The legal system is notorious for being cumbersome and slow. The workers’ compensation process is no exception. Workers’ compensation cases, like any other legal proceeding, has many different steps that need to be completed before the case can be resolved. How long the case will take depends on a variety of different factors.
Any workers’ compensation case begins when the worker who sustained a work related injury files a claim. The case cannot start until the worker takes this step. Following the filing of the petition, the claim administrator has ninety days to investigate the claim of injury or illness. While the investigation is ongoing, the employee does not have to wait for benefits. Medical benefits must be authorized within one day. Temporary or permanent disability payments must be made within fourteen days of when there is knowledge of the injury. However, if the employer offers the employee a job that pays at least 85% of the compensation he or she was making at the time the injury occurred, the fourteen-day timeline does not apply.
Next, some cases require a Qualified Medical Evaluator. A QME will review the employee’s medical file and make an independent assessment about the injury and the disability. The QME may need to be deposed by both sides, and scheduling the deposition can take weeks. After the QME completes his or her assessment, he or she will have thirty days to issue the initial report. The QME will determine the percentage of disability that the employee has suffered, which will directly impact the amount and duration of benefits the employee will receive. The employee can dispute the conclusions in the report, and can present a case to the workers’ compensation administrative law judge to ask the rating be adjusted.
The parties will also likely go through a process called “discovery.” During discovery, the parties will exchange documents and information that may support their respective positions. Discovery can sometimes be relatively quick, ending after just thirty days, and sometimes can take months if the parties disagree about the process or need to do multiple rounds of discovery.
If you and the other side cannot come to an agreement on a settlement, the case will go before a workers’ compensation administrative law judge. The judge will then make the ultimate determination of disability rating. Other issues may also be presented to the judge, such as whether the worker is an independent contractor who would not be eligible for workers’ compensation benefits.
These are just a few examples of the hurdles that must be cleared before a workers’’ compensation case can be completed. Contact us today for a consultation to discuss the process and how we can help you.