Workers Compensation Appeals – How an Attorney Can Help Secure Your Benefits

If your employer’s insurance company denies your claim for workers’ compensation benefits or if you are unhappy with the decision made by an Administrative Law Judge, you may appeal. This process includes a hearing before a three-member review board panel. It is not uncommon for a workers’ comp decision to be overturned on appeal. However, the appeals process can be lengthy and complex.

Initial Hearing

The first step in the appeals process is a hearing with a panel of three administrative law judges. During this hearing, you and your long term disability attorney Seattle can present information regarding the dispute to the panel. Once the panel has heard the evidence, it will decide on your case. The decision can uphold or deny the previous judge’s decision or may change it in part or entirely. If you are dissatisfied with the panel’s decision, you can request a rehearing. However, this is usually only granted when you can provide new evidence to support your case or show that the initial panel made a mistake in applying the law to your situation. Experienced worker’s compensation attorneys can help you file a petition for reconsideration. They can also assist you in filing a writ of review with the appellate court, and they can even work to secure long-term benefits for you, such as state short-term disability benefits or Social Security disability.

Appeals Hearing

A workers’ compensation hearing involves a judge, court reporter (who types the transcript of your hearing), witnesses, coworkers, supervisors, medical professionals, insurance company representatives, and possibly your employer. If you have an attorney representing you, they can help ensure all the proper evidence is presented. If the judge rules against you, you can request a full review of your case by the board panel. The appeals hearing allows you to present new evidence and arguments to the board judges. This is an essential step in ensuring you receive the benefits you are entitled to. If you lose at this stage, you can file a writ of appeal to your state’s supreme court. However, these writs are rarely granted.

Final Hearing

Once the pre-hearing conference is completed, a formal hearing is scheduled with an administrative law judge. You and the insurance company can present evidence and testify about your injury during this hearing. After the judge reviews all exhibits and testimony, a written decision is issued. During the hearing, your attorney will argue why you should receive benefits and why the insurance company should pay you the appropriate award. During this time, your attorney will also take depositions of witnesses and obtain medical records and reports from the insurance company, perform legal research, and write “pleadings,” documents submitted to the judge for review. After the judge decides, either party can request further review within the Workers’ Compensation Board or appeal to the Appellate Division’s highest court. Alternatively, parties may resolve outstanding issues by entering into a written agreement, which is subject to approval by the Board.

Appellate Division

When the Appeals Board issues a decision, it is final unless you appeal the ruling. If you decide to do so, you must have a quality attorney to help ensure that your right to file an appeal is preserved and that the Social Security Administration (SSA) receives all of the information it needs on this second go-around. Every state’s Workers’ Compensation Appeal Board (WCAB) is structured differently, but all have members tasked with hearing challenges to workers’ compensation denials. At a WCAB hearing, an administrative law judge or commissioner will listen to your argument and apply your state’s laws in making a decision. The Appellate Division is the highest level of the Board’s appeals process. It consists of two (2) Board members who serve as appellate administrative law judges. The Appellate Division also monitors federal civil rights cases not handled by the Division’s trial sections. All parties may submit written briefs for the Appellate Division’s review and consideration. Oral arguments are not permitted unless requested by an appropriate party.