Whenever someone files an appeal from an order entered by the Department of Labor and Industries, the appeal is filed with the Board of Industrial Insurance Appeals.
In its process of handling the appeals, the Board of Industrial Insurance Appeals will assign a judge to act as a “mediator”. As a mediator, the judge has no power to decide the case, but will typically bring the parties together, whether it be the Department of Labor and Industries and an injured worker, or a self-insured employer and the injured worker, and discuss with them openly the relative strengths and weaknesses of their case or appeal.
This mediation process can be quite effective in resolving appeals. The mediation judge will often offer his or her thoughts on possible outcomes of the appeal considering the information that is shared.
It is usually helpful to have an observation of a disinterested third party to help everyone try to achieve a middle ground.
The Board of Industrial Insurance Appeals will send out notice that the case has been assigned to a judge for a mediation conference. The parties are asked to share with one another any evidence they have that pertains to the matter currently being appealed. This can deal with appeals regarding denial of claims, time loss rate, denial of time loss benefits, rejection or segregation of certain conditions, or closure of a claim with or without permanent partial disability.
It can be very helpful to have an attorney involved at this point, as the attorney can give you a better idea and understanding of what it would cost to proceed with your appeal and what evidence is necessary to prevail.
Often the decision of whether or not to proceed is affected by substantial costs for presenting expert medical testimony.
The Department of Labor and Industries, during the mediation process, is usually represented by a paralegal. We have found that the Department’s paralegals generally have a sincere interest in finding a fair result. They too are concerned about what it might cost in terms of expert testimony and time costs for the Department’s attorney representative.
Knowing the opinion of your treating doctor, as you go into the mediation/appeal process is very important. You should always discuss the appeal with your treating doctor and see what they think about your right to such benefits.
-David L. Lybbert