Perez v. Illinois Workers' Compensation Comm'n, 2017 IL App (1st) 170086WC

Rocio Perez slipped at work on June 19, 2007, injuring her left knee and later receiving conservative care and surgery for a lateral meniscal tear.
At arbitration the employer challenged causation; the arbitrator and IWCC initially found no causal connection; the circuit court affirmed; this court reversed on appeal (finding erroneous admission of employer expert testimony and that claimant met her burden).
On remand the Commission awarded temporary total disability and loss-of-use benefits and ordered employer to pay medical expenses under 820 ILCS 305/8(a) and 8.2(e) but did not state an amount.
A later remand hearing produced a Commission award of $17,857.96 for medical expenses, representing $17,597.96 paid by Cigna (the claimant’s then-husband’s insurer) plus $260 in claimant out-of-pocket payments; the Commission relied on the negotiated/paid amounts rather than the higher stipulated fee-schedule total.
The circuit court confirmed the Commission’s remand decision; Perez appealed, arguing the employer should have to pay fee-schedule amounts rather than the lower third-party negotiated/paid amounts.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether employer must pay medical charges based on fee-schedule amounts or the negotiated/paid amount by a third-party insurer	Perez: employer liable for negotiated rate only if negotiated by employer or its insurer; otherwise fee-schedule applies	TFN: plain statutory text requires employer to pay the negotiated rate or the lesser of actual charge or fee-schedule, so employer owes only the amount actually paid under a negotiated rate—even if negotiated by a third party	Court: Affirmed Commission — employer liable for negotiated/paid amount ($17,857.96); statute unambiguous and does not limit who may negotiate the rate

Cassens Transport Co. v. Illinois Industrial Comm’n, 218 Ill. 2d 519 (statutory construction of Workers’ Compensation Act reviewed de novo)
Tower Automotive v. Illinois Workers’ Compensation Comm’n, 407 Ill. App. 3d 427 (an employer satisfies section 8(a) by paying the amount actually paid to providers under a negotiated agreement)