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Workers' Compensation Blog

Can I get treatment for my work injury if I move out of state

Thursday, August 29, 2019

Workers' Compensation is predominantly a state regulated system, therefore, each state has its own set of rules, laws and governing body. When life happens for the injured worker and the need to move out of state arises whether due to financial, health, family or lifestyle changes, it is important that you understand your medical rights before you move out of the state in which you receive your medical benefits.

Injured workers are entitled to medical treatment out of state, however the insurance company is still governed by the medical fee guidelines of the state in which they received the compensation benefit. This is the rule, but it is important to keep in mind that it is up to the providers' discretion whether they choose to accept out of state workers compensation. It can be difficult to find a provider that will allow their medical bills to be paid at the workers' compensation rate of the state in which the benefit is paid. For instance, if you receive workers' compensation benefits from a Maryland claim and the worker moves to Florida, then the insurance company only has to pay medical bills at the Maryland Workers' Compensation fee guide rate. Depending on the state this could work out more favorably for the provider if the state, in which they practice, has less favorable payout rates, but less favorably if the state is more generous to Workers' Compensation medical fees. In addition, some providers out of state will require a set-up fee to accept out of state workers' compensation and the insurance company may only agree to pay this extra fee under some circumstances.

It is increasingly more difficult to find providers willing to accept out of state workers' compensation, therefore if you are planning a move it may be time to settle your medical claim by agreeing to a medical set-aside account. With a medical set-aside account the money can be used to pay future medical bills, but are not beholden to the rates of the home state.

Attorney Julie Mirman

Written by Julie Mirman, an Associate Attorney with Berman, Sobin, Gross, Feldman & Darby, specializing in medical treatment coverage under workers' compensation.
Julie Mirman
jmirman@bsgfdlaw.com

What Documents Do I Need to File a Death Claim?

Thursday, June 13, 2019

Filing a Claim for Death Benefits

As attorneys working in workers’ compensation law, we tirelessly fight to ensure that injured workers receive the benefits they are entitled to, the medical treatment they need, and can hopefully get back to work. Unfortunately, not every claimant we represent is able to get back to work and some may succumb to their injury or occupational disease and pass away. We acknowledge that this is an extremely difficult time for you and your family, however it is vastly important for you to understand that you could be entitled to death benefits, and accordingly should gather the documents needed to file a successful death claim.

What do I need to file a claim?

To file a successful death claim, it is your responsibility, with the help of your attorney, to gather the needed documents within the allotted period of time. According to Labor and Employment § 9-710, “[i]f a covered employee dies from an accidental personal injury, the dependents of the covered employee or an individual on their behalf shall, within 18 months after the date of death, file with the Commission: (i) a claim application form (C35); (ii) proof of death; (iii) certificates of any physician who attended the covered employee; and (iv) any other proof that the Commission may require by regulation.” It is critical that you act quickly in obtaining these documents so that you may begin the process for filing a claim. For deaths from accidental injuries, the death has to have occurred within 7 years from the underlying accident. For death’s that are related to an occupational disease, the time frame can be longer and so you should contact an attorney as soon as possible to discuss the statute of limitations as it relates to your specific situation.

Are there any other documents I need?

In addition to what you have gathered, there are other documents that need to be collected and procedure you will need to follow to successfully file your claim. While this information is listed on the claim form C35, here are some of the other documents needed when filing a death claim:

When completing the Dependent Claim for Death Benefits the dependent claimant or authorized individual shall submit:

  • An authorization for disclosure of health information signed by the dependent claimant or authorized individual, directing the deceased employee’s health care providers to disclose to the dependent claimant’s attorney, deceased employee’s attorney, the deceased employee’s employer, the employer’s insurer, or any agent thereof, the deceased employee’s medical records…;
  • A certification of funeral expenses, if the dependent claimant is making a claim for funeral benefits…;
  • A certified copy of the certificate of death for the deceased employee; A certified copy of the certificate of death;
  • A certified copy of the certificate of marriage for a surviving spouse;
  • A certified copy of the certificate of birth for the dependent claimant, if the dependent claimant is the surviving child of the deceased employee.

[A detailed explanation of these requirements is provided on the claim form]

Though you may be reading this as a result of an unfortunate, life-changing event, do not hesitate to contact one of the attorneys at Berman, Sobin, Gross, Feldman & Darby if your spouse has recently passed away as a result of his/her work-related injury or occupational disease so that we may assist you in filing your claim. Death claims are an extremely complex subject, and this blog does not cover each and every legal requirement for filing a claim, that’s why it is so important to contact an attorney as soon as possible to look at the specific situation that you and your loved ones are dealing with.

Attorney Robert Hagans

Call or email me with your questions:
Robert Hagans
rhagans@bsgfdlaw.com

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