Preparation by an experienced workers compensation lawyer is the key to success at a California workers compensation hearing
Most workers’ compensation cases settle without a hearing before a judge. Routine benefits, like medical treatment and temporary disability benefits that are paid until an injured worker returns to work, are sometimes uncontested. A workers’ compensation lawyer can generally negotiate a fair settlement of a workers’ compensation claim without the need for a formal hearing.
In some cases, however, a workers compensation hearing may be necessary. Hearings sometimes occur because the claims administrator for the employer’s workers’ comp insurance company disputes that the claim is work-related. Hearings can also be necessary when the claims administrator and the injured worker disagree about the nature and extent of the employee’s permanent disability.
Claims administrators are particularly motivated to dispute disability ratings of 70% or higher because they trigger an award of a life pension. A life pension is a disability benefit which is paid to the injured worker over the remainder of her life. Hearings are common when a life pension is at stake.
Preparation for a Workers Compensation Hearing
If your case goes to a hearing, a lawyer for the workers’ compensation insurance company may want to take your deposition. A deposition is sworn testimony given before a court reporter, but outside of court. The insurance company lawyer will ask you questions that you will answer under oath. Your lawyer will be there to protect your rights, but cannot help you answer questions.
Before your deposition, your lawyer will explain some basic rules about how to answer questions. Of course, the first rule is to tell the truth. Other rules will help you phrase your answers carefully and concisely. It is important that you understand questions before you try to answer them, that you answer only the question you were asked, and that you avoid guessing at answers.
Your lawyer will help you anticipate the questions you will likely be asked. The goal of preparation is to avoid surprises so that you will give clear answers and will be comfortable during the process.
At some point after your lawyer determines that the insurance company will not offer a fair workers compensation settlement, your lawyer will ask for a trial before a workers’ compensation judge. Prior to the trial, there is a settlement conference. At the settlement conference, a workers’ compensation judge will meet with your attorney and the claims administrator in an attempt to resolve the case.
In most cases, you need to be present at the settlement conference so that you can consult with your attorney and give approval if your attorney is able to negotiate a settlement. In unusual cases (for example, if you live far from the hearing location), your availability by telephone may be sufficient, but you and your attorney would arrange that in advance.
The judge will require the opposing lawyers to agree on the basic facts so that only disputed facts remain to be resolved at the trial. For example, if the claims administrator agrees that you were injured at work, there will be no need to waste time at the hearing proving how the injury occurred.
The judge will first encourage your lawyer and the claims administrator to attempt to negotiate a settlement. Some judges are more aggressive than others about encouraging settlements. If issues remain unresolved, the judge will define the issues that need to be decided and will then set the case for a trial.
Preparation for the trial is generally completed at the mandatory settlement conference. However, sometimes the judge will encourage the parties to do some more legal work before the trial. The judge might want a Disability Rater to rate the disability when the lawyer and the claims administrator cannot agree on a rating, or the judge might want a Qualified Medical Evaluator to examine the injured worker to develop additional evidence about the permanent impairment that might help the judge decide issues in the case.
In a workers’ compensation trial, there is no jury. The judge is an “administrative law judge” whose job is to decide disputed issues in workers’ compensation cases. The case is heard in a conference room rather than a courtroom. The hearing is less formal than trials that occur in courtrooms before civil judges, but there are still rules of evidence and procedure that must be followed.
A hearing might last an hour or it might continue over several days. If the hearing does not finish in one day, it might not start again for months, because hearings are generally scheduled to last one day or less.
When the only issue is the extent of a disability, however, evidence is usually presented in the form of medical reports and the injured worker’s testimony. Since doctors are not allowed to testify, a workers’ compensation trial is often shorter than a civil trial.
Injured workers will generally testify in their workers’ compensation trials. In some cases, the contested issues may boil down to the judge’s assessment of a witness’ credibility. If you need to testify, your lawyer will prepare you in the same way that your lawyer would prepare you to testify in a deposition. Your lawyer will explain the questions that he or she will ask and will try to anticipate the cross-examination questions you will be asked by the insurance company’s lawyer. The goal of preparation is to avoid surprises.
Your lawyer will present any other evidence that is relevant to your case. The lawyer for the employer’s insurance company then has an opportunity to present evidence.
The judge will not make an immediate ruling. Instead, the judge will prepare a summary of the evidence and will issue a written decision about ninety days after the trial. If there are grounds to appeal an unfavorable ruling, your lawyer may file a motion for reconsideration to the Workers’ Compensation Appeals Board, and may eventually file an appeal to the District Court of Appeals. Most cases, however, end with the trial judge’s decision.
Representation at Workers Compensation Hearings
Injured workers can represent themselves at a trial, but they may be at a disadvantage if they do not understand the rules of procedure and evidence. Representation by an experienced workers’ compensation lawyer maximizes the opportunity for success. To discuss your case with a Santa Rosa workers’ comp lawyer, call Kneisler & Schondel at (707) 542-5132. You can also tell us about your problem by submitting our online contact form.