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How does the workers’ comp appeals process work?

On Behalf of | Aug 2, 2020 | Workers' Compensation

Many injured on the job each year file a workers’ compensation claim. They likely understood that this safety net helps workers injured on the job by providing money to pay bills while out of work, cover medical expenses, and help with rehabilitation or retraining. They may not have known that it is common for the workers’ compensation carrier to deny these injury claims.

This is not the final word on the matter, however. The Workers’ Compensation Commission here in Connecticut has an appeal process for disputed claims. While the initial claim is not overly complicated, the appeals process and hearings get increasingly complex as the claim moves through the system.

The steps for an appeal

As with many government programs, there is a series of steps for resolving disputes. These are:

  • Informal hearing: This is a relatively quick meeting with the Workers’ Compensation Commissioner, where the injured provide evidence supporting a claim for benefits.
  • Pre-formal hearing: If the dispute remains unresolved, this hearing is scheduled to outline a schedule for preparing for the formal hearing.
  • Formal hearing: Like a trial in court, this hearing is presided over by the Workers’ Compensation Commissioner. Evidence is submitted, and witnesses provide testimony. The commissioner will then return a decision of “Finding and Dismissal” or “Finding and Award.”
  • Workers’ Compensation Review Board appeal: The board involves two Commissioners and a Workers’ Compensation Chairman. The three review records from the Formal Hearing Decision. There is no hearing for an appeal.
  • Connecticut Appeals Court or Supreme Court: The case then moves into the state’s legal system, although it is rare that the state Supreme Court would hear a case on this matter.

 Legal guidance is essential

The injured often get the best results if they hire an attorney with experience handling workers’ comp claims. These legal professionals can help reduce the chances of an initial denial because they understand the paperwork and deadlines involved in the initial claim. They can also guide the injured claimant through the entire appeal process.