Santa Clara, CA asked in Workers' Compensation for California

Q: What is an AOE/COE and what do I need to bring to the hearing?

I have been to two hearings for ttd and the judge is now scheduling a third hearing. During the last hearing, the defense attorney already disputed that termination of cause is the reason why I’m not entitled to ttd. I explained to the judge that I never returned to work after my injury and the employer said it was an investigation from a month prior. He told me ttd is a medical issue and being fired has no effect on ttd.

The judge wanted to wait for my qme appointment before he makes a decision. I brought him the qme report but now he rescheduled for another date for Aoe/COE.

Is this standards procedure for an accepted claim? If so, what’s the reason for the qme to give an opinion. It’s a slip and fall injury on wet floor.

Related Topics:
2 Lawyer Answers

Ronald Mahurin

Answered
  • Workers' Compensation Lawyer
  • Point Arena, CA
  • Licensed in California

A: No, because if the claim is accepted there is no reason to have a hearing on AOE/COE. (Arising of employment, Caused by employment). This type of hearing is used for cases that a denied as not being industrial. You need to review your QME report very carefully and see if there is a statement on causation. If the QME says your injury is industrial, then file a penalty petition and request a 25% increase in payments for late TTD. Again, if the claim is accepted, the carrier should have already started making TTD payments based upon whatever report established the injury.

I thin you will need an attorney. You should also see if there is a potential PI case based upon the negligence of the person who is responsible for the floor. Often times it is a contractor, not the employer.

Nancy J. Wallace

Answered
  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: 'Accepted' claims do not go to an AOE/COE hearing, so you are missing a huge part of the story.

AOE means Arising Out of Employment. COE means Course Of Employment. So when the employers wants to prove this injury did NOT Arise Out of Employment and did not occur in the Course of Employment, the employer requests an AOE/COE hearing to prove what happened to you was not at all work-related.

If the judge finds that you did not sustain any industrial injury at this hearing, all your benefits end. This is no time to be representing yourself and posting questions on Justia. IF that QME you saw wrote that there is nothing wrong with you and if you had any troubles from the fall they completely resolved with no need for treatment and no residual temporary or permanent disability, you better know in advance the judge could rule that he's right. GET AN EXPERIENCED ATTORNEY before it's too late.

Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.

The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.

Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.