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Presenting Your Workers' Compensation Claim to the Office of Judges
 
 

Presenting Your Workers' Compensation Claim to the Office of Judges

TIPS, HELP, AND POINTERS

    YOU MUST SUBMIT EVIDENCE OR ARGUMENT TO THE OFFICE OF JUDGES OR YOU WILL LOSE.

Evidence already submitted to the claims adjustor will not win your case before us.  You must submit evidence, or written argument, or your protest will be dismissed by Rule. 

If you have already submitted evidence to the claims adjustor, and you believe that evidence is enough to win, then you must write to us and tell us what evidence you have submitted and why you should win.

    YOU HAVE A DEADLINE TO SUBMIT ALL EVIDENCE OR ARGUMENTS.

The time limit to submit evidence or argument to us is given to you in the document called “ACKNOWLEDGEMENT OF PROTEST AND AUTOMATIC TIME FRAME ORDER”.  Evidence or argument submitted to us after that deadline WILL NOT BE CONSIDERED in our decision.

If you cannot submit your evidence to us before the end of the Time Frame, then you can ask for more time.  You must write to us at least ten (10) days before the Time Frame ends and tell us why you need more time, and how much time you need.

    COPIES OF ALL EVIDENCE FILED MUST BE SENT TO THE OTHER PARTIES.

There are always two, and sometimes three, interested parties to any protest:

    The injured worker (called claimant)
    The employer (or employers)
   

The Offices of the Insurance Commissioner (for Old Fund, Uninsured Fund, and other State Fund claims)

We will not accept evidence filed with us unless it is shown that a copy was sent to the other parties (or their attorney).

The mailing address for the Offices of the Insurance Commissioner, if not represented by an attorney, for evidence copies, is the same as the claim administrator.

    YOU WILL NOT AUTOMATICALLY HAVE A HEARING FOR THIS PROTEST.

Usually we only schedule hearings when one is requested by a party.  Many issues can be decided based entirely on written documents without any testimony.

If your claim is initially denied by a self-insured employer, then we will automatically schedule a hearing whether or not you ask for one.

If you have a hearing, the hearing may not be conducted by the Judge who will decide your case.  Hearings are usually conducted by judges.

There will be several hearings scheduled at the same time and the hearing examiner will decide in what order to conduct the several hearings.  This is done as a matter of administrative convenience because many hearings get cancelled by the parties at the last minute.  Also, we have no way of knowing whether a hearing will last five minutes, or one hour.  So we have to schedule them all at the same time.

    YOU WILL NEVER GO TO COURT.

Unlike some other areas of the law, there are no juries and no court appearances.

    IF YOU ARE AN INCORPORATED EMPLOYER, THEN YOU MUST BE REPRESENTED BY AN ATTORNEY. EVERYONE ELSE CAN HAVE AN ATTORNEY, OR NOT, AS THEY WISH.

This is a rule set by the State Supreme Court and the WV State Bar Association, not by the Office of Judges.

If you are incorporated, you may ask for a hearing and testify, but you cannot question the claimant, make procedural motions, or make legal arguments.

    KNOW WHAT THE ISSUE IS AND STICK TO THE ISSUE.

Many inexperienced people get the issues confused and get sidetracked.  They can try to offer evidence on an issue that is not contested. 

For example:
If the issue is the degree of Permanent Impairment (PPD award) then testimony about how the injury occurred or who the witnesses were is completely irrelevant.

Also, several different orders of the Commission or self-insured employer may be pending before us at the same time.  Evidence submitted for one protest does not automatically get considered in all protests.  Make sure that you identify each protest in which you want your evidence considered.  Use the DOCUMENT SUBMISSION FORM, found in the “Forms” section of this website, to help us know for which protest the evidence is intended.
 

    AFTER THE TIME FOR FILING ALL EVIDENCE IS OVER, THEN WE WILL DECIDE THE PROTEST.

At the end of the time frame, we will issue a notice that contains a list of all the evidence received.  If there is any mistake in that list, you must immediately call us and let us know of the error.

Our rule requires us to issue our final decision within ninety (90) days of the Order Submitting Protest.  We decide about 60% of all protests within thirty (30) days, 90% within sixty (60) days, and the rest within ninety (90) days.

    IF YOU LOSE, YOU MAY APPEAL OUR DECISION TO THE WORKERS’ COMPENSATION BOARD OF REVIEW.

You must notify the Workers’ Compensation Board of Review in writing within thirty (30) days that you intend to appeal. The Board of Review will require you to complete an APPEAL FORM.

You may NOT submit new evidence to the Board of Review so make sure you get all your evidence to us within the time limits.

    IF YOU HAVE QUESTIONS ABOUT OUR PROCESSES, CALL US AT 304-558-0852 OR 304-558-1686

If you have legal questions and you are represented by an attorney, you should ask your attorney for the answers.

Do NOT try to contact directly the Judge to whom your case has been assigned. Judges must remain neutral and cannot discuss your case without the other sides also being included in the conversation.

    PLEASE LOOK AT THE “FREQUENTLY ASKED QUESTIONS” SECTION OF THIS WEBSITE FOR MORE INFORMATION.
 
 
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