursuant to the medical fee schedule, of $ to ,$ to , and $ to , as provided in Sections 8(a) and 8.2 of the Act. Respondent shall pay reasonable and necessary medical services of $ 8.2 of the Act. , as provided in Sections 8(a) and Respondent shall be given a credit of $ for medical benefits that have been paid, and Respondent shall hold petitioner harmless from any claims by any providers of the services for which Respondent is receiving this credit, as provided in Section 8(j) of the Act. 1 American LegalNet, Inc. www.FormsWorkFlow.com Temporary Partial Disability Respondent shall pay Petitioner temporary partial disability benefits of $ commencing through , as provided in Section 8(a) of the Act. Temporary Total Disability Respondent shall pay Petitioner temporary total disability benefits of $ /week for commencing through , as provided in Section 8(b) of the Act. Respondent shall pay Petitioner the temporary total disability benefits that have accrued from , and shall pay the remainder of the award, if any, in weekly payments. Respondent shall be given a credit of $ weeks, through /week for weeks, for temporary total disability benefits that have been paid. Permanent Partial Disability: Schedule injury (For injuries before 9/1/11) Respondent shall pay Petitioner permanent partial disability benefits of $ /week for weeks, because the injuries sustained caused the % loss of the , as provided in Section 8(e) of the Act. Permanent Partial Disability: Person as a whole (For injuries before 9/1/11) Note: If awarding both 8(e) and 8(d)2 benefits, list each benefit in a separate sentence. Do not combine benefit amounts. Respondent shall pay Petitioner permanent partial disability benefits of $ /week for weeks, because the injuries sustained caused the % loss of the person as a whole, as provided in Section 8(d)2 of the Act. Permanent Partial Disability with 8.1b language (For injuries after 9/1/11) With regard to subsection (i) of §8.1b(b), the Arbitrator notes that no permanent partial disability impairment report and/or opinion was submitted into evidence. The Arbitrator therefore gives no weight to this factor. With regard to subsection (i) of §8.1b(b), the Arbitrator notes that no opinion comporting with the specific requirements of §8.1b(a) was submitted into evidence. However, the Arbitrator has considered the doctor's comments as a factor in the evaluation of Petitioner's permanent partial disability as required by §8.1b(b)(i). The doctor noted . Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. With regard to subsection (i) of §8.1b(b), the Arbitrator notes that the record contains an impairment rating of % of as determined by Dr. , pursuant to the most current edition of the American Medical Association's Guides to the Evaluation of Permanent Impairment. (Exhibit #). The Arbitrator notes that this level of impairment does not necessarily equate to permanent partial disability under the Workers' Compensation Act, but instead is a factor to be considered in making such a disability evaluation. The doctor noted . Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. With regard to subsection (ii) of §8.1b(b), the occupation of the employee, the Arbitrator notes that the record reveals that Petitioner was employed as a at the time of the accident and that he is/is not able to return to work in his prior capacity as a result of said injury. The Arbitrator notes . Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. 2 American LegalNet, Inc. www.FormsWorkFlow.com With regard to subsection (iii) of §8.1b(b), the Arbitrator notes that Petitioner was years old at the time of the accident. Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. With regard to subsection (iv) of §8.1b(b), Petitioner's future earnings capacity, the Arbitrator notes Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. . With regard to subsection (v) of §8.1b(b), evidence of disability corroborated by the treating medical records, the Arbitrator notes . Because of , the Arbitrator therefore gives greater/lesser/no weight to this factor. Based on the above factors, and the record taken as a whole, the Arbitrator finds that Petitioner sustained permanent partial disability to the extent of % loss of use of pursuant to § of the Act. Permanent Partial Disability: Wage differential Respondent shall pay Petitioner permanent partial disability benefits, commencing , of $ /week for the duration of the disability, because the injuries sustained caused a loss of earnings, as provided in Section 8(d)1 of the Act. For accidents on or after 9/1/11: Respondent shall pay Petitioner permanent partial disability benefits, commencing , of $ /week until Petitioner reaches age 67 or five years from t