Workers Compensation FAQs: The Help You Need
If you are hurt on the job in Maryland, would you know what to do and what the process of reporting your injury entails? We’ve gathered these FAQs for you to help you become informed. Forewarned is forearmed.
If I am hurt on the job, what are the next steps to take?
In order, you should:
- Notify supervisor or company immediately.
- Make sure an incident report is done.
- See a doctor immediately.
- Record information about, or take note of, any witnesses.
- Make a Maryland Workers Compensation Commission claim on an official Maryland Workers Compensation Commission claim form.
- Call a lawyer.
What if I don’t report an incident immediately?
If you don’t report an incident immediately, there is a chance that the insurance company will dispute the claim, arguing that it didn’t happen because of your delay in reporting. They might also argue that you couldn’t have been injured, because otherwise you would have reported it. Remember, the insurance company is always looking for a reason to deny your claim and your rights.
What if the injury is not serious? Do I still need to report it?
Yes! Whether it is minor or serious, if you want to get compensation or benefits, you must report the incident. One problem can be that people have injuries that don’t seem serious initially, so they don’t report them, thinking that the injury or pain will go away. But if the injury shows itself to be serious and you have delayed reporting it, your case is likely to be disputed because of the delay. Always report all workplace injuries immediately, no matter how minor they might appear to you.
What if the accident was my fault? Should I still report it?
Yes! In Maryland, workers compensation law is no-fault, so you are still entitled to workers compensation benefits even if it’s your fault. The notable exceptions are if you intentionally hurt yourself, if you are under the influence, or if you engaged in horseplay or misconduct.
Why do I need to request that an incident report be filled out?
If you report the incident to your supervisor, there is always a chance that they will forget to fill out the incident report. There’s also a chance they will deny that you told them, and deliberately not fill out the report due to bad intentions or motives. If you insist that an incident report be generated, then you have everything in writing. It is crucial to get everything in writing and to have your own copy.
What if my supervisor or employer refuses to fill out an incident report?
If your supervisor or the company refuses, then what you should do is write a description of what happened and submit it to your supervisor, to your human resources department, and to your employer. Ask your employee representative to sign it and date it. Be sure to make and keep a copy of the signed and dated statement for yourself.
Why does it matter that I see a doctor immediately?
If you don’t report an incident in a timely fashion (which generally means within 24 hours), the longer you take to report and the longer you take to see a doctor hurts your claim. You want to see the doctor immediately so that your claim is not contested and so that the doctor can document your injuries. If you delay, your employer might argue that you weren’t really injured; otherwise, you would have seen a doctor right away.
In Maryland, can I see any doctor I want?
Yes. In Maryland, you can choose any doctor you want. This is not the case in some other states. Our advice to you is that you go to the ER or urgent care center immediately, or as soon as you get off work, because of the need for timeliness regarding your claim. You also need to receive appropriate medical attention, and to talk with the doctor before you forget any details concerning what happened. The employer will rely on the details of the doctor’s report to see if your description of what happened is the same as the description in the incident report or Maryland workers compensation commission claim form. Employers will look for inconsistencies in their efforts to deny claims. So even if your injury is not serious, see the doctor, ER, or urgent care center immediately and give them a precise description of what happened to you.
In Maryland, what happens if the doctor puts me off work?
Take a copy of the disability slip you receive from the doctor indicating that you are not able to return to work fully or partially, and give it to your employer right away. In Maryland, if you are out three days or less, you are not entitled to temporary disability benefits. If you are out three to seven days, day one begins on the fourth day of your disability. But if you are out seven or more days, day one begins on the first day of your disability.
If you are not able to return to work, you are entitled to temporary total disability benefits. Workers compensation pays at 66 2/3 percent of your average weekly wage. The average weekly wage is determined by adding your gross income for the 14 weeks you worked prior to the accident. That figure is then divided by 14 to get your average weekly wage. Overtime is included in this calculation. If your employer pays for housing, that can also be included in the figures.
Who pays the doctor bill?
If your case is compensable, then your employer must pay all reasonable and necessary medical bills for your treatment. In reality, their insurance may try to deny medical treatment or send you to their doctor, who will likely find in the company’s favor. However, the law says they are obligated to pay. If your case is disputed, they won’t have to pay until the issue is resolved, and they will likely want their own doctor to look at you. As we said previously, to make sure your claim is compensable, you must file a claim using the official Maryland workers compensation form, and file it with the Maryland workers compensation commission.
If the insurance doesn’t dispute your claim, they must pay as long as the treatment is reasonable and necessary. If they do dispute, they don’t pay until the case is resolved. If it is resolved in your favor, they must pay.
Once I report the claim, does that mean I’m covered?
When you report the claim, it doesn’t mean you’re covered. Depending on injury or circumstances, sometimes the workers compensation insurance does begin paying. But just reporting your injury does not mean insurance will automatically start paying. Determinations will need to be made.
