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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.

Workers’ Compensation and FMLA

Tuesday, June 27, 2017

If you find yourself injured on the job, and are required to miss work while you recover, you may be concerned about whether your job will still be waiting for you when you are able to return. Certain employees have federal protections available to them, in addition to their workers’ compensation benefits, which they may not be aware of.

What is FMLA?

Employees who suffer work related accidents may be covered under the Maryland Workers’ Compensation Act. In addition those same employees, who sustain what is known as a “serious health condition”, are entitled to federal protections under the Family Medical Leave Act, or FMLA. The most important safeguards available to injured workers require that employers provide twelve (12) weeks of job-protected unpaid leave and continue to provide group health benefits during that twelve (12) week period. Put another way, FMLA holds your job open for twelve (12) weeks, if you are injured on the job and qualify for FMLA.

How Do I Know if I Qualify for FMLA?

If you work for a private employer who has at least fifty (50) employees, a federal, state ,or local government, or an elementary or secondary school (regardless of the number of employees), you are eligible for FMLA in addition to workers’ compensation benefits as long as you suffer a “serious health condition” in the course of your employment.

If you do work for a covered employer, you must have worked for that employer for at least twelve (12) months in order to qualify for job protection through FMLA, even if that work is seasonal.

A “serious health condition” includes a work injury where (1) you required an overnight stay in a hospital or medical facility; or (2) you were off work for more than three days and required ongoing medical treatment (such as multiple doctors’ appointments and/or follow up care).

What is the Difference Between FMLA and Workers’ Compensation?

Pay: Workers’ Compensation entitles you to payment of temporary total or partial disability benefits while you are off work and the payment of all reasonable treatment for your compensable work related injury. FMLA, however, is unpaid leave, which ensures that, as long as you return to work within the twelve (12) week period, you are entitled to return to the same or equivalent job. So, if you suffer a “serious health condition” on the job you may be entitled to payment through workers’ compensation, while your job is held open by FMLA.

Medical Expenses and Health Insurance: FMLA requires that covered employers continue to pay health insurance as if you were still working. However, this does not include the medical expenses that you incur as a result of your work related accident. This is not usually a concern since Workers’ Compensation gives you the lifetime right to request payment of any medical treatment which is reasonable, necessary, and related to the on the job accident. In other words, if you injure your knee on the job and require a knee replacement surgery as a result of that accident, you have the right to request that the medical expenses and recovery from that surgery be paid for under Workers’ Compensation. If you catch a cold while out of work for that knee replacement surgery during the twelve (12) week FMLA period, you will still be able to see your primary care physician under your employer provided health insurance and the job will be held open for you.

Navigating how Workers’ Compensation interacts with the Family Medical Leave Act can be complicated. In addition, workers may not realize the rights that they have under the Maryland Workers’ Compensation Act and Federal FMLA. If you are injured on the job and require an extended leave of absence to recover from your injury, please contact Natalie Whittingham.

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.

 

Why Workers Compensation’ For Police Is More Important Than Ever Before

Tuesday, October 04, 2016

Police officers are not only covered for accidental injuries arising out of and in the course of their employment, but they are also covered for occupational diseases arising from the unique hazards of their employment such as heart disease, hypertension, and hearing loss. Maryland law presumes that the heart disease or hypertension developed from the officer’s stressful employment. This presumption is based upon medical evidence that police officers, due to their many pressures and responsibilities, have a greater risk of heart disease and hypertension than the general public.

When choosing a workers' compensation attorney, it is important to go with an attorney who, “backs the blue.” Attorney Matthew Engler, a former Maryland State’s Attorney, now practices workers’ compensation with BSGFD and devotes his attention to the needs of Maryland police officers. From his experience as a prosecutor, he knows how difficult policing is today and fully appreciates the sacrifices made every day by our men and women in blue. Contact Attorney Matthew Engler today for a free consultation.

I was told I have lifetime medical coverage, under workers' compensation, but they are denying my claim!

Friday, September 23, 2016

The Law. Many injured workers remember that towards the end of their case, when they settled, received a lump sum award, or weekly payments for a set period of time for their workers’ compensation claim, they were told that there right to medical treatment was left open for the duration of their life. However, of course, this comes with a caveat; according to the Workers’ Compensation Law of Maryland, injured workers are entitled to medical treatment with no time limitation, unless stipulated otherwise, for the body part that was injured at the time of the accident as long as the requested medical treatment is reasonable and necessary and is casually related to the original accidental injury.

