How to Fill Out Illinois IWCC Form 45 (w/Examples) + FAQs

Illinois IWCC Form 45 is the Petition for an Immediate Hearing Under Section 19(b-1) that an injured worker (or their attorney) files with the Illinois Workers’ Compensation Commission to force a fast hearing when temporary total disability (TTD) benefits have been cut off, lowered, or never started. The form is a statutory tool created by 820 ILCS 305/19(b-1) and is used when a worker’s bills are stacking up and the employer or insurer refuses to pay weekly checks.

Filing Form 45 starts a 15-day clock for the employer to respond and a 30-day clock for the arbitrator to hold an emergency hearing under the rules at IWCC Rule 9020.20. Filers who get the form wrong lose their expedited status, fall back into the regular trial queue, and can wait many additional months for benefits to resume.

Roughly 30,000 new workers’ compensation claims are filed in Illinois each year, but only a small fraction qualify for the Section 19(b-1) emergency track that Form 45 unlocks, which makes precision on this form especially important.

• 📝 How to fill out every field, box, and signature line on Form 45 without triggering a rejection
• ⚖️ The exact statutory grounds under Section 19(b-1) you must check, and what each means in plain English
• 📅 Filing deadlines, response windows, and the 30-day emergency hearing rule
• 📂 The medical records, wage records, and off-work slips you must attach
• 🚫 The most common mistakes filers make on Form 45 and how each one delays your benefits

What the Form Is and Who Must File It

Illinois IWCC Form 45 is the official petition that triggers the emergency hearing track inside the Illinois Workers’ Compensation Commission. It is not used for a regular trial; it is used only when a worker meets the strict statutory grounds in Section 19(b-1) of the Illinois Workers’ Compensation Act. Those grounds focus on stopped or reduced TTD benefits, denied medical care, or a dispute that is keeping a worker from getting paid while still off work due to a job injury.

The agency that receives and processes Form 45 is the Illinois Workers’ Compensation Commission, often shortened to IWCC. Once filed, the form is assigned to the arbitrator already handling the case, or to a new arbitrator if no underlying Application for Adjustment of Claim (Form IC1) has been filed yet. The arbitrator then sets the matter for an emergency hearing within 30 days unless the parties agree otherwise.

The people who must file Form 45 are injured workers whose TTD checks have stopped, who have been denied prescribed medical treatment, or whose employer has simply refused to start paying after a clear work injury. Attorneys file the form on behalf of most claimants, but pro se (self-represented) workers can file it too. Employers and insurers do not file Form 45; they only respond to it. The form’s revision date is printed in the lower corner of the official PDF, and you should always pull a fresh copy from the IWCC website right before filing because the agency updates wording without much public notice.

A misconception worth correcting up front is that Form 45 is a substitute for the Application for Adjustment of Claim. It is not. You still need a pending Form IC1 Application on file, or you must file one at the same time, because Form 45 only accelerates an existing claim; it does not start one.

Before You Start: Documents and Information You Need

Form 45 is short, but the proof you must bring with it is not. Gather everything below before you open the PDF, because missing attachments are the single biggest reason arbitrators kick a 19(b-1) petition off the emergency calendar. The IWCC expects a clean, complete package on day one, and arbitrators have wide discretion to deny expedited treatment when key documents are missing.

• Your IWCC case number. This is the number assigned to your underlying Application for Adjustment of Claim. Without it, the clerk cannot match your petition to your file, and your form may sit unprocessed for weeks.
• The employer’s full legal name and address. Use the name printed on your W-2 or paystub, not a trade name. A wrong employer name can void service and reset your hearing date.
• The insurance carrier or third-party administrator (TPA) name and address. This is on the denial letter or the NCCI proof of coverage database. Without it, service of the petition fails.
• Date of accident and a one-sentence description of the injury. The arbitrator uses this to confirm the case fits Section 19(b-1) grounds.
• Average Weekly Wage (AWW) calculation. Pull 52 weeks of paystubs or a wage statement from the employer. AWW drives the TTD rate, and a wrong number gets challenged on the spot.
• All medical records and off-work slips. The arbitrator needs proof you are still authorized off work or that treatment was denied.
• The denial letter, TTD termination letter, or last check stub. This proves the employer stopped paying and anchors your Section 19(b-1) grounds.
• Proof of service. A signed certificate showing you mailed or delivered a copy of Form 45 to the employer’s attorney or insurer on the same day you filed.
• Photo ID and contact information. The arbitrator’s office uses this to schedule the emergency hearing and reach you quickly.
• Any prior IWCC orders in the case. If an arbitrator has already ruled on TTD, bring that order so the new petition lines up with the existing record.

