LEVEL #1 - CONCILIATION SESSION
This is an informal meeting between you and your company's insurer. Results of a conciliation WON'T be binding unless you agree to them. Even when you are satisfied that you are being paid everything required by law, you MAY get a notice to attend a conciliation that you DID NOT request. This means that either the insurance company thinks it is paying TOO MUCH and would like to REDUCE your benefits or STOP your benefits.
These insurance company requests are called "complaints to reduce or discontinue compensation." Once again, conciliations CANNOT result in changes in compensation rates unless both parties agree.
LEVEL #2 - CONFERENCE
If your case is referred to an Administrative Judge by the conciliator, a CONFERENCE is scheduled. This conference is also informal, with discussion between the parties. If the matter is NOT settled, the Judge will issue a temporary order indicating whether or not the insurer must pay you compensation. If you are not satisfied with the Judge's order you may appeal it within fourteen (14) days of the filing date of the decision. The insurance company also has the right to appeal.
LEVEL #3 - HEARING
If your case is appealed by the insurer OR yourself, it will go to the HEARING stage, where the Administrative Judge conducts a FORMAL hearing of all the evidence. Hearings are like regular trials; witnesses are called and sworn in, and testimony is taken by stenographers.
LEVEL #4 - REVIEW BOARD
Either party may APPEAL the Administrative Judge's decision to the REVIEW BOARD within thirty (30) days. Three (3) Administrative Law Judges will examine the hearing transcripts. They may ask for legal arguments. The Review Board will reverse the previous decision ONLY if the decision was beyond the Administrative Judge's authority, conflicted with the law, or was without any justification.
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