If your workers’ comp case is going to trial, don’t panic. It doesn’t mean you’ve done anything wrong, and it definitely doesn’t mean you’re going to lose. In fact, trials are a normal part of the process when there’s a disagreement that can’t be resolved through negotiation.
In this article, we’ll break down:
- The most common reasons workers’ comp cases go to trial
- What happens during a workers’ compensation hearing
- How long the process usually takes in Pennsylvania
- Why legal representation matters
- How to prepare and protect your rights
Why Do Workers’ Comp Cases Go to Trial?
First, let’s understand what a “trial” is in regards to workers’ compensation. Workers’ Compensation does not involve a jury of your peers; rather, an Administrative Law Judge called a Workers’ Compensation Judge (WCJ) will oversee the litigation. This means that the WCJ is charged with determining resolutions not only to legal issues but also to factual disputes. Essentially the WCJ serves as a “jury” of sorts in determining which witness is more credible (believable) than the other. While many workers’ compensation claims are resolved without a hearing, others move to trial when there’s a dispute that can’t be settled. Here are the most common reasons why:
Disagreement About Benefits
Sometimes, your employer or their insurance company doesn’t agree with the amount or type of benefits you should receive. They may argue that you’re not entitled to wage loss benefits or challenge the extent of your injury. When these disagreements can’t be resolved informally, a workers’ comp trial may be necessary.
Denied or Delayed Claim
If your claim is denied outright, or if the insurer keeps delaying payments without valid reason, you may need to take the case to a hearing. This often happens when:
- The insurer claims your injury isn’t work-related
- There’s insufficient documentation
- There’s a delay in medical evaluations
Medical Disputes
Medical evidence is a key part of any workers’ compensation case. If your treating doctor says you can’t work, but the insurer’s doctor says you can, that’s a classic medical dispute. Conflicting opinions about the severity of your injury, your treatment plan, or your ability to return to work can push the case into a formal hearing.
Settlement Issues
You might be trying to settle your case with a lump sum payment, but the insurance company’s offer doesn’t reflect the full value of your claim. If negotiations break down, a trial may be necessary to get a fair outcome.
Employer Disputes
In some cases, your employer may dispute the legitimacy of your injury or claim altogether. They might argue that your injury didn’t happen at work or that you had a pre-existing condition. These types of disputes typically require a judge to review the evidence and make a ruling.
What Happens During a Workers’ Comp Trial?
A workers’ comp trial in Pennsylvania is not a jury trial, it’s a hearing held before a workers’ compensation judge. These hearings are less formal than courtroom trials, but they still follow a structured legal process.
Here’s what to expect during the hearing:
- Testimony: You may be asked to testify about how your injury happened, your symptoms, and how your daily life has been affected. Your employer and any witnesses may also testify.
- Medical Evidence: Both sides will present medical records and reports from treating and independent doctors.
- Judge’s Decision: After reviewing all the evidence and hearing testimony, the judge will issue a written decision. This decision usually comes several weeks or months after the hearing ends.
How Long Does the Process Take?
The PA workers’ comp trial process can take anywhere from several months to over a year, depending on the complexity of the case and how many hearings are required.
After the trial concludes, there may still be delays while waiting for the judge’s decision, or if one side appeals the ruling.
Patience is key, but having an experienced attorney can help move things along and ensure no deadlines are missed.
Do I Need a Lawyer for My Workers’ Comp Trial?
While you’re not legally required to have a lawyer, having one can make a big difference, especially in complex cases.
A skilled workers’ comp attorney can:
- Prepare and present your medical evidence
- Cross-examine the insurance company’s witnesses
- Handle procedural rules and filing deadlines
- Negotiate better settlements
- Appeal a decision if needed
The workers’ compensation hearing process can be confusing. Having a legal expert in your corner helps protect your rights and improve your chances of success.
How to Prepare for Your Workers’ Comp Trial
Here are practical tips to help you get ready for your hearing:
- Gather Medical Records and Evidence: Keep copies of all relevant medical documents, injury reports, and correspondence with your employer or insurance company.
- Follow Your Doctor’s Treatment Plan: Failing to follow medical advice could hurt your case.
- Avoid Social Media Mistakes: Don’t post anything that could be used to suggest your injury isn’t serious. Even innocent posts can be taken out of context.
- Stay in Touch With Your Attorney: Make sure your lawyer is aware of all developments in your condition and your case. Prompt communication makes for better strategy.
Conclusion
Having your workers’ comp case go to trial may feel overwhelming—but it’s often just a step in getting the benefits you deserve. It’s not a sign that your claim is weak or that you’ve done something wrong.
If you’re facing a workers’ comp dispute or have questions about the process, speaking with an experienced attorney can make all the difference.
Contact our office today for a free consultation and get the support you need to move forward with confidence.