We have all seen some sort of version of the following scene in a movie or television show.
The judge looks down at the counsel table. He moves his reading glasses further down his nose so he can clearly see the attorney sitting at the desk, writing something on a note pad. He speaks with his slow, southern drawl. “You may proceed with your opening statement to the jury.”
The attorney slowly rises from her chair. She looks over at her client. She puts her hand on their shoulder and tells them, “It’s going to be okay.” She buttons her coat and then walks around the table, stopping in front of the wooden rail.
Twelve people sit in front of her, all slightly leaning forward, ready for her to tell them the story of what happened to her client. She begins. “Your Honor, ladies and gentlemen of the jury...”
The first thing an injured worker needs to understand about the workers’ compensation process is that there are no juries. Your case will be presented to an administrative law judge. There are no opening statements, nor closing arguments. And it is a rare occasion when the judge rules from the bench on the date of the hearing.
So now we know what does not happen. Let’s break down what does.
Filing a Workers’ Compensation Hearing Request
To file a request for a hearing, the party must file a WC-14 Notice of Claim Form with the State Board of Workers’ Compensation. The form is essentially broken down into six parts:
- Claim Identification: This section identifies the employee, their social security number, and the date of injury.
- Claim Information: In this section, one must list and identify the employee, the employer, and the insurance company. Addresses, phone numbers, and emails are also listed.
- Hearing/Mediation Issues: This section requires the party that is requesting the hearing to specifically list what issues need to be resolved at a hearing or mediation.
A worker is injured on the job in the course and scope of their employment on August 1, 2020. They are totally disabled for a month due to their injuries and have not returned to work. The insurance company for the employer has not yet started their wage benefits nor paid for their medical benefits.
The attorney requesting the hearing would list the following:
- TTD benefits from 08/01/20 and continuing
- Medical benefits (emergency room, orthopedist, physical therapy, dates of service and balances to be supplemented, etc.)
- Late-payment penalties/assessed attorney’s fees
- O.C.G.A. 34-9-221(e)
- O.C.G.A. 34-9-108(b)(1)
- O.C.G.A. 34-9-108(b)(2)
If a mediation is requested, the filing party must specify which issues are ripe for mediation.
- Affirmation of Filing Party: This section affirms that the party (or their representative that is filing the request for hearing) certifies that the information contained in the hearing request is true and correct.
- Entry of Appearance: This section certifies that the attorney that is handling the claim on behalf of the designated party has a signed contract with that party that is in compliance with the Act and Board Rules.
- Certificate of Service: The person filing the hearing request certifies that he/she has sent a copy to all parties named in the WC-14 Hearing / Mediation Request, along with a copy to the State Board for filing.
A hearing will generally be scheduled within 60 days after the WC-14 Request for Hearing is filed with the Board. However, this does not necessarily mean the hearing will take place on that date. It seems to be the general practice that the board will allow either party to request a continuance if it is the first time the hearing appears on the calendar.
Workers’ Compensation Discovery Period
Whenever either side requests a hearing, the Workers’ Compensation Act allows the parties to conduct “discovery” regarding the case from the opposing party. Discovery procedures within the workers’ compensation arena are governed by the Civil Practice Act of Georgia.
According to Board Rules, “[D]iscovery conducted pursuant to the Civil Practice Act shall only be permitted after a hearing has been requested in the claim, or as otherwise specified in these rules, or by agreement of the attorneys or permitted by an Administrative Law Judge or the Board.”
Discovery is essentially the process of gathering important, relevant information regarding the claims of the employee, or the defenses of the employer/insurer.
It is important to note that some exchange of documents can occur prior to a hearing request:
- The injured employee must sign a WC-207 Medical Authorization whenever he/she submits a claim for compensation. This medical release allows the employer/insurer to get a copy of the claimant’s medical records from any doctor the employee has seen, not just the treating physicians for the on-the-job injury.
- All parties are entitled to receive from each other any documents that are specified in the Form WC-102 Requests for Documents to Parties. When this form is sent to the opposing party, documents must be produced, including Board Forms, wage records, medical reports, job descriptions, etc. This request can be sent prior to or subsequent to a hearing request.
- The employer/insurer can also compel an employee that is seeking workers’ compensation benefits to attend a medical examination at reasonable times and places while the claim is ongoing.
The following items are also usually sent to the opposing party when a hearing has been requested:
Interrogatories: These are a series of questions that must be answered under oath by the party to whom they are directed.
Request for Production of Documents: This is a formal notice to produce documents within the custody and control of the party to whom they are directed.
Requests to Admit: This is a series of questions directed to a party that asks them to either “admit” the statement, “deny” the statement, or state that they do not have enough information available to them to either admit or deny. This is a low cost, effective way to find out the facts to which all parties agree so one can focus on the issues in dispute.
