This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you have an accident at work, you should report an accident to your employer as soon as possible-if not immediately. Seek the appropriate medical attention if necessary.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
The state workers' compensation scheme identifies the employer as the party responsible for paying out workers' compensation benefits. Every employer employing one or more employees has to provide workers' compensation coverage. The employer may elect to be self-insured or purchase a workers' compensation policy from a private insurance group.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
Not all injuries are covered by the workers' compensation scheme in Maryland. In order to qualify for workers' compensation, the injury must have been the result of an accidental personal injury arising out of and in the course of employment. This means that just because your injury happen at work or while on the job does not guarantee you will qualify for benefits.
To qualify for workers' compensation, you must establish three things: 1) you are an employee 2) that suffers from an accident 3) arising out of employment and 4) in the course of employment. To be considered an employee for the purposes of qualifying for workers' compensation, you and your employer must have a traditional employer-employee relationship in existence. An independent contractor, for example, would not qualify as an employee within this construct. For an injury to be considered the result of an accident, you must show that an extraordinary event caused an unexpected result a bodily injury. The injury must also arise out of employment, meaning that the conditions or environment of the workplace contributes to the resultant injury. In addition to arising out of employment, the injury must also arise in the course of employment- that means the accident occurred while you were at work, at your place of work, and while you were working to complete your work tasks or responsibilities.
All four of these factors must be met in order to qualify for workers' compensation benefits.
4. What benefits might I be eligible to receive?
Under the Maryland State law, you may qualify for one of the following types of benefits:
- Temporary Total Disability: Payment of lost wages when you are unable to return to work for a period of three (3) days or more as a result of your injury.
- Temporary Partial Disability: Compensation for the difference in wages if you are able to return to work at a lower capacity. This will be calculated as roughly fifty percent (50%) of the difference between pre-injury and post-injury wages.
- Permanent Total Disability: The loss of or the loss of use of both arms, both eyes, both feet, both hands, both legs or a combination of an arm, eye, foot, hand or leg will categorize your injury as a permanent total disability. In addition to receiving benefits for this type of disability, you may also qualify for a cost of living adjustment.
- Permanent Partial Disability: Payments for the partial loss of function to a body part as a result of your work-related injury. Benefits of this sort are paid to you for a limited duration, usually categorized based on the body part afflicted with the disability
- Medical/Hospitalization: Payment for the medical services and care necessary and reasonably related to the treatment of your injury.
- Wage Reimbursements: Wage replacement for lost work time and wages due to scheduled physical examinations and evaluations requested by the employer or the employer's insurance provider.
- Vocational Rehabilitation: Services provided to help you obtain new and sustainable employment in cases where you are able to work, but not in the particular field or position you had prior to the injury.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
If you believe your injury qualifies you for benefits under state Workers' Compensation, file an Employee's Claim with the Workers' Compensation Commission.
Your employer will likely report the details of your accident to the insurance provider upon notice of your injury. The insurance provider will then evaluate the circumstances of your accident and should you request a payment of benefits, will make a determination of whether to accept liability. Your employer or employer's insurance provider may have objections or find discrepancies with your claim. If so, the parties are expected to contact you and the Workers' Compensation Commission in regards to the objections. If the claim becomes contested, a hearing will be scheduled before a Commissioner.
The Commissioner will conduct a hearing much like a judge- by listening to both sides of the case. After listening to the evidence presented, the Commissioner will make a decision, in which he can determine what benefits you are entitled to receive.
6. If I am not happy with the determination, how do I appeal?
If you are unhappy with the Commissioner's determination, you may appeal the decision to the state Circuit Court. Circuit Court rules and procedures will apply.