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Workers' Compensation Blog

The Importance of Documenting All of Your Injuries

Tuesday, July 18, 2017

All too often when workers are injured the focus is on the most severe parts of the body hurt. Frequently the minor pains and bruises from other parts of the body are ignored. However, in a workers’ compensation claim it is very important to report every hurt, bruised, or swollen body part no matter how minor it may seem at the time. The human body is interconnected and when you fall, for instance, you may land on your knee, but your hands may have eased the impact, which can cause shoulder and arm pain as well. If you injure your back, the nerve pain and/ or damage can cause problems in your legs. You may not feel any symptoms to those other areas until a day or two later, but these are all parts of your body that could get worse over time and require additional medical treatment. It is important in a workers’ compensation claim to document every part of the body that was affected by the accident no matter how small it may seem. It is more difficult to try and convince a Commissioner or insurance company that another body part was also injured in the same accident if there is no documentation of it within a few days of the accident.

What’s In The Injury Report Matters

This rule is important to remember when filling out your accident report at work, your workers’ compensation claim form, and any forms you are given at every medical office you visit after the accident. In our practice, we frequently read emergency room reports where an injured body part is left out or the wrong body part is documented. We all know hospitals are busy places and not everything is always documented with 100% accuracy, but insurance companies will use this to discredit your injury or the cause of your injury. It is important for you to check that how the accident occurred and that all injuries are clearly described and documented. Make sure to tell the medical professional you are dealing with every ache, pain and/or discomfort that you are feeling as a result of the accident.

Contact Us With Questions

If you have any questions about a new pain or problem that developed after your injury it is always best to contact an attorney. Our attorneys have years of experience and know the right questions to ask to ensure that you receive the full coverage, you are entitled to for your injuries.

Workers’ Compensation Claims Process - How long does it take to get a hearing and what is a “consideration date?

Friday, July 14, 2017

One of the most common questions I receive from clients concerns how long it takes to get a hearing before the Maryland Workers’ Compensation Commission. As with any court or judicial body, the Commission sets its own schedule and the claimants and attorneys appearing before it are subject to that schedule. Generally speaking, however, it is a safe assumption that your hearing will be scheduled within three to four months from the date you file your claim or request a hearing. This can vary based on your hearing venue. For example, hearings are scheduled much quicker in Baltimore or Beltsville (the hearing sites with a higher volume and where hearings are held more frequently), than in La Vale or Cambridge (where hearings are held less frequently based on a lesser volume).

What is the “Consideration Date?”

The claim process begins when you file an “Employee Claim Form” with the Commission. This document asks you basic demographic and injury-specific questions. Once this is submitted, the Commission will send a Notice of Claim to your employer and your employer’s workers’ compensation insurance carrier, referred to as the insurer. On the bottom-right of this Notice of Claim, you will find a “Consideration Date,” which is typically about a month from the date your original Employee Claim Form was filed. Your employer and insurer have until this date to either accept or contest your claim. If they contest the claim, they will file Contesting Issues with the Commission and you will have to wait for a hearing to present the evidence of your work-related injury or illness. You cannot request a hearing on your own behalf until after the “consideration date,” has passed. That’s why it is so important to file your claim as soon as possible.

My Employer and Insurer filed Contesting Issues; what next?

When your employer and insurer file Contesting Issues, they are, in effect, opposing the claim until the Commission can hold a hearing to determine the validity of your claim. As stated above, this will typically be scheduled anywhere between three to four months from the date your claim is initially filed. At this first hearing, you will be called upon to testify and present evidence of your work-related injury or illness, including medical records supporting your claim. After the hearing, the Commissioner will decide whether or not your injury or illness is covered by the workers’ compensation laws of Maryland. However, up until that time, you will not be able to recover any workers’ compensation benefits such as temporary total disability. You may or may not receive medical coverage. For this reason, it is all the more urgent that you consult with an attorney to determine your options and to prepare for this hearing.

How can my hearing be scheduled on an emergency basis?

