When your workers’ comp claim is denied, you have the right to take it to court. A court hearing is then scheduled to determine whether or not you should receive workers comp benefits. Workers comp hearings are most likely your only chance of convincing the judge that you deserve those benefits. So it’s crucial that you understand the process and how to prepare for it.
Before that, however, you should know that not all denied workers compensation claims end up in court. Only about 5% of workers comp cases go to trial. Most cases are settled during the mediation and negotiation process. But if your case does end up in court, here’s what you need to know about workers comp hearings:
What Happens Before a Workers Compensation Hearing?
Before you can take your case to court, you need to appeal your denied workers comp claim with your employer first. In most cases, you will have to go through mediation. Some states also require mediation before a workers comp case can be taken to court.
Also known as a settlement conference, mediation is an informal negotiation process where you and your employer or insurance company will negotiate a settlement with the help of a neutral third party. Since it’s informal, you don’t have to testify under oath or present any witnesses. Though you don’t necessarily need to hire a lawyer at this point, having one can boost your chances of getting a favorable settlement.
If you and your employer cannot agree on a settlement, your appeal will proceed to the next stage – typically a formal court hearing.
When a workers comp case is taken to court, a pre-trial hearing is then scheduled. Just like mediation, a pretrial conference is an informal hearing with both parties and the administrative law judge. This is just to clear up any administrative issues that can be handled before the trial such as:
- settling undisputed facts
- filing pretrial motions
- presenting settlement offers
- agreeing to or denying claims and accusations
Doing all of the above during the pretrial hearing also enables all parties to focus on the real legal issues during the final hearing.
If you have a lawyer, you don’t need to attend the pretrial hearing. Though you have to be present during the mediation or settlement negotiation.
What to Expect At Your Workers Comp Hearing
After the pretrial hearing is concluded, the final workers comp hearing will then follow.
Final workers comp hearings are usually held days (or even months) after the pre-trial hearing. They’re formal proceedings where all parties are sworn in and typically last from two to four hours. But in some cases, it can last for days. Your workers’ comp attorney (if you have one) will present evidence supporting your claim. Witnesses will be questioned and the evidence examined.
Your employer or insurance company’s lawyer will also make their argument. Evidence and witnesses disproving your claim will be presented too.
The ruling judge will listen to both sides, inspect the pieces of evidence, and rule any objections.
Here are some of the things you can expect during your workers comp hearings.
Workers comp hearing venues depend on the state. In some states, these are held in circuit courts. But in Florida, the hearing is held in a courtroom of the Office of the Judges of Compensation Claims. They have set up districts all over the state.
In general, however, a workers compensation hearing is conducted in the county that has legal jurisdiction over the place where the accident happened. So if you got injured at work, your workers comp hearing will be in the county where your workplace is located. Your lawyer will also tell you where the hearing will be held.
Aside from your workers’ comp attorney, a legal representative of your employer or insurance company will also be there. Of course, the administrative law judge will be present too. Any witnesses who will prove or refute your claim will be called in to testify too.
What Questions Are Asked at a Workers Compensation Hearing?
Since you are the aggrieved party, you’ll also have to stand as a witness (sometimes the only one) during the hearing. Some of the questions you can expect are:
- General Background Questions. At the start of the hearing, you’ll usually be asked about your name, age, date of birth, address, and marital status among others. You may also be asked about your spouse and children to establish dependency. If you have dependents, you’ll receive higher benefits.
- Employment Questions. To determine if there is wage loss on your part, expect questions about your job and employment history.
- Questions About the Incident. To be eligible for workers comp, you need to establish that your injury is indeed work-related. For this, you’ll be asked questions about the incident. This includes describing the nature of your work, how the incident happened, and all the little details.
- Medical Questions. Your medical records are an important source of information both for you and your employer. You need to give out information about preexisting medical conditions and your medical history in general.
- Ability to Work Questions. Your lost wages compensation is based on your ability to work. That’s why you should expect questions about what you can do as well as any work restrictions.
If you have a workers’ compensation lawyer, they’ll give you a list of questions beforehand so you can prepare your answers.
When Can I Expect a Decision?
Workers compensation judges typically release a decision at the conclusion of the final hearing. But with complicated cases, it can take a few weeks to several months. Your workers’ comp attorney can usually tell you when you can expect a decision.
How to Prepare For Your Workers Comp Hearing
Though workers comp hearings usually resolve in the injured worker’s favor, it’s not exactly a walk in the park. This is why you need to be fully prepared before going to court. Some of the things you can do to prepare for your hearing are:
There’s a reason why workers comp hearings are also known as “evidentiary hearings” in some states. Like most justices, workers compensation law judges rely heavily on the evidence presented to them. Thus, even if you clearly deserve those workers comp benefits, if you can’t produce solid evidence to support your injury claim, the ruling won’t likely be in your favor.
Some of the documentary evidence you will need are:
- medical records
- evidence of lost wages (payslips from before your injury)
- unpaid medical bills
- employment records
- reports from your treating doctors
- evidence that you’re following the prescribed treatments
- documents to prove you’re searching for a job (if relevant)
If you have a lawyer, you won’t have to worry about gathering these pieces of evidence. They’ll do the legwork for you.
Look for Witnesses
Aside from documentary evidence, workers compensation law judges may also take into consideration witness accounts. Eligible witnesses include people who have first-hand knowledge of the accident or those who know about your injury. You may also present as witness the vocational expert working on your case and any other experts that can prove your claim.
Hire a Workers Compensation Attorney
Technically, you don’t need to hire a workers compensation attorney to represent you in court. But you need to remember that your insurance provider has its own legal team. If you’re not that familiar with the law, going against these experience corporate defendants on your own will most likely cost you your benefits.
This is why the most effective preparation for a workers comp hearing is hiring an experienced workers compensation lawyer like Victor Malca.
Victor Malca Law, P.A. is one of the most trusted names for workers compensation cases in Florida. For almost three decades, we’ve been helping thousands of injured workers get the benefits they rightfully deserve. We can help you throughout the entire process – from gathering the necessary pieces of evidence to winning your case in court. Talk to us now for a free consultation.
ABOUT THE AUTHOR
Judy Ponio is a writer for Victor Malca Law P.A. and enjoys helping people with questions about social security, workers compensation, and other serious matters involving people’s livelihood. She is not an attorney and her writing should not be considered legal advice.