What does this really mean? For continued medical treatment the injured worker must prove that their current need for medical treatment is still related to the original claim. Thus, the insurance company may not approve any treatment without a doctor’s letter stating that the current need for treatment is still related to the original claim. In my practice, clients often call me after two (2) - five (5) years of feeling fine and now have an onset of the same symptoms they felt several years ago from their accidental injury or disabling occupational disease. Injured workers are often frustrated that their employer’s insurance company will not automatically approve a visit or treatment. This is compounded when the injured worker finds out that before treatment is approved, the employer’s insurance company is allowed to send them to the insurance company’s own “independent” medical evaluation, which often times will state that the current need for treatment is no longer related to the claim. When there has been a large gap in time from the last date of treatment until the present need for treatment usually an injured worker must participate in a hearing to request the Commission to order the treatment or visit. Scheduling of these hearings can take several months.

What should I do? First the insurance company needs evidence through medical reports that the new symptoms are related to the original injury. Then the insurer will need to verify that the requested treatment is reasonable and necessary. Finally they will investigate to ensure there was no intervening event or accident that might have caused the onset of new symptoms. The best way to get your treatment as quickly as possible is to visit your doctor and ask them to write a letter that describes what treatment has been recommended, why the treatment is recommended and whether or not it relates back to the original Workers’ Compensation claim make sure all of your providers have your workers’ compensation insurance claim number and send reports and bills directly to the insurance company to ensure time is not lost in updating the workers’ compensation insurance file. In addition, verify that your attorney also has all of the appropriate recent medical reports, thereby supporting the effective and expeditious advocacy on your behalf. If Berman, Sobin, Gross, Feldman & Darby LLC was the law firm you used for the original claim we will continue to fight to get the medical treatment you need.

For More Information, Contact Attorney Julie Mirman 301-740-3306

Sick Leave Bank or Temporary Total Disability? An Introduction to How Leave Benefit Options Will Affect Your Workers’ Compensation Case

Friday, September 23, 2016

Many of my teacher clients often ask, and understandably so, how will I be paid while I am out of work and recovering from my injury? Because many boards of education in Maryland offer benefits other than what the Workers’ Compensation Act allows – the answer is - “it depends”. Oftentimes, the type of benefit received may be your choice – making it a good time to contact your attorney and make sure you understand the implications of what benefit you choose.

Maryland Law for Teachers Workers' Comp

Maryland law requires an Employer to pay you at the rate of 2/3s of your salary for the period of time you are recovering from your work related injury (legally known as temporary total disability or “TTD”). For many private sector employees, other than possibly a short or long term disability plan, the 2/3s wage benefit is the only benefit available while out of work. The 2/3s TTD benefit is tax free; however, oftentimes your health insurance is placed on hold, along with your contribution to any pension or other 401k type program while you receive this wage benefit – oftentimes placing you in a precarious position.

Additional Benefits Through Unions

Many teacher unions however, have collectively bargained for additional benefit options for their members. These benefits differ by County. Many boards of education will pay anywhere from 90 days to one year of “disability leave” (also known as “accident leave” or in certain cases “assault leave”) which takes the place of the workers’ compensation act’s 2/3s leave benefit. This benefit pays 100% of wages for the period of time you are recovering from your injury, effectively taking the place of your normal salary. Perhaps most importantly, this allows you to continue to pay for your own health insurance and contribute to your pension, FSA, etc., which many of my clients find to be extremely beneficial – especially if they provide health insurance for their families.

Once the “accident leave” or “disability leave” benefit has run its course, other potential TTD alternatives may be available to you. Personal and sick leave can always be used – however, these are earned leave benefits that should not be wasted on a work related injury if at all possible (if an employer is requiring you to use your own accrued leave to recover from a work injury, consult with your attorney). These are leave benefits you have earned – you are entitled to keep them if you are hurt on the job. Also important to note, even if your employer forced you to use your own personal or sick leave, oftentimes these benefits can be reimbursed at a later date.

Sick Leave Bank

Many school boards also offer “sick leave bank” benefits as another payment option. To be eligible you must contribute a set number of personal leave days to the bank per year to qualify – each County has its own set of rules and regulations to access the “bank”. You must be a member of the bank prior to needing to the days, however, when a work injury takes place this is another option which pays at 100% of your wages and continues the other benefits noted above (e.g. health insurance, etc.).

