Illinois workers compensation: Fill out & sign online

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Click ‘Get Form’ to open the Illinois Workers Compensation form in the editor.
Begin by entering your case number at the top of the form. This is essential for tracking your appeal.
Fill in your name as the Employee/Petitioner and the Employer/Respondent's name in the designated fields.
Indicate the date you received the arbitration decision and when it was filed. This information is crucial for adhering to the 30-day filing requirement.
In section one, check off whether you request a transcript of arbitration hearings and guarantee payment for its preparation.
Proceed to section three, where you will check any issues you take exception to, such as accident details or medical expenses.
Complete your contact information, including your telephone number and address, ensuring all details are accurate.
Finally, sign and date the form. If applicable, ensure that a notary public completes the Proof of Service section.

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