ROADMAP FOR A MARYLAND WORKER’S COMPENSATION CASE

DAY I

Interview client

Obtain details of accident

Obtain clients medical history from accident

Obtain clients medical history before accident

Set client up for appropriate medical treatment

WEEK ONE

File workers compensation claim

Report accident to workers compensation insurance company

Send for all medical records before and after the accident

WEEK TWO

Send insurance company any off work slips and attempt to get insurance company to pay for clients lost time

Talk with any witnesses

WEEK THREE

Follow up on medical records and treatment

Forward medical record obtained to the insurance company

WEEK FOUR

Follow up with client on treatment status

Determine if client needs to see other doctors

Continue to gather medical records and forward them to the insurance company

If insurance refuses to pay client for lost time or refuses to authorize treatment then under the rules we can request a worker’s comp hearing

If the claim itself is being contested it will take approximately 3 months to get a hearing

A decision after a hearing can take as long as 30 days.

TREATMENT PHASE

After week four the timing of the case is dependent upon the treatment status of the client

Issues that typically have to be dealt with after the first four weeks and continuing until client’s treatment is complete include hearings to:

  1. Obtain medical treatment
  2. Obtain lost wages
  3. Authorizations for surgery
  4. Vocational rehabilitation

If any of the above requests are being contested it will take approximately 3 months to get a hearing

A decision at a hearing can take as long as 30 days.

Insurance companies will typically have you seen by one of their doctors every two or three months in order to attempt to speed up your treatment or cut the treatment off entirely.

The treatment period of the case can be as little as a few weeks to as long as five or ten years as there is no limit to medical treatment other than it has to be necessary and related to accident

During the treatment phase the lawyer will continue to gather medical records, consult with the doctor, make sure the reports contain the information required by the workers compensation commission and the insurance company. The lawyer may also request addition medical experts, obtain authorizations for medical visits, and make sure the client is paid on a timely basis for lost time.

RETURN TO WORK PHASE

Client is able to return to work full duty and has been discharged by the doctor then the case will proceed to the rating stage which is discussed below

Client able to return to work but only on light duty and continues to receive treatment. – Lawyer will discuss with insurance and employer on taking client back to work on light duty

Client unable to return to old line of work, but is able to do some work-then the case goes to the vocational rehabilitation stage discussed below

VOCATIONAL REHABILITATION STAGE

Get insurance company to agree to vocation rehabilitation to help client find a new line of work or set the case in for a hearing to determine if client is entitled to vocational rehabilitation

Hearings take two to three weeks. Decisions can take as long as 30 days

If vocation rehabilitation is agreed to or ordered, a vocational counselor will be agreed upon by the parties

Client meets with vocational counselor

Vocational plan is agreed upon -30 days

Vocational rehab process begins with job placement and or eventually some training if unable to find a job

The vocational rehab process can be for as short as 60 days or as long as two years.

RATING STAGE

After treatment is complete and client is back to work then the rating stage begins

Stage cannot start before 6 months after the accident and can be delayed indefinitely until medical treatment is complete and client is back to work.

Client is scheduled by their lawyer to go to a specialized doctor who will do a disability rating to determine their numerical disability. This appointment is typically 30 to 60 days after client has completed treatment and returned to work

PERMANENT INJURY AWARD STAGE

A permanency hearing will be requested and scheduled once the permanent injury rating is provided by the rating doctor. This request for a hearing will take approximately three months

While waiting for your permanent injury hearing the insurance company will get their own rating from a doctor of their choice.

PERMANENT INJURY HEARING STAGE

Lawyer will prepare client for hearing typically a day or two before hearing

Client to attend hearing with lawyer

Decision usually rendered within 30 days

Insurance company must pay the order within two weeks

For more info on Workers Comp claims in Maryland, CLICK HERE

 



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