Not all workers’ compensation claims are settled immediately. Though the statistics aren’t clear, it’s estimated that around 47% of claims initially get denied. Sometimes, they’re denied for the most mundane reasons, like missed deadlines or clerical errors.
When a claim is denied by the insurer, the injured worker can file an appeal. This usually leads to a workers comp hearing and a judge weighing the facts of the case. Depending on the evidence presented, they can approve or deny your claim.
But, as you may well know, the workers comp process can take a long time. And if you’re an injured worker who can’t go to work, time is something you don’t have. Bills and landlords don’t wait for workers comp settlements.
So if you’re currently in the middle of a workers comp court battle, you’re probably wondering how soon the workers comp judge’s decision will come out.
To answer that, you first need to understand the workers comp process and the role of the judge’s decision in your workers comp case.
How Important is a Workers Comp Judge’s Decision?
A workers comp judge’s decision has far reaching consequences than you might imagine.
Contrary to popular belief, it doesn’t just affect your workers comp benefits. If your case involves a civil or ciminal liability, the workers comp judge’s decision may influence the outcome of those cases too.
In addition, the decision of a workers comp judge is final in most cases. Meaning, you can’t file any more appeal if they denied your claim.
With these, we cannot stress enough the importance of a favorable workers comp decision. To make sure the judge decides in your favor, you should come to the hearing fully prepared. Hiring an experienced workers comp lawyer like Victor Malca will also increase your odds of winning your case. He’s been defending the rights of injured workers for almost three decades. He can help you get the benefits you deserve too.
How Long Do Most Workers Comp Cases Take?
How long it takes for a workers comp claim to get settled depends mostly on the circumstances of each individual case. If the claim is approved at the initial stage, you should get your check within a few weeks. But if you have to go through a court hearing, it can take anywhere from 3 months to 2 years. Some cases may even take longer.
So if you’re wondering when you can expect a workers comp decision, you need to consider the facts of your case first.
In general, work injury claims that are “indisputable” tend to get approved faster. This usually means:
- you have workers comp coverage
- you reported your injury within the timeframe prescribed by the law
- your medical records support your injury claim
- there are witnesses to the accident who can prove that it happened while you’re at work
If you can’t produce evidence to prove the above, your claim can turn into a long drawn-out court battle between you and your insurance provider. In cases like this, the workers comp judge may take months or years to come up with a decision.
The Workers Comp Claims Process
To understand why some workers comp cases take years while others only weeks, you need to understand the workers comp claims process.
Though workers comp laws vary across states, most workers comp claims process starts with an injury report. In Florida, you only have 30 days to report your injury to your employer. They, in turn, have to inform your insurance provider within 7 days.
After receiving a report of your injury, your insurance carrier will evaluate your claim. This usually involves validating the evidence submitted. They may also conduct their own investigation. Depending on their evaluation, they may approve or deny your claim.
If your claim is denied, you can file an appeal with your state’s workers compensation board. After this, a mediation hearing will be conducted.
During the mediation, you and your employer together with your counsels will sit down and try to reach a settlement. A third-party mediator will also be present to arbitrate. If a settlement isn’t reached during the mediation, the case will have to be settled in court.
At the workers comp hearing, you’ll have to present your case before a judge. This is your last chance of convincing the judge why you deserve those benefits. If you have a workers comp lawyer, they can help you throughout the entire process.
When Should You Expect a Notice of Decision?
One thing you need to remember is that the judge won’t make a decision at the final day of your workers comp hearing. It will take some time for them to formulate and write their decision.
In most cases, it takes around 30 to 90 days after the last day of hearing to receive a notice of decision. It will be sent by mail to your registered mailing address. Your insurance provider and workers compensation lawyer will each receive a copy of the decision too.
Can You Appeal a Judge’s Decision?
As mentioned, the decision of a workers comp judge is final in most cases. But if you think the judge made an error, you can still appeal their decision.
The appeals process varies by state but in general, you’ll need to file a Notice of Appeal in your state’s appellate court and pay the necessary filing fees. The court will then review your appeal and the workers comp trial to see if the judge did indeed make a mistake.
Remember, however, that appealing a workers comp judge’s decision won’t be easy. The appeals hearing is not a review of the facts of your case. Rather, the appeals board will review the record of the trial to see if the judge misapplied the law or made mistakes in the procedure. As such, you must have indisputable proof that the judge really erred to win the appeal.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.