How Are Maryland Workers’ Compensation Commissioners Selected?

By Clifford B. Sobin, Esq.

Workers’ Compensation Commissioners are nominated by the Governor.  The Maryland Senate must then approve the appointment. Their appointment is for twelve years unless a Commissioner leaves office before their term is up. If so, the new replacement Commissioner only serves for the remainder of that term. After a Commissioner’s term expires, the Commissioner must be reappointed by the Governor to serve a new twelve year term.

Commissioners must devote their full time efforts to their job.  Therefore, they may not:

  • Practice law
  • Hold another political position
  • Do any business or other activity that interferes with their ability to serve the citizens of Maryland as a Workers’ Compensation Commissioner

Commissioners are paid the same amount as a District Court Judge except for the Chairman who receives an additional $1500.00

There are a total of nine Commissioners.  Each Commissioner must be a licensed attorney.  There is no requirement that they must have practiced Workers’ Compensation law before their appointment although that is frequently the case.  In fact, many outstanding Commissioners have had experience in other areas; including litigation, the legislative process and advisory or management capacities.

Generally, each Commissioner has scheduled before them approximately twenty cases a day, of which, ten to fifteen are heard in a hearing. Since many of their decisions involve tens of thousands of dollars, they have a significant impact on Maryland’s economy and the plight of injured workers.

At times retired Commissioners will hear cases. This occurs due to retirements, illnesses vacation, etc. Since the Commission Chairman’s priority is to make sure that scheduled cases are heard, retired Commissioners provide an important “reserve” force. The most significant requirements for eligibility for recall are that a retired Commissioner must have served for at least three consecutive years and that the retired Commissioner may not serve more than 120 working days in a calendar year.

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Maryland Workers’ Compensation Book

I apologize if this appears to be shameless promoting of a new book that I just wrote. But, if you were injured at work in Maryland while working for someone other than the Federal Government then this short book is for you.

wcwebsitebookcoverI wrote it for injured workers – not lawyers. It is basic and practical – not complex and nuanced. I hope to replace any fears and uncertainty you may have with knowledge and understanding. I want you to know how long things take, why things happen, and what to expect. It is not a replacement for obtaining legal advice from an attorney, but instead is a supplement to help educate and insulate you from some of the surprises that otherwise may come your way.

I have represented thousands of injured workers in Maryland over more than thirty years. I wrote and continue to update a 1400 page two volume workers’ compensation legal treatise for Maryland lawyers. I taught attorneys Maryland Workers’ Compensation law, testified before the Maryland Legislature on many proposed Workers’ Compensation bills and continue to speak at many Union meetings concerning the “nuts and bolts” of Maryland Worker’s Compensation.

Now, I want to help you. If you want to know:

  • What to do if you need medical treatment as a result of your injury.
  • How much the insurance company will pay you while you are unable to work.
  • What happens if you are physically unable to ever return to the type of work you were doing.
  • How much money you will you receive at the end of your case.
  • The role of an insurance company in a workers’ compensation case.
  • If you should hire an attorney and what will it cost.
  • If you have to go to a doctor chosen by the insurance company for an evaluation and what will happen when you go.
  • If you have to speak to the nurse case manager when she calls or the vocational counselor who keeps telling you what to do.
  • Why is your check late.
  • Why won’t the insurance company approve your treatment right away.
  • Why your medical bills are often not paid timely.
  • If private investigators are used by insurance companies.
  • What happens at a Maryland Workers’ Compensation hearing.
  • How long it takes to get a hearing.
  • How evidence is presented.
  • How long takes to get a decision.
  • Your appellate rights.

Then this book is for you. You can get if for free by downloading a PDF from my law firm’s web site, www.bsgfdlaw.com. Or you can purchase a Kindle version from Amazon at  the following link: KindleEbook.

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How Maryland Workers’ Compensation Law is Made and Changed

By Clifford Sobin, esq.

Three types of laws impact the Workers’ Compensation process. They are:

  1. Statutes,
  2. Regulations, and
  3. Appellate decisions.

In addition, the Workers’ Compensation Commission develops specific policies that guide them but do not bind them.

Statutes

The starting point for workers’ compensation is statutory law. A statute is a written law. If it is not covered by a statute, it cannot be done, no matter how unfair something may seem to you.

Statutes start as “bills”. They are written and voted on by the Maryland Legislature. If both the Maryland House of Delegates and the Maryland Senate approves the “bill” it goes to the Governor. If the Governor signs it, the “bill” becomes law.

Before the legislature votes, testimony is taken from both those in favor of the bill and those against it. This occurs in designated House and Senate Committees and often preliminarily in front of a designated Legislative Oversight Committee.

