Get Illinois Workers'' Compensation Commission Petition For An Immediate Hearing Under Section 19(b) Of

Filing a petition for an immediate hearing under Section 19(b) can be a crucial step for individuals seeking benefits related to workplace injuries. This guide provides clear instructions on how to complete the Illinois Workers' Compensation Commission Petition form online, ensuring you understand each section and field involved.

Follow the steps to successfully complete the petition form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in your case number at the top of the form labeled 'Case #.' This information is crucial for identifying your case within the commission's records.
3. Next, fill in the names of the parties involved in the petition. The first section requires you to list the employee or petitioner on one side and the employer or respondent on the other.
4. In the section labeled 'I, the petitioner, request an immediate hearing in this matter,' briefly explain why you are unable to return to work due to injuries sustained during your employment. Ensure this statement is clear and concise.
5. Provide the date, time, and location of the accident in the respective fields. It is essential to be as accurate as possible to allow for proper review.
6. Describe the accident in detail. This section should provide a thorough account of what occurred, making sure to include all relevant information.
7. State the nature of your injury. Be specific about the injuries you have sustained as a result of the accident.
8. Indicate how you notified your employer about the accident. Check whether the notification was given orally or in writing, and include the name and date of notification.
9. If the employer has refused to pay proper compensation, mark the appropriate box and provide any supporting details available.
10. List any medical providers you have seen for treatment related to the accident, along with dates of your treatments.
11. If there are any medical bills in dispute, list them clearly in the designated area.
12. Indicate the last date you received temporary total disability benefits, if applicable.
13. Document any attempts made to resolve disputes with the employer regarding the issues at hand. Note the date and the individuals involved in those discussions.
14. Finally, ensure that you, or your attorney, sign and date the petition. Include your contact number for any follow-up communications.
15. Once completed, ensure to save changes to your file, and consider downloading or printing the form for your records or to share with relevant parties.

Start filling out the petition form online to ensure your request for an immediate hearing is submitted properly.