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Appealing a workers' Compensation Decision

Introduction

Frequently, the actual trial of your workers' compensation claim can be one of the most frustrating aspects of the workers' compensation system. The workers' compensation judge may have limited the evidence you could bring or the subject matters you could talk about. Witnesses for your employer may have come and offered untrue testimony or statements. You may have lost your case and had your benefits cut off, even though you are still unable to return to your job and your pre-injury earnings. Alternatively, you may have settled a claim in the past and have now experienced a significant worsening of your condition. In all of these instances, you may have the right to bring a workers' compensation appeal. Because the rules that govern how and when an appeal can be brought are highly technical and contain strict time deadlines, it is important to consult an experienced workers' compensation attorney as soon as possible. An experienced workers' compensation attorney will review your settlement or the decision from your workers' compensation trial and advise you as to whether an appeal will improve the unfavorable situation or decision.

Understanding the Workers' Compensation Appeals Process

In most states, the workers' compensation system is founded on administrative law. That means that there is some administrative agency, operating under the executive authority of the governor in your state, which oversees the worker's compensation laws created by the state legislature. Under an administrative law system, administrative law judges conduct trial-type hearings. Your workers' compensation trial was probably an administrative law hearing before a specially trained workers' compensation administrative law judge.

If you are unhappy with the decision from the administrative law hearing that was held to determine some aspect of your workers' compensation claim, procedures exist for you to appeal the unfavorable result. In some states, your first appeal must be made to a workers' compensation court of appeals. A workers' compensation court of appeals is also an administrative law panel. Once the workers' compensation appeals has made its ruling, or if no such administrative law appeals court exists, judicial appellate review can usually be commenced if you are still unsatisfied with the results of your workers' compensation case.

Judicial appellate review happens when a court, outside the workers' compensation administrative law system, examines the decision of the administrative law judge. Usually, the court examining or reviewing the workers' compensation decision will be the state supreme court or the state court of appeals. Regardless of which court actually considers the appeal, the judicial appellate system calls for a review of the law, the record of events that happened at the hearing, and the actions of the trial court.

In many states, workers' compensation review is limited to questions of law. If the worker's compensation judge made a mistake using or applying the worker's compensation law or rules, the reviewing court can change the judge's decision as it sees fit. Fact questions and decisions the worker's compensation judge made about the evidence are harder to get changed on appeal. If there is substantial or significant evidence in the record from the hearing to support the decisions made by the workers' compensation judge about the facts of the case, the appeals court will usually not change those factual decisions or any final ruling that comes from those factual decisions. Accordingly, decisions made about things like the character or believability of witnesses, what evidence to allow in and what evidence is most believable, can usually not be changed by judicial appellate review. However, in some states, if a workers' compensation judge totally ignored rules of evidence, a judicial appellate review may change the judge's decision because it relied too heavily on evidence that is not acceptable to the judicial appellate court.

In some states, you may also be able to get judicial appellate review of the settlement of your worker's compensation claim. Change in disability status, fraud or mutual mistake are all reasons why a judicial appellate court may review or re-open a previously settled claim. Each state has different requirements that must be met before an earlier settlement will be re-opened by judicial appellate review.

All workers' compensation appeals are governed by specific, technical rules. These rules dictate the amount of time after the workers' compensation decision is made in which an appeal must be filed, who must receive copies of the appeal, what documents need to accompany the appeal, and what the appeal itself must look like. The requirements for an appeal differ significantly from state to state. Because of the complexities associated with appealing a workers' compensation decision, it is extremely important to work with an attorney who knows the worker's compensation laws in your states. A knowledgeable, experienced workers' compensation attorney will review the decision from your hearing and determine if there is good basis for appealing your claim.

Conclusion

Appealing a bad decision from a workers' compensation hearing can be very difficult. You must meet formal requirements regarding mistakes made by the workers' compensation judge in order to convince the reviewing court that good reasons exist to change the decision. You must also comply with specific rules that govern the time of the appeal and how the actual appeal papers look. Choosing an attorney who understands workers' compensation and the appeals process can provide you with a way to meet the challenges raised when you have to bring an appeal of a workers' compensation decision. An experienced workers' compensation attorney will take all possible steps to review your decision and let an appeals court know that you are entitled to a different, better result.