Workers Compensation - Hearing and Appeal Procedures
You will receive numerous letters from the insurance company during the course of your workers compensation case. You will also notice that at the end of each letter it says that if you disagree with the insurance company’s decision about your case, then you may request a hearing. And after you have had a hearing, if you disagree with a decision, you may file an appeal. These letters are ticking time-bombs if you do not know what to do with them.
Oftentimes an insurer will make decisions about your case with which you will disagree. For example, in the acceptance of claim letter, they may state that they accept your claim for “lumbar sprain/strain,” when in reality you suffered from a fracture.
If you have good grounds on which to challenge the insurance company on their findings, have your attorney request a hearing or file an appeal. You will attend the hearing and meet with a hearing officer who will read the brief prepared by your attorney and argue the points against the employer’s insurance carrier. Sometimes these matters can be resolved by stipulation between the parties, without a hearing being needed.
