The insurance carrier can contest, or controvert, the claim for a variety of reasons (e.g., the injury was not work-related or the employee is not injured to the extent claimed.) An employer can also request that the insurance carrier contest the claim. However, since the insurance carrier has assumed the liability for the claim, it is not required to comply with the employer's request.
Once a claim is controverted, a hearing will be scheduled to give a judge the opportunity to hear both sides. The Board may hold a hearing or hearings before a Workers' Compensation Law Judge. The judge may take testimony, order depositions, review medical and other evidence and will decide whether the claimant is entitled to benefits. If the claim is determined to be compensable, the judge determines the amount and duration of the compensation award.