Lobbyists and special interest groups are heavily involved in the process. As a result, changes often take years.

Regulations

The Workers’ Compensation Commission has the authority to create mandatory regulations. It is the purpose of a regulation to identify and determine precisely how the intent of a statute will be carried out. A regulation cannot create new law. It can only clarify a statute and provide procedures for its implementation.

Before a regulation is enacted, it must be circulated to the general public and hearings are held where anybody may speak in favor or against it. Regulations usually take several months to travel from an idea to reality. As with statutes, lobbyists and special interest groups are heavily involved in the process.

Appellate Law

Appellate law is created by the Court of Special Appeals, which must hear every appeal, and the Court of Appeals which only hears appeals it chooses to be worthy of consideration (almost always only after the Court of Special Appeals has heard the case). Appellate decisions interpret statutes, regulations, the Constitution and other Appellate cases.   The Courts may not create new law (although some criticize them for seemingly doing so), they may only interpret existing law.

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10 things you need to know about IMEs (Independent Medical Evaluations)

The insurance company has the right to send you to a doctor of their choice for a medical opinion.  This doctor is not going to provide you with any treatment or become your doctor, but rather only give an opinion.  Here are 10 things you need to know:

  1. The IME is for the benefit of the insurance company, not you.
  2. The doctor is not required to keep anything you say in confidence; everything you tell him/her, or fail to tell him, will be contained in his report.
  3. Contrary to the letter you receive from the insurance company, you are not required to bring any test results or medical records with you.  It is the insurance company’s responsibility to provide their doctor with the reports they want him to review.
  4. The IME doctor and his staff will watch how you walk, move, whether you bend down to tie your shoes or pick up a piece of paper you might have dropped, or how you remove a piece of clothing, and they will compare it to the complaints you tell them about during the exam and what is contained in your medical records, so be consistent.  And never lie or exaggerate, but rather be specific about what pain you feel or limitations you experience.
  5. You should tell the doctor about any other accidents you were involved in, whether they happened before or after the work-related injury.  Failing to inform the doctor of a prior accident hurts your credibility and makes it look like you are hiding information.
  6. Do not miss your appointment or arrive late.  This could result in the insurance company terminating benefits, such as your lost wages, and the Workers’ Compensation Commission could order you to pay for the missed appointment.
  7. The doctor does not have the right to perform any invasive tests on you, such as xrays, injections or EMG/nerve conduction studies.
  8. A female should never be alone in the examination room with a male doctor, so typically the doctor will have a member of his staff in the room during the examination for your safety.
  9. The examination will likely be very short (a few minutes), so it’s important that you be as comprehensive as possible about the complaints you have.
  10. The day of the IME is typically when insurance companies hire a private investigator to video tape you in hopes of “catching you” doing something that is inconsistent with what you tell the doctor or which reveals that you are capable to working.  You should be consistent at all times and with all doctors.
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Medical Treatment Rights Under Maryland Workers’ Compensation Law For Out Of State Treatment

By Clifford B. Sobin, Esq.

Last month I discussed medical treatment rights stemming from a compensable Maryland Workers’ Compensation claim. Since medical costs are controlled by the Maryland Workers’ Compensation system, you never have to pay anything for treatment required for injuries sustained as part of your compensable claim – with one catch – the treatment must be in Maryland.

Medical bills of health care providers who provide treatment outside of Maryland are not controlled by the Maryland Workers’ Compensation system. Therefore, in those circumstances you may have to pay a portion of the costs for treatment you need for injuries sustained as part of your compensable claim.  The amount you will pay is the difference between what the medical provider charges and the amount the Maryland fee schedule requires employer/insurers to pay.

What should you do? Continue reading

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What Are Your Medical Treatment Rights Under Maryland Workers’ Compensation Law

By Clifford B. Sobin, Esq.

The easy answer is that you have the right to medical treatment reasonably related to your injury on the job. Furthermore, once accepted by the workers’ compensation insurance carrier, you do not have to pay deductible or co-pay if the medical provider is in Maryland (see my next blog article for out of state treatment issues). Your Treatment rights include payment of:

  • Hospital bills
  • Prescriptions
  • Doctor bills
  • Physical Therapy bills
  • Mileage reimbursements for travel to health care providers
  • Medically necessary equipment

However, there is also a hard truth. Continue reading

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Do You Need An Attorney For Your Maryland Workers’ Compensation Claim?

If You have been injured at work and have been dealing with the insurance company’s adjuster without any problems (for now), should you still hire a lawyer?

The short answer is YES.