In some circumstances, you can request the Commission to schedule your hearing sooner based on an “emergency” situation. For example, if you are unable to work on account of your injury or illness and have received collection notices on past-due bills or if you require emergency medical treatment, then the Commission may schedule your hearing sooner, within a matter of weeks rather than months. However, you must submit documents to support the urgency and these requests are not always granted.

If you have any questions or require assistance with your work-related injury or illness, please do not hesitate, contact Matthew Engler, Esq. today at 301-740-3322 or mengler@bsgfdlaw.com.

Why Should I File A Claim With The Workers’ Compensation Commission If My Employer’s Insurance Is Already Paying For My Doctor?

Tuesday, October 04, 2016

Attention Injured Workers! There is a huge difference between filing a workers’ compensation claim with the Workers’ Compensation Commission and your employer’s insurance company. Many injured workers do not realize this and may miss out on all the other benefits entitled to them under the law if they had only filed their claim with the Commission. The benefits that you may miss out on include:

 
- ONLY by filing a claim with the Commission do you have access to lifetime medical coverage for your injury, with NO copays;
- ONLY by filing a claim with the Commission do you have access to compensation for permanent impairment suffered from your injury, even if you return to work or it is only a scar;
- ONLY by filing a claim with the Commission do you have access to vocational rehabilitation services if your injury prevents you from returning to your prior job;
- ONLY by filing a claim with the Commission can you fight your employer’s insurance company when they deny medical treatment or compensation for lost wages;
- And much more…
 
Additionally, there is no cost or fee associated with filing a claim either. You normally must file within two years of the date of injury, so time is often of the essence. Do not be subject to the whims of your employer’s insurance company: take charge of your recovery and contact Attorney Matthew Engler today for a free consultation.

 

Advice for the Apprehensive Injured Worker

Thursday, September 22, 2016

By Charles Schultz, Esq.

A few times a week I get a call from an injured worker who is considering filing a workers’ compensation claim with the Maryland Workers’ Compensation Commission but is concerned about the repercussions that may take place after filing their claim.

While it is understandable, and in certain circumstances a very real concern that an employer may retaliate against an injured worker after a claim is filed, if you are injured on the job you must understand what rights you may be giving up if you don’t file a workers’ compensation claim. Often times you may be giving up more by deciding not to file a claim than you would be even in the worst case scenario for employer retaliation – termination. (It should be noted that Maryland is an “at-will” employment state, meaning an employer can fire an employee for any non-illegal reason. However it is against Maryland law to fire an employee for filing a workers’ compensation claim). Those who have been lucky enough to avoid the workers’ compensation process understandably may have little to no knowledge of what benefits may be available to them through Maryland’s workers’ compensation laws. The following paragraphs will detail the rights potentially available to injured workers in Maryland who are successful in filing their workers’ compensation claim. (As a quick aside, it is of utmost importance to understand that filling out a report of injury for your employer is NOT filing a claim with the Maryland Workers’ Compensation Commission. If a claim is not properly filed you may be forfeiting your rights. It is important to consult legal counsel to ensure proper filing).

By failing to file a claim you may be giving up compensation at 2/3s of your pre-taxed wages for the period of time you are unable to work while you recover from your work injury. Often times this means exhausting your hard earned personal, vacation and/or sick leave when your employer or its insurer is the legally responsible for paying your wages for each day missed – and doing so without tapping into your personally accrued leave time. This benefit becomes especially important if you are separated from your employment. This is because the payment of workers’ compensation leave benefits that you are entitled to while you are unable to work as a result of your work injury has no correlation to your employment itself. Whether you are still employed or have been separated from employment, you are still entitled to compensation if you cannot do your job and your doctor agrees that you must be out of work.