A quick note on the wage records: the AWW rule under Section 10 of the Act requires a 52-week look-back, and many filers shortcut this with a single paystub. That shortcut is the most common reason the employer’s lawyer kills the emergency hearing on day one. Do the full calculation before you file.

Where to Get the Form and How to Access It

The only authoritative copy of Form 45 lives on the IWCC forms page. Download the PDF directly from that page rather than relying on a third-party legal blog, because the IWCC updates its forms without versioned URLs and an old copy can mean rejected fields. The current PDF is fillable in Adobe Acrobat Reader, which is free, and you can also print and complete it by hand in black ink.

You can also pick up a paper copy at any IWCC regional office. The main office is at 100 W. Randolph Street, Suite 8-200, Chicago, IL 60601, and downstate offices are in Springfield, Peoria, Rockford, Collinsville, and other regional venues. Each office keeps Form 45 in a public lobby rack, and the clerks will hand you a clean copy if you ask.

Attorneys filing on behalf of clients usually use the IWCC e-filing portal when available, but Form 45 is most often filed in paper because it must be served on the employer the same day, and a wet-ink certificate of service is the cleanest proof. The IWCC accepts typed entries, handwritten entries in black ink, and electronic signatures that comply with the Illinois Uniform Electronic Transactions Act. Pencil entries are not accepted.

A misconception filers carry is that they can scan and email the form to the arbitrator and call it filed. They cannot. Filing means the form lands in the IWCC’s case file with a date stamp, and emailing the arbitrator without filing through the clerk’s office leaves you with no record. Always file with the clerk first and then notify the arbitrator’s secretary.

Step-by-Step: How to Fill Out Form 45 Line by Line

The fields below appear in the order they show on the official Form 45 PDF. Use the exact labels printed on the form and follow the formatting rules for each box. Sample entries are shown in italics so you can tell them apart from instructions.

Caption: Case Number

The caption at the top of Form 45 asks for the IWCC case number assigned to your underlying claim. The case number looks like a year followed by the letters WC and a sequence number, such as 25 WC 012345.

To answer, copy the case number exactly as printed on your Application for Adjustment of Claim or any prior IWCC order. Use the year, the WC prefix, and the full sequence number with no extra spaces.

A specific example: Maria Lopez writes 25 WC 018742 in the case number box because that is the number printed on her stamped Application for Adjustment of Claim.

A nuance: if you have not filed an Application yet, leave this box blank and file Form IC1 the same day, then write To Be Assigned in pencil so the clerk can fill it in once the new case number is generated.

A common mistake on this field is writing only the sequence number without the WC prefix or the year, which makes the clerk unable to match the petition to your case file and can delay assignment by a week or more.

A misconception about this field is that any number from a prior IWCC matter will work. It will not; each injury gets its own case number, and using an old one routes your petition to the wrong file.

Petitioner’s Name

This field asks for the legal name of the injured worker bringing the petition. Plain English: who got hurt and is asking for a fast hearing.

To answer, write your full legal name as it appears on your Social Security card, last name first if the form’s layout requires it. Use no nicknames and no initials in place of full names.

A specific example: Carlos Mendez Rivera writes Mendez Rivera, Carlos in the petitioner’s name field, matching his Social Security card.

A nuance: if you have legally changed your name since the date of accident, list the current legal name and add a parenthetical with the prior name, such as Smith, Jane (formerly Jane Doe), so the arbitrator can reconcile prior medical records.