Additional Options to Review and Discuss

There may be other options aside from those noted above to compensate you when you’re injured on the job. Leave benefits are just one of the benefits you may be entitled to if you are injured on the job. Compensation for permanent problems, retraining and reimbursement for travel expenses are just a few of the other benefits that may be available to you.

Consult with your attorney to be sure you are not leaving money on the table.

Can Teachers Collect Leave Benefits During Summer Break?

Friday, September 23, 2016

The days are now long, morning frost is a thing of the past, and thousands of Maryland’s educators’ are enjoying their summer breaks. What better way to kick off this year’s few months of relaxation (or switching gears for that summer job) than to brush up on your workers’ compensation knowledge?

Workers' Comp Benefits and Summer Break

This time of year, I always hear from a number of my teacher clients who are wondering how the summer break will affect their workers’ compensation benefits. Generally speaking, under the Workers’ Compensation Act, Maryland workers are entitled to 2/3s of their wages (known legally as temporary total disability or “TTD”) during the recovery period after an injury when they are incapable of working. (Most boards of education offer a 100% wage benefit to their employees for a specified time period. This issue and its implications on workers’ compensation benefits will be discussed in greater detail in a future blog).

Boards of Education however, will often refuse payment of TTD during our educators’ summer vacation - making the argument that the injured teacher is a 10 month employee and would not be paid during the summer months if they had not been injured at work.
The law in Maryland, however, makes clear that the having an actual intention to work or the opportunity to work for that matter, is not a requirement to collect TTD. Maryland’s test is loss of earning capacity, or the inability to work, regardless of whether there would be actual wage loss. Maryland’s highest court has held that both retired workers – who may never work again (no intention of working), and incarcerated employees (no opportunity to work), are both entitled to payment of TTD during the period they would be physically unable to perform their job duties.

In short – teachers are entitled to TTD over the summer if they are still recovering from a work injury and can’t physically perform their job duties, regardless of whether or not there are any job duties available to perform.

Pay Plans and Benefit Coverage

Another important factor to consider under these circumstances is whether an individual takes a 10 month pay or chooses to spread out their pay over 12 months. Boards of Education will often argue that if a teacher is compensated on the 12 month plan, they should not be entitled to TTD benefits during summer because they are already being paid and would then be “double dipping”. However, this could not be further from the truth. Even if the pay is spread over 12 months, teachers are still only being paid for 10 months of work and accordingly, are still entitled to summer TTD. Deferring earned income does not preclude TTD benefits during the summer months.

Bring on the heat.

Matt Darby Wins Big For Fire Fighters and Government Employees

Thursday, September 22, 2016

Clifford B. Sobin, Esq.

 

Eight years ago, almost to the day, I attended hearings at the Maryland Legislature related to some newly proposed laws that would help people claiming Workers’ Compensation benefits. My firm for more than two decades has worked with Unions throughout Maryland to help people that have been injured on the job; with their claims and with enacting new laws. That day, Matt Darby was there as well. He was a principle partner in a firm that had the same mission as ours. Once the meetings were over he was kind enough to drive me to my car.

We got to talking and realized that both of our firms had similar cultures and similar values. The light bulb went off. Why not merge? Almost three years later we did.

Now, as further proof of the validity of that vision, only two months after my partner, Ken Berman, scored a huge victory in the Court of Appeals for fire fighters, now Matt Darby has done the same in the Court of Special Appeals.

Facts

The case involved one of our clients who suffered from coronary heart disease. Matt succeeded in convincing the Maryland Workers’ Compensation Commission that our client’s condition was compensable and that he had a 25% percent industrial disability as a result. The Commission awarded him more than $33,000 dollars.

However, there was a problem. Baltimore County argued he was not entitled to the money because he was receiving a retirement benefit that paid more than the Workers’ Compensation award. Therefore, to use a tired legal expression; the award was “set-off” by the retirement benefit. In theory they had a point – but in practice they did not. The County argued that the money our client received in a lump sum five years before the Commission hearing, as part of the DROP program, should be included in the “set-off” calculations.

Matt said no!

Argument

He argued that the law required looking week by week to see what retirement benefits were actually paid for that week and compare it to what was owed under the Commission award for that week; then calculate the “Set-off” separately for each week. Matt won before the Commission. He won before the Circuit Court. And now he has won in front of the Court of Special Appeals.

Not only did the win benefit our client, but it will help all fire fighters, police officers and any other employee of a county, municipality or the state. If you would like to read the case it is located at:

http://www.mdcourts.gov/opinions/cosa/2014/2053s12.pdf.

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.

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