What do I have to do to ensure I am covered for the injury?
See the first question in this list of FAQs and follow every step in it, including filing your workers compensation claim on an official Maryland Workers Compensation Commission claim form with the Maryland Workers Compensation Commission. You have two years to file a claim, but it is in your best interests to file your claim immediately.
After you have performed all of the steps listed in the first question, and have filed your claim workers compensation claim on an official Maryland Workers Compensation Commission claim form with the Maryland Workers Compensation Commission, your employer still has a period of time during which they can dispute your workers compensation claim, called the consideration date. It is their right to do so if they wish.
Within a few weeks, after you file your workers compensation claim on an official Maryland workers compensation claim form the commission will send a copy of the claim form to you, your employer, the insurance company, and your attorney. This form will contain the consideration date. The consideration date is the last day your employer has to dispute your claim after the claim is processed. It is located on the bottom right of the form. The employer has up until the consideration date to contest the case. If the employer disputes your claim before the end of the consideration date a hearing will be scheduled.
My employer said they reported the incident to their insurance company. Shouldn’t that mean I’m covered?
Remember, just because the employer reported to the insurance company doesn’t mean you are covered. The employer might try to make you think you are covered, but you are not covered simply because it was reported. You have to first file your claim on an official Maryland workers compensation claim form with the Maryland workers compensation commission and your case has to be found compensable by the Maryland workers compensation commission.
If the insurance company sent me a letter with a claim number, does that mean I’m covered?
No, that is not evidence of coverage. A claim number does not mean you are covered or protected. (For your information, Maryland workers compensation commission claim numbers begin with B or W and are followed by six numbers.) It simply means the employer has reported it to their insurance company and the insurance company has assigned your incident a claim number.
If the insurance company starts paying my medical bills and lost wages, doesn’t that mean I’m covered?
No! You must file a claim on an official Maryland workers compensation claim form with the Maryland workers compensation commission. If you file a claim on an official Maryland workers compensation claim form with the Maryland workers compensation commission but your employer disputes your claim, it’s favorable evidence for you that they paid you. Why? Because it means that the judge will think it is implied that that the insurance company believes the claim is valid. But—it still does not mean you are covered unless you have filed an official Maryland workers compensation claim on a Maryland workers compensation claim form with the Maryland workers compensation commission. If the employer disputes the claim, you will have to go to the Maryland workers compensation commission to have a workers compensation judge decide if your case is covered.
Then what do I have to do to guarantee that I’m covered?
We know we are repeating ourselves terribly, but you must follow the steps in the first question of this list of FAQs, including filing a claim with Maryland Workers Compensation. That is what you need to do. You also must then successfully get past the consideration date without your claim being disputed. If your claim is disputed, then the case will be decided in court. If it is decided in your favor, you will be covered. If your claim is not disputed, you are covered.
Once I file a claim, am I covered?
Once you file a claim form with the Maryland Workers Compensation Commission, you are almost home.
In our practice, we see disputed claims about 25 to 30 percent of the time, so there is still a possibility that some things will need to be resolved.
If I file a claim with the Maryland workers compensation commission, and my company doesn’t dispute it, am I covered?
Yes. If the claim is not disputed by the consideration date, you are covered. However, this does not mean your medical care is 100% covered, because at any time your employer can still dispute medical treatments as being unreasonable and unnecessary. Also, any lost time for which you are not paid, they can also contest by filing a dispute with workers compensation.
Once covered, what benefits am I entitled to?
You are entitled to medical treatment for the rest of your life, or for as long as is reasonable and necessary. You are also entitled to lost wages, otherwise known as temporary total or temporary partial disability benefits. The longer you are actively treating with medical providers or missing work due to the accident, the more likely it is that they will eventually begin disputing medical care and lost wages. Additionally, the insurer must pay you for any permanent impairment you have sustained. They must also pay for funeral expenses.
If the doctor says that you can’t go back to your job, you have a right to vocational rehabilitation and to be paid lost wages during this time period.
Let “The Injury Lawyer” Help You
Steven Heisler has devoted 25 years to helping injured people and their families pursue compensation from negligent people and companies who caused them to be injured. He genuinely cares about each and every one of his clients. If you think you might have a workplace injury case, you may be eligible for workers compensation, disability and other resources to assist with medical bills and your financial obligations. Call The Law Offices of Steven H. Heisler, today for a free initial consultation by calling 1-877-228-HURT (1-877-228-4878), or use our online form.
Workplace Accidents & Injuries
Injured @ Work?
Employers, Businesses and Managers have a responsibility to ensure proper training and as safe a workplace as possible, in accordance with all regulations. Unfortunately, equipment malfunctions, co-worker negligence and bad decisions can place workers at risk. You may be eligible for Workers Compensation, Disability and other resources to assist with medical bills and your financial obligations. We offer free consultations, so why not call us now?