FAQs About Mediation And Arbitration In Workers' Comp Cases

Posted on: 22 February 2016

Some states are turning to arbitration and mediation to settle disputes concerning workers' compensation claims. If you and your employer's insurance company are unable to reach an agreement on whether or not you are entitled to benefits, heading to arbitration or mediation might be a good way to settle your case. Before you decide whether or not to attend, here is what you need to know. 

Is It Mandatory?

In some states, whether or not you have to attend arbitration or mediation is not voluntary. The Department of Labor, or DOL, and the appeals court could order that you and the insurance company attempt to reach a resolution before any further actions can be taken in the case. Since the rules regarding mandatory attendance can vary by state, check your state's laws before taking any actions. 

If your state does allow for voluntary attendance, both parties have to agree to attend. Both parties will have a say in which mediator or arbitrator is used. You also need to decide on who is responsible for paying the mediator or arbitrator's fees. 

Is the Agreement Binding?

Depending on your state's laws, whatever is determined during mediation or arbitration might be binding. In other words, you cannot appeal the decision that is made during the negotiations. 

For instance, in the state of Texas, the arbitrator has the final word in how a dispute is settled in a workers' compensation case. However, if at least one party does not want to attend arbitration, it can be skipped and the case can be heard at a formal hearing with the Texas Department of Insurance. The decision made during the hearing can be appealed. 

What If the Agreement Is Not Binding?

If you live in a state in which the agreement reached during mediation or arbitration is not binding, you have the right to proceed to the next step in the appeals process in your state. 

Depending on your state, that could mean going back to the DOL for an appeals hearing. In some states, it could mean filing a formal appeal in the state courts.  

The decision to continue the appeals process is solely up to you. However, it is important to note that it can be time-consuming and emotionally taxing for some people. Before continuing, consult with an experienced attorney who is familiar with your state's laws to determine the best course of action. To learn more, contact a company like McMullen & Ochs PLLC.