You might need to attend a Workers’ Compensation hearing before getting benefits for a workplace accident. If so, our lawyers can prepare your claim and what to if it is still denied.
Workers’ Compensation hearings are for claims that are being disputed by an insurer. The Massachusetts Department of Industrial Accidents (DIA) will decide the matter, but requires a few informal meetings between the parties before the hearing. We can prepare your medical records and gather insurer’s independent medical reports to settle the claim during conciliation or the pre-hearing conference. If an agreement cannot be reached then, we will be ready to argue the evidence and call witnesses at the formal hearing.
For a free case review with our Massachusetts Workers’ Compensation attorneys, call the Law Office of John J. Sheehan today at (617) 925-6407.
What Do I Have to Do Before a Workers’ Compensation Hearing in Massachusetts?
Most employees in Massachusetts can file for Worker’s Compensation benefits if they are injured at work. If an employer’s Worker’s Compensation insurance provider denies a worker’s new claim or wants to modify benefits on an already approved one, it usually initiates the dispute resolution process. Eventually, a formal, legal hearing might be necessary to settle the dispute.
Our Worker’s Compensation attorneys can help prepare for your hearing so you have the best chance of recovering benefits. However, you should start your case immediately after your accident since the following initial steps must be completed before a hearing is scheduled:
Workers’ Compensation Conciliation
When a claim is challenged, the DIA will help resolve the dispute. The first step of this process is called “conciliation,” which is an informal meeting between an injured worker, their lawyer, and their employer’s insurer’s attorney. A conciliator from the DIA will conduct the meeting but they are impartial to each side.
Conciliation works much like mediation in other legal cases. The DIA conciliator is not there to make legal conclusions on the evidence or ultimately decide the matter. Instead, the help the parties negotiate a voluntary agreement. If a settlement cannot be reached, your claim will be referred for a conference with an administrative judge.
You will need your most current medical records for conciliation, but you should also bring any relevant documentation dated within the last six months. You are also entitled medical records that the insurer possesses, like independent medical exams, follow-up exams, and any other records that contain history of your injuries and treatment.
Initial Conferences
A Workers’ Compensation conference, sometimes called a proceeding, is the next step of the dispute resolution process and operates much like conciliation. The parties will meet for an informal discussion to settle the claim and present their case to the administrative judge. The judge can review documents, like medical records, wage statements, and witness affidavits, but is not bound by the rules of evidence.
The major difference between a conciliation and a conference is that the administrative judge will make a final ruling on the claim. If you show that your disability is work related and the disputed medical bills covered necessary treatment, the judge will order the insurer to pay benefits.
Alternatively, they might conclude the insurer is not required to pay benefits or can stop paying them. If so, you have 14 calendar days to file Form 121 to appeal the conference order. Upon appeal, your claim will be scheduled for a formal hearing before the same administrative judge.
How Do I Prepare for My Workers’ Compensation Hearing in Massachusetts?
The next step in the dispute resolution process is the Workers’ Compensation hearing, which is essentially the trial phase. Before the hearing, though, you must prepare for the mandatory pre-hearing conference.
Pre-Hearing Conference
A pre-hearing conference will typically be scheduled no later than 10 business days before the hearing date. You must submit a pre-hearing memorandum at least five business days before the pre-hearing date. The purpose of the pre-hearing conference is to give the parties an opportunity to file and argue motions before the hearing.
If we are close to settling, we can request a mediation, potentially saving on legal costs and time.
Hearing
The Workers’ Compensation hearing is like a trial because the rules of evidence apply. Lawyers can present arguments, call witnesses, and testimony is given under oath. Much of the necessary evidence will already be in the record, but new evidence and oral testimony can be submitted before a hearing decision is issued.
To prepare, our team will organize your medical records and review arguments and evidence from the insurer’s pre-hearing memorandum. We will also ensure that the insurer has turned over all impartial medical exams and records. We can also have your physician exam you and offer their report as evidence.
The administrative judge has 28 days to decide, but it could take longer. If the judge upholds a claim denial, you can appeal the hearing order.
Can I Appeal the Hearing Decision if My Massachusetts Workers’ Compensation Claim is Denied?
You have 30 days from the date of the hearing decision to file an appeal with the DIA’s Reviewing Board. This will lead to a new hearing before three administrative law judges.
During an appeal hearing, these judges can request attorneys make oral arguments and weigh the evidence from the prior hearing. They can send the case back to the original administrative judge for further findings of fact or affirm the hearing decision.
The Reviewing Board will reverse a hearing decision only if the administrative judge went beyond the scope of their authority, acted arbitrarily or capriciously, or the decision was contrary to law.
If the Reviewing Board still denies your claim, you can file one last appeal, which the Massachusetts Court of Appeals will hear.
Contact Our Massachusetts Workers’ Compensation Lawyers Today
Call the Law Office of John J. Sheehan at (617) 925-6407 for a free case review with our Boston Workers’ Compensation lawyers.