A common mistake on this field is using a nickname like Tony instead of Anthony, which can break the chain of identity between the petition, the medical records, and the wage records, and the employer’s attorney will use that gap to challenge your AWW.

A misconception about this field is that married names automatically replace maiden names in IWCC records. They do not; the IWCC uses the name on the original Application, so any later change must be flagged on Form 45.

Respondent’s Name

The respondent is the employer at the time of the work accident. Plain English: the company that was paying you when you got hurt.

To answer, write the employer’s full legal name as it appears on your W-2 or paystub. Avoid trade names, doing-business-as names, or holding company names unless they are the legal entity.

A specific example: Aisha Brown writes ABC Logistics, LLC because that is the legal entity printed on her W-2, even though the trucks say “ABC Express.”

A nuance: if your employer is a staffing agency that placed you at a host site, the staffing agency is the respondent, but you may also need to add the host employer as a co-respondent under the borrowed-employee doctrine.

A common mistake is naming the trade name instead of the legal entity, which results in a service failure when the petition is mailed and forces you to amend and re-serve.

A misconception is that the parent corporation is the right respondent. It usually is not; only the legal entity that issued your paycheck and carries the workers’ compensation policy belongs in this box.

Date of Accident

This field asks for the calendar date of the work injury. Plain English: the day you got hurt on the job.

To answer, write the date in MM/DD/YYYY format. If the injury is a repetitive trauma claim with no single accident date, use the manifestation date, which is the day the worker first knew or should have known the condition was work-related.

A specific example: Janet Park writes 03/14/2025 because that is the day her foreman sent her to the ER after she felt her shoulder pop.

A nuance: for occupational disease cases under the Occupational Diseases Act, use the date of last exposure rather than the manifestation date.

A common mistake is using the date the worker first saw a doctor, which can be days or weeks after the actual accident and may push the claim outside the three-year statute of limitations under Section 6(d).

A misconception is that the date on the employer’s incident report controls. It does not; the IWCC uses the petitioner’s sworn date, and the incident report is just one piece of evidence.

Description of Accident and Injury

This field asks for a one- or two-sentence description of how the accident happened and what body part was hurt. Plain English: what you were doing and what got hurt.

To answer, write a short, factual sentence that names the activity, the mechanism of injury, and the body part. Skip legal conclusions and emotional language.

A specific example: Marcus Johnson writes Lifting a 75-pound box of tile onto a forklift, felt sudden pain in lower back; injury to lumbar spine.

A nuance: if multiple body parts are involved, list each one separated by commas, because the arbitrator’s order will track each body part separately and unlisted parts may be excluded from the TTD award.

A common mistake is using vague phrases like hurt at work or back problems, which give the employer’s lawyer room to argue the claim is undefined and unripe for emergency hearing.

A misconception is that this box must match the medical records word-for-word. It does not; it must be consistent with the records, but the field is your sworn statement, not a copy of a chart note.

Statutory Grounds Checkboxes — Section 19(b-1)

This is the heart of Form 45. The form lists the specific statutory grounds under 820 ILCS 305/19(b-1), and you must check at least one. Plain English: tell the arbitrator why you qualify for an emergency hearing.

To answer, check every box that applies, not just one. The grounds typically include that the employer has refused to pay TTD, has terminated TTD, has refused to authorize medical care that has been prescribed, or has refused to pay for medical services already rendered.

A specific example: Maria Lopez checks the box for “Respondent has terminated temporary total disability benefits” and the box for “Respondent has refused to authorize prescribed medical treatment” because both are true in her case.

A nuance: if the employer has reduced rather than fully terminated TTD, check the termination box and add a brief written explanation in the margin or attach a one-page rider, because partial reductions are still “terminations” under the case law interpreting Section 19(b-1).

A common mistake on this field is checking only one box when several apply, which limits the scope of the emergency hearing and can force the worker to file a second petition for the unchecked grounds.

A misconception is that pain and suffering qualify as a Section 19(b-1) ground. They do not; the statute is limited to TTD and medical disputes, and emotional distress is not a ground for emergency relief.

