A 19(b) hearing can occur any time your insurance company denies you reasonable and necessary medical treatment before your treating doctor says that you have reached maximum medical improvement (MMI) and returned you to work. At this hearing, the arbitrator will decide whether the insurance company must continue paying for your past medical treatment. Also, this hearing can be used to determine whether your insurance company must approve any future medical treatment. For instance, if your treating doctor is recommending a surgery then a 19(b) hearing is necessary in order for it to be approved by your insurance. Please understand that there are often reasons for delay that are outside our control. Opposing counsel must receive notice of any hearing at least 15 days in advance of the arbitrator’s call date. Before I can present your case at the hearing, I must assemble all the evidence pursuant to subpoena and the doctors must certify these records. If this does not happen, I will not be able to present this crucial evidence at your hearing. Unfortunately, some doctors’ offices can be slow in responding to my subpoenas.
Sometimes, the opposing counsel will have a conflict and will ask to wait another month, or ask for an IME. Sometimes the arbitrator may be too busy to hold a hearing that day. We do everything we can to expedite the process, but both sides are entitled to a fair hearing with all the evidence. These cases are very important and must be treated as such, so time will be given to both sides to allow the arbitrator to rule on all the issues.
After the hearing, we must usually wait approximately two months for the arbitrator’s written decision. Each side then may appeal the arbitrator’s decision to a panel of three commissioners. This can add an additional year of waiting.