Resource Guide

Introduction

Part 1: The Workers' Compensation Process

Part 2: Special Issues In Workers' Compensation

AFTER THE HEARING - DECISIONS, PAYMENTS AND APPEALS

After each hearing the Workers' Compensation Board sends out a Notice of Decision. You can expect to receive your decision within two weeks of your hearing date. The decision should set forth all findings made at your hearing, including a direction to the insurance company to pay benefits. Although the insurance company had a lawyer present at the hearing, they are not required to pay benefits until they receive the Notice of Decision. It is the Notice that tells them what they need to do with regard to your benefits.

When will I receive my check?

In most situations, the insurance carrier has 10 days from the date of the Notice of Decision to make the required payment. Keep in mind that the hearing date is not the same date as the date of the Notice of Decision. Check the date on your Notice of Decision to determine if you have been paid on time. If the decision awards on-going payments you should receive a check every two weeks. If you do not receive a payment, or if a payment is late, you may be entitled to a penalty.

What should I do if my check is late, or doesn't arrive at all?

You should contact our office and let us know if you are not paid, or paid late. This information can be left with a secretary. If you think your check is late, you should keep the envelope the check came in, and make a copy of the check before you cash it. Otherwise, we cannot prove a late payment. Once we receive your message regarding a late, or non-payment, we will review your file and contact the insurance company. If we can verify a late payment, we will request a hearing to correct the error and if appropriate, ask for a penalty.

Reasons for late payment or non-payment

Sometimes the insurance carriers forget to make a payment due to an oversight or error. When this happens, we can generally take care of the problem with a phone call. If a phone call doesn't work, we need to request a hearing. However, you should also be aware that the insurance company might deliberately withhold payment because they plan to appeal the Notice of Decision.

Appeals

Any of the parties to a Workers' Compensation claim can file an appeal of the judge's Notice of Decision. An appeal must be made within 30 days of the date the decision was filed. If the insurance company objects to the judge's decision regarding your payments, they do not have to pay you while the appeal is pending. Please note that when an insurance company files an appeal, we have 30 days following the receipt of that appeal to submit a rebuttal. Three commissioners of the Workers' Compensation Review Board decide appeals. The law does not require that appeals be decided within any specified period of time. We often wait six months to over one year for decisions from the Review Board. Please keep in mind that this office does not receive any information as to when an appeal will be decided. We receive our notice from the Review Board on the same day you do. Additional appeals are possible, and will be pursued depending on individual circumstances.