When you file your claim for workers’ compensation benefits after a workplace injury, your employer or their workers’ compensation insurance carrier will investigate your claim. They have a duty to do this within 21 days of the date they receive your notice of injury. Once they complete their investigation, they will either begin paying you workers’ compensation benefits for your medical bills and lost wages or will deny your claim.
If your claim is denied, you will have two options for disputing the denial. You can either file an Application for an Informal Hearing or a formal Claim Petition with the New Jersey Division of Workers’ Compensation. Before deciding what to do, you want to hire an experienced workers’ compensation attorney who can advise you on which route is the best for your situation.
What Is an Application for an Informal Hearing?
An Application for an Informal Hearing is a less formal proceeding for resolving disputes regarding workers’ compensation claims. It can be filed by the worker, the employer, or the employer’s insurance company. By filing an Application, you are requesting an informal hearing before a judge of compensation.
This process is a way of resolving disputes without the need for more lengthy and complex proceedings associated with filing a Claim Petition. Informal hearings are used to resolve a number of issues, including the following:
- Amount of temporary workers’ compensation benefits
- Medical treatment
- Permanent workers’ compensation benefit awards
Once you file the application, you and your employer and/or its insurance company will receive a notice regarding your scheduled hearing. Your hearing will often be scheduled within a few weeks after you file your application. While you are not required to have an attorney present, it is best to be represented by an attorney to increase the likelihood of a favorable outcome. At the hearing, the judge will offer suggestions on how to resolve your disputes. Generally, disputes are resolved in one or two hearings—if they can be settled through this process.
The suggestions the judge makes are not binding, and you have the option of filing a Claim Petition if you are unable to resolve your dispute. Filing an Application for an Informal Hearing does not stop the statute of limitations for filing a Claim Petition. This deadline is two years from the date of your injury or the last compensation check—including for medical benefits—that you receive.
Filing a Claim Petition
If you are unable to resolve your dispute in an informal hearing or the disputed issues are too complicated to be resolved in one or two hearings, you will need to file a Claim Petition. Before filing it, you should retain an attorney if you have not already done so to ensure that the petition is filed properly and to represent you at your hearings. Once your Claim Petition is filed, you can expect the following to happen:
- Your first pre-trial hearing with the judge of compensation will generally be scheduled approximately six months after you file your Petition.
- Your hearing will be in a Division of Workers’ Compensation office in the county where you live or work.
- Before and after your hearing, your attorney will investigate your claim, prepare your case for trial, and attempt to negotiate a settlement with the workers’ compensation insurance company.
- If your disputes are not resolved before or at the pre-trial hearing, your case will be scheduled for trial where you will have an opportunity to present witnesses and other evidence, such as your medical records and expert testimony, to support your claim.
- Most workers’ compensation disputes are settled before the trial date.
- If your case goes to trial, the judge will issue a decision on your claim. Unlike an Informal Hearing, the judge’s decision is binding unless your employer or you file an appeal.
Did your employer deny your claim for workers’ compensation benefits? Call our office today to schedule your free consultation with Manfred Ricciardelli to learn about your legal options and whether filing an Application for an Informal Hearing or a Claim Petition is the best option for you.