If your workers' comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can file an appeal through the Oklahoma workers' compensation system. (For an overview of eligibility and benefits, see our article on filing an Oklahoma workers' comp claim.)
Because of major changes to Oklahoma's workers' compensation laws, there are two different appeals processes depending on when you were injured. The forms, timelines, and other requirements are different for each appeals process.
The appeal processes described below apply to employers that have not opted out of the workers' compensation system in Oklahoma. If your employer has opted out of the workers' comp system by creating an alternative benefit plan, different rules apply. However, these rules are fairly new and still being ironed out. If you have been denied benefits under an alternative benefits plan, you should contact a workers' comp lawyer right away.
For injuries before February 1, 2014, appeals are handled by the Workers' Compensation Court of Existing Claims. To appeal a denial of your claim, you must complete Form 3 and file the original, along with four copies, with the Court of Existing Claims. For occupational diseases, use Form3B. You can deliver the claim form in person or mail it to the following address:
Court of Existing Claims
1915 North Stiles
Oklahoma City, OK 73105
(405)522-8760 or in-state toll free at (800) 522-8210
You must file your workers' comp claim within two years of your injury or within two years of the last date of authorized treatment or receipt of a benefit payment. The Workers' Comp Court will not automatically schedule your case for a hearing. You (or your attorney) will need to file a Form 9 in order to have the court schedule a hearing before a workers' comp judge.
For injuries on or after February 1, 2014, appeals are handled by an administrative body called the Workers' Compensation Commission. To appeal, you must complete and file a different Form 3 with the Commission. For occupational diseases, use Form3B. Deliver the original form and four copies to the following address:
Workers' Compensation Commission
1915 North Stiles Avenue
Oklahoma, City OK 73105
(405) 522-8760 or in-state toll free at (800) 522-8210
For traumatic injuries, you must typically file your claim within one year of your injury. If you received any temporary disability payments, you must file your claim within one year from receipt of the last payment or two years from your injury, whichever is later. Claims for occupational diseases must be filed within two years from the last hazardous exposure.
The Commission will not automatically schedule your case for a hearing. Rather, you (or your attorney) will need to file a Request for Hearing with the Commission.
The Oklahoma's counselor program is designed to assist injured workers and employers with questions about the workers' compensation system. The counselor program can help you verify your employer's workers' comp insurance, guide you on how to file a claim, and send you written materials to help you better understand the process. While the program's staff can respond to requests for information, they cannot provide you with legal advice about your claims.
The program is available for all workers, regardless of date of injury. For more information, call
(405) 522-8760 or (800) 522-8210 and ask for the counselor program.
Voluntary mediation is available if both parties agree to participate. In limited circumstances, mediation may be ordered by the court or by an administrative law judge (ALJ). Mediation is an informal settlement conference where a neutral third party mediator will hear from you and the insurance company. The mediator will work with both sides to try to achieve a settlement. The mediator does not, however, make a decision on the dispute. If you and the insurer can't reach an agreement, your case will continue on to the hearing.
For injuries prior to February 1, 2014, a trial will be held in the Workers' Compensation Court of Existing Claims. During the trial, each side will have the opportunity to present witnesses, submit documents, and make legal arguments. The trial follows formal court rules and procedures, similar to other lawsuits that are brought in court. A trial court judge will preside over the trial and make a decision in your case. Trials are held either in Oklahoma or Tulsa.
As of February 1, 2014, Oklahoma has an administrative process for filing workers' compensation appeals. An administrative law judge (ALJ) will be assigned to your case, and a hearing will be held in Oklahoma or Tulsa. While the hearing follows a less formal format than a trial, each side will still have the opportunity to question witnesses, submit documents, and make legal arguments. The ALJ will preside over the hearing and make a decision in your case.
Under the previous workers' comp system, if you disagree with the trial judge's decision, you may file an appeal to a panel of three judges within ten days. If you disagree with the Panel's decision, you have 20 days to file an appeal to the Oklahoma Supreme Court.
Under the current system, if you disagree with the ALJ's decision, you may appeal to the Workers' Compensation Commission within ten days. If you're not satisfied with the Commission's decision, you may file an appeal with the Oklahoma Supreme Court within 20 days.
Workers' compensation trials are similar to other trials in court and follow complicated procedural rules. Although administrative hearings are more informal, there are also legal and procedural rules that you must be familiar with. Regardless of what system you're appealing through, you should consult with a workers' comp attorney to represent you. Workers' comp attorneys usually work on a contingency fee basis, which means that they take a percentage of any award recovered on your behalf. In other words, you won't have to pay out-of-pocket for attorneys' fees.
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