PA 97-18 establishes the State Workers’ Compensation Program Advisory Board within CMS to review, assess, the workers’ compensation program involving state employees, and to advise CMS regarding improvements to the system. The board shall consist of 5 voting members, one appointed by the Governor who serves as Chairman, and one each by the four legislative leaders. The board also includes non-voting ex officio members consisting of the Chairman/Director/Secretary, or their designees, of CMS, the Attorney General, Department of Insurance, Department of Transportation, Department of Corrections, Department of Human Services, Department of Revenue, and the IWCC. They shall meet at least thrice annually and submit an annual written report to the Governor, General Assembly, and CMS with recommendations for improving the system.
The Department of Central Management Services/Risk Management Division has the statutory responsibility to administer the Workers' Compensation Program for State of Illinois agencies, boards, commissions, and universities (non-inclusive of the University of Illinois and the Illinois Toll-Highway Authority).
As authorized by PA 97-895, the Department of Central Management Services (DCMS) has contracted a Third Party Administrator (TPA). The TPA for DCMS is TriStar.
The primary objectives of the Workers' Compensation Program are to provide prompt and equitable services to eligible employees, to return them to productive work as safely and quickly as possible, to provide prompt payment to providers for reasonable and necessary medical treatment, and to ensure that fund resources are managed effectively and prudently.
The Illinois Workers' Compensation Act and Occupational Diseases Act, governed by the Illinois Workers' Compensation Commission, provide protection to employees from the economic hardship resulting from a work-related accident or disease. The benefits include payment of bills for necessary medical treatment, rehabilitation services, temporary disability income payments, and in some cases a settlement to compensate for permanent impairment that the employee may have as a result of the injury or disease.
TriStar Claims Examiners and Claims Supervisors are available to ensure efficient and proper claims administration in the following principal areas: 1) initial claim review for determining compensability; 2) ongoing benefit management (including payment of medical charges and temporary disability and; 3) proper negotiation of settlements based on partial or total permanent disability.
The initial claims process begins with the injured employee contacting TriStar within twenty-four hours via the toll free injury reporting hotline (1-855-495-1554) to initiate a claim. The injured employee should also report the injury to his/her supervisor as soon as possible. The agency's Workers' Compensation Coordinator, or immediate supervisor, is responsible to provide the employee with proper forms that need to be completed to ensure timely and efficient processing of the claim. If the employee requires medical treatment or does lose time from work, all necessary documentation must be forwarded to TriStar in a timely manner. By receiving the accident information in a timely manner, a claim may be adjudicated in a prompt and efficient manner, thereby benefiting the employee and claims administration unit.
The Office of the Attorney General is responsible for the defense of claims arising from work-related injuries or disease. The CMS Workers' Compensation Supervisors work closely with the Office of the Attorney General to bring litigated cases to a resolution if such resolution is advantageous to the State. Otherwise, when both parties fail to reach an agreement, a disputed claim is heard in front of an Illinois Workers' Compensation Commission Arbitrator for disposition.
The principal point of contact for an injured employee is TriStar and Workers' Compensation Coordinator or supervisor at the employing agency/university. The Plan Administrator is the TriStar. Further questions may be directed to the TriStar at (312) 445-8700.
Forms for State Agency Coordinators and Employees
The forms listed below are in PDF format. To view these documents, you need to use Acrobat Reader.
The Illinois Workers' Compensation Commission provides this handbook to supply general information, procedures for reporting an injury or exposure, medical benefits, compensation benefits, and claims, settlements, and the hearing process. The handbook is in a PDF format.
The Early Intervention Program contains frequently asked questions and steps to take if you are injured on the job.