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Workers Compensation laws are designed to compensate an employee or their family members in work related injuries. But too often the benefits due are not paid. Frequently victims are forced to suffer administrative delays and lengthy appeals before obtaining any Workers Compensation benefits. Baltimore Attorney Marc Atas is a highly-skilled attorney based in Baltimore, Maryland who represents individuals throughout Maryland who have been involved in a Workers Compensation claim.
Workers Compensation Frequently Asked Questions
Workers Compensation Attorney Marc J. Atas has compiled a list of the most frequently asked questions. If your question is not answered here, please feel free to contact us the question and we will be happy to answer it.
Any employee injured on the job regardless of whether the accident is the fault of the employer or the fault of the employee, unless the employee is guilty of gross misconduct.
The are two types of workers compensation claims. The first type is an accidental personal injury claim.For an accidental injury claim the employee needs to be able to prove that a specific time and place at work the employee was injured. The second type is an occupational disease claim. Occupational disease claims occur when do to repetitive type work over an extended period of time and in certain occupations the employee develops a work related injury.
In order to file a Maryland workers compensation claim, the state of Maryland must have jurisdiction over the claim. Maryland covers employees that 1) work in Maryland or 2) work regularly in Maryland , but are hurt outside of Maryland on a job that is casual, incidental or occasional or 3)injured while working wholly outside United States under a contract of employment made in Maryland.
Must be an employee and not an Independent contractor.An independent contractor is one who contracts to perform a certain work for another according to his own means and methods, free from control of his employer in all details connected with the performance of the work, except as to it’s product or result.
Not covered under Maryland law if they are covered by federal law such as federal employees and longshoreman.
Employment must be more than casual. Casual employment is found when the work is occasional,incidental, or a usual concomitant of the employers business.
Maryland recognizes specific classes of employees that might not be considered employers under the regular definition.They include distributors of newspapers, farm worker, helper, jockey,juror,miner, minor, prisoners,school aide, vanpool operators, and volunteer fireman.
The employee can file a workers compensation claim even if the accident is totally his fault.Employee does not have to prove the employer or anyone else is at fault.
Every employer in the State of Maryland is required to purchase workers’ compensation insurance. Any claims insurance company your employer has named. All workers’ compensation benefits are paid by that insurance company and as long as there is insurance, the employer is not responsible for any payments. Other than a workers’ compensation claim, no claim is actually filed against your employer, although he is notified that a claim has been filed with the Workers’ Compensation in order to protect you if you are injured on the job. Bottom line, no you are not suing your employer. Employees are provided with many benefits as part of their wage package. Some benefits like workers compensation, social security, minimum wage and unemployment are government mandated and others like vacation pay, sick leave, gas card, personal leave, company picnics are volunteered by the employer. Which ever one of these benefits you apply for and receive it is part of your employment benefits. An employee should have no more reservations filing for a work related injury than for asking for their vacation pay.
When workers compensation was started it had the intention of relieving the employee, employer and government of the hardships created when an employee is injured on the job and place that burden on the workers compensation insurance company who was paid a premium to insure such a loss. Just like life insurance protects your family in case of untimely death, workers compensation insurance protects all parties in case of untimely injury at work.
In fact the law specifically provides that you can not sue the employer and your only remedy most of the time for your injuries no matter how serious is usually workers compensation except under very limited circumstances.
Under Maryland Workers’ Compensation law unless the employer intentionally hurts you, you have no right to sue the employer. The reason for this is that back in the early 1900’s prior to workers’ compensation law, an employee could sue his employer if the employer was negligent, however, those suits would typically take years and in the meantime the employee would receive no benefits. Also, if the employer could prove that the employee was contributory negligent or assumed the risk, then the employee would not be able to sue the employer and the employee would receive no benefits. As a compromise between labor, the employers, employees and the government the workers’ compensation system was set up so that an employee could recover workers’ compensation benefits quickly even if the employee was contributory negligent or assumed the risk and even if the employee could not prove that the employer was negligent. However, in exchange for these rights the employee had to give up the rights to sue the employer. The government passed a law agreeing that the employees would give up the rights of lawsuits against the employers in exchange for the workers’ compensation system and that is why today employees cannot sue their employers.
Workers compensation does not however prevent you from suing a negligent third party.
Can I be fired for filing a workers’ compensation claim?
