The Ombudsman
An ombudsman is a free state employee who helps injured workers without lawyers get through the dispute process. Who ombudsmen are, what they do at each stage, and where the law draws their limits.
Free help from the state, with a defined job
Many people have had help filling out a tax return from a volunteer at a free tax clinic. The volunteer explains the forms, catches mistakes, and answers questions about how the process works. The return is still yours, the signature is still yours, and the consequences are still yours. The ombudsman program runs on the same arrangement.
An ombudsman is an employee of the Office of Injured Employee Counsel (OIEC, the independent state agency created to assist injured workers), assigned to help workers who do not have a lawyer handle a benefit dispute. The service is free in every case, paid for by the state. State law requires ombudsmen to complete training in the workers' compensation system before they assist anyone, and experienced ombudsmen know the rules and procedures as well as many adjusters do.
Is an ombudsman the same thing as a lawyer?
No. An ombudsman assists you; a lawyer represents you, and the difference controls everything that happens in a dispute. An ombudsman cannot give you legal advice, cannot negotiate for you, cannot argue your case to a judge, and cannot sign anything on your behalf. With an ombudsman's help you are still representing yourself, and every decision and deadline remains your own.
The differences line up plainly:
| Ombudsman | Attorney | |
|---|---|---|
| Cost to you | Free | A regulated share of benefits, approved by DWC |
| Gives legal advice | No | Yes |
| Speaks for you at hearings | No, you speak | Yes |
| Negotiates with the carrier | No | Yes |
| Responsible for strategy | You | The attorney, with you |
Before an ombudsman assists you, you sign an acknowledgment accepting these limits. Read it. It means exactly what it says.
What an ombudsman does at each stage
An ombudsman can do real work. Before a benefit review conference (BRC, the informal first meeting in a dispute), an ombudsman can explain the issues, help you gather medical records, and help you complete DWC045, the form that requests the conference. At the BRC, the ombudsman sits with you and helps you present your position. If the dispute continues to a contested case hearing (CCH, the trial-like stage before an administrative law judge), the ombudsman helps you prepare your evidence, explains the procedure, and attends the hearing with you, though you question witnesses and make your own arguments. An ombudsman can also help you prepare a written appeal after a hearing.
Preparing for a Benefit Review Conference and Preparing for a Contested Case Hearing describe those stages in detail.
The limits, stated once
An ombudsman does not file your paperwork for you, and sending dispute forms to the ombudsman's office files nothing; forms go to the Division of Workers' Compensation (DWC, the state agency that runs the comp system). An ombudsman cannot tell you whether to accept an offer, cannot value your case, and carries a caseload shared among many workers. When the help feels thin, When You're Frustrated With Your Ombudsman explains what is fixable, and When the OIEC Ombudsman Isn't Enough explains the boundary the program cannot cross.
One more point deserves respect. Good attorneys sometimes send workers to the ombudsman program. When a claim is sound and the remaining dispute is small, a law firm may honestly conclude that a free ombudsman and a correctly calendared deadline serve the worker better than a fee. The program is not a lesser version of a lawyer. It is a different tool, correct for some disputes and not for others.
How to get an ombudsman
Contact OIEC, described at The Office of Injured Employee Counsel (OIEC), when a dispute begins or a proceeding is scheduled. Assistance is available only to workers without an attorney; if you hire one, the ombudsman steps aside.
Contact Us