Average Weekly Wage (AWW)

This field asks for the worker’s AWW under Section 10 of the Act. Plain English: how much you earned per week, on average, in the year before the injury.

To answer, total your gross earnings for the 52 weeks before the date of accident, divide by 52, and write the result rounded to the nearest cent. Include overtime that was mandatory and regular, but exclude bonuses and tips that are not part of the wage agreement.

A specific example: Carlos Mendez Rivera writes $1,142.31 because his 52-week gross was $59,400.12, divided by 52.

A nuance: if you worked fewer than 52 weeks, divide your total earnings by the number of weeks actually worked, and if your hours were irregular, use a similar-employee comparison under Section 10.

A common mistake is using gross earnings from one paystub, which inflates or deflates the AWW and gives the employer’s attorney an easy win at the emergency hearing.

A misconception is that AWW is the same as the TTD rate. It is not; the TTD rate is two-thirds of AWW, subject to statutory minimums and maximums published by the IWCC each year.

Compensation Rate Sought

This field asks for the weekly TTD rate the petitioner is asking the arbitrator to order. Plain English: how much per week you want the employer to pay.

To answer, multiply the AWW by 0.6667 and round to the nearest cent, then check that the result falls within the statutory minimum and maximum for the date of accident on the IWCC’s TTD rate chart.

A specific example: Janet Park writes $761.54 because her AWW of $1,142.31 times two-thirds equals $761.54, which is below the maximum.

A nuance: if the AWW is so low that two-thirds falls below the statutory minimum, write the statutory minimum in this box and attach the rate chart for the relevant year as proof.

A common mistake is multiplying by 0.66 instead of 0.6667, which shorts the worker by a few dollars per week and signals to the arbitrator that the petition was prepared sloppily.

A misconception is that the TTD rate is taxable. It is not; TTD benefits are tax-free under federal and Illinois law, which is one reason the rate is set at two-thirds rather than full wages.

Period of TTD Owed

This field asks for the date range during which TTD was owed but not paid. Plain English: the weeks the employer skipped.

To answer, list the start date as the day after the last TTD check covered, and the end date as the present (or the date the worker returned to work). Use MM/DD/YYYY format for both dates.

A specific example: Aisha Brown writes 02/01/2026 to present because her last check covered through 01/31/2026 and she is still off work.

A nuance: if there were multiple gaps, list each gap separately on a one-page rider, because the arbitrator’s order will track each gap as a separate period of liability.

A common mistake is overlapping the dates with periods already paid, which gives the employer’s attorney an easy argument that the petition is inflated and unreliable.

A misconception is that the period must end on the hearing date. It does not; TTD continues until the worker reaches maximum medical improvement, and the period in this box can be open-ended.

Verification and Signature

This field is the petitioner’s sworn signature verifying that the contents of the form are true. Plain English: you swear under oath that the form is accurate.

To answer, sign your full legal name in black ink, print your name beneath the signature, and date the form in MM/DD/YYYY format. The signature must be the petitioner’s own; an attorney’s signature is not a substitute except where specifically allowed.

A specific example: Marcus Johnson signs Marcus T. Johnson, prints Marcus T. Johnson, and dates 05/15/2026.

A nuance: if the petitioner is illiterate or unable to write, an X mark witnessed by two adults is acceptable, but the witnesses must sign and print their names beside the mark.

A common mistake is forgetting to date the signature, which can make the form unverifiable and force re-signing in front of the clerk.

A misconception is that the signature must be notarized. It does not have to be notarized for Form 45; the verification language built into the form serves the same function under 735 ILCS 5/1-109.

Proof of Service

This block at the bottom of the form is where the petitioner certifies that a copy of Form 45 was served on the respondent or its attorney. Plain English: you tell the IWCC that you mailed or handed a copy to the other side.

To answer, list the name and address of the person served, the date served, and the method (U.S. Mail, hand delivery, or email if the respondent has agreed to email service), and sign the certificate.

