Hearing general information
The hearing is the "trial" phase of the resolution of a disputed workers' compensation claim or complaint.
The administrative judge makes the necessary inquiries and investigations, and may require and receive any documentary evidence or oral testimony not previously obtained, to help the judge to make a decision on the issues.
By statute, a decision issues within 28 days from the close of the hearing. The actual time frame is usually longer. MGL c. 152 § 11.
Multi Insurer cases
In a multiple insurer claim, all the individual appeal forms accompany a cover sheet, approved by the department, which identifies each insurer and states the board number of each claim.
One check payable to the department in the amount of the requisite fee, appended to the multiple appeal cover sheet.
When presented in a timely manner, perfects all appeals if the correct forms are attached.
Hearing date, impartial exam, and impartial report
No hearing conducted pursuant to MGL c. 152, § 11A(2), where medical issues are presented to an impartial physician, commences sooner than 1 week after the parties receive the impartial physician's report.
In any hearing conducted pursuant to MGL c. 152, § 11 where medical issues will be presented to an impartial physician, all medical records will be marked for identification only.
Hearing judge assignment
Except when events beyond the control of the department make such scheduling impracticable, the same administrative judge conducting any conference held pursuant to MGL c. 152, § 10A shall preside over any hearing regarding the matter that is the subject of such conference.
Grounds for the appeal
Before testimony is given in a hearing before an administrative judge, the insurer must state clearly the grounds on which the insurer either declines to pay compensation or on which it seeks modification or discontinuance.
The grounds for the insurer's position must be based on facts reported by the insurer or based on newly discovered evidence within the provisions of MGL c. 152, § 7 and § 8, and 452 CMR § 1.00 et seq.
On all other issues the employee's rights under MGL c. 152 are deemed to have been established.
Testimony and interpreters
At a hearing, any testimony of parties and witnesses before an administrative judge is given under oath or affirmation. Where the administrative judge finds that testimony must be given through an interpreter, the interpreter must swear an oath to interpret faithfully and impartially. 452 CMR § 1.11(4).
In all hearings before an administrative judge, the testimony of witnesses is taken either orally or by deposition.
Unless otherwise provided by MGL c. 152 or 452 CMR § 1.00, the admissibility of evidence and the competency of witnesses to testify at a hearing is determined under the rules of evidence applied in the courts of the Commonwealth. 452 CMR § 1.11(5).
Allowance of additional medical reports
At a hearing pursuant to MGL c. 152, § 11 in which the conference appeal was filed prior to July 1, 1992, or in which the case does not involve a dispute over medical issues as defined in 452 CMR § 1.02, or in which the administrative judge, upon motion of a party or upon the judge's own initiative, finds under MGL c. 152, § 11A(2) that additional testimony is required due to the complexity of the medical issues involved, or due to the inadequacy of the report submitted by the impartial physician, a party may offer as evidence medical reports prepared by physicians engaged by the party, together with a statement of such physician's qualifications. The administrative judge may admit such medical reports as if the physician so testified, provided that where specific facts are in controversy, the administrative judge shall, on motion by a party, strike any part of such reports that is not based on:
- The expert's direct personal knowledge;
- Evidence already in the record; or
- Evidence that the parties represent will be presented during the course of the hearing.
The administrative judge presides over the hearing and controls the conduct of parties, attorneys, and witnesses.
Each party may give a brief opening statement and closing argument, and may submit briefs, motions, requests for findings of facts, and requests for rulings of law, within such time as the administrative judge may prescribe.
The administrative judge may require the filing of briefs in such form, and within such time, as discretion allows.
The decision of the administrative judge is based solely on the evidence introduced at the hearing.
What to expect at the DIA when coming in for an in-person hearing
|Date published:||August 10, 2018|