When the state agency decides on the outcome of a workers' compensation dispute, it's possible for any party involved in the case to appeal the decision, including claimants, employers, physicians, or anyone else affected by the decision. The party filing the claim has the burden of proof when appealing the decision. If you are considering filing an appeal, consider hiring a workers' compensation attorney because the process can be challenging and overwhelming.
Appealing a Decision
There are many reasons why you might need to appeal your claim. For example, a workers' compensation insurance provider might argue that you were not injured at work, and you may wish to appeal the decision.
The Decision of the State Agency and the Board
The state agency responsible for handling workers' compensation claims receives the appeal and assigns it a "docket number." The number allows you to identify the particular claim to reference it more easily.
The agency makes a decision regarding the claim and then sends the claimant an official response. They can choose to reverse the decision themselves. They'll send the claim record to the board if they do not reverse the decision.
The board must determine whether the claimant filed the appeal on time and whether it is legally appropriate to grant the request. They must also decide whether they have the proper jurisdiction to appeal that claim.
The Mediation Conference
An important step when granting an appeal is the mediation conference, often held over the telephone or through teleconferencing software. A workers' compensation attorney can help you through this process so you can have the best possible outcome. If the mediation conference cannot resolve the problem, the next step is for you to have a hearing.
The Scheduling Conference
You must attend the scheduling conference, and the board hearing judge will set a litigation schedule. During the scheduling, the judge will set several dates and milestones. You must meet these scheduled milestones for your claim to be approved. For example, you must participate in the discovery process and assemble any witnesses who will participate in your hearing.
The Hearing
The hearing can be the most challenging part of the process because it is similar to having a trial. Each party, or the representative of the party, will present evidence. Each party is expected to follow specific evidence and court procedure rules.
The burden of proof rests on you to prove that the original decision was incorrect. The judge must be neutral throughout the process and will review all evidence and issue an order that includes the findings of fact and conclusions of the law. If you disagree with the decision, you can further appeal through a petition for review.
Contact a workers' compensation lawyer to learn more.
Share20 March 2023
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