Preparing for a Workers' Compensation Appeals Hearing

When you experience a workplace accident, personal injury, or illness caused by your working conditions, you can pursue workers’ comp benefits. However, some employers and insurance companies fight even legitimate workers’ compensation claims.

You can appeal the decision if you receive a claim denial for your work-related injury. For the best chance of winning the appeal for your workers’ comp claim, you need help from a workers’ comp lawyer in your state. They can prepare your workers’ comp case for the workers’ compensation appeals hearing. We explain the process for preparing for a workers’ compensation hearing.

Preparing for a Workers’ Compensation Appeals Hearing

When you receive a workers’ compensation denial, you must appeal the decision under the rules required by your state’s workers’ compensation laws and administrative rules.

An experienced workers’ compensation attorney in your state can explain why you received the claim denial. When you understand the reason for your denial, you can gather evidence demonstrating why the decision was incorrect.

Gathering and Organizing Evidence

A critical step in your appeal is gathering relevant evidence that shows why the denial decision was incorrect. If the opposing counsel claimed your injury didn’t occur at work, you can submit evidence such as:

• Accident reports
• Surveillance videos
• Witness statements
• Employment records

If the decision stated that your workers’ compensation case didn’t prove a personal injury, you should submit evidence such as:

• Medical evidence, including medical records showing medical treatment
• Reports from expert witnesses, including vocational experts
• Records of unpaid medical bills
• Photographs and test results from your doctor showing the severity of your injury

Whatever the reason for the denial, you must submit evidence at the workers’ comp hearing to support your claim. A workers’ comp attorney can help ensure that the documentation you submit with your appeal supports your claim.

Deadlines and Timelines

Your appeal of a denial must be made within the deadlines. Failure to file within the applicable deadlines may result in you forfeiting the right to pursue your appeal.

Keeping track of all relevant dates, including the hearing date, is critical. Be sure to submit documentation within the required timeframes.

The Appeals Hearing

The appeals hearing is a critical point in the workers’ compensation process. It’s generally a formal proceeding before an administrative law judge or a workers’ compensation board panel. Understanding what to expect can help you prepare and reduce stress.

Presenting Your Case

Effectively presenting your case requires you to share your side of the story and support it with evidence. At most appeals hearings, you can expect to see your employer and representatives from your employer’s workers’ compensation insurance company. A court reporter will probably also be at the hearing to record all testimony.

Whether or not you have legal representation, you must present legal arguments supported by evidence and witnesses. You can also present witness testimony from any depositions taken in the case. You must present evidence relating to why you should receive workers’ compensation benefits.

The hearing process allows for cross-examination. The insurance company’s lawyer can cross-examine witnesses and question any evidence. You should anticipate any defenses in advance and prepare for them.

After the Workers’ Compensation Hearing

After the hearing, you must wait for the judge’s decision. In the appeals process, the workers’ compensation panel or the judge rules and issues a written decision. How long it takes for the decision is highly variable. It can take weeks or months.

Following the result, you may be able to further appeal to your state’s appellate system, the court of appeals, and then the Supreme Court of your state.

A Workers’ Compensation Lawyer Can Help

The workers’ compensation appeals process can be complicated. You don’t need to go through the process alone. An experienced workers’ compensation attorney can help you collect relevant records and evidence to prepare for your workers’ compensation case hearing. They can:

• Explain the reasons for your denial
• Keep track of all case deadlines
• Gather evidence
• Interview witnesses
• Review your case materials
• Present your evidence at the hearing
• Explain all your legal options during the appeals process

If you need help with the hearing for your workers’ compensation appeal, contact a local workers’ compensation lawyer for a case review. Many workers’ compensation attorneys offer free case evaluations.