A specific example: Maria Lopez writes Served on John Smith, Esq., 200 N. LaSalle, Chicago, IL 60601, by U.S. Mail on 05/15/2026, and signs.

A nuance: if the respondent has counsel of record in the underlying case, you must serve counsel and not the company directly, because service on the wrong person voids the 15-day response clock.

A common mistake is dating the proof of service before the date of filing, which is impossible and gets the petition rejected by the clerk.

A misconception is that mailing alone is enough. It is not; the proof of service block must be filled out and signed, or the IWCC treats the petition as un-served.

Three Filled-Out Examples Using Real Scenarios

These three named scenarios show how different injured workers complete Form 45. Each is a 2-column walk-through of the major fields.

Scenario 1 — Maria Lopez, construction worker with a back injury whose TTD was cut off

Form Section	What Maria Enters
Case Number	25 WC 018742
Petitioner’s Name	Lopez, Maria
Respondent’s Name	Skyline Builders, Inc.
Date of Accident	11/04/2025
Description of Accident	Lifting rebar bundle, felt sharp lumbar pain; injury to lumbar spine
Statutory Grounds	Boxes checked: TTD terminated; medical care denied
AWW	$1,420.00
TTD Rate Sought	$946.74
Period of TTD Owed	03/01/2026 to present
Verification Signature	Maria Lopez, 05/12/2026

Scenario 2 — Marcus Johnson, warehouse worker denied benefits after an MRI dispute

Form Section	What Marcus Enters
Case Number	26 WC 002311
Petitioner’s Name	Johnson, Marcus T.
Respondent’s Name	Midwest Distribution, LLC
Date of Accident	01/22/2026
Description of Accident	Pushing 800-pound pallet, felt right shoulder tear; injury to right shoulder
Statutory Grounds	Boxes checked: TTD never paid; MRI authorization denied
AWW	$985.50
TTD Rate Sought	$657.00
Period of TTD Owed	01/29/2026 to present
Verification Signature	Marcus T. Johnson, 05/14/2026

Scenario 3 — Aisha Brown, nursing home aide whose employer disputes causation

Form Section	What Aisha Enters
Case Number	25 WC 027418
Petitioner’s Name	Brown, Aisha R.
Respondent’s Name	Sunrise Care Center, Inc.
Date of Accident	09/18/2025
Description of Accident	Catching falling resident, felt cervical pop; injury to cervical spine and right wrist
Statutory Grounds	Boxes checked: TTD terminated; treatment denied; disputed causation
AWW	$762.40
TTD Rate Sought	$508.27
Period of TTD Owed	02/15/2026 to present
Verification Signature	Aisha R. Brown, 05/16/2026

How to File the Completed Form

Form 45 can be filed in person, by U.S. Mail, or, in limited circumstances, electronically. Each channel has its own quirks, and choosing the right one depends on how fast you need the emergency hearing on the calendar. The fastest channel is in-person filing because it produces a same-day stamp from the clerk.

In person. Bring two copies of the completed Form 45 plus all attachments to the IWCC Chicago office at 100 W. Randolph, Suite 8-200, Chicago, IL 60601, or to any regional office. The clerk stamps both copies, keeps one, and returns one to you as your file-stamped receipt. There is no filing fee. Accepted payment methods are not applicable because no fee is owed. Processing time is same-day, and the proof of filing is your stamped copy.

By U.S. Mail. Mail two copies of Form 45 with a self-addressed stamped envelope to the same Chicago address or the regional office handling the case. There is no fee, and no payment is needed. Processing time is typically 5 to 10 business days from the postmark, and the proof of filing is the stamped copy returned to you in your envelope.

By the IWCC e-filing portal. When available through the IWCC website, licensed attorneys can upload Form 45 with the underlying case file. There is no fee. Processing is typically next business day, and the proof of filing is the system-generated confirmation email plus the electronic file-stamp on the PDF.

Whichever channel you use, you must serve a copy on the respondent (or its attorney) the same day, because the 15-day response clock starts running on the date of service, not the date of filing. Keep the post office certified-mail receipt or the hand-delivery acknowledgment with your case file.

