The Insurance Company Denied my Claim

If your claim is denied, you will most likely have to go through the full evidentiary hearing process to receive a decision from the North Carolina Industrial Commission on whether your claim is compensable. The full evidentiary hearing process can unfortunately be very lengthy, time-consuming, and stressful on an injured worker and their family. Going to hearing does not guarantee a better outcome to your case. Each case is different. Our board certified workers' compensation specialist at the Olsinski Law Firm can help you evaluate if proceeding to hearing makes sense in your case.

Before a case goes to hearing, the parties will be ordered by the Industrial Commission to participate in a mandatory mediation. Mediation is an informal process which affords both parties an opportunity to explore a resolution that will allow them to avoid a full evidentiary hearing. The mediator will help the parties explore a resolution. Most workers' compensation claims settle at mediation. Even if a case does not settle at mediation, the mediation process can still help the parties exchange information and their respective positions about the case. The parties may then be able to settle the case after the mediation but before hearing.

If your case does not settle at mediation, then it will be referred for a full evidentiary hearing. A Deputy Commissioner will preside over your hearing. Similar to a trial, both parties are able to call lay witnesses to testify at the hearing. Lay witnesses in a workers' compensation hearing are usually the injured worker and representatives from the employer. However, your family, family, and other individuals who observed your injury may also be called as lay witnesses.

After the hearing, deposition testimony is obtained from your medical providers and potentially other experts. The attorneys will ask your medical providers questions about your condition, future treatment needs, and may inquire about causation issues. The outcome of a workers' compensation case often hinges on the statements of your medical providers. The Deputy Commissioner will often consider the testimony of your medical providers when issuing a decision in your case.

After depositions are completed, the attorneys will be given 30 days to submit written Contentions to the Deputy Commissioner. Contentions are legal briefs that state each party's arguments, positions, and supporting law. Contentions can often be dozens of pages long. Extensions to deadlines to take depositions and submit Contentions are often granted.

After Contentions are submitted, the Deputy Commissioner has six months to issue a decision in your case. The Deputy Commissioner's decision may be "all or nothing", meaning one party wins on all the issues and other party loses.

Either party can then appeal the Deputy Commissioner's decision to the Full Commission in Raleigh, North Carolina. This will result in approximately six additional months of litigation. Only attorneys argue an appeal before the Full Commission. If your case hinged on the credibility of the witnesses, the Full Commission may be inclined to agree with the Deputy Commissioner's decision because the Deputy Commissioner observed the testimony of the witnesses. In limited circumstances, a workers' compensation case may be appealed to the North Carolina Court of Appeals and then the North Carolina Supreme Court.

As you can see, the full evidentiary hearing process can be lengthy and cumbersome for you and your loved ones. There is no guarantee you will prevail at hearing. While your case is litigated, you may be out of work and not receiving treatment for your injuries or last wages.

The Olsinski Law Firm can help you decide if a hearing makes sense in your case. If so, we will zealously represent you throughout the entire hearing process. We can also help you evaluate whether you should work to negotiate a reasonable settlement instead of going through the litigation process.

Contact us today for a free and confidential initial consultation about your workers' compensation claim.