Applying for Worker’s Compensation in Maryland

A worker’s compensation claim in Maryland must meet the statutory definition in order for it to be approved by the Commission. The injury must be accidental and must arise out of and occur within the scope of the injured worker’s employment. If the injury falls outside of that definition, or if the person is an independent contractor and not an employee, the claim could be denied by the Commission. A lawyer would then have to file issues with the Commission, and a hearing would be set in.

Upon hiring a worker’s compensation lawyer, an attorney will be involved at all stages of the process. If the claim is denied, then an attorney can file issues with the Commission to get it resolved. However, the very first step to obtaining compensation is to submit a claim form.

Information Available

The information the application requires includes the individual’s name, address, employer information, the address of the employer, where the incident occurred, and how it occurred. The next step is, if the individual is claiming an occupational disease like asbestos or certain kinds of medical conditions, they will be asked about the circumstances of how the condition came about, the body parts that were injured, who their doctor is, and their contact information.

Steps Involved

Once the claim form is filed, there is a thirty-day window for the regulatory review to accept or deny the claim. An average weekly wage is established by the wages earned 13 weeks prior to the week of the incident. Benefits are paid by the employer/insurer for those weeks the individual is medically deemed unable to work, known as Temporary Total Disability (TTD) payment, which amounts to 2/3 of their average weekly wage.

If the claim is denied, or if there is a dispute as to the amount of the average weekly wage, they can then file issues with the Commission.  If the applicant has any other kind of dispute that arises, such as a discontinuation of Temporary Total Disability Benefits (TTB), for example, then that is when they or their lawyer will file issues with the Commission and go in for a hearing. The Commissioner will essentially hear evidence and accept documentary evidence, and make a decision on whatever issues are in dispute.

The biggest reason why issues are filed is as to nature, extent, or permanency. When those issues are filed, a nature, extent, or PPD – permanent partial disability – hearing is set in by the Commission and all parties must attend.  The Commissioner will make a decision about permanency at that hearing.

If the Application is Denied

If the claim is denied, your lawyer will file issues, so a hearing will be scheduled. Issues are filed concerning the amount of temporary total disability TTD benefits paid, discontinuing benefits, or permanency. Whoever loses can appeal the Commissioner’s decision to the circuit court.

The Maryland Worker’s Compensation Commission is an administrative agency not affiliated with the courts, but if the Commissioner decides something that you do not agree with, then you can appeal to the circuit court level. There is a presumption that the decision of the Commissioner is correct.

If the Application is Approved

The first thing that someone should do after their worker’s compensation claim is approved is to make sure they attend all medical appointments and physical therapy sessions and follow the advice of the healthcare provider(s) who is/are treating them.

They should follow all of the instructions they are given and be active participants in their treatment. They should be sure not to skip appointments or show up late. Also, at the initial appointment with the healthcare provider, the injured person should inform the healthcare provider that the injury was sustained on the job

If the injured worker fails to do these things, the attorney for the employer/insurer will bring it up at any hearing before the worker’s comp commission. If the injured worker does not follow through with the treatment protocol or if there are large gaps in treatment, the attorney for the employer insurer will raise those issues on cross-examination at any nature/extent (permanency) hearing before the Commission.

Role of the Attorney

A lawyer can file the claim form on the client’s behalf, they can review the form, make sure that everything is completed accurately, that it is filled out completely, and provides how the incident happened and what the worker’s injuries were, as well as that it complies with the Maryland statute and provides all the elements necessary to establish a claim.

If and when disputes arise throughout the course of the case, a lawyer can file issues with the Commission, get a hearing, represent the injured at the hearing, and get the issue resolved. Also, if the case gets to a point where the injured worker has reached a level of maximum medical improvement (i.e. things are as good as they are going to get, even if they’ve not recovered 100%, and they are not going to require any future surgery or treatment), a lawyer can help the injured worker to reach what is called, in Maryland, a stipulation or a full and final settlement.