A misconception is that filing Form 45 stops the underlying claim from moving forward. It does not; the underlying Application for Adjustment of Claim continues on its regular track, and Form 45 simply pulls one slice of the case onto the emergency calendar.

What Happens After You File

Once Form 45 is filed and served, the respondent has 15 days to file a written response under Rule 9020.20. The response either admits the worker is entitled to TTD and starts paying, or contests the petition and lays out the employer’s defenses. A non-response is treated as an admission for purposes of the emergency hearing, which is a powerful tool for the worker.

The arbitrator then sets the case for hearing within 30 days of the filing date. The hearing is short, focused only on the Section 19(b-1) issues, and uses a relaxed evidence standard so the worker can get a quick decision. Medical records can come in by affidavit under Section 16, and live testimony is usually limited to the worker and one or two witnesses.

The arbitrator issues a written decision, typically within 30 days of the hearing. If the worker wins, the employer must start TTD within 14 days or face penalties under Section 19(k) and attorney fees under Section 16. If the employer loses and refuses to pay, the worker can file a separate petition for penalties.

A misconception is that a Form 45 win ends the case. It does not; the win only addresses the temporary issues, and the parties still have to litigate permanency, medical bills, and any vocational issues at a later trial.

Mistakes to Avoid When Filling Out the Form

These are the errors that most often blow up a Section 19(b-1) petition. Each one has a direct, predictable consequence at the arbitrator’s desk.

• Writing the case number without the WC prefix or the year, which makes the clerk unable to match the petition to the case file.
• Naming the trade name instead of the employer’s legal entity, which breaks service and forces re-filing.
• Using a single paystub to compute AWW, which the employer’s attorney will challenge and which can derail the hearing.
• Multiplying AWW by 0.66 instead of 0.6667, which understates the TTD rate and signals careless preparation.
• Checking only one statutory ground when several apply, which narrows the scope of the emergency hearing.
• Leaving the verification signature undated, which makes the form unverifiable.
• Filing Form 45 without an underlying Application for Adjustment of Claim, which the arbitrator will dismiss for lack of jurisdiction.
• Serving the company directly when counsel has appeared in the case, which voids service and resets the response clock.
• Using vague injury descriptions like hurt at work, which gives the employer room to argue the claim is unripe.
• Forgetting to attach off-work slips and medical records, which can move the case off the emergency calendar.
• Listing overlapping TTD periods that cover weeks already paid, which makes the petition look inflated.
• Mailing the form without certified mail or proof of delivery, which leaves no record of timely service.

Do’s and Don’ts

These rules are the operating instructions every Form 45 filer should keep at the elbow.

• Do download a fresh copy of Form 45 from the IWCC website every time, because forms are quietly updated.
• Do complete a full 52-week AWW calculation under Section 10, because the TTD rate flows directly from it.
• Do check every applicable statutory ground in the 19(b-1) box, because each ground expands the relief available.
• Do serve the respondent the same day you file, because the 15-day response clock starts at service.
• Do keep a stamped copy of the filed petition in your case folder, because the stamp is your evidence of timely filing.
• Do attach all medical records and off-work slips, because the arbitrator may rule on the papers if the employer defaults.
• Don’t use nicknames or trade names anywhere on the form, because identity gaps invite challenges.
• Don’t sign the form in pencil or blue gel ink that the IWCC scanner may misread.
• Don’t mail the form without certified-mail tracking, because lost mail equals no proof of service.
• Don’t wait more than a few weeks after a TTD termination to file, because delay weakens the emergency posture.
• Don’t include emotional language or legal arguments in the description-of-accident box, because that field is for facts only.
• Don’t forget to file a new Application for Adjustment of Claim if you do not already have one on file with the IWCC.

Pros and Cons of Filing on Your Own vs. With Help

Filing Form 45 pro se is allowed, but it is not the same as filing through a workers’ compensation attorney. Each path has trade-offs that show up at the emergency hearing.

