Workers’ compensation payments help injured workers get back on their feet by covering their medical bills, lost income, and rehabilitation costs. So what happens when a claims adjuster denies your claim? In this post, we review the vital role played by the Workers Compensation Appeals Board.
Consult expert Phoenix Workers’ Compensation Attorneys when facing a dispute with a workers’ compensation claims adjuster.
What Is the Workers’ Compensation Appeals Board?
The Workers’ Compensation Appeals Board in Arizona is a judicial body designed to review workers’ compensation petitions. It adopts rules of procedure and practice which help regulate the adjudication process. Simply put, if you don’t agree with the decision of a workers’ compensation administrative law judge on your case, you can appeal it to the Workers’ Compensation Appeals Board.
Every state has its Workers’ Compensation Appeals Board. In Arizona, workers’ compensation attorneys practice law before this judicial body where they represent injured or ill workers in the state. They present cases, which seek to get the injured worker compensation for the following:
- Medical treatment
- Lost income
- Rehabilitation
- Wrongful death
Petition for Reconsideration
An injured worker will usually work with an insurance company adjuster to process payment for a workers’ compensation claim. While this process could go off without a hitch, there is also the possibility that disputes may arise. In some cases, the claims adjuster may deny the injured worker’s claim. The two could also disagree on the following:
- Level of permanent disability
- Weekly disability rate
- Authorization for medical treatment
If the injured worker and the claims adjuster cannot resolve their dispute, they can file for a formal hearing with a Workers’ Compensation Judge (WCJ). The WCJ will then review the case and issue a decision to resolve the disputes. Either party can appeal this decision by filing a Petition for Reconsideration at the Workers’ Compensation Appeals Board.
Workers’ Compensation Appeals Process
An injured worker has 90 days from the denial date of their workers’ compensation claim to file a hearing request with the Claims Division of the Industrial Commission of Arizona (ICA). Once this is done, the ICA will provide the filer with a date and time for the hearing. The appeals case will then go through the following stages:
- Prehearing Conference
A prehearing conference is a discussion between the administrative law judge and the concerned parties about the case. It is not a mandatory process but can be ordered by the judge and is usually conducted through the phone.
- Discovery
During the discovery stage, both parties will exchange and examine each other’s crucial evidence for the appeal. This process is mandatory for both parties before the hearing.
- Hearing
The hearing will typically begin with an overview of the case by the judge, then testimony from the injured worker. The judge may question the parties involved, and the attorneys may be allowed to cross-examine witnesses.
- Decision
The judge will provide both parties with copies of the decision 30 to 60 days after the end of the hearing.
Talk to a Phoenix Workers’ Compensation Attorney
The Phoenix Workers’ Compensation Attorneys at Snow, Carpio, and Weekley have a combined legal experience of over 100 years. We are dedicated to defending the rights of workers in Arizona and their families. If you have any questions about how the Workers Compensation Appeals Board works, contact us today at (877) 370 – 5788 to schedule a consultation.