Insurance company adjusters often formulate their questions in a way that encourages people to reveal more information than is needed or required.  They will then use that information against you later on. For example, an adjuster may ask if you’ve ever had any prior injuries, prompting you to tell them about every medical condition or injury you’ve ever sustained, instead of limiting it to the body part that you just injured.   They may also take recorded statements and focus on areas that will assist with defending against your claim.  In addition:

  • The insurance company adjusters have access to the lawyers at their company, who provide them with the most recent court decisions and advise them about the law.  Shouldn’t you also have a lawyer to advise you?
  • Your employer, who pays premiums to the insurance company, also has access to the lawyers at the insurance company who can advise them about the law.  If your employer has a lawyer, shouldn’t you?
  • It does not cost you anything up front to have a lawyer for a Maryland Workers’ Compensation case.  Your attorney will only be paid out of any compensation you are awarded in your case and only with the permission of the Maryland Workers’ Compensation Commission. Your lawyer cannot seperately bill you or charge you for their time.  Your attorney will not receive a fee if you do not receive compensation.

Your lawyer can assist you with all aspects of your case, including obtaining: Continue reading

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How Long Does It Take For My Maryland Workers’ Compensation Hearing To Be Scheduled?

By Clifford B. Sobin, Esq.

The Short answer is – it depends.

Generally, hearings are scheduled within three to four months after they are requested. However, some cases take longer and others less.   The following things seem to impact the timing of hearings:

  • Location of the hearing (some locations are inherently busier than others)
  • Number of hearing requests filed within the same time period
  • Last minute cancellation of a full Commission docket due to weather
  • Number of cases that were continued after being scheduled.
  • Priority given to some issues over others
  • Inclusion of the Subsequent Injury Fund or Uninsured Employer’s Fund as a party

As a result, it is impossible to determine with confidence how long it will take for a hearing to be scheduled and the one claimant may wait much longer than another, even if the hearing requests are made on the same day.

There are two exceptions to the three to four month norm for having your hearing scheduled:

  • The first is if the issue only involves vocational rehabilitation. If the appropriate forms are filed, a Workers’ Compensation Commissioner will attempt to mediate the dispute over the phone within 24 hours of the forms being filed. If that is not successful, a hearing will be scheduled within several business days of the failed phone conference.  However, the Commission will not any issue other than Vocational Rehabilitation to be heard at the expedited hearing.
  • The second exception is if an emergency hearing is granted.  While it is true that an emergency hearing can be requested for any issue, it is equally true that they are infrequently granted. The purpose must be an emergency that far exceeds the fact that the insurance company is refusing to pay.  There must be significant demonstrable impact as a result of a delay, beyond what other claimants will normally experience for the same delay, to have a chance of having the request granted.   Generally, it is recommended not to ask for an emergency hearing unless there is a high likelihood of it being granted.
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More Cancers Presumed To Be Caused By The Job – Just Not Yet

By Clifford B. Sobin, Esq.

Fire FightersMaryland fire fighters and fire instructors both paid and most volunteers, paramedics, most volunteer rescue squad members and advanced life support unit members, and State Fire Marshals are eligible to claim a presumption under Maryland Workers’ Compensation law that certain cancers are caused by their jobs. Until May 31, 2013, the cancers are:

  • Leukemia
  • Pancreatic Cancer
  • Prostate Cancer
  • Rectal Cancer
  • Throat Cancer

As a result of new laws passed in April of 2012, for Workers’ Compensation claims filed on June 1, 2013, or later, the list of presumptive cancers increases to include:

  • Multiple Myeloma
  • Non-Hodgkin’s Lymphoma
  • Brain Cancer
  • Testicular Cancer
  • Breast Cancer

Continue reading

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Medicare and Old Workers’ Compensation Claims

Medicre LetterA letter from Medicare is in the mail. The envelope doesn’t look much different from others you have received from Medicare.  You open it without thinking or much concern.

What it says shocks you.

Medicare (actually an outfit called MSPRC) is alerting you that it no longer will pay for treatment or wants money back for bills they have paid.  Why?

Because you filed a Workers’ Compensation claim more than ten years ago – it makes no sense to you.  The Workers’ Compensation claim was for your right leg, the treatment you now need is oxygen for your lungs!

How Could This Happen?   

Insurance companies are now required to send Workers’ Compensation claim information to Medicare.  If:

  • bills are coded incorrectly by a medical provider
  • a medical report erroneously says the treatment is for a job related injury
  • Medicare makes a mistake; or
  • who knows why

Continue reading

Posted in Medicare and Workers Compensation, Uncategorized | Leave a comment