Suffering a workplace injury can turn life upside down — physically, financially, and emotionally. Most workers’ compensation cases end in settlements, but sometimes, the process becomes more complicated. Many injured workers find themselves asking, “Why is my workers comp case going to trial?”
The truth is, not every case can be resolved through simple negotiation. Some disputes require a judge’s decision. Understanding why this happens can help you stay prepared and confident as your case moves forward.
What Is a Workers Comp Trial?
A workers comp trial is a legal proceeding before a judge (or in some states, an arbitrator) who reviews evidence and determines whether an injured worker is entitled to benefits. Unlike criminal or civil jury trials, these hearings are usually less formal and focus on the facts of your injury, medical records, and employer or insurer responses.
Trials occur when the insurance company, employer, or employee disagrees about part of the claim — whether it’s how the injury happened, how severe it is, or how much compensation should be paid.
Why Is My Workers Comp Case Going to Trial? 5 Common Reasons
There are several reasons a workers compensation case may go to trial. Here are the most common ones you should know:
Disputed Workers Comp Claims
The most frequent reason a workers comp case goes to trial is a dispute over the claim itself.
- Disagreement about the injury: Sometimes, the employer or insurance company might question whether the injury truly happened at work.
- Dispute over severity: Insurers may claim that the injury is not as serious as stated, which affects the amount of benefits.
- Questions about eligibility: If they believe you were acting outside your job duties or under the influence at the time of injury, your eligibility for workers compensation might be challenged.
When these disputes arise and can’t be settled, a trial becomes necessary so the judge can review medical evidence, witness statements, and employment records to make a final decision.
Settlement Disagreements
Most workers compensation cases end with a settlement. You and the insurance company agree on a lump-sum payment or structured benefits that cover your medical costs and lost wages.
However, sometimes both sides can’t agree on an amount. You may feel that the insurer’s offer doesn’t fairly reflect your pain, medical bills, or long-term impact, while the insurance company might believe your request is too high.
If negotiation or mediation fails, the next step is a trial — where the judge decides what compensation is appropriate. This process can ensure you receive a fair outcome, but it may take longer than a settlement.
Conflicting Medical Evidence
Medical evidence plays a central role in workers comp cases. Your doctor’s reports, test results, and treatment history prove the seriousness of your injury.
But what happens when medical opinions conflict?
Insurance companies often hire their own doctors for independent evaluations. These physicians may downplay your injury or claim it isn’t work-related. When your doctor’s findings don’t match the insurer’s medical expert, a dispute arises that can only be resolved at trial.
The judge will review both sides’ evidence and may even call medical professionals to testify before making a final ruling.
Employer or Insurer Pushback
Sometimes, your employer or the insurance company simply refuses to cooperate. They might deny the claim, delay payments, or stop benefits altogether.
Common reasons for pushback include:
- Claims that your injury is pre-existing or unrelated to work
- Beliefs that you’ve reached Maximum Medical Improvement (MMI) and no longer need benefits
- Accusations of exaggerating symptoms
When this happens, a trial ensures your rights are protected. The court examines the facts and decides whether benefits should continue or be reinstated.
Legal or Procedural Complexities
Workers compensation laws differ from state to state. Complex legal issues — like determining jurisdiction, interpreting medical reports, or addressing employer negligence — sometimes can’t be resolved informally.
When multiple factors complicate a case (for instance, if you work across states or have overlapping injuries), a workers comp trial is often required for clarity and fairness.
An attorney specializing in workers compensation can help navigate these complexities, ensuring deadlines, paperwork, and evidence are handled correctly.
Understanding the Workers Compensation Process
If you’re wondering why is my workers comp case going to trial, it helps to understand the process leading up to it.
Here’s what a typical workers compensation claim looks like before reaching court:
- Injury Occurs: You get hurt or develop an illness related to your job.
- Report the Injury: Notify your employer as soon as possible — most states have strict deadlines.
- File a Claim: Your employer submits the claim to their insurance provider.
- Medical Evaluation: You see a doctor to document the injury and get treatment.
- Insurance Review: The insurer reviews your claim and decides whether to approve, deny, or dispute it.
- Negotiation or Mediation: If disagreements arise, both sides try to reach a settlement.
- Trial or Hearing: If no agreement is reached, the case moves to trial for a judge to decide.
Each stage requires patience, organization, and often, professional legal support to ensure your rights are upheld.
The Workers Comp Trial Process: What to Expect
Going to trial can sound intimidating, but understanding what happens can ease some of your anxiety.
Pre-Trial Preparation
Before trial, both sides gather evidence. This includes:
- Medical records and bills
- Witness statements
- Accident reports
- Expert testimonies
Your lawyer and the insurer’s attorney exchange information in a process known as “discovery.” Depositions (recorded testimonies) may also be taken. Preparation is key to ensuring your side of the story is fully supported by facts.
Court Proceedings
A judge or arbitrator oversees the workers comp trial.
- Each side presents opening statements.
- Evidence and witness testimonies are introduced.
- Lawyers cross-examine witnesses and present closing arguments.
The trial typically takes place in an administrative court and is less formal than criminal or civil court.
Judge’s Decision
After hearing all evidence, the judge makes a written decision. They may:
- Approve your claim and order payment of benefits.
- Partially approve benefits for limited time or treatment.
- Deny the claim altogether.
If you disagree with the outcome, your attorney can file an appeal.
How Long Does a Workers Comp Trial Take?
There’s no one-size-fits-all answer. Some hearings last only a few hours; others can stretch over days or weeks depending on the complexity of the case.
After the trial, the judge may take several weeks or even months to issue a decision. The waiting period often depends on how busy the court is and the depth of evidence involved.
Tips to Strengthen Your Workers Comp Case
If your case is going to trial, preparation and organization are key. Here are some practical steps to help:
- Keep detailed records: Maintain copies of all medical reports, prescriptions, and correspondence with your employer or insurer.
- Follow medical advice: Attend all appointments and follow treatment plans.
- Avoid inconsistencies: Ensure your testimony matches your medical records and reports.
- Seek legal help: A workers compensation attorney can guide you through deadlines, documentation, and representation at trial.
Final Thoughts
If you’re asking, “Why is my workers comp case going to trial?”, remember that it doesn’t mean you’ve done anything wrong. It simply means there’s a disagreement that needs formal resolution.
Trials can be challenging, but they also offer an opportunity to present your side fairly before a neutral judge. With strong evidence, medical documentation, and experienced legal help, you can improve your chances of receiving the benefits you deserve.