In the ideal world, injured workers would quickly receive workers’ compensation benefits to help them pay for medical care and other expenses when they cannot work. They would also continue to receive benefits for as long as necessary, without any pressure to get back to work despite their pain.
Unfortunately, the state of Vermont is not that ideal world.
Instead, too many workers’ compensation claimants are denied benefits. They are seriously injured on the job; yet, their application is denied, often for frivolous reasons.
In Vermont, there’s a process called “mediation.” This is a type of alternative dispute resolution technique which has grown in popularity. Under state law, the parties are required to mediate before having the formal hearing, so you should know more about this process. Call Larson & Gallivan Law if yourVermont workers’ compensation claim was denied. We can attend mediation with you and, if necessary, represent you at a hearing.
What is Mediation?
Mediation is a method of getting two sides to a dispute together so they can talk through their disagreement. A trained mediator guides discussion. This mediator is neutral, meaning he or she doesn’t take a side. The mediator also is not a judge.
Instead, mediators are skilled at listening and getting other high-conflict people to listen to each other. Often, two sides don’t know why they are disagreeing. In reality, they might not be very far apart on what they want. The mediator might also propose solutions to resolve any disagreement. Some people refer to mediation as “guided negotiation.”
Many people resolve disagreements in mediation. It really does work. Mediation has a role to play in workers’ compensation. By participating, you give yourself a chance to resolve the dispute with the insurance company on the other side without a hearing. Remember: the mediator cannot force you to accept any proposed resolution. You can still have a formal hearing if you want.
Vermont’s Law on Mediation
The current law is found at21 VSA § 663a. It states that the Commissioner shall require mediation of your dispute after you request a formal hearing. Under the law, the Commissioner will order you to attend one mediation session before you have a formal hearing.
You and the insurance company attorney will have to pick a mediator from a list of mediators that have been approved by the Vermont Department of Labor. Vermont law states mediation costs are divided equally. You should participate in good faith. If your case settles, the insurance company lawyer will then draft a settlement agreement, which both sides will sign. If you are not represented you should ask a lawyer to review the agreement before you sign.
What Can You Expect?
The lawyers at Larson & Gallivan law have participated in many mediation sessions, so let’s provide an overview.
Usually, we meet in a conference room: you, your lawyer, the insurance company representative (usually their lawyer), and the mediator. An insurance adjuster might also join by phone or Zoom. Your employer probably will not be present, since their insurer is charged with paying benefits.
Mediation begins with each side sharing their version of events: how you were injured and what type of benefits or compensation you want. Based on these statements, the mediator will have some understanding of the disagreements and can ask questions for clarity.
In most mediations, the issue in dispute is a final settlement of your workers’ compensation claim. This would result in you agreeing to a certain amount of money for your workplace injury.
A key part of mediation is caucusing. Essentially, you go into one room and the insurance company’s lawyer goes to another. The mediator moves back and forth between the rooms, offering her perspective on the disagreement. She might also frankly discuss the strengths and weaknesses in your claim.
Mediators are unbiased, and they don’t play favorites. But we need to be honest: they usually are trying hard to get each side to reach an agreement. That’s the point of mediation. You should have your own lawyer present, who can provide their own perspective.
When Negotiations Fail
No one can force you to settle with the insurance company. If you choose to walk away from mediation, you’ll get a formal hearing. At that point, the Administrative Law Judge will decide if you are entitled to benefits and how much.
There’s a risk in not settling. You might lose at your hearing, which will result in no benefits paid. One reason to hire an experienced lawyer is that we can help you analyze your options. If your evidence is strong, you can be more aggressive in negotiations.
By contrast, you might be willing to accept less if your evidence is weak.
Talk with Our Workers’ Compensation Lawyers Today
Mediation has the potential to resolve disputes and get injured workers benefits without the stress and delay of a formal hearing. However, you should never walk into mediation without a lawyer by your side. The mediator is neutral, but she’s not your advocate. Only we are.
At Larson & Gallivan Law, we have negotiated many workers’ compensation settlements. We understand how to analyze the strength of a claim, as well as an insurer’s proposed settlement. Feel free to call our firm, anytime, to discuss your case. We’ll even offer a free consultation to discuss where you are in your workers’ compensation journey and how we can help you get benefits.
