The Five Most Common Questions I Answer About Maryland Workers’ Compensation
By Perry Choren
Hopefully this isn’t like every other blog entry that you have read. I’m not here to talk about Kim Kardashian or on the other end of the spectrum, the recent relationship between the American dollar and the Euro. My aims are twofold: to try and keep you engaged with this topic and to teach you a few key points about an area of law that has a great deal of significance. Hopefully you are reading this because you have somewhat of an interest in the Maryland workers’ compensation system. If you made it through the first few sentences, you were likely told by a friend that you need an attorney, are likely contemplating the thought of looking for an attorney, or have fully committed to the understanding that you need an attorney to help sort out the madness that has become your workplace injury. That is where I come in.
I want to answer the five most common questions that are asked of me about the Maryland workers’ compensation laws. These questions come from clients, family members, friends, potential clients, strangers in elevators when the ride takes entirely much too long, overly talkative travelers sitting next to me on an airplane, etc. You get the gist. It is a complicated area of law that, without the proper understanding, can confuse and frustrate the most patient person out there. However, keep in mind that this is just a short summary of those questions and the answers to those questions. This is simply me skimming the surface of the vast arena that is Maryland workers’ compensation law. Hopefully this brief entry can shed some light on a few of the most common issues nonetheless.
- What am I actually entitled to if I am injured at work?
You are entitled to three main benefits – a lifetime supply of donuts, knowing you’ll never have to deal with a rock in your shoe again, and good hair days EVERY SINGLE DAY! I’m just joking, but the real benefits are just as good: medical treatment, compensation while you cannot work, and compensation at the end of your case for any lingering problems you have once you finish treatment. The first benefit is HUGE – medical treatment. This is the main benefit in workers’ compensation law and one that most people associate with the term “workers’ comp.” Medical treatment can mean almost anything: appointments with your doctor, surgery, medication, crutches, physical therapy, etc. If your doctor states in writing that because of your injury you need the treatment, there is a good chance that the insurance company will have to pay for it. It is also a lifetime benefit! If you do not settle your case, this right remains open for your entire life!
The second benefit is compensation while you cannot work. This is known as temporary total disability benefits (or TTD for short). This benefit is predicated on your doctor keeping you out of work – it is not enough for you to stay out because you believe that you cannot work due to the injury. If your doctor believes you cannot work, he/she will give you an out-of-work note, sometimes called a disability slip. Once that is sent to the insurance company, the insurer has to pay you at least 66.66% of your weekly wage. These benefits are tax free
The final benefit is compensation at the end of your case for any lingering problems that you have once you finish treatment. This is known as permanent partial disability benefits (or PPD for short). First, due to the fact that you have lifetime medical treatment, there really is no “end to the case.” That is a misnomer. Second, you are entitled to this compensation when you have returned to work and are released from your doctor – a term known as “maximum medical improvement” or MMI. When you reach MMI, you are entitled to some money if your injury has had a permanent effect on your ability to do your job. You won’t become the next Bill Gates, but this is tax free money that you are entitled to.
- I don’t want to sue my employer – what can I do?
A Maryland workers’ compensation claim is not a lawsuit against your employer – it is a claim against the insurance company that insures your employer. Maryland requires employers to carry workers’ compensation insurance just like you have to have car insurance to drive. Claims are not directly filed in the regular Maryland District and Circuit courts where lawsuits are traditionally filed. Instead, each claim (again, not a lawsuit) is filed with the Maryland Workers’ Compensation Commission headquartered in Baltimore. The Commission resolves disputes that arise between the injured worker (you) and the insurance company (your employer’s insurance company). The Commission has several different hearing locations all over the state to hear these disputes and resolve them.
- If I change jobs, will that affect my claim?
No it will not – you can move to Alaska and become a grizzly bear trainer and this insurance company is still on the hook for this specific claim for the rest of your life. However, there are some caveats that come with moving out-of-state. If you move to a different state, and you want to pursue more treatment for your workplace injury, you need to find a doctor that is willing to accept Maryland workers’ compensation rates. For example: let’s say you go to a doctor in Maryland and she performs a cortisone injection to your knee. That appointment and injection might cost $800. However, the law states that the doctor’s office can only collect a portion of that, let’s say $500, from the insurance company. Therefore, if you go and see a doctor in Orlando, Florida after moving there to become a crocodile wrestler and receive a cortisone injection to your knee, you need to be sure that this Floridian doctor will accept the Maryland rate (that $500 discussed above). However, this situation is rare (although I’m not sure on the exact stats of how many people are active crocodile wrestlers in Florida). Most people change jobs and stay within Maryland. That will not affect your case. You are still entitled to the three benefits discussed under the first question above.
- Perry, my doctor wants me to undergo a MRI for my injured back. His office keeps telling me it is denied. What gives?
This denial is coming from the insurance company. The insurance company is not your friend. It won’t listen to you while you vent after a long day at the office. It won’t hold the luggage while you reach for your keys to unlock the front door with your dog yapping at your heels to get outside and do its “business.” Insurance companies have a ton of money because they are looking for any way to deny you your treatment and your compensation. The denial could be based on many different reasons: perhaps the insurance company doesn’t believe you need the MRI, perhaps the insurance company sent you to one if its doctors and that doctor states the need for the MRI is not related to the work incident, etc. Whatever the reason, you need to let your attorney know ASAP! Your attorney will reach out to the insurance company and try to resolve the issue over the next few days via the telephone or email. If your attorney cannot force the insurance company to pay for the MRI, then the attorney will file for a hearing in front of the Maryland Workers’ Compensation Commission. At that hearing, your attorney will argue that you need the MRI for X,Y, and Z reasons. If you win, the Commission (and the State of Maryland) will force the insurance company to pay for the treatment. Basically, the Commissioner, as one of its roles, helps resolve disputes when the parties can’t reach an agreement on their own.
- I don’t have a single cent to pay for an attorney right now. How can I afford one to help me?
In workers’ compensation claims, you don’t have to pay your attorney out of your own pocket. Your attorney will receive a portion of the compensation that the insurance company owes you. This is called a contingency fee. If you miss time from work due to the injury, and the insurance company won’t pay you (for whatever reason), your attorney will file for a hearing in order to have the Commission force the insurance company to pay you for missing time from work. Your attorney will receive 10% of that compensation once you win. When you have returned to work and are no longer treating for the injury, your attorney will receive a fee of generally no more than 20% of the compensation you are entitled to.
Therefore, every time your attorney works on your case, every time you call your attorney, or email him/her, every time your attorney argues with the lazy insurance adjuster – you are not paying an hourly fee! Your attorney will receive compensation based on the scenarios above – and your attorney will only be paid if they are successful in getting you paid!
Stay tuned for my next blog entry!