Resolving work comp disputes: The prehearing conference

Jun 23 2017

When an individual suffers a work-related injury that has left them unable to perform their duties and, by extension, unable to cover the costs of everyday living, he or she will naturally look to their employer’s workers compensation coverage for much-needed relief.

What happens, however, when an employer or adjuster makes a critical decision with which the injured worker disagrees, or, worse, the insurer denies work comp benefits altogether?  

The good news is that injured workers are by no means at the mercy of uncooperative employers or insurers. That’s because state law grants them the right to request a formal hearing before the Office of Administrative Courts on any disputed issue.

In fact, state law also provides mechanisms through which the parties can seek to resolve differences prior to making the request for the formal hearing request or while waiting for the hearing date: the prehearing conference and the settlement conference.

What is a prehearing conference?

A prehearing conference is essentially an informal hearing overseen by an administrative law judge. While it can be scheduled by the injured worker, the employer or the insurer, all parties are required to attend.

What types of issues are addressed at a prehearing conference?

Prehearing conferences are typically held so that the ALJ can resolve matters that must be settled prior to the formal hearing.

Indeed, the ALJ may be called to decide upon everything from requests to have the injured worker submit to an examination, access to medical records, alteration of the issues to be reviewed at the formal hearing, and/or postponement of the formal hearing.

Can the ALJ make decisions concerning the work comp claim?     

The ALJ presiding over the prehearing conference may not decide issues relating to the work comp claim, such as the amount to which the injured worker is entitled or whether their claim is indeed compensable. These issues are to be decided at a formal hearing or perhaps a settlement conference, a proceeding we’ll examine next time.

If your claim for work comp benefits has been denied and you are looking for answers, consider speaking with an experienced legal professional who can explain the law and pursue solutions.