|
An injured worker or
Victim of Crime Program applicant, may request a hearing if they receive a
determination from an insurer or self-insured employer, or VOCP, that they
do not agree with.
If the injured worker has
written to the insurer or self-insured employer and they have failed to
respond to the injured worker’s written request within (30) days the may
appeal the “failure to respond” to the injured workers letter. An injured
worker has (70) days from the date of the insurer’s determination or the
date the worker mailed the written request to the insurer, to request a
hearing before the hearing officer.
The request for hearing
must be made in writing and must include a copy of the letter or notice that
is being appealed. If the decision letter is not included it will result in
delays and possible dismissal of the appeal.
Initial hearings are
scheduled within (5) days from the date the hearing request is received at
the Hearings Division and are set within (30) days. All parties are given at
least (15) days prior notice of the date of hearing.
Copies of all
documentation to be submitted to the hearing officer must be provided to the
other side.
If an interpreter is
necessary for translation at the initial hearing, including an interpreter
for the hearing impaired, it is up to the appealing party to notify the
Hearings Division of need for assistance.
At the initial hearing,
the appealing party will usually be required to provide their own
interpreter.
HEARING OFFICER’S
AUTHORITY AND JURISDICTION
A Hearing Officer’s
authority and jurisdiction is to conduct initial administrative hearings for
review of final determinations made by an insurer in contested claims for
compensation, or written decisions of the compensation officers in Victims
of Crime appeals.
The Hearings Officer
level is the first level of hearing and is an informal process. The parties
are encouraged to attend the hearing in person, but they may participate by
telephone conference call (at their expense if long distance) or a party may
submit their appeal position in writing.
All initial contested
workers’ compensation claims and VOCP appeals are heard and decided at the
Hearings Division by a Hearings Officer. If a party does not appear or
submit a position statement their appeal will be dismissed.
IMPORTANT POINTS ABOUT
YOUR HEARING BEFORE THE HEARING’S OFFICER
Your hearing is only to
address issues you appealed as a result of the insurer’s written
determination, or failure to respond to a written request.
It helps to be present at
the hearing, but you can appear by telephone if necessary, or you may submit
a written position statement and not appear at the hearing in person. If you
wish to be present by telephone, you must notify the Hearings Division at
least (1) week prior to the hearing date.
To help avoid unnecessary
delays, hearing attendees should provide copies of any documents presented
to the Hearing Officer, to the other side.
It is the appealing
parties responsibility to prove their case. Know your issues and the
documentation necessary to prove them.
The Hearing Officers are
trained in mediation and will attempt to resolve the issue. The Hearing
Officer is required to conduct a fair and impartial hearing, so it helps to
follow their directions and allow them to control and direct the hearing.
At the appropriate time,
when directed by the Hearing Officer, present your evidence and state your
case as calmly and briefly as you can.
If
the injured worker, employer or insurer, or the VOCP applicant disagrees
with the hearing officer decision, they may appeal to the Appeals Officer. |
