Who Decides My Case
Most clients ask us who decides worker’s compensation cases. Frankly, the answer surprises them.
There is no jury for workers’ compensation matters. Unlike a personal injury case, a criminal matter, or even a small business dispute, there is no entitlement to have your workers’ compensation case decided by a jury of your peers.
The Role of the Administrative Law Judge
Instead, your case is decided by a single person: the Administrative Law Judge assigned to your case. Each District Office has its own resident Administrative Law Judges. The District Offices are located at the following locations: Hartford, Norwich, New Haven, Bridgeport, Waterbury, New Britain, Stamford, and Middletown. These Administrative Law Judges mediate disputed issues and decide the benefits that you will receive in your case.
The reason for this is plain expediency. Workers’ compensation represents a bargain between the employee and the employer. Both have an interest in resolving the workers’ compensation claim as quickly as possible and in the employee returning to work as soon as they can. The result is a trade-off. The employee loses the ability to bring a lawsuit against their employer and to receive compensation for pain and suffering damages. However, the employee gains the ability to receive immediate medical care and treatment. The employee also gains the ability to receive immediate wage replacement benefits. The employee gains these valuable benefits without the employer being able to retaliate against them or bring a lawsuit against the employee to delay the employee’s receipt of these benefits. This is the no-fault system upon which our workers’ compensation laws are based.
Since our workers’ compensation system is a no-fault system, there is no need, or entitlement, to have a jury decide these types of cases. A single Administrative Law Judge, assigned directly to your workers’ compensation case, is perfectly capable of deciding the issues raised by the parties. An Administrative Law Judge is a judicial-like official that presides as an impartial mediator and fact-finder at workers’ compensation hearings. An Administrative Law Judge functions within the workers’ compensation system similarly to how a trial judge functions within the state’s judicial system in civil, family, or criminal matters. By law, an Administrative Law Judge is nominated by the Governor, then formally appointed by the General Assembly, and must have been a lawyer admitted to the Connecticut Bar, in good standing, for at least five years before their nomination to the office.
Most workers’ compensation cases resolve without the need for a hearing before an Administrative Law Judge. Most employees with workplace injuries or illnesses have undisputed cases in which their medical treatment and wage replacement benefits will proceed smoothly and without delay. However, for those cases in which there is a difference of opinion or in which the employer contests the employee’s claim, the Workers’ Compensation Act provides for several levels of hearings in which disputes can be resolved.
When a case is disputed, the dispute will be addressed by the Administrative Law Judge in an Informal Hearing. This type of hearing is an informal conference held between the parties and the Law Judge at the District Office. The purpose of an Informal Hearing, which usually lasts no more than fifteen minutes, is to try to mediate the parties’ dispute. As a claimant, you have the absolute right to attend any Informal Hearing. There is no formal record, or transcript, from an Informal Hearing, and the Administrative Law Judge will end the hearing by making informal recommendations to the parties as to how to resolve the dispute. If the parties cannot reach an agreement, either side may claim the matter for a Formal Hearing.
In very few cases, usually involving very complex issues, the disputes require Formal Hearings for resolution. Unlike an Informal Hearing, a Formal Hearing is a formal legal proceeding presided over by the Administrative Law Judge. There is no set time limit. Formal Hearings can require several hours of time, and they can continue for several hearing dates until the evidence is complete. Either side can request a Formal Hearing. Every claimant is recommended to have legal counsel represent them at this hearing.
At the Formal Hearing, which is like a court trial, evidence is submitted through witnesses and exhibits. Testimony is under oath, and a transcript record is made of the testimony. After the hearing, the Administrative Law Judge issues a written decision in which they make a “Finding and Award” (in favor of the employee) or a “Finding and Dismissal” (in favor of the employer). The written decision is binding on both parties unless someone files for an appeal to the Compensation Review Board within twenty (20) days of the date of the written decision.
Decisions from Formal Hearings can be appealed to the Compensation Review Board. The Board is a panel of two Administrative Law Judges. The Board does not re-try the case. Instead, it decides issues of law based on the record from the Formal Hearing. The Board may affirm, modify, or reverse the prior Administrative Law Judge’s decision. In very rare cases, appeals can be taken from the Compensation Review Board to the state’s Appellate Court (and to the Connecticut Supreme Court if necessary).
If disputes arise over your workers’ compensation case, you should retain legal counsel to represent your interests. Contact us right away.