This post explains what happens when “issues” are filed in your workers’ compensation claim. You either have or will receive a paper notice in the mail from the Workers’ Compensation Commission (WCC) telling you that “issues” have been filed in your case.
The WCC uses a lot of odd terminology. If either party has a dispute with the other side and wants to request a hearing in a workers’ compensation claim, you file “issues” in the claim. That tells the WCC that you want a hearing, and a hearing will be automatically set. They give you notice of the “issues” being filed, and then later (sometimes a lot later) they will send you the hearing date notice.
So all this really means is that somebody filed for a hearing in your case and we are now waiting for a hearing date. If we filed for the hearing, you should know what it is about. If you are in the PPD process, you may want to re-read this post about how that process works.
Timing: It may take anywhere from 60 to 90 days to get a hearing to resolve this issue. I know that may sound unfair, but this is the normal wait time. Hopefully we will get the hearing date notice within 30 days, and then have the hearing about 30 days after that. That is how it is supposed to work, but I don’t make any promises. I don’t control how fast they set hearings at the Workers’ Compensation Commission. I have seen long, unexplainable delays, and I have seen hearings set in 2 weeks. Nobody can predict it.
Emergencies: If you have a genuine emergency, you may be able to get an emergency hearing. This is an “add on” hearing at the end of an already full docket. As you can imagine, the Workers’ Compensation Commission doesn’t like to do them. But they will if you (a) have a good enough reason, and (b) have documented proof of your reason.
Just being behind on bills is not enough. You have to be about to lose your house or car, or something major like that. If that is your case, you need to let me know immediately and provide me with some documentary proof (like an eviction notice or repo letter). Call me if you think you qualify for an emergency hearing.
What Caused This? You should be aware of the dispute that generated the need for issues in your case. We have probably discussed it. If you are not aware, call me immediately. It is probably because the insurer denied you something and we are fighting for it, or because we are pursing PPD benefits at the end of your case.
Sometimes the insurer files issues and doesn’t tell us what the problem is. They are supposed to send me a copy of the issues they file, but they do not always do that. We may have to talk about what has been happening in your claim before I can figure it out. (This only happens when the insurer is being sneaky or lazy. It is not the normal way it happens – so don’t necessarily worry about your particular claim when reading this.)
Sometimes we file issues in your workers’ compensation claim just to light a fire under their rear end. Sometimes they just don’t respond to our requests. If that happens, it may be because they are slow in responding. Or it may be that they are denying the request altogether. I may not be sure. There is nothing in the law saying they must let me know when they deny something (one of the many things I would change about workers’ compensation law if I were a politician). If that happens, I have to assume the worst and file issues. That will get a response from them.
I do not just file issues at the drop of a hat. The Workers’ Compensation Commission hates that. I don’t want to make them mad at us! So I always try to get a response or resolve a dispute. But if we cannot resolve something, or at least get an answer, we have to file issues and request a hearing.
If we resolve the underlying dispute, we can always withdraw our issues and cancel the hearing. I can literally do that at the very last minute. And if we do resolve these issues, you should assume they won’t resolve until right before the hearing.
It is always in the best interests of the insurance company to delay everything. This is one way they do that. They don’t resolve disputes until the last minute. Often my clients have to wait a month or two until a hearing date is set, then the insurer just gives up and resolves everything anyway. This seems unfair, but it is the system we have now. The law allows the insurer to do this. Hope they don’t act like that, but assume the worst and prepare for it.
As always, if you have any questions or concerns after reading this, give me a call to discuss it.
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