Deposition: This is when a party can question witnesses to a claim, under oath, to find out what that person knows prior to a hearing. Their testimony is usually transcribed by a court reporter.
Hearing: Once the WC-14 hearing request is filed, the State Board of Workers’ Compensation will assign the claim to one of the administrative law judges and the claim will be set for a hearing date. The hearing will be held at the location listed on the hearing notice.
What Happens During a Workers’ Compensation Hearing?
There are no juries in any workers’ compensation hearing. The case will be heard by an administrative law judge in the form of a “bench trial.”
When the judge calls the case, the attorneys and parties will sit and tables in front of the judge. The judge will then ask the attorneys for the parties to concisely state the issues to be decided by him/her in the hearing. A brief statement of either side’s contentions is made.
The judge will then ask the court reporter to start recording the proceedings and he/she will then state the reason for the hearing, as well as identify all parties present. The party with the burden of proof goes first in the hearing.
If you were injured on the job and the employer/insurer is refusing to provide a benefit to you, such as paying you your weekly workers’ compensation check, then you have the burden of proving that you are eligible to receive those benefits.
Or, the employer/insurer may claim that you are receiving workers’ compensation checks, but you have experienced a change in condition for the better. So they are asking the judge to discontinue benefits to you because the reason for your current disability is not due to injuries sustained on the job, but for some reason completely unrelated to your on the job injury.
The attorneys will call the witnesses they feel are necessary to prove their case. The other side is given the opportunity to ask questions of the witnesses if they desire. All witnesses will be sworn in by the court reporter and must tell the truth subject to perjury charges if they fail to testify truthfully.
Documents may also be tendered into evidence, such as medical records, bills, disability slips, or lost wage information. At the conclusion of the hearing, if either side has requested an assessment of attorneys’ fees because the claim has been prosecuted or defended in bad faith, the attorney may present evidence of the conduct as well as evidence of the reasonable value of their fees.
When the hearing is completed, the judge will likely close the record, meaning no additional evidence will be submitted nor reviewed.
It is important to note that, absent extraordinary circumstances, the judge will not issue his/her decision on the date of the hearing. The judge will allow the attorneys to present briefs on the hearing to summarize their positions and comment on the evidence introduced at the hearing.
After reviewing the hearing transcript and the briefs, and considering all of the evidence, the judge will issue the hearing decision setting forth the Findings of Fact and Conclusions of Law.
Either side has the option of appealing a decision from the administrative law judge. If an appeal is filed, it will be heard by the Full Board at the State Board of Workers’ Compensation.
Helpful Tips for Attending a Workers’ Compensation Hearing
Going to court and sitting before a judge and attorneys can feel intimidating. As a workers’ compensation attorney, here is some advice on what to expect and do at your hearing.
- You should always tell the truth. You are sworn in by the judge or the court reporter and your testimony is under oath.
- Answer the questions that are asked of you truthfully, politely, and directly.
- Dress appropriately when attending the hearing to show respect to the judge, as well as to the justice system. This is an important day and it should be treated accordingly.
- Make sure to listen and give the judge, the attorneys, and any witnesses your full, undivided attention.
- Be sure you understand a question before you answer. If you do not understand the question, please let the person asking you the question know this. Wait for them to ask the question again or rephrase it.
- Always be courteous and respectful to the judge. The administrative law judges are expected to act fair and impartial to all the parties. I assure you they will try to decide your claim based upon the evidence and the law.
- Understand that there are delays that are beyond your attorney’s control. It may take several months before the judge issues a decision on your case. There is nothing an attorney can do to expedite the process. The judge is going to read, review, and consider all the evidence before issuing the decision.
- Hearings are stressful. If it is necessary to go to a hearing over your claim, it is because there was no reasonable compromise that could be reached with the opposing side. Your attorney should discuss your claim in-depth prior to the hearing so you will know the issues and points of contention that will be addressed. Also, do not be surprised if the opposing party attempts to discredit you by introducing surveillance video taken of you, or by asking you about “negative” information about you or your alleged disability.
Should You Hire a Workers’ Compensation Lawyer?
We’re a little bit biased when it comes to this question, but it’s for two important reasons.
First, we understand the Georgia workers’ compensation process. It’s routine for us — very little surprises us at this point, so we can work quickly to contact the right people and get your case moving.
Second, we have the time and the resources to work on your case. The average person, especially after being injured at work, often doesn’t have the energy to pursue their workers’ compensation claim.
A workers’ compensation hearing can make or break your case. Why not have the best legal team at your side to support your claim and advocate for your rights?
Our Atlanta workers’ compensation attorneys are available now to discuss the facts of your work injury and situation. Call (770) 934-8000 or contact us online.