Disputes resolved at the Workers’ Compensation Board
The Workers’ Compensation Board’s Hearings Division provides a forum for timely and impartial dispute resolution. In hearings conducted by administrative law judges (ALJs), parties have an opportunity to present their case. They have the right to be represented by counsel, to have a qualified interpreter, to present evidence (lay and expert witnesses, personal testimony, medical and vocational reports, etc.), to compel testimony by subpoena and under oath, to receive pre-hearing disclosures of evidence, to present arguments on issues of fact and law, to provide cross-examination and impeachment evidence, to have the hearing postponed or continued, to have the hearing at a location not distant from the worker’s home, and to request reconsideration of an order and appeal an order.
SB 1197 (1990) created the reconsideration process, which reduced hearing requests and resulted in a shift in the issues involved. Permanent disability decreased from being an issue in 32 percent of hearing orders in 1989 to 18 percent of hearing orders in 1991. In 1995, SB 369 also reduced litigation by requiring that workers with a condition they believed was omitted from a notice of acceptance needed to notify the insurer rather than claim a de facto denial in a hearing request.
The Board Review Division hears appeals of ALJ orders, decides WCB own-motion cases (re-openings or additional benefits after aggravation rights have expired), approves CDAs, hears appeals of Department of Justice decisions in the crime victim assistance program, and resolves third-party disputes (distribution of proceeds from a liable third party, between insurer and worker). The board is composed of five governor-appointed members: the chair, two members selected for their understanding of employer concerns, and two members selected for their understanding of employee concerns. Appeals are heard by at least one “worker” member and at least one “employer” member.