workers’ compensation is a mandatory employer-paid insurance coverage provided to
cover work-related injuries and illnesses. workers’ compensation is the sole remedy
provided an employee injured in the course of his/her employment. workers’ compensation benefits are state-determined and payment levels vary from state-to-state.
Employers secure coverage for their employees through either private insurance carriers, a state fund, or a self-insurance program. Injuries and/or illnesses that arrive in and out of the course of employment and are proven to be causally related to job duties and responsibilities.
To be covered under an employers policy, a person must be a genuine employee on the company payroll. Contractors and sub-contractors working for employers are not covered under an employers policy and are required to secure their own coverage.
Work-related accidents/ injuries must be reported to the employer who then notifies
the workers’ compensation carrier of the incident/illness. To secure lifetime medical benefits on a work-related claim and assure appropriate benefits are executed, a claim should also be filed with the Maryland State workers’ compensation Commission within two years of the date of accident/disablement. Discrepancies between the employee and the employer/insurer which can not be negotiated are decided at hearing by one the the Commissioners of the Maryland workers’ compensation Commission. Either side can file ‘issues’ requesting a hearing before the Commission to resolve the matter in question. Issues that may be decided by the workers’ compensation Commission include such matters as determining if the claim meets state ‘compensability’ requirements, securing lost wages, medical bill payment, vocational rehabilitation, and nature and extent of permanent disability, among
Temporary Total Disability If an employee is authorized off work by his/her treating
physician, he/ she is entitled to 2/3rds of his/her average weekly wage, non-taxed, for the disability period. This wage rate is determined by securing the gross wages for 13 weeks before the accident and averaging them ( including over-time paid during this period).
The injured employee is then entitled to 2/3rds of that amount non-taxed, payable either weekly or bi-weekly for the period of disablement. In Maryland, an employee is allowed
to treat with the physician of his/her choice. Since the employer/insurer is paying for the treatment/care per the Maryland Fee Schedule, however, the employer/insurer is allowed to send the injured worker for an occasional IMEs ( Independent Medical Evaluations) to assure the treatment the employee is receiving is warranted, appropriate and necessary.
Occasionally, a treating physician and IME physician are in disagreement regarding the
employees ability to work. These discrepancies are usually decided at hearing by the
workers’ compensation Commission.
Temporary Partial Disability If an employee can return to work, but not on a full-time basis, or is required to take an alternate position making significantly less than
his/her original job, the employee is entitled to temporary partial disability. This is
a weekly or bi-weekly payment which pays a percentage of the difference between the
the employees salary at the time of injury and the pay rate based on his present situation.
Medical Treatment If the claim is deemed compensable under Maryland workers’ compensation law, the employer /insurer is responsible for all appropriate medical
treament bills, including therapy, diagnostic tests, surgery, etc. These bills are paid in accordance with the Maryland State Fee Guide. Additionally, the injured employee is
entitled to be reimbursed for mileage to and from the doctor as well as parking, tolls, etc.
Vocational Rehabilitation If it is determined that an injured employee can not return to his regular employment due to his/her injury, he /she is entitled to be vocationally
rehabilitated for a comparable position. This benefit is paid for by the insurer/employer
and includes services from job search through re-training and re-education. During the
period of vocational rehabilitation, the employee is entitled to receive temporary total
Permanent Partial Disability When an employee reaches ‘maximum medical improvement’ and the physician deems that there is no additional treatment/care
that will substantially improve his/her condition, the employee may be entitled
to permanent partial disability. This is a lump sum benefit payable to the employee
to compensate him/her for the ‘permanent’ damage resulting from the injury and to compensate him/her for the fact that he/she will never be exactly as he/she was
prior to the injury/illness. This benefit is determined by the part of the body injured and the nature and extent of the disability. Disability ratings to discern the payment are performed by AMA certified physicians.
Death Benefits If an employee dies as a result of his/her work-related injury/illness,
and has dependents who were either wholly or partially dependent on the deceased
for financial care may apply for monetary benefits. These benefits are determined by
the relationship to the deceased and the level of financial dependence which must be
demonstrated through appropriate documentation. Depending on the dependency determination, caps exist on amount of life-time benefits that may be received.
Additionally, the employer/insurer are responsible for funeral expenses limited to $5,000.00.
Ingerman & Horwitz, LLP are Baltimore, Maryland workers’ compensation attorneys with over 100 years of collective experience in recouping benefits that have been denied by an insurance company, employer or the government. Persons who have worked their whole lives shouldn’t be penalized if they are injured or become ill and can’t work. Loss of Workers’ Compensation benefits can affect the entire family and could result in serious emotional and financial hardships, including the loss of savings, property and other assets. Learn more about your workers’ Compensation rights and options below.
If youve been denied benefits, contact Ingerman & Horwitz, LLP for a consultation on your legal rights.