After being injured on the job, the last thing on most people’s minds is fighting with an insurance company. Although the process varies by state, the reality is that most worker’s compensation claims, especially those pertaining to serious incidents, are not going to be quick or straightforward. At least to some degree, the claim will be adversarial and likely involve a formal hearing. Thus, while the worker’s compensation process can be a daunting one, understanding how the basics can help make an already unnerving situation less stressful.
1) Filing a Claim
Generally, the first step in a worker’s compensation hearing is to file a claim. If an injury is minor, this may be the first and only step the injured employee needs to take. The insurance company may simply agree to pay for some doctor’s visits, and if applicable, lost wages.
After a claim is filed, and it becomes clear there will likely be a dispute, it is not uncommon for an employee to be deposed.
2) Disputing a Decision or Claim
However, and more commonly, a dispute arises as to the severity of an injury or as to whether the payment of compensation was required. Although usually initiated by the employee or their surviving spouse or family, occasionally a state’s worker’s compensation board will initiate the process.
If a dispute does occur, the parties will likely be required to meet at some mandatory settlement conference or pre-trial hearing. Here, the issues will be argued over, articulated, and ultimately laid out. It is also possible at this stage that the insurance company will agree to simply make some payments, possibly ending the need to dispute the claim any further.
If a settlement is reached, it will likely either be in the form a lump sum or a bi-weekly payout. Which settlement is best an employee agrees to largely on the laws of the state and whether or not the employee will continue working.
If a settlement cannot be reached, a hearing will be scheduled. A hearing is typically what most people would think of as a trial. However, there are many unique characteristics to a worker’s compensation hearing that are not found in a traditional trial, such as:
- Rules of evidence are relaxed
- Both sides argue only to a judge and not a jury
- Trial will not necessarily continue the next day, but potentially months down the line
Who Will Be Present at a Worker’s Compensation Hearing?
As mentioned above, the audience is typically limited to the attorneys for either side, the administrative law judge, and the injured employee. In some instances, a court reporter will be there to document the proceedings, however, it is becoming more common for transcription to be done electronically.
If witnesses are going to be called, such as doctors, experts, or other medical professionals, they will be in the room as well. Occasionally, family members will be allowed to attend the hearing.
Should I Hire a Lawyer?
If you have been injured on the job, you should strongly consider hiring a worker’s compensation or employment attorney immediately. While your absolute first priority should be healing, it is important to keep in mind that insurance companies are well represented, and in order to protect your best interests, it will probably be best to hire a professional.