The law says an employer can not fire someone for filing a workers compensation claim.In reality, if an employer wants to get rid of you badly enough, he will still fire you and probably get away with it.
Maryland Law provides that it is actually a criminal offense to fire someone for filing a workers’ compensation claim, subject to one year in jail and One Thousand Dollar ($1,000.00) fine. However, As far as I know, no states attorney has ever filed charges against an employer for firing an employee for filing a workers compensation claim. When I first started practicing law, i sent a client over to the States attorney to see if they would press charges and the states attorney did not know what he was talking about. I then sent the client back to the states attorney with a copy of the law and they still refused to prosecute.
One employee filed a civil suit against the employer for firing him for filing a workers compensation claim.You would think the appeals court would see the light. The appeals court ruled, however, if an employer needs to replace you because your job is essential and they need someone to do the work, they do have the right to replace you and that may result in your job being not available when you return back to work. If they do replace you, you may be eligible for vocational rehabilitation as part of your workers compensation case if you can prove you will never be able to do your old job due to your work related injuries.
Employers get around the criminal law by finding other reasons to fire you after you are injured on the job. If you were fired the day the employer found out you actually filed the claim perhaps someone would prosecute them. The employer is usually smart enough to wait and come up with another excuse.Because the law says firing for filing the claim, an employer firing you because you were injured on the job , but before you file the claim would probably not qualify.
If you can prove that they fired you specifically for filing the claim only, then you may have a right to file criminal charges, as well as a possible civil suit.
The workers’ compensation insurance company is responsible to pay for all of your medical treatment for the rest of your life, as long as the medical treatment is related to the work related accident.
9-660. Provision of medical services and treatment
(a) In general. — In addition to the compensation provided under this subtitle, if a covered employee has suffered an accidental personal injury, compensable hernia, or occupational disease the employer or its insurer promptly shall provide to the covered employee, as the Commission may require:
(1) medical, surgical, or other attendance or treatment;
(2) hospital and nursing services;
(4) crutches and other apparatus; and
(5) artificial arms, feet, hands, and legs and other prosthetic appliances.
If you reach a full and final settlement agreement with the insurance company, then those medical expenses could be closed. Most workers’ compensation cases stay open and can only be closed at the request of the employee.
The issue of whether medicare was going to pay for expenses related to workers compensation cases or third party liability cases has been out there since 1981. The answer to this question was quickly answered in the workers compensation arena by medicare with the requirements that medicare must be considered by all parties in a workers compensation case before a case is settled and the medicals are closed.
In response to these issues the Maryland Workers Compensation board has taken the lead by requiring that all full and final settlement agreements that close the medicals take medicare into consideration by way of a medicare set aside and failure to do so will result in denial of the settlement approval.The Maryland Workers Compensation Commission Requires that all settlements have the following language in the body of the settlement. “Employer and Insurer also agree to reimburse Medicare for any provisional or conditional payments made by Medicare that are ultimately determined to be the responsibility of the employer and insurer, up to the date of approval Md. Labor and Employment Code Ann. § 9-660 (Lexis 2009)
The workers’ compensation insurance company is responsible to pay two-thirds of your average weekly wage for every day you miss from work with a doctors excuse, except you do not get paid for the first three days until you have missed two weeks of work. These payments are called temporary total benefits and are paid until the time when you have reached maximum medical improvement which means that they are paid until such time as the doctor says that your condition is now permanent and you will not get any better and no further treatment will help you.
Your average weekly wage is calculated by adding the last 14 weeks of gross pay before the accident together and then dividing by fourteen and this produces your average pay over that period. Workers compensation then pays you as part of your Maryland Workers Comp benefits two thirds of that number. If you have missed time from work for other reasons during those previous 14 weeks than this will affect the amount you are paid while you are off. If you worked more hours around the time of the accident but less hours for other weeks this will affect the average. Overtime is included as long as it occurred within the 14 weeks. Vacation or sick time for which you were not paid may be excluded from this calculation.
In calculating wages in addition to your salary, the Maryland workers comp commission must also consider housing allowance, lodging allowance, personal use of business vehicle, meals provided by employer, and rent subsidy provided by employer. Fringe benefits such as health insurance, pension benefits, 401K, IRA, lost vacation time are not included in the calculation of average weekly wage. This seems unfair since health and pension benefits could exceed the value of actual wages paid and often result in a lower wage because these benefits are paid in lieu of wages. Tips are included as part of the average weekly wage.