Compensation for time out of work is important – everyone has bills to pay – and the money received for lost time from work can help to make sure you don’t fall behind while you work to get back on the job. However, the best benefit in Maryland’s workers’ compensation law is the payment of medical treatment necessitated by your work injury. Maryland is unique in that you have the right, as an injured worker, to seek treatment with a doctor of your choice. And most important of all, there is no time limitation on your ability to seek treatment as a result of a work injury. (The right to fight for treatment never expires once a claim has been accepted, however, there are no guarantees your employer or their insurer will authorize the treatment you wish to have – yet another good reason to consult with a legal professional). If you fail to file a claim with the Workers’ Compensation Commission, often times the insurance adjuster will take longer to authorize treatment as there is no real motivation to do so. Further, if the insurance company decides to deny your treatment you will have no means to force them to pay for the treatment your doctor is recommending. This leaves you with the responsibility of convincing your own insurance company to pay for your treatment, or worse yet, paying for your treatment out of pocket. By successfully filing a claim, you’re guaranteeing at least the right to fight for your employer to pay for the treatment you need to get you better and back to work.

Compensation for permanent disability is the last main benefit available to those who are successful in filing a workers’ compensation claim. Often times the money received for an individual’s permanent disability does not truly compensate him/her for the affect their injury has had on their life - especially with more serious injuries. However, some compensation is certainly better than receiving no compensation at all. By failing to file a claim, you forgo this right altogether.

You work hard at your job every day, giving up precious time with your family to help further your companies’ goals. If you get hurt while on the job you owe it to yourself to protect both you and your family by filing a claim. You should not have to pay out of your own pocket for medical treatment, struggle to make your bills because you are incapable of earning an income, or worse yet be forced to suffer from a life altering disability without receiving any assistance from your employer and their insurer to get you back on your feet.

So if you get hurt on the job – protect yourself and your family by filing your claim. And if you’re concerned about the potential repercussions of doing so, consult with legal counsel to make sure you understand not just what problems may arise if you do file your claim, but what problems may arise if you don’t.

Charles Schultz, Esq.
1301 York Road, Suite 600
Lutherville, MD 21093
(410) 769-5400
www.bermandarby.com

Hearing Loss and Tinnitis Claims - Maryland Workers' Compensation Law

Monday, September 19, 2016

By Clifford B. Sobin, Esq.


Occupational Deafness claims under Maryland Workers Compensation generally involve two different medical problems. The first is actual inability to hear sounds. This is referred to as hearing loss. The second often shows up as "ringing in the ears" and frequently is caused by tinnitus. Despite the fact that they both impact your ability to hear and understand what other say, they are treated differently by Maryland law.

This blog entry is part of a three part series.

  • This blog post discusses hearing loss.
  • My next blog will cover tinnitus.
  • The third in this series will talk be about money you may receive if your case is found compensable and the importance of filing a claim due to the potential future expense of hearing aids.

How Much Hearing Loss Do You need to File a Claim?

Unfortunately, not all hearing loss that you may have is covered. Typically, occupational hearing loss first appears at the higher frequencies. If your employer provides hearing tests, as is the case with many fire fighters, the records will include a chart that summarizes the testing results. The same is the case if you go to your private physician.

Usually, if you have hearing loss it will first show up at the higher frequencies; between 4,000 and 6,000 hertz. Although that type of loss is annoying because it means you have difficulty hearing high pitched sounds and perhaps voices on the telephone – it is not covered under Maryland Worker's Compensation law. Only frequency loss in the 500 to 3,000 range is covered. And then, only if the average is more than 25 decibels of loss and your age was less than fifty when you were last exposed to noise (your hearing tests will show the loss at 500, 1000, 2000, and 3000 herz).

If you were older than fifty when last exposed to loud noise on your job, the average goes up by one half decibel for each year. Therefore, if your last exposure was at age 54, you need more than an average of 27 decibels of loss.

Which Employer Pays?

Generally, the last employer you worked for when last exposed to loud noise is responsible for paying your hearing loss claim if you worked there for at least ninety days. However, that employer has the right to try to lay off some of the responsibility to pay you if they can prove your prior employers caused some of your hearing loss. But that is their problem, not yours.

