Part 1: The Workers' Compensation Process
- How do I know if I Have a Workers' Compensation Claim?
- How Do I File a Workers' Compensation Claim?
- Is There a Time Limit for Filing My Claim?
- What Benefits Am I Entitled To?
- Independent Medical Examinations
- The Hearing Process
- After the Hearing – Decisions, Payments and Appeals
- Finalization of a Workers' Compensation Claim
- Attorneys' Fees
Part 2: Special Issues In Workers' Compensation
THE HEARING PROCESS
Whenever an injured worker files a claim with the Workers' Compensation Board, a process is set in motion that will eventually result in a Board decision. There are no exceptions to this - once a claim is filed, the Board will have to render at least one formal decision.
Administrative Decisions
In the simplest of cases, the Board may issue a decision without holding any hearings. Such decisions are called "Administrative Decisions." These decisions are usually used when an examiner at the Board thinks that the insurance company has been paying everything that the injured worker is entitled to. However, you should not automatically trust that you are getting all that you deserve if you receive a decision in the mail without having had a hearing. In fact, claimants are often shortchanged in Administrative Decisions. If you receive an Administrative Decision and you are not sure if it is proper, you should call our office and discuss the decision with one of our attorneys. If necessary, we can object to an Administrative Decision (within 30 days of the decision) and request a hearing to protect your rights.
Conciliation Meetings
Conciliation Meetings are scheduled when the Board perceives that the claimant and the insurance company might be able to come to an agreement on the disputed issues. A conciliation is not the same as a hearing. The Conciliator is not a Law Judge, and there is no written record of the proceeding. Conciliators do not have the power to make decisions on their own. If an agreement cannot be reached, the Conciliator will schedule a regular hearing so that a Law Judge can hear your case.
Hearings
In the majority of cases the Workers' Compensation Board schedules hearings. We can request hearings, but we do not have any control over when they will take place. If a hearing is scheduled in your case, you will receive a notice in the mail directing you to appear. Our office receives a copy of the notice on the same day as you. At the hearing you can expect to see a Law Judge, an attorney for the insurance company, a court reporter, and of course, your Lewis & Lewis attorney.
At a hearing, the Law Judge will listen to arguments from both sides, review the evidence in the file and make decisions regarding your claim. There may be several hearings before a claim is finalized. This is particularly true in cases where the insurance company has "controverted" your claim. In controverted cases, the issues are almost never resolved at the first hearing. Further hearings are scheduled so that you can testify about your injury, so that the doctors can testify about their opinions, so that either side can present additional evidence, or for any other reason the Judge deems necessary and proper.
It is important that you attend any Conciliation Meetings or Hearings that are scheduled on your case unless our office specifically tells you not to. If you don't appear for your hearings you may give the Judge the impression that you do not care about your case. It is also important that you are cooperative and respectful at your hearings, particularly with the Judge. Remember: the Judge is going to decide the issues on your case. Although they are supposed to remain impartial, Judges are only human. If you antagonize the judge, or fail to make a good impression, it could easily turn him or her against you. You should also keep in mind that a Workers' Compensation hearing is a formal administrative proceeding. It is in your best interest to dress appropriately.