Hearing and Appeals
For cases where there is a difference of opinion between the parties, our workers’ compensation law provides for several levels of administrative hearings to resolve disputes.
The first level of hearing is referred to as an Informal Hearing. An Informal Hearing is a conference held at a District Office before an Administrative Law Judge. The purpose of this conference is for the parties to negotiate and resolve their disputes in workers’ compensation cases or for the Administrative Law Judge to make recommendations to the parties as to how to resolve their disputes. These conferences, which are not recorded, typically last fifteen minutes. The Administrative Law Judge does not “represent” either party but instead serves as an independent mediator.
Either you or your employer can request an Informal Hearing. The Administrative Law Judge will expect that you communicated with the other side ahead of the Informal Hearing and that you made an effort to solve your dispute prior to filing the hearing request.
You should attend all Informal Hearings held in your case. As the claimant, you have the absolute right to attend any hearing involving your own case, even when you are represented by legal counsel. We always make sure that our clients attend their case hearings. No one knows more about your own case than you. Claimants can attend alone, can bring an interpreter (if needed), and can be represented by an attorney or other representative. You should expect that your employer will attend the hearing. Most of our clients’ employers are represented by either their insurance carrier representative or their attorney at the Informal Hearing.
The Informal Hearing is truly informal in nature. The Administrative Law Judge will encourage the parties to reach an agreement, and then they may offer recommendations to assist the parties. If the parties reach an agreement, the Administrative Law Judge will enter an award that is binding based upon the terms of the agreement.
If an agreement cannot be reached after the first Informal Hearing, the Administrative Law Judge may schedule a further hearing to facilitate more discussion or the exchange of evidence between the parties. In cases where the parties have a difference in opinion and cannot reach an agreement, the case may move on to a Formal Hearing.
If the Judge determines that a Formal Hearing is necessary because the parties cannot resolve their dispute, a Pre-Formal Hearing may be held prior to the Formal Hearing. The purpose of the Pre-Formal Hearing is to prepare the case for trial at the Formal Hearing. The Administrative Law Judge will try to clarify the issues in dispute. After the Pre-Formal Hearing is concluded, the parties should know what will be expected at the Formal Hearing.
The Formal Hearing is the trial of your workers’ compensation case. The Administrative Law Judge serves as both the judge and jury. A Formal Hearing is a full legal proceeding. It can last several hours, and it may involve more than one session of evidence.
The Formal Hearings are not scheduled unless the parties have failed to resolve their differences at one, or more, Informal Hearings. You and your employer, as well as both of your legal representatives, must attend the Formal Hearing. Although you can represent yourself, we strongly discourage you from doing this. Your employer will be represented by a lawyer who will know the law, as well as the in’s and out’s of the hearing procedure. You would be at a disadvantage in trying to represent yourself.
In Formal Hearings, which are like court trials, witnesses can testify under oath, exhibits are submitted for evidence, and a stenographic record of the hearing is recorded. Following the hearing, the Administrative Law Judge reviews the evidence, including the testimony and exhibits submitted, and issues a formal written decision – either a “Finding and Award,” or a “Finding and Dismissal.” In their written decision, the Administrative Law Judge decides on fact-finding and renders conclusions of law. The written decision is binding upon both parties, unless either party takes an appeal to the Compensation Review Board (known as the CRB).
A very small number of cases are appealed each year to the CRB, which is made up of a panel of two Administrative Law Judges and the Workers’ Compensation Commission Chairman. The CRB does not try the case again on appeal. Instead, it determines if the Administrative Law Judge applied the correct principles of law in their decision. The CRB is unlikely to overturn a decision based on the submitted evidence at the Formal Hearing.
Help With a Hearing
If you have a workers’ compensation case that has been scheduled for a hearing to resolve an issue in dispute, you should not go it alone. Contact our legal counsel to obtain legal advice and representation. We are here to help.