However, if you worked for more than one employer at the same time of your last noise exposure, and you were exposed to loud noise while working for both, then things get a little bit more complicated. Frequently, both employers will be added to your Workers' Compensation claim and both will share the responsibility to pay you.

How Long Do You have To File a Hearing Loss Claim?

The easy answer is two years, but two years from what? To be on the safe side you should seek legal advice as soon as you think you are suffering from hearing loss. It is a simple matter for your attorney to review your medical records and determine if it is time to consider filing a claim. I usually ask my clients to forward me their last hearing test and then I tell them in a quick telephone call if they should move forward. If you are curious for yourself, I invite you to contact me. There is no charge for me reviewing the records.

But what if it has been more than two years since you first have had tests showing hearing loss? The simple answer is … it's complicated. There is an appellate case that said an employee filed his claim too late because he waited more than two years from when he was told by his doctor that he had hearing loss caused by his job and – this is important – the test showed a level of hearing loss that was covered under Maryland law. The bottom line is the following factors matter:

  • When were you advised that you have hearing loss?
  • What were the test results when you were told?
  • Did your physician say it was occupationally related?
  • Has your employment changed since your last test and has your hearing worsened in the new employment?
  • Has it been more than two years since you first have had hearing test that is compensable under Maryland law?

Unfortunately, as you might guess by now, I can't provide you with a definite answer for you to be sure how long you have to file a claim. To what extent the factors above make a difference is very fact specific. Only an attorney can make an informed decision and provide you with the proper advice customized to you.


The First Week After Your Maryland Workers’ Compensation Injury

Monday, September 19, 2016

By Clifford Sobin, Esq.

 

What you do during the first week after being injured on the job will set the tone for the rest of your claim. It is the most important time. You must:

  • Report the injury to your employer.
  • Get medical treatment as soon as possible. Don't let several days pass.
  • Give an accurate history of the injury to your medical provider.
  • Don't speak to the insurance company unless you are sure you are not going to get an attorney (a decision that almost always is a bad one).
  • If you want an attorney, choose one who will guide you, educate you, and that you trust. If the conversation is only about money, consider choosing another attorney.
  • File a Workers' Compensation claim.
  • Choose a doctor for follow up care and obtain authorization to go.
  • Decide if you are going to speak to a nurse assigned by the insurance company to your case.

If you make the wrong decisions, you might make it difficult to win your case. The insurance company may deny your claim. What you say or do in the first days after you are injured matters once you are in front of a Commissioner. Even if the insurance company pays benefits in the beginning, when the inevitable disagreement with the insurance company occurs, you will not be in a position to obtain a speedy hearing in front of the Workers' Compensation Commission if a claim was not previously filed appropriately.

What You Do Matters

You should report your injury to your employer immediately after it occurs and at worst not later than the next day. Never wait until Monday to report an injury that occurred on Friday. If your injury was not witnessed by anybody else, you risk it will be assumed you hurt yourself over the weekend and are now lying.

Always get prompt medical treatment and tell the doctor what happened. If for some reason you did not report the injury to your employer but told the emergency room you were injured on the job earlier that day that will usually be enough to win your case if the insurance company contests it. Furthermore, by getting the treatment immediately:

  • You get the care you need when you need it.
  • You protect yourself from the insurer arguing you had a new injury between your job related injury and the medical treatment you are now receiving.

You should not speak to the insurance company without having hiring, or at least meeting with, an attorney. Workers' compensation is an extremely complex area of law. The insurance adjuster is experienced in finding reasons not to accept a claim. You are not experienced with dealing with insurance adjusters looking for reasons not to pay you. Your desire to be helpful to the adjuster may be hurtful to you. Instead, you should have an attorney control all communications with the insurer.

You should also have the assistance of an attorney when your Workers' Compensation claim form is filed. It matters what is written on the form. It matters even more if you have not reported all the details of your injury to the employer or if your doctor did not write down the correct history of the injury you provided. The average weekly wage you write in the claim form matters as well. It is up to the insurance company to dispute whatever you claim. If you state too low a number because you are not clear on the law, will the insurance company correct it? You already know the answer to that.

