If you’ve been injured on the job site in Massachusetts and your company’s insurance provider is disputing your claim, you may be worried that you will not receive compensation. Here is an overview of the disputed claims process timeline to see how long and what steps you will have to take to appeal your disputed workers’ comp claim.
Disputed Claims Process Timeline | Conciliation
Conciliation consists of an informal meeting between the worker, the worker’s attorney (if he or she has one), an attorney for the workers’ compensation insurance company and the DIA conciliator. The conciliator serves as a neutral third party to try and help negotiate a settlement. Conciliation meetings take place at the closest DIA regional office to the employee. If the worker is out-of-state, the conciliation will automatically take place in Boston. In some circumstances, the location of the conciliation meeting can be changed.
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Disputed Claims Process Timeline | Conference
The second step is the conference (sometimes referred to as a proceeding). And while the worker still isn’t required to have an attorney, it’s strongly recommended they have an experienced workers’ compensation hearings and appeals attorney with them for this process. This is because even though a conference is an informal meeting between the workers’ compensation insurance company and the worker, instead of being before a conciliator, it’s in front of an Administrative Judge.
Disputed Claims Process Timeline | Hearing
A hearing is a formal legal proceeding and is a lot like a trial. A hearing is held before an Administrative Judge and many rules from a regular courtroom apply, such as the Massachusetts rules of evidence. At the hearing, both sides present evidence in support of their position and may call witnesses to testify. In certain situations, either side may be required to submit new evidence before the Administrative Judge issues a decision. If either side is unhappy with the Administrative Judge’s decision, they can appeal it to the Reviewing Board.
Disputed Claims Process Timeline | Reviewing Board
At this level of the workers’ compensation settlement process, the parties may only present legal arguments in support of their position. Generally speaking, no new evidence may be presented to the Reviewing Board. If the Reviewing Board feels additional evidence is necessary, they will usually remand the case back to the Administrative Judge for further consideration of additional evidence.
If you are refused workers’ compensation benefits, all is not lost. To learn more about the workers’ compensation dispute resolution and appeals process, please contact our office for a consultation with a dedicated Massachusetts workers’ compensation hearings and appeals attorney. Let our experience work for you.