Maryland Workers Compensation Claims: Eligibility, Filing and Appeals
Employees in the State of Maryland are entitled to collect workers' compensation benefits if they are injured while performing their job or develop an illness that is related to their work (an “occupational” disease). Workers' compensation covers medical care for the work-related injury as well as lost income due to being unable to work for the short or long term.
The State of Maryland requires all employers that have at least one employee to provide workers' compensation benefits. This applies to both part-time and full-time employees, and employers are not permitted to waive any provisions of the law. Employers do not, however, have to provide workers compensation coverage for independent contractors.
Covered Injuries and Illnesses
A Maryland employee can receive workers’ compensation benefits only if the injury occurred as the result of an accident “arising out of and in the course of employment." In addition, an accidental injury is defined as an injury caused by some special exertion, unusual strain, or condition in your job. This means something out of the ordinary occurred in the course of your employment that unexpectedly resulted in an injury. If you are unsure your injury qualifies under this definition, it is important to consult a workers’ compensation attorney to ensure that your rights to benefits are protected.
Maryland employees who develop illnesses related to their type of job, called “occupational diseases,” are also entitled to workers' compensation benefits. If a job exposes an employee to toxins, for instance, and the worker gets a disease known to be caused by those toxins, that is a compensable occupational disease. Occupational diseases are an exception to the accidental injury rule mentioned above.
What to Do When You Are Injured or Become Ill
If you become injured or ill on the job, let your employer know about it immediately.
File a Claim
Your employer will file a form with the Workers’ Compensation Commission, but in addition, there is also a claim form which you must submit. Submit this form as soon as possible to avoid any delay in your benefits. Technically you have two years to file your claim, but it is to your advantage to file it right away. The employee claim form is available online where you can complete and submit it.
Handwritten claim forms are not accepted. If you need a claim form so you can use a typewriter to complete it, do not print a copy of the form off of the computer. The claim form will be rejected if you do it this way. Check with your employer to see if they have a paper copy of the form you can use. If they don’t, contact the Maryland Workers’ Compensation Commission to request a paper copy of the form (contact information is below). The form will then be mailed to you. Be sure to follow the instructions for completing the form.
Maryland Workers' Compensation Commission10 East Baltimore StreetBaltimore, Maryland 21202-1641
Phone: (800) 492-0479
Seek Medical Treatment
See a doctor as soon as you can. In Maryland, you are allowed to choose your own physician for workers’ compensation purposes. You will need your doctor to determine if you are unable to work, to monitor your improvement under treatment, and finally, to determine when you are ready to return to work.
If your claim is approved, medical treatment that you seek for your work-related injury or illness will be covered by workers’ compensation. Keep track of the miles you travel to see the doctor, how much you spend on co-pays, and costs of medications. Save all your receipts so you can be reimbursed for these medical expenses.
Types of Maryland Workers’ Compensation Benefits
Workers compensation will pay for your doctors visits, hospital bills, prescriptions, physical therapy and other needed medical care.
Temporary Total Disability Payments
If your injury has made you completely unable to work, you will be entitled to temporary total disability benefits, calculated as two-thirds of your average weekly wage (but not more than the state’s average weekly wage). In no case shall the payment be less than $50 per week.
If you are completed disabled for two weeks or less you might not get paid for your first three days out of work, except for medical expense reimbursement. If you are completely disabled for longer than two weeks, then you will be paid from the date you became injured.
Temporary Partial Disability Benefits
If your work-related injury limits how much you can work, you may be eligible to receive partial disability benefits on a temporary basis.
The amount of these benefits is calculated as half of the difference between your average weekly wage and what you are able to earn while partially disabled. These payments cannot exceed half of the average weekly wage for the state.
Permanent Total Disability Payments
If you are totally disabled, meaning completely unable to work, you will be paid a weekly benefit for a certain period of time based on what kind of permanent disability you have and how severe it is. This will normally be determined by your doctor, and in some cases your benefits will be permanent.
Payments will be two-thirds of your average weekly wage of but can’t exceed the state average weekly wage. The minimum payment will be $25.
Permanent Partial Disability Benefits
If you are not permanently disabled such that you are totally unable to work, you may still suffer a partial disability that is permanent.
The amount of your permanent partial disability benefit will vary based on what type of injury you have and how severe it is. Some payments will be permanent and others will be for a limited period of time. The period of time will vary according to the body part injured. For example, you will be paid for 100 weeks if you lost a thumb. You will be paid for 25 weeks if you lost a little finger.
The amount you will receive per week is based on your average weekly wage. You will receive a minimum of $50 weekly, unless your average weekly wage was under $50, in which case you will receive compensation that equals your average weekly wage.
Wage Reimbursement Benefits
Employees are also entitled to be reimbursed by their employer for any time spent at medical examinations required by the employer or their insurer. Reimbursement is also available for any time spent going to a Workers' Compensation Commission hearing if the hearing was rescheduled due to actions of your employer or its insurer, so long as you are eligible for benefits. These reimbursements are known as wage reimbursement benefits, and are separate from temporary total disability benefits, which also compensate you for lost wages.
Claim Approvals and Denials
After you filed a claim, you can check the status online or by calling 800-494-0479.
If your claim has been approved, your insurer may contact you about negotiating a settlement amount for permanent partial or total disability. If you've signed a settlement, the Workers’ Compensation Commission will direct your employer (or their insurer) to make payments to you. Payments will begin being made 15 days after you are awarded benefits or 15 days after payment of the award is due, whichever is later.
If you have an attorney, contact him or her for information about when you can expect to receive payment. Or, if you do not have an attorney, check with the insurance adjuster who handled your claim. If you don’t know how to contact the insurance adjuster, check the “Insuree Designee” website.
If your claim was denied, you have the right to appeal by requesting a hearing with the Workers’ Compensation Commission. An appeal is filed by completing and submitting an Issues Form. For more information, see our article on appealing a denial of workers' comp in Maryland.