Wisconsin Worker’s Compensation Hearing: What to Expect.

If worker’s compensation benefits are disputed, there are two options to recover some or all of the benefits: settlement or a hearing. A hearing is a trial with a worker’s compensation administrative law judge (ALJ), following which the ALJ decides whether to award or deny the disputed benefits.

More than 90% of disputed cases settle, but if your case does not settle, having an experienced and skilled Wisconsin worker’s compensation attorney certainly helps. We do this every day. Our practice is to meticulously prepare cases for hearing from the start to maximize chances of a favorable settlement or success at hearing.

Key Takeaways

  • Statutorily required language in insurance carrier denial letters informs you that you have the right to file a hearing application with the Department of Workforce Development (DWD). DWD also communicates with individuals in a manner that suggests hearings are commonplace and can be done on your own. In reality, it is difficult for almost all unrepresented individuals to adequately prepare their case for hearing, the vast majority of cases settle, and it is easy for unrepresented individuals to receive disadvantageous settlement offers or terms from insurance carriers or their attorneys.
  • The best way to strengthen a negotiating position is by preparing a case as if it will proceed to a hearing.
  • The experienced worker’s compensation team at Kingree Law Firm communicates with clients and diligently structures cases to maximize chances of recovery, whether that is through settlement negotiations or at a hearing before an administrative law judge.

Preparing Your Worker’s Compensation Claim for a Hearing Is the Best Way to Achieve a Favorable Settlement

Many people who were injured in a workplace accident or experienced an occupational injury are denied benefits by the insurance company, or are not paid all the benefits they are entitled to under Wisconsin’s worker’s compensation law. It is a myth that only fraudulent or weak claims are denied. Denials happen every day to legitimate and strong claims supported by treating medical providers. Even if claims are conceded and all benefits appear to have been paid, insurance carriers are not required to inform claimants of additional benefits they may be entitled to. Kingree Law Firm prepares every worker’s compensation case as if it will proceed to hearing. Based on our years of experience, we have learned that the best way to consistently achieve outstanding results for our clients is by preparing every case as if it will go to a hearing.

How to Prepare for Your Worker’s Compensation Hearing

The process of receiving worker’s compensation benefits begins with reporting the injury to your employer, opening the claim with the insurance carrier, and seeking medical treatment. Your employer’s insurance carrier will review the claim and decide to accept or reject it. If your claim is denied or there is a dispute regarding the extent of your injuries, whether they are job-related, or the amount of benefits you should receive, settlement or a hearing resolves the dispute.

Before the Hearing

Meticulous preparation, and certain actions that need to occur in or shortly after the medical healing period, are the keys to a successful worker’s compensation case. Our worker’s compensation attorney team will gather and analyze evidence, including medical records and reports from your medical providers, to prove the nature and extent of your injuries and that they were caused by a workplace accident or a hazardous condition at your place of employment. We also advise you of the process, guide you throughout the case, and inform you of things you need to do, to build the strongest case possible given the facts and the law.

We prepare you for your testimony at hearing and cross examination by the insurance carrier’s attorney. We will handle hearing procedure and strategy. We will clarify the specific factual and legal issues we anticipate will be addressed at the hearing, and determine the best way to present your case.

During the Hearing

A worker’s compensation hearing is less formal than a trial in court. Worker’s compensation hearings typically follow a structured process.

  • The administrative law judge (ALJ) will go over and confirm the basic facts of the case and the claims being made.
  • Both sides present evidence in support of their position. Evidence may include medical records, accident reports, physician reports, and testimony from witnesses – including the injured worker – and experts.
  • You will be asked about your injuries, medical treatment, and how your injuries have affected your life and your ability to work.
  • The insurance carrier’s attorney will have the opportunity to cross-examine you and any witnesses we call to testify.
  • After all the evidence has been presented, the ALJ has 90 days to issue a written decision after closing the record.

In many worker’s compensation cases, the largest dispute the judge will need to decide is which doctor is correct: the insurance company’s doctor or your treating doctors. At Kingree Law Firm, we build your case based on the opinions of your treating doctors, and work to secure benefits that would not otherwise be paid voluntarily by a carrier even when there is no dispute between doctors.

After the Hearing

Once the hearing is over, the administrative law judge (ALJ) will review the evidence before making a decision. The ALJ can rule on several issues, including:

  • Whether your injuries arose out of your employment
  • The extent of temporary or permanent disability
  • The amount of wage loss compensation you are due
  • Responsibility for medical expenses
  • Whether vocational rehabilitation or loss of earning capacity benefits are appropriate

Each of these issues will determine the total amount of compensation you will receive and the amount and level of medical care you will receive.

Why You Need Legal Representation at Your Worker’s Compensation Hearing

Employers and their insurance companies may aggressively defend claims for worker’s compensation benefits. They may challenge the nature and extent of your injuries and disabilities, whether they are related to a work injury, and the amount of compensation you are owed. An experienced worker’s compensation attorney can ensure your rights are protected, evidence is presented effectively, the appropriate medical questions are answered, and that the judge hears a compelling case.

How Kingree Law Firm Can Help

Kingree Law Firm is a premier worker’s compensation law firm in Wisconsin. Our experienced worker’s compensation attorney team will protect your legal rights and work to secure the benefits you are entitled to. While most claims for worker’s compensation benefits are resolved through settlement, we prepare every case as if it will proceed to a hearing. Based on our extensive experience, we have learned that this is the best way to consistently achieve outstanding results.

If you experienced a workplace accident or suffered an occupational injury that caused significant lost time from work, permanent disability, permanent wage loss, or if your claim for worker’s compensation benefits was denied, contact Kingree Law Firm today to schedule an appointment to discuss your situation and how we can assist you.