Health Care

How Do Workers’ Compensation Mediation Processes Work?

How Do Workers’ Compensation Mediation Processes Work?

How Do Workers’ Compensation Mediation Processes Work?

Years ago, the North Carolina Industrial Commission instituted rules for mediations in workers’ compensation claims processes. When an individual requests a hearing before a Deputy Commissioner, the Industrial Commission will require all involved parties to resolve their disputes via Workers’ Compensation mediation. Although the parties are not obliged to reach an agreement, agreements are reached typically more than 75% of the time.

Why are Workers’ Compensation Mediation Services Needed and How do they get Scheduled?

Disputes arise in many Workers’ Compensation claims. Disputes can appear from the very beginning when the Workers’ Compensation carrier denies a claim. Rejections can also occur months into a claim and/or over the proper course of medical treatment. Any claimant may request a hearing before the Industrial Commission to get an opinion on the ongoing dispute. The Industrial Commission, however, will typically order a mediation before litigation.

Another situation that triggers a mediation is when the parties agree to mediate. Some cases go on for such a long time that everyone involved in the case (the injured worker, the employer, and the insurance company) agree that mediation is the most appropriate option.

Mediations are scheduled when all parties agree on a neutral mediator, as well as a date and time to hold the meeting. In most cases, Workers’ Compensation mediations are held at the plaintiff attorney’s office. Alternatively, one can consider facilitating these mediations at government centers or county courthouses.

If nobody agrees on a mediator, the Industrial Commission will select a mediator on behalf of all involved parties. Most Workers’ Comp attorneys often keep a list of the most capable mediators who can help their clients find common ground.

What Happens During Mediation?

Mediations usually start with a general briefing. The mediator, the plaintiff, the plaintiff’s attorney, the insurance company’s attorney, and other representatives from either the carrier or employer meet in a room to educate the mediator on the case. Both sides are typically given ample opportunities to voice their opinions, concerns, and other facts about the case.

After the initial meeting, the plaintiff and defendants (and their counsels) will separate themselves. These “breakout” sessions allow the mediator to get more details and provide further advice for both sides.

Who Pays for the Mediation?

In North Carolina, all parties share the cost of Workers’ Compensation
mediation. Insurance companies, however, will typically be responsible for paying all the upfront fees. If an injured worker proceeds to claim his or her Workers’ Comp benefits at some point after the mediation, the insurance company may seek the Industrial Commission’s approval to recover the plaintiff’s portion of the mediation fee at that time.

If you’re involved in a Workers’ Comp mediation, feel free to contact Cardinal Law Partners for any inquiries. Our Board-Certified Workers’ Compensation attorneys have represented injured workers in hundreds of mediations over the last 15 years. We understand how these mediations work and the types of deals that insurance companies tend to propose. Call our toll-free hotline at 833-444-4257 today!