In calculating average weekly wage, periods of involuntary layoff and involuntary authorized absences are not included in the 14 weeks.Average weekly wage calculations should only include the weeks the employee actually worked as well as vacation days paid.If you worked less than 14 weeks because you are a new employee than only the actual weeks worked should count.If your employer laid you off for a week or longer or failed to put you on the schedule for a week or longer those weeks should not count.Bonuses owed or incurred prior to the injury but not paid until after the injury should be considered.
Second jobs income will not be considered as part of your average weekly wage. In addition, if you choose to work your second job, while unable to work the job you were injured on , you will not be eligible for temporary total although you may be eligible for temporary partial. See attached article on what happens to your tt benefits when you are released for light duty and fail to return to work
Under the Maryland Workers’ Compensation law the employee has the right to choose whatever doctor he would like to see, as long as the doctor is willing to accept payments under the Maryland Workers’ Compensation fee schedule. In addition the employer has the right to have the injured employee seen by one of their doctors in order to determine if the treatment that the injured worker is receiving is necessary and reasonable, however, they have no right to demand that you treat with the doctor chosen by the employer.
In the real world, the system works differently.While the employee has a right to treat with the doctor of his choice, that choice is severely limited. First, many of doctors do not want to get involved in litigation and therefore do not want to accept patients with workers compensation claims.Numerous doctors do not like to do the paperwork the insurance companies demand. Few doctors like the delay in payment as the adjusters do not make paying medical bills a priority. The workers compensation law has a fee schedule that many doctors feel is too low so they are not willing to work for the low fees.
In the real world most doctors will not see you unless the insurance company provides an authorization and then timely pays you. Most insurance adjusters want you to go to their doctor so they usually refuse to provide the authorization.Then the only way to get authorization is by court order which can take months.
A few doctors will see you without authorization and are willing to deal with the delays and the litigation. However these doctors work on volume meaning they do alot of workers compensation only and are use to the red tape. These are the doctors that most claimant workers compensation lawyers refer their clients to.
The insurance companies have company clinics that they have contracts with, but they sell themselves to the insurance companies as insurance and employer friendly. These are to be avoided as their main interest is to provide low cost care not high quality care.
What happens if I cannot return back to my old job because I am physically unable to do the job any longer?
If as a result of the injuries received at work you are no longer able to do the type of work you were doing before, then the workers’ compensation insurance company must pay to provide either job placement or vocational rehabilitation to retrain you for a new type of work. Under Maryland law if the insurance company finds you work or trains you for a new job, they must provide suitable gainful employment which is defined as work providing wages as close to as possible as to what you were making before, taking into consideration your injuries, your education, your work experiences and any other relevant factors.
Once you are able to return back to work at a new job in a new field, then the next step in your case will be a permanent injury award.If you return to work in your old job or in a new job in a new field but make the same salary or more than you were making at the time of the accident, you will receive a permanent injury award but it will be less than if you had actual wage loss.If you return to work making less than you were at the time of the accident than your permanent injury award should be higher to make up your wage loss although it will not make up dollar for dollar all that you have lost.
If you are unable to find work because you did not cooperate in the vocational rehabilitation process, your permanent injury award will be minimal. If you find a job and get fired because you did not try very hard your permanent injury award will be minimal.
If you are unable to return back to any substantial gainful employment because of your injuries then you may be entitled to permanent total benefits that could pay you benefits for the rest of your life.
Will I automatically receive vocational rehabilitation and/or retraining if I am unable to return back to the type of work I was doing before?
If as a result of the injuries received at work you are no longer able to do the type of work you were doing before the accident, then the workers’ compensation insurance company must pay to provide either job placement or vocational rehabilitation to retrain you for a new type of work. Under Maryland law if the insurance company finds you work or trains you for a new job, they must provide suitable gainful employment which is defined as work providing wages as close to as possible as to what you were making before the accident, taking into consideration your injuries, your education, your work experiences and any other relevant factors.
You will not automatically receive vocational rehabilitation and/or retraining if you are unable to return back to the type of work you were doing before. The Maryland Workers’ Compensation Commission favors job placement over vocational rehabilitation. Vocational rehabilitation is only provided as a last resort when other employment is not obtainable at a suitable wage. All efforts are exhausted in order to find work either with the old employer or a new employer before providing any kind of vocational rehabilitation, including training or schooling.
