07 Oct Workers’ Compensation: What You Need To Know About The Hearing Process
Requesting a Hearing
If you disagree with the Notice of Claim Status or any other notices or awards document that contains a protest period, you may formally disagree with the determination by requesting a Hearing. You request a hearing by completing a Request for Review Form and filing it at the ICA office.
In this form, you should clearly indicate which notice or award you are protesting and the grounds on which you are protesting the decision. Failure to state your reason for the request may cause a delay.
When receiving your request, the ICA Claims Division will forward your file to the Administrative Law Judge (ALJ) Division. ALJ’s are attorneys, licensed to practice law in Arizona, employed by the ICA. This is also referred to as the Hearing Division.
Within thirty days of filing the request, you will receive a Notice of Hearing with the initial hearing date, time and location of your hearing. The initial hearing is normally scheduled about sixty days from the date of notification and about ninety days from first receiving your file.
The rules for hearings are set out in Arizona Administrative Code (AAC) R20-5-101 to R20-5-164.
The rules allow the AJL to request a prehearing conference to identify issues and address other matters relevant to your case. If you fail to participate, your hearing request might be dismissed.
Before the hearing, you will go through the Discovery process where you exchange information with the defendant. See the section on Discovery.
At the Hearing
The hearing is similar to any other trial. The ALJ will preside over your case and you and the insurance company will both have the opportunity to argue your sides of the case. Both parties will have the opportunity to call and cross-examine witnesses and file evidence, such as your relevant medical records. You might need expert witnesses regarding your medical situation or the labor market; that type of evidence will often be heard at the next hearing date. Some cases can be finalized in one hearing, but most cases will require more than one hearing. Injured workers usually bear the burden of proof, which means you will have to present your case first. You will have the opportunity to address any defense raised by the insurance company and cross-examine their witnesses. The duration of the hearing process will depend on the complexity of your case.
How do you get your witnesses to the hearing?
You may request the ALJ to issue written subpoenas for witnesses that you want to testify at your hearing. The commission will pay medical witnesses a set fee, but you have to pay your nonmedical witness’ fee and travel expenses.
Do you need legal assistance at the hearing?
The insurance company will, in all likelihood, arrive with an experienced workers’ compensation lawyer. To protect your rights and ensure that you get the benefits that you are entitled to, you should have an experienced lawyer on your side too. You may represent yourself, but an experienced lawyer will be familiar with the applicable laws and rules and will be able to look after your interests in the case.
Decision upon Hearing
After the hearing, the Judge will, within sixty days, issue a decision upon hearing. A copy of the decision will be mailed to your last known address. If one of the parties to the dispute is not satisfied with the outcome, they can file a written request for review at the ICA within thirty days of the decision date. If no request is received within the time limit, the award becomes final and is not appealable.
If a request for review is received, the Judge will review the matter and issue a decision upon hearing. The parties have thirty days from the new decision to appeal the matter by filing a Petition for Special Action. This appeal is lodged at the Arizona Court of Appeal. If no appeal is filed the decision upon hearing becomes the final award.