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Hearing prep pp
- 2. 1. How to put your file together • Left side: • Right Side: • FROI • Correspondence, Memos and • Accident report Email • – Anything to/from claimant or Hearing notice ER • BWC/ER medical • If SI, and not contested, • Medical from treating doctors allowed conditions – Anything from treating doctors • Wage information • Decisions • Appeals Things to Note on File: AWW, FWW, SOL • Letters advising of exams • Questions and documents sent to ER doctor
- 3. Why you need to organize your file • Only way to prepare • Saves time in preparation • Ability to find something at the hearing table • Ability to answer your member’s question when asked
- 4. 2. Interview the Injured Worker Find out all you can • Exactly how did it happen • Witnesses • Repetitive motion What’s different Weight, frequency, motion • Injury • Report it to employer? • Medical • What else do I need to prove • Questionnaire • Sample
- 5. 3. Next up: what evidence do I need? • Get file from SI employer • If records are on BWC file, copy them • If exam by employer, get questions and records from employer or TPA • Medical from claimant’s doctors
- 6. 4. What’s next? Hearing Preparation Checklist • Hearing checklist for each type of hearing: Allowance—initial or additional causation, causation, causation substantial aggravation quicksand Treatment Benefits Temporary Total Wage Loss Maximum Medical Improvement (MMI) Permanent Partial • These are the most common. Less common— death benefit, PTD • Need to go on IC website and make sure your evidence is in the hearing officer folder
- 7. 5. Prepare to argue—Anticipation • What would you argue if you were the employer? List the evidence that supports your contrary position Get ahead of it—don’t wait for rebuttal Possible mistakes in employer/BWC medical File Review failure to review all medical records on file failure to accept factual findings in medical records IME failure to examine all conditions “slippery” words range of motion is “adequate” reflexes are “intact” strength is “sufficient” • After reading the IME—do you need something additional from claimant’s doctor? • If the doctor scores a significant point, consider getting a rebuttal
- 8. 6. After hearing—Appeal or Not? • Appeal even if you are not sure—you can always withdraw it • Review decision carefully—is there any way to obtain further support • Send out request for additional information asap before appealing to give you the maximum time for a response
- 9. 1. Appeal to IC? Yes • Even though this appeal is usually futile, it buys time • This is a good time to have claim reviewed by attorney
- 10. www.markadamslegal.com click on “News”