Whether you’re an employee or an employer, the Indiana workers' compensation system may be a mystery if you haven’t gone through the process before. The attorneys at Coriden Glover educate our clients not just about applicable laws but also about how the system works and their best options as their case proceeds.
Most workers' compensation disputes are worked out between the employer, insurance company and employee. If the parties can’t come to an agreement, the case proceeds through the state’s workers' compensation system, which is an administrative law process, not a civil matter like a personal injury case. If that outcome goes against a party, an appeal can be taken to the state’s appellate court system.
Most Indiana workers' compensation disputes are resolved early in the process.
If a claim is initially denied, the worker’s attorney normally talks to the employer's insurance carrier or the self-insured employer to find out why. There may be miscommunication between the parties or missing medical records; clearing up these details may reverse the denial. Most claims are successfully resolved at this level.
If that’s not the case, the Workers' Compensation Board’s ombudsman division can help find ways to avoid pursuing a more confrontational approach. The Board offers a number of alternative dispute resolution (ADR) services to which save time, energy and resources which would be expended in a formal hearing process.
The informal dispute resolution process starts by filing a Request for Assistance form, and the Board’s Case Coordinators next conduct an investigation into the claim to try to bring it to a resolution. If the end result isn’t favorable to the requesting party, he or she can appeal it through the formal hearing process.
Indiana workers' compensation hearings are less complex than litigation through the courts.
The case would next be assigned to a Single Hearing Member of the Workers' Compensation Board to decide the unresolved issues. An Application for Adjustment of Claim must be filed by an individual with the Board within two years of the date of the injury. If an occupational illness is at issue, the claim must be filed within two years of the person's becoming disabled. An employer can submit an Application for Adjustment of Claim at any time a claim is in dispute.
A conference or a hearing is scheduled before a Single Hearing Member in which each side presents its evidence. The burden of proving the accidental injury happened in the course and scope of employment is on the employee. After the hearing, an award is served on the parties. It spells out the stipulations of the parties (the issues which the two agree on), findings of fact and the conclusions of law reached. If either party objects to the award, an appeal can be filed with the Board within thirty days of the date of the award.
Full Indiana Workers' Compensation Board hears cases as last step in the administrative process.
The case is normally scheduled for the next date the full Board is available (normally about three months). Generally these appeals are not new hearings, with the introduction of new evidence (though a party can petition to introduce new evidence). The full Worker's Compensation Board (composed of six Single Hearing Members and the Chairman) reviews the evidence already submitted at the prior hearing and hears legal arguments from the parties.
After the hearing, the Board serves a written award upon the parties which will affirm, reverse or modify the prior award by the Single Hearing Member. Decisions by the full Board are conclusive and binding concerning questions of fact, but either side can appeal to the Indiana Court of Appeals if the party believes legal errors were made which caused the improper award. The Board could also decide to stay an action while they certify questions of law to the Court of Appeals for interpretation of a legal issue.
If a party is dissatisfied with the Court of Appeals’ decision, it can be appealed to the Supreme Court of Indiana.
How we can help
No matter what side of a claim you’re on, a workers' compensation dispute might seem like an intimidating process. With the help of Coriden Glover, it doesn’t have to be. Our knowledge and competence in the field ensure that your interests are being represented.
At Coriden Glover, our experience is an asset to our clients, and we can give you knowledgeable, skilled representation in all stages of a dispute. Contact us today to learn how we can assist you.
