What Happens at a Pennsylvania Workers’ Compensation Hearing?
Receiving notice of a workers’ compensation hearing can be intimidating, especially if you have never been involved in a legal proceeding before. You may wonder who will be there, what questions you will be asked, how long the hearing will take, and whether a decision will be made that day.
In Pennsylvania, workers’ compensation disputes are handled by the Workers’ Compensation Office of Adjudication (WCOA), which is part of the Pennsylvania Department of Labor & Industry. When a petition is filed involving a disputed workers’ compensation issue, the case is assigned to a Workers’ Compensation Judge, commonly referred to as a WCJ.
Understanding what to expect can make the process a little less overwhelming.
Why Is a Workers’ Compensation Hearing Scheduled?
A hearing generally occurs because there is a dispute that requires a Workers’ Compensation Judge to resolve. An injured worker may file a petition seeking benefits, while an employer or insurance carrier may file a petition seeking to modify, suspend, or terminate benefits. Other types of workers’ compensation disputes can also be assigned to a WCJ.
Once a petition is filed, the WCOA assigns the matter to a judge. The parties then receive information about the assigned judge and scheduled proceedings.
One important point: a workers’ compensation hearing is not necessarily a one-time event. More complicated cases may require several hearings while the parties gather and submit testimony, medical evidence, depositions, and other information.
What Happens at the First Hearing?
The exact procedure can vary depending on the type of petition and the individual judge handling the case. The WCOA publishes procedural rules and policies for individual Workers’ Compensation Judges, so there is not one identical format used in every case. Current judge procedures may also provide for either virtual or in-person proceedings.
Under the WCOA’s general guidance, the judge typically establishes deadlines for the parties to submit evidence. The injured worker may testify at the first hearing, although that does not happen in every case.
When an injured worker does testify, questions may address topics such as:
- The worker’s job and job duties
- What happened when the injury occurred
- The nature of the injury
- Whether anyone witnessed the incident
- When and how the employer was notified
- Medical treatment received
- The worker’s current physical condition and ability to work
- If the worker has an attorney, the attorney will generally ask questions first. The employer or insurance carrier’s attorney is then permitted to cross-examine the worker concerning the testimony and matters related to the petition.
Who Has to Prove the Case?
There is no single answer that applies to every workers’ compensation petition. According to the WCOA, the party that filed the petition usually has the burden of proving the facts stated in that petition. The specific legal burden depends on the type of petition and the issues being decided.
That distinction is important. A worker pursuing a Claim Petition, for example, is in a different procedural position from a worker defending against an employer’s petition seeking to terminate existing benefits.
Because the burden and evidence required can change depending on the petition involved, workers should avoid assuming that every workers’ compensation hearing works the same way.
What Evidence May Be Presented?
Workers’ compensation cases can involve considerably more than the injured worker’s own testimony.
Depending on the dispute, evidence may include medical records, medical opinions, testimony from doctors, testimony from vocational experts, and testimony from other fact witnesses. Medical and vocational experts frequently provide their testimony through depositions rather than appearing personally before the judge. Pennsylvania’s workers’ compensation rules specifically provide for oral depositions and allow qualifying deposition testimony to be admitted as evidence.
An employer or insurance carrier may also require an injured worker to undergo a medical evaluation by a health care provider selected by the employer or insurer when permitted by Pennsylvania workers’ compensation law. The need to schedule examinations, expert testimony, depositions, and other evidence is one reason a contested case can take more than one hearing to complete.
Will There Be Mediation?
In most litigated Pennsylvania workers’ compensation cases, mediation is also part of the process.
Pennsylvania’s system provides for mandatory mediation unless it is determined that mediation would be futile. The mediation is conducted by a Workers’ Compensation Judge other than the judge deciding the underlying case. If the dispute is not resolved through mediation, it proceeds before the assigned judge. Mandatory mediation discussions are generally confidential under Pennsylvania’s workers’ compensation regulations.
Mediation does not mean that either side is required to settle. Its purpose is to give the parties an opportunity to resolve all or part of the dispute voluntarily.
Does the Judge Decide the Case at the Hearing?
Usually, a final decision does not come immediately at the end of the first hearing.
The parties may need additional time to present medical testimony, take depositions, introduce other evidence, or attend additional hearings. After the evidence is completed, each party has the right to submit a legal brief within the timeframe established by the judge. The judge then reviews the record and issues a written decision that is sent to the parties and their attorneys.
That written decision contains the judge’s determination of the disputed workers’ compensation issues.
Can a Workers’ Compensation Judge’s Decision Be Appealed?
Yes. A party that disagrees with a final decision of a Workers’ Compensation Judge may appeal to the Pennsylvania Workers’ Compensation Appeal Board.
The deadline is short: an appeal generally must be filed within 20 calendar days from the circulation date of the WCJ’s decision. The Pennsylvania Workers’ Compensation Appeal Board notes that special rules apply when the twentieth day falls on a Sunday or holiday.
Because missing an appeal deadline can have serious consequences, anyone considering an appeal should act promptly.
How Should You Prepare for a Workers’ Compensation Hearing?
Preparation will depend on the particular issues in the case. In general, it is important to understand what petition is being heard, review the important facts surrounding the injury and medical treatment, and be prepared to answer questions accurately.
Do not assume that you need to memorize answers. Testimony should reflect what you actually remember. If you do not know or cannot remember something, saying so is generally better than guessing.
It is also important to carefully review the hearing notice. Current WCOA procedures can differ among judges, including whether particular proceedings are conducted virtually or in person. The WCOA maintains individual procedural rules and policies for its Workers’ Compensation Judges.
Pennsylvania also currently warns injured workers about workers’ compensation scams. According to the Department of Labor & Industry, official hearing notices are sent by U.S. mail, and injured workers should not provide money or sensitive personal information to someone claiming that payment is required to receive workers’ compensation benefits or a settlement.
Do You Need an Attorney for a Pennsylvania Workers’ Compensation Hearing?
Pennsylvania permits an injured worker to represent themselves in workers’ compensation proceedings. However, a non-lawyer cannot represent the worker, and the Workers’ Compensation Judge cannot present the worker’s case for them. The Pennsylvania Department of Labor & Industry also cautions that workers’ compensation litigation is complex and notes that employers or insurers are represented by attorneys in these proceedings.
A workers’ compensation hearing can affect medical benefits, wage-loss benefits, and other important rights. Understanding the petition, the evidence that must be presented, and the procedural requirements can be critical.
If you have received notice of a Pennsylvania workers’ compensation hearing or are involved in a dispute over your benefits, Banks Law can help you understand what the hearing means and what comes next. Contact Banks Law to speak with an attorney about your individual situation. Banks Law serves injured workers in Philadelphia and throughout Pennsylvania.