Your choice of medical provider can have a significant impact on the future of your claim. Some doctors are better than others. Some injuries require specific medical specialties. Your attorney can guide you through this unfamiliar territory.

Frequently, insurance companies assign nurses to manage the medical aspects of compensation claims. They will attempt to contact you, your doctor and be present at your medical appointments. They are often beneficial in catastrophic cases. However, the value of having them versus the risk they present is an issue, especially with less severe injuries. The insurance company will obtain information through their involvement that they may otherwise never know. Also, nurses often pressure health care providers to do things that you might not welcome. That is why most attorneys place stringent ground rules on their involvement. Furthermore, experienced attorneys have a much greater sense of which nurses can be trusted and which nurses cannot. You should never speak to one without the assistance of counsel.

The bottom line is that the first week after an injury is the scariest and most dangerous time for you. The injury is scary because of the pain it is causing you and your fears of how it will impact your future. It is also dangerous because your actions, non-actions, statements, and non-statements may haunt you throughout the rest of your claim.

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

Monday, September 19, 2016

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. You have the right to claim treatment, but the insurance company may object, delay or ignore your request. Unfortunately, the solution often requires a hearing before the Maryland Workers' Compensation Commission. At the hearing, your testimony and medical reports from your doctors are presented for a Commissioner's consideration.

How can this be you might ask? It is because the injured worker always has the burden to prove the treatment requested is:

  1. related to the injury on the job; and
  2. reasonably likely to be beneficial.

Therefore your right to medical care under a Workers' Compensation claim is not as extensive as when you make an insurance claim with a medical insurance provider. In that instance, you and/or your employer has paid an insurance premium that entitles you to payments for medical care. Workers' compensation settings are adversarial, your right to payment flows from your injury, not a contract. Nevertheless, the medical protection that flows from an accepted Workers' Compensation claim may be crucial to your recovery and your financial wellbeing.

Three Problems Caused by Maryland’s Medical Fee Guide for Workers’ Compensation Claims

Friday, September 16, 2016

By Clifford B. Sobin, Esq.

The Workers’ Compensation Commission regulates the amount a Maryland medical provider can charge for treating work related injuries. The permitted amounts are found in a document entitled, “Guide of Medical and Surgical Fees”. The medical provider may not charge the injured worker an amount in excess of the amount provided in the fee guide.

These rules cause difficulties in three areas:

1) When the treatment is out of state. In that case, Maryland fee guides do not restrict the health care provider from charging whatever they want. Nevertheless, the workers’ compensation insurance company will only pay an amount called for in the fee guide – the injured worker is stuck for the difference. Although the statute permits the Commission to Order a higher payment when special circumstances permit, it almost always declines to do so. Therefore, it is crucial that an injured employee explicitly obtain the agreement of the out of state health care provider to accept the fee schedule before becoming a patient.

2) When the claim is initially denied. If the workers’ compensation insurance company denies a claim, usually if there is a medical insurer, bills will be paid by the medical insurer while a hearing is pending. As a result the claimant may pay a deductible and the health insurer will pay pursuant to its fee schedule. Problems can occur when the claim subsequently becomes compensable. This may result in:

  1. payments being yanked from the medical provider by the health insurer; or
  2. issues concerning who reimburses the claimant for co-pay expenses (health care provider or workers’ compensation insurer) as well as what happens if the medical insurer has paid more to the health care provider than the fee schedule permits.

3) Difficulty in finding medical providers. Many physicians, especially orthopedic surgeons and neurosurgeons, are refusing to accept patients who rely on workers’ compensation insurers to pay for the medical treatment. This is due to the reduced rates, increased documentation, and uncertainty or delay of payment which is part and parcel to administering a workers’ compensation claim.

Please do not hesitate to contact us at Berman, Sobin, Gross, Feldman & Darby LLP in order to assist you in these matters

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