By Judge Allen Phillips, Jackson
When there is a dispute over medical and/or temporary benefits, the expedited hearing process provides an avenue for efficient resolution. This post will detail the process with an emphasis on a “file review” expedited hearing.
Rule 0800-02-21-.14 (scroll to page 9) provides the procedure for Expedited Hearings. First and foremost, it must be understood that a dispute must exist before a party may request an expedited hearing. Thus, if there is no dispute, i.e., an accepted claim where the employer is paying benefits, there is no need for an expedited hearing. The employee may complete treatment, file a Petition for Benefit Determination for mediation and then request an initial hearing if the case does not settle at mediation. Conversely, if there is a dispute between the parties as to payment of benefits, i.e., a denied claim, then an expedited hearing is the proper path to resolution. Either party may request an Expedited Hearing on a form provided by the Bureau or by filing a motion with the Court. Filing of the form is the better, simpler method.
What if the issue prompting a denial is purely one of law? Or, what if the issue turns on interpretation of documentary evidence where the testimony of witnesses at a hearing will, in the opinion of the parties, add little to an ultimate resolution?
In those situations, the Request for Expedited Hearing form allows a party to request “[t]he assigned judge issue a ruling based on a review of the file without an evidentiary hearing.” In other words, the Court will decide the issues based upon a “file review.” Also, the rules state that, “the judge shall have the discretion to either set the matter for a hearing or enter an interlocutory order based on a review of the file upon determining that no additional information is needed to determine whether the employee is likely to prevail at a hearing on the merits of the claim.” Rule 0800-02-21-.14(1)(c). (A proposed change to the Mediation and Hearing Rules will clarify the ability of the parties to request the “file review” at the expedited hearing stage of the proceedings.)
Our Appeals Board recently expounded upon the language “no additional information” being needed to make a determination in Phillips v. Carolina Construction Solutions, et al., No. 2015-01-0208, 2016 TN Wrk Comp. App. Bd. LEXIS 10 (Tenn. Workers’ Comp. App. Bd. Feb. 26, 2016). This is a must-read for parties looking to request a file review-only expedited hearing.
It is important to note that the rules regarding expedited hearings allow either party to request an evidentiary hearing: The requesting party may do so by choosing the option of an evidentiary hearing on the form and the opposing party may do so by requesting an evidentiary hearing in its response to the request. See the Request for Expedited Hearing form and Rule 0800-02-21.14(1)(b), respectively.
Any Request for Expedited Hearing must be accompanied by affidavits and any other information demonstrating the employee is entitled to temporary disability or medical benefits. The opposing party must, within five business days after the request, submit, “all information demonstrating the employee is not entitled” to the requested benefits. Within seven days after filing, the Clerk will assign the case to a judge, who may then decide to set a hearing or decide the case by a review of the file. Remember: either the requesting party or the responding party may request the setting of an evidentiary hearing. In other words, either the employee or employer may ask for a full, in-person hearing.
If the Court does not use its discretionary authority to set the matter for an in-person evidentiary hearing, the Clerk will place the case on the docket for a file review determination. The Court then will provide a docketing notice to the parties that will advise the case will be determined by a file review and remind the parties that the responding party (generally the employer) did not request an in-person hearing. The notice will list what documentation is in the Court’s file and that the Court needs no additional information to determine whether the employee is likely to prevail at a hearing on the merits. The parties have seven days to object to any information in the Court’s file, giving the legal basis for the objection. They also have the opportunity to submit position statements within those seven days.
Remember, the Court will decide the case based upon what is on file unless one of the parties objects to the admissibility of a document. The Court will rule on any objections and proceed with a decision accordingly. If the evidentiary issues merit, the Court may decide that an evidentiary hearing is needed and it can exercise its discretionary authority under Rule 0800-02-21-14(1)(c), detailed above.
The mission of the Court is a fair, efficient and professional system. The expedited hearing is an integral part of an efficient system because of its proclivity to resolve temporary issues in a timely manner. The file review provision augments this efficiency by featuring the convenience of document submission, arguments by position statement, and the avoidance of a court appearance. But, the rules allow a party a full evidentiary hearing if desired, even if one party requests only a file review. The provisions of the rules reflect the desired intersection of efficiency and fairness.