Most worker’s compensation claims in Wisconsin are resolved without the need for a hearing. In many cases, the insurance company accepts the claim and simply pays the benefits that are owed. However, worker’s compensation cases often involve complex medical and legal questions, and the insurance company may take a different position about what benefits are owed. In some cases, the insurance company denies a claim but the parties are able to reach a settlement to resolve the case. If the parties are not able to settle, the dispute may need to be decided by a judge at a worker’s compensation hearing.
For many injured workers, this is the first time they have ever participated in any type of legal proceeding. It is normal to feel nervous or unsure about what will happen. Many people imagine a dramatic courtroom scene like you might see on television. In reality, worker’s compensation hearings are usually much less formal than a traditional trial. There is no jury, they are typically held in a conference-room style setting, and the focus is simply on gathering the information needed to resolve the dispute.
Still, it is natural to have questions such as:
- What actually happens during a worker’s compensation hearing?
- Will I have to testify?
- What questions will I be asked?
- Who will be present at the hearing?
Understanding the process ahead of time can make the experience far less stressful and help you feel more prepared if your case goes to a hearing. Below is an overview of what to expect at a Wisconsin worker’s compensation hearing.
What Is a Worker’s Compensation Hearing?
In Wisconsin, disputes about worker’s compensation benefits are decided by an Administrative Law Judge through the Wisconsin Department of Workforce Development. A hearing is scheduled when the injured worker and the worker’s compensation insurance company disagree about issues such as:
- Whether the injury happened at work
- Whether the worker is still disabled
- Whether ongoing medical treatment is necessary
- Whether the worker is entitled to additional benefits
- The amount of permanent disability
A worker’s compensation hearing is essentially an opportunity for an Administrative Law Judge to hear both sides of the dispute, review the medical evidence, and determine what benefits the injured worker is entitled to receive under Wisconsin law.
Where Worker’s Compensation Hearings Take Place
Once you receive a notice of hearing, the address of the hearing room will be listed. The city a hearing is scheduled in depends on where you live, where the injury took place, and judge and hearing room availability.
Who Attends the Hearing
Several people may be present at a worker’s compensation hearing, including:
- The Administrative Law Judge
- The injured worker
- The worker’s attorney (if they have one)
- The employer’s attorney or insurance representative
- Witnesses for injured worker
- Witnesses for the employer/insurance company
- A court reporter who transcribes the testimony
Doctors generally do not appear at the hearing in person. Instead, their opinions are typically presented through their written medical reports. (See “Think Your Doctor’s Opinion Is Enough to Beat a Worker’s Compensation Denial? Not Without This Form.)
What Should I Wear to a Worker’s Compensation Hearing?
Many injured workers wonder what they should wear to the hearing. While the setting is more informal than a traditional courtroom, it is still a legal proceeding. In general, it is best to dress neatly in “business casual” clothing, such as a collared shirt, sweater, or blouse paired with slacks or khakis. You do not need to wear a suit, but you should avoid overly casual clothing such as shorts, ripped jeans, or clothing with large graphics or slogans.
Your attorney can also give guidance about what is appropriate for your specific hearing.
What Happens During a Worker’s Compensation Hearing
Although each case is different, most worker’s compensation hearings follow a similar structure.
First, the court reporter, judge, and both sides will handle preliminary procedural measures, such as marking exhibits and ensuring that both sides agree on what issues are in dispute.
Second, the injured worker’s attorney will call their first witness. This is usually the injured worker themselves. Testimony is given through the worker’s attorney asking open-ended question and the injured worker answering them.
After the worker testifies, the insurance company’s attorney has the opportunity to cross-examine the worker. Their goal is to bring out evidence that is unfavorable to the worker’s case or poke holes in the injured worker’s side of the story. Then, the worker’s attorney gets to ask questions again (called “redirect”) to clarify items discussed during cross.
After the injured worker and any witnesses that they have testify, the employer and insurance carrier have the opportunity to call any witnesses. In many cases, they do not call any witnesses. Depending on the facts of the case, they may call witnesses such as the following:
- A coworker who will testify that they observed something different about the injury than what you testified to.
- A manager who will testify about how your employment ended, if that is an issue in the case.
- A private investigator who conducted video surveillance that is being shown at the hearing.
Your attorney will also have the opportunity to cross-examine these witnesses.
You should generally expect the hearing to take between two to four hours. (The presiding judge on the case will be able to confirm exactly how much time is reserved for the hearing.)
What Questions Will I Be Asked at a Worker’s Comp Hearing?
One of the biggest concerns injured workers have is what questions they will be asked during their testimony.
While every case is different, many hearings focus on similar topics, including the following:
Questions About the Injury
- What job duties you were performing
- When and where the injury happened
- Whether anyone witnessed the accident
- When you reported the injury to your employer
Questions About Your Job
- What your normal duties were before the injury
- Whether your job required lifting, standing, or repetitive motions
- Whether your employer offered modified or light-duty work
- When and whether you returned to work
Questions About Medical Treatment
- When you first sought treatment
- What doctors you have seen
- What treatments or surgeries you have had
- Whether your symptoms have improved or worsened
- What future treatment is recommended or upcoming
Questions About Your Current Limitations
- Whether you are able to work
- Physical limitations you experience
- Activities you can no longer perform
- Ongoing pain or symptoms
These questions help the judge understand how the injury occurred and how it affects your ability to work. If your condition was not caused by a specific injury, but rather your job duties over time, testimony will focus on the specific job duties you performed over the course of your work with the employer.
If how your employment ended is also an issue for your case (such as, if you are claiming that the employer terminated your employment because of your injury), testimony will also focus on how your employment ended.
What Happens After the Hearing?
In some cases, the testimony cannot be completed in a single hearing session. If that happens, the case may be scheduled for a second day of hearing weeks or months later.
Even if all the testimony finishes on one day, the judge will not make a decision at the hearing. Instead, the Administrative Law Judge reviews the testimony, medical evidence, and legal arguments before issuing a written decision within about two to three months. If either party disagrees with the decision, they may appeal to the Wisconsin Labor and Industry Review Commission, who will review the decision and either reverse or uphold it.
Do I Need an Attorney for My Worker’s Compensation Hearing?
While you are not required to have an attorney to attend a worker’s compensation hearing in Wisconsin, it’s important to remember that these hearings are legal proceedings where evidence is presented and witnesses are questioned. During a hearing, both sides have the opportunity to present testimony, submit medical records, and cross-examine witnesses. The insurance company will usually be represented by an attorney whose job is to challenge the claim or limit the benefits that are paid. It is beneficial to also have an attorney on your side who has handled numerous cases in the past and can help with important parts of the process, including preparing you to testify, organizing and submitting exhibits, and questioning witnesses. Proper preparation can make a significant difference in how clearly your case is presented to the judge.
If you don’t yet have an attorney, contact our office today to discuss your case. Especially if you already have a hearing date scheduled, acting quickly can help ensure there is enough time to properly prepare.