Pros of filing pro se

• No attorney fee, which preserves more of any award for the worker.
• Direct control over timing, because no schedule conflicts with counsel.
• Faster initial filing, because there is no intake delay.
• Personal involvement, which keeps the worker informed at every step.
• Useful in clear-cut TTD-stoppage cases where facts and medical records are uncontested.

Cons of filing pro se

• AWW miscalculation risk, because Section 10 is technical.
• Service errors, because the rules on serving counsel-of-record are easy to miss.
• Evidence missteps, because affidavit rules under Section 16 are unforgiving.
• Cross-examination at the hearing, where employer counsel will pressure the worker on every word.
• No leverage in settlement talks, because employers know unrepresented workers usually accept less.

Pros of filing with an attorney

• Proper AWW computation and statutory-ground selection.
• Clean service, with proof that holds up at the hearing.
• Polished evidence presentation under Section 16 affidavit rules.
• Penalty and fee petitions filed alongside Form 45 for added leverage.
• Better settlement outcomes, supported by IWCC fee statutes capping attorney fees at 20 percent.

Cons of filing with an attorney

• Twenty-percent fee on most awards, which reduces the worker’s net recovery.
• Less direct control over timing and strategy.
• Longer intake before the petition is filed.
• Possible conflicts if the attorney already represents the employer’s insurer in other matters.
• Communication delays during busy litigation cycles.

Filing on Paper vs. Online

Channel	What to Expect
Paper, in person	Same-day stamp at the Chicago IWCC office, no fee, immediate proof of filing
Paper, by mail	5-to-10-day processing, no fee, certified-mail receipt as proof
Electronic, e-filing	Next-day processing through the IWCC portal, no fee, system confirmation as proof

FAQs

Is there a filing fee for Form 45?

No. The IWCC does not charge a fee for filing Form 45 or any other workers’ compensation form, because the system is funded by employer assessments and the state.

Can I file Form 45 without an attorney?

Yes. Illinois allows pro se filing, and the IWCC clerk’s office will accept a properly completed form from the injured worker directly with no representation required.

Do I need a pending Application for Adjustment of Claim?

Yes. Form 45 only accelerates an existing claim, so you must file the Form IC1 Application at the same time if you have not already done so.

How fast will the hearing be set?

Yes, fast. Under 820 ILCS 305/19(b-1), the arbitrator must hold the hearing within 30 days of filing unless both parties agree to a different date.

Do I write my maiden name or married name in the petitioner’s name field?

Yes, use your current legal name. Add the prior name in parentheses if it appears on older medical records so the chain of identity stays intact for the arbitrator.

What format do I use in the date-of-accident box?

Yes, use MM/DD/YYYY. The IWCC scanners and e-filing portal both expect this format, and other formats can confuse the case file or trigger a clerical correction.

How many statutory grounds boxes should I check?

Yes, check every box that applies. Multiple grounds expand the scope of the emergency hearing and let the arbitrator order broader relief in a single ruling.

Do I need to notarize Form 45?

No. The verification language under 735 ILCS 5/1-109 substitutes for notarization, and signing under that statute is enough.

Can I file Form 45 by email?

No. Email alone is not a recognized filing channel; use in-person filing, U.S. Mail, or the IWCC e-filing portal for licensed attorneys.

What happens if the employer ignores my Form 45?

Yes, you win by default in most cases. A non-response within 15 days is treated as an admission, and the arbitrator can order TTD on the papers without a contested hearing.

Is the TTD I recover taxable?

No. TTD benefits are tax-free under federal and Illinois law, which is why the rate is set at two-thirds of AWW rather than full wages.

Can I add penalty and fee claims to Form 45?

Yes. You can file companion petitions under Sections 19(k), 19(l), and 16, and most attorneys file all three together to maximize leverage at the hearing.

What if the employer disputes my AWW number?

Yes, expect a fight. Bring 52 weeks of paystubs and a written AWW calculation under Section 10 to defend the figure at the emergency hearing.

Does winning Form 45 end my case?

No. A Form 45 win only addresses temporary issues; permanency, medical bills, and vocational rehabilitation are still litigated at a later full trial before the arbitrator.