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Process: What happens after a claim is filed, and how long does it take for my Second Injury Fund case to settle?

The Division of Workers’ Compensation will send the Claim for Compensation to the Attorney General’s Office for their response. (Remember that the Attorney General is responsible for defending claims against the Fund.) The Attorney General has 30days to file its Answer to the Claim for Compensation. You will receive a copy of the Answer. The Answer will either admit or deny the allegations or statements made in the claim. The Second Injury Fund also may state that it lacks information to admit or deny the statements made in the claim and in this instance will re-evaluate the case when additional information is made available.

The claim will be scheduled for a “pre-hearing” conference before an administrative law judge. You (or your lawyer, if you are represented) must appear at the pre-hearing to discuss your claim with the assistant lawyer general and the judge. This is an informal meeting which may result in a settlement of your claim.  After a pre-hearing, a mediation may be requested. A mediation is a confidential settlement conference with an administrative law judge.

As in other workers’ compensation cases, the Fund or the employee may request to have an evidentiary hearing (trial) held before an administrative law judge to determine if the employee is eligible for the benefits being sought. Evidence, including medical evidence, is required. The employee has the burden of proof on all contested issues. For more information about evidentiary hearings, awards and appeals, read What to Expect If Your Case Goes To Trial and Appealing The Judge’s Decision. As for an actual time period, time depends on the judge’s caseload and the severity of your case.

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