Even under the most enlightened management, occasions will arise where the employer is engaged in a dispute with an employee or a health care provider who is treating the employee. The following is an introduction to the procedures and legal issues an employer should know so they can help the adjuster and attorney prepare for trial. A flow chart demonstrating the litigation process can be found in Part II, Adjusting Tools.
The filing of the claim – The litigation process begins when the claimant (employee alleging injury) files a notice of a claim with the Office of Workers’ Compensation (or the employer files a notice he intends to controvert the employee’s hermes replica handbags entitlement to benefits). While in most cases the employee will be represented by an attorney, it is not required by law. Thus, the claim of the employee may be filed by the employee alone.
Communications with claimants’ attorney – Should you receive a letter from an attorney advising you of his representation of an employee, you should immediately forward this information to your Third Party Administrator (TPA) or workers’ compensation insurance company. You should not respond to the letter or speak with the attorney. You should also request that any employees refrain from communicating with the claimant’s attorney unless your attorney or the adjuster responsible for your workers’ compensation claims is present.
Notice of a Mediation Conference – Upon the employee’s filing of a notice of claim, the Office of Workers’ Compensation will mail a notice of Mediation Conference to the employer. It is extremely important that you send this notice to your TPA or workers’ compensation insurer immediately. They may not have received a similar notice. You should contact the TPA or workers’ compensation insurer to discuss your role at the mediation conference. Only if the attorney representing you is present, can you avoid appearing at the conference. The Office of Workers’ Compensation has established penalties to be imposed upon parties who fail to appear at the conference (either in person or through an attorney). The mediation is an informal meeting. The purpose of this meeting is to determine whether the parties can resolve any issues without going to a formal trial. Should the parties be unable to resolve the dispute, the employer and his insurer (if present at the hearing) will be served with a formal citation (a notice that you have been sued). This document should be given immediately to your TPA or workers’ compensation insurer so that they can arrange for your legal representation.
Assisting your attorney – You can expect to receive correspondence and telephone calls from the adjuster and the attorney appointed by the TPA or insurer to defend you in this claim. They may request the personnel file and wage records of the claimant. Be sure to give them ALL the information requested. You may think that some of the file material is not important, however, it is best to give all of the information and let the attorney decide what will be needed at trial. The wage information should be provided exactly as requested. They will need original documents to use as evidence at trial. The attorney may also need your help in identifying any co-workers who will help you in defending the case (individuals who were working with the claimant when he alleges to have been injured). Should you have any information that replica omega watches suggests that the claimant is not disabled (i.e., activities since job accident), be sure to provide your attorney with this information. You may want to refer to Part II, Adjusting Tools – Adjuster’s Checklist for Meeting with Insured.
Your deposition – In some cases the attorney representing the claimant will request your deposition. The deposition is arranged in “question and answer” format. All of the attorney’s questions and your responses to them are recorded by an official court reporter. The deposition is usually taken at the office of your attorney or the office of the claimant’s attorney. Usually, your attorney will contact you to arrange a meeting prior to the deposition. When an employer’s deposition is taken, the common issues addressed are those involving the question of whether or not an iwc replica watches accident occurred at work and issues involving the calculation of the claimant’s wages. Although it is understandable that you may be anxious about the deposition, it is important to remember that your only responsibility is to tell the truth. It is not your job to worry about whether the truth will help or hurt the case.
- While you are required by law to be truthful, you are not required to volunteer information that is not asked by the claimant’s attorney.
- Be sure to listen carefully to the question and answer the question truthfully and directly.
- You are only required to give information that you have developed from your own senses (what you personally saw, did, heard or felt).
- You are not required to give testimony which is only your guess, speculation, or assumption.
The trial – The workers’ compensation judge will schedule a telephone scheduling conference to be held 60 days after the defendant files an answer. This conference is to set all pre-trial deadlines and a trial date. A pre-trial conference will also be scheduled at this time. The pre-trial conference will be set no less than 45 days prior to trial. Trial will be set for not more than 6 months from the scheduling conference. At the pre-trial conference, the attorneys and the judge will discuss the issues to be litigated. You may receive a subpoena from your attorney to appear at trial. This is necessary so that your attorney will be legally entitled to continue the trial should you be unable to appear (e.g., illness or family emergency).
Your trial testimony – Your attorney or the claimant’s attorney may call you as a witness during the trial. Be sure to show respect for the court by wearing appropriate, professional clothing. When called as a witness:
- Sit up straight and speak loudly and clearly so that the judge and court reporter can hear you.
- When answering questions from the attorneys, listen carefully to the question and answer that question directly and truthfully.
- At all times, show respect to the attorney and the judge.
- Do not allow yourself to be tricked into arguing with the claimant’s attorney. Your job is to simply answer the questions and let your attorney do the arguing.
The trial judgment – Do not expect the judge to render a decision on the day of the trial. In most cases, the court will ask the attorneys to prepare post-trial memorandums in which they argue the points they believe they made at trial. Within a month of the trial, the court will issue a decision.
Appeals – The party who is unhappy with the decision of the court, has the right to appeal the decision to the appellate court. After the appellate court has ruled, the losing party has the right to ask the Louisiana Supreme Court to review the decision of the appellate court. The Supreme Court is not required to hear an appeal in civil matters (such as workers’ compensation claims).