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What Happens When You File a Worker’s Compensation Claim?

Understand the process of filing a workers’ compensation claim to protect your legal rights.

workers' comp cliam

While the workers’ compensation system aims to take care of the financial and medical needs of a person injured at work, there are times when the worker is denied benefits or offered benefits that are insufficient. What is the workers’ compensation claims process? In this post, our Missouri workers’ compensation attorney explains the process that follows when a worker files a claim for compensation.

Pre-Hearing

Once you file a claim for compensation, a pre-hearing is scheduled wherein an administrative law judge discusses the issues pertaining to the case where the claim has been filed. The employee can request a pre-hearing by filing a request. An injured worker may request a pre-hearing in the following situations:

  • The employer want to make an offer for settlement.
  • There are disputes or problems that need to be resolved for the case to proceed.
  • The parties believe that meeting with a judge can help move the case more quickly to settlement or final hearing.

Mediation

Mediation is another way that both parties can reach a settlement. During mediation, both parties and their lawyers meet with an administrative law judge and discuss the issues confidentially. The aim is to identify areas of agreement between the parties and facilitate a settlement. The parties can request mediation by filing a request for mediation, provided that the judge feels that mediation can be helpful. Mediation may be requested in the following cases:

  • There are important issues that need to be addressed and resolved in order to proceed the case further.
  • Only one of the parties has a final rating report and the other party has obtained it within a reasonable period of time.
  • Even after exchanging the final reports, the parties could not reach a settlement.
  • Employee has requested initial or additional treatment.
  • Employer has refused initial or additional treatment.
  • The employee has medical evidence to prove the need for additional treatment. Generally, this kind of request is considered a hardship request.

Hardship Hearing

This is an evidentiary hearing that is held before an administrative law judge when the injured employee feels that he or she has not reached maximum medical improvement and needs further treatment or temporary disability benefits, but the employer is not ready to pay for the treatment or the benefits. In the hardship hearing, the injured employee requests for a partial or temporary award to address issues pertaining to medical treatment and temporary disability benefits. However, if the party requests a final award and presents evidence to prove the merit of the claim, the judge may issue a permanent award as well.

Final Hearing

A final hearing is requested when the injured employee has achieved maximum medical improvement or the case is set for final resolution. It is an evidentiary hearing on the record. The record is then presented to the reviewing tribunal. To learn more about workers’ compensation claims, contact an experienced Missouri workers’ compensation lawyer.

The Law Office of James M. Hoffmann

(314) 361-4300

Updated: January 27, 2015