If I cannot sue my employer because of the injuries that I sustained at work, what benefits, if any, can I receive?
If I cannot sue my employer because of the injuries that I sustained at work, what benefits, if any, can I receive?
Under workers’ compensation law you are entitled to get paid temporary total benefits which is two-thirds of your pay for every day you missed, except you don’t get paid for the first three days unless you miss two weeks. You are entitled to have all treatment paid for the rest of your life as long as the treatment is related to the accident. Finally you are entitled to a permanent injury award, which is a substitute for an award you might have received if you were allowed to sue someone and it is something like, although not equal to a pain and suffering award.
Lifetime Medical benefits
The first of the workers compensation benefits you received is medical treatment. The medical treatment must be causally related to the accident. Medical treatment can include seeing the doctor, going to the hospital, having surgery, physical therapy, medical devices, etc. and you’re entitled get reimbursed for any mileage to and from the doctor. The medical treatment covers you for the rest of your life as long as it’s related to the accident.
After you have completed your treatment and your condition is now permanent and will never get any better, then you are entitled to a permanent injury award. That award is determined based upon what the doctor says your permanent disability rating is and also looks at factors including permanent wage loss, as well as many other factors, including education, other injuries that you have had, age, experience and your actual complaints. Typically in order to prepare for a permanent injury hearing, the claimant is sent to a doctor by both the claimant’s attorney and the insurance company and then the case is scheduled for a hearing.
At a workers’ compensation hearing for a Md workers comp settlement any medical records are automatically admissible without the necessity of bringing the doctor in to testify. Normally, the claimant testifies first and will testify as to what injuries they received, how they received those injuries, what medical treatment they had and what period of time, if any, they were off from work. On a claim for permanency in order to receive the Md workers comp settlements the claimant will testify as to any permanent complaints they have. The insurance company lawyer will then be able to ask the claimant questions regarding any prior injuries they may have had, any treatment that they may need in the future, whether they had any other accidents after the accident. A typical workers’ compensation hearing may be as short as five or ten minutes or can last as long as one or two hours.
If you are not able to go back to any type of work, including the type of work you used to do, as well as any other job, then you are permanently and totally disabled and may be entitled to receive workers’ compensation benefits for the rest of your life, even it was your intention to retire at the age of sixty-five.
An ailment, disorder, or illness which is the result of work under conditions naturally inherent in the employment and which is ordinarily slow and insidious in its origin. What this means is if you work under the same conditions for a long period of time or do the same type of activity over and over again over a long period of time and this eventually causes the body to wear out or causes some disease to occur and if this is very common in the type of work that you do, then these are considered occupational diseases and are a compensable injury covered by workers’ compensation. (Examples of occupational diseases are carpal tunnel and heart disease)
Another form of an occupational disease occurs when manifestation of symptoms is consistent with those known to result from exposure to a biological, chemical, or physical, agent that is attributable to the type of employment in which the employee was employed.
Examples of occupational diseases are:
- carpal tunnel in grocery clerk
- heart disease in police officer
In order to have an occupational disease, there must be a disablement incurred by the employee as a result of the occupational disease. If you have a technical occupational disease-meaning the medical diagnosis, but miss no time from work, you may not have a compensable occupational disease. For that reason, it is important to make sure the doctor gives you 3 days off from work in order to recover from your injury and that you in fact take those three days off. If there is no lost time or the court does not accept your loss time as being due to the disabling condition, then it may be sufficient and necessary to argue that the disablement caused only partial disability. Many commissioners consider other sets of facts as disabling including,the necessity to take medication when accompanied by disabling symptoms even if no work is lost, you are in pain while working and cannot do all of the functions of your job, you need help from others to do your job or additional time to do your job or accommodations to do your job.
What does conditions naturally inherent in the employment mean? In order to meet this test, you must first decide what the employee does. Then you need to see if other people who work for the same employer have the same condition. It is not essential that others in the same employment have the same injury especially if it is a small employer, but it is certainly helpful. It is not necessary that everyone in the employment has the same condition, but one or a few employees will begin to show a pattern. In addition, it is sufficient if employees who typically do the same type of job for other employers tend to develop this condition that would show it is inherent in the employment, even if no one at your employment has the condition as long as the job duties are similar.
Can I be paid for injuries that I had prior to a work related injury, as well as the work related injury that I received?
The employer and the insurance company will have an attorney to represent them in these particular matters. The Workers’ Compensation Commission has Commissioners who are bound by the Maryland Workers’ Compensation Law. Workers’ Compensation Law is very complicated and is usually a specialized area that only certain Maryland work injury lawyer practice in. A person who is injured on the job and goes to a workers’ compensation hearing without a Maryland work injury lawyer will be at an extreme disadvantage since everyone else at the hearing will be an attorney, including the Workers’ Compensation Commissioner, as well as the employer’s attorney. You should have your own attorney
If you do attend a workers’ compensation hearing without a Maryland work injury lawyer, you will be called up to the front of the courtroom and told of your right to ask for a postponement to obtain an attorney and most commissioners will attempt to influence you to obtain a Maryland lawyer .
Baltimore Workers Comp Attorney Is Essential In Workers Comp Claim
You NEED A Baltimore Workers Comp Attorney TO OBTAIN FOR YOU THE BENEFITS YOU DESERVE!
Workers’ compensation laws are meant to ensure that employees, who are injured on the job, are provided with the following benefits:
- excellent medical treatment
- lost wages until you can return to work
- vocational rehabilitation
- monetary award or settlement
- right to reopen your case if your condition gets worse for more money or medical treatment
- mileage reimbursement
- The Workers Compensation laws also provide benefits for dependents of those workers who are killed because of work-related accidents or illnesses.
YOU NEED A Baltimore Workers Comp Attorney WHO HAS REPRESENTED ALL TYPES OF EMPLOYEES ALL OVER THE STATE. see attached article that outlines all of the benefits the insurance company will overlook if you do not have an attorney
Being represented by an experienced Baltimore Workers Comp Attorney is important. Baltimore Workers Comp Attorney Marc Atas has successfully represented workers throughout Maryland in their Workers Compensation cases.
Baltimore Workers Comp Attorney Marc Atas is also highly-experienced representing Maryland State Employees as well as Local Government employees who have been injured on the job in Baltimore and throughout the State of Maryland.
YOU NEED A Baltimore Workers Comp Attorney WHO IS FAMILIAR WITH ALL OF THE DIFFERENT TYPES OF CLAIMS.
Under Maryland’s Workers’ Compensation Law. There are two types of Workers Compensation claims.
- Accidental Injuries-An accident at work at a specific time and place where an exact description of how the injury took place can be explained
- Occupational Diseases-An injury caused by constant repetitive activity over a long period of time which is common in the type of employment the employee is doing
What happens at a workers’ compensation hearing?
After you file the claim part of the process of a Maryland Workers Compensation Commission claim is what it’s like to go to a Maryland Workers Compensation Commission trial at the Maryland Workers Compensation Commission. See attached link to see the entire workers compensation process prior to the workers compensation hearing.On the day of the hearing at the Maryland Workers Compensation Commission you appear and there will be many other hearings for other clients on that particular day. The hearings at the Maryland Workers Compensation Commission tend to take anywhere from ten minutes to two hours depending on how complicated the case is. When your case is called, you will go up to the witness stand. Your attorney will appear with you at the Maryland Workers Compensation Commission. At the trial table will be the lawyer who represents your employer and your insurance company and there may be an attorney from another fund called the Subsequent Injury Fund. Before the hearing at the Maryland Workers Compensation Commission starts the person who hears the case is called the Worker’s Compensation Commissioner. The Worker’s Compensation Commissioner makes the decision in your case. You will typically not get a decision from the Maryland Workers Compensation Commission on that particular day as the Maryland Workers Compensation Commission is going to listen to your testimony, listen to the testimony of the witnesses, listen to what the lawyers have to say in closing, and then when the cases are over for the day, read over the medicals, compare that with the testimony and then render a decision. Sometimes you get the decision from the Maryland Workers Compensation Commission the next day. Sometimes it can take as long as a month.
At a workers’ compensation hearing any medical records are automatically admissible without the necessity of bringing the doctor in to testify. Normally, the claimant testifies first and will testify as to what injuries they received, how they received those injuries, what medical treatment they had and what period of time, if any, they were off from work. On a claim for permanency the claimant will testify as to any permanent complaints they have. The insurance company lawyer will then be able to ask the claimant questions regarding any prior injuries they may have had, any treatment that they may need in the future, whether they had any other accidents after the accident. A typical workers’ compensation hearing may be as short as five or ten minutes or can last as long as one or two hours.