- May 8, 2017
- Posted by: admin
- Category: Medical, Workers Compensation
What Maryland workers compensation benefits a person can recover in a workers’ compensation claim?
When a person is injured on the job, he/she can file a workers’ compensation claim and receive workers compensation benefits .Filing a Workers Compensation claim entitles you to valuable workers compensation benefits including lost wages, medical benefits, vocational rehabilitation and a permanent injury award. You should have an attorney to help you get all of the benefits you are entitled to.
Lifetime Medical benefits
The first of the Maryland workers compensation benefits you received is medical treatment. The medical treatment must be causally related to the accident. Medical treatment can include seeing the doctor, going to the hospital, having surgery, physical therapy, medical devices, etc. and you’re entitled get reimbursed for any mileage to and from the doctor. The medical treatment covers you for the rest of your life as long as it’s related to the accident. So if you injured your back in a work related accident and can prove that whatever problems you are having have been ongoing for 10 years then your treatment can go on for 10 years. If you stopped treating and then five years later you can prove that you are having problems again and it relates back to the original injury, then you’ll be covered. There is no limit to the medical treatment or the amount of the medical treatment and it basically covers you for the rest your life.
Lifetime medical treatment can be interrupted if there was a pre-existing condition, meaning the condition existed before the accident, that you then aggravate at work, then you receive work related treatment , then you stop treating after you recover from the work related condition, then the same body part flairs up again with no new incident, and then there’s an argument about whether the treatment’s is related to a natural worsening of the pre-existing condition or to the natural worsening of the subsequent work related accident.
Lifetime medical treatment can be interrupted if you have some a new accident that occurs after your work related accident involving the same body part. Then the insurance company will argue that the treatment you now need is causally related to the new accident.
Temporary Total benefits-Lost wages
The second of the Maryland workers compensation benefits you’re entitled to under workers compensation claim is lost wages. If as a result of the accident you were out of work, you’re entitled to get paid two thirds of your average weekly wage for the period you’re out of work until you reach maximum medical improvement.
If you’re injured on the job, and you can’t go back to the type of work you were doing at least temporarily, then you’re entitled to get paid temporary total. It’s called temporary total because the benefits are temporary until you’re released to go back to work or until basically your medical treatment is over. It’s based upon your average weekly wage. Your average weekly wage is calculated by the average of your wages over a 14 week period before the accident. Your employer will provide the insurance company a wage statement indicating what you made for the 14 weeks before the accident. Those 14 weeks are added altogether, and then you divide it by 14, and that’s your average weekly wage.
Under Worker’s Compensation your Maryland workers compensation benefits require you to be paid two thirds of your average week wage for each week you missed. The reason it’s two thirds is because the money is tax-free. Normally when you’re working you have taxes are taken out. When you’re on Worker’s Comp. no taxes taken out. In theory, the money you clear while you’re collecting Worker’s Comp. should be similar to the money you are clearing when you are working. It’s paid until you reach maximum medical improvement. Once you reached maximum medical improvement then your condition is no longer temporary but it’s now permanent if you’re still having problems.
Maximum medical improvement means no treatment that can be provided will make your condition any better. That may not mean that you don’t need other medical treatment. You may still need some pain management. The purpose of the pain management is to help you deal with the pain, but your medical condition will stay the same. You may need some physical therapy but the purpose for the therapy would be to keep you at your present baseline and prevent you from getting worse. At maximum medical improvement, you’re no longer entitled to temporary benefits.
If you’re not back to work but the doctor says you’re at maximum medical improvement, your temporary total benefits would end.
The next of the Maryland workers compensation benefits you’re entitled to is vocational rehabilitation. If you’re not able to go back to the type of work you were doing at the time of the accident as a result of the injuries you sustained as a result of the work- related accident and if the employer will not provide you with permanent light duty, then you are entitled to receive vocational rehabilitation. Maryland Worker’s Compensation law defines the steps involved in vocational rehabilitation. Vocational rehabilitation first looks at whether your employer take you back to work doing permanent light duty. Is there some accommodation your employer can make for you? If they can, then you go back to your old job.
If your employer will not accommodate you then the insurance company’ will have to help you find work. The parties mutually agree on a vocational counselor. Next you will meet with the vocational counselor. The Counselor will review your entire medical, work, and educational history. The Counselor will contact your doctor to discuss your limitations. The Counselor will test your math, spelling and reading to determine your educational level. Then the vocational rehabilitation counselor will submit a vocational rehabilitation plan as to what type of work you can do based upon your education, your limitations and your prior work experience. The plan usually begins with job placement. The vocational rehabilitation counselor will work with you to help you look for work. The job of a vocational rehabilitation counselor is not to find you a job, it’s just to help you look for work. The Counselor will feed you some places to look for work. In addition they will instruct you on how to look for work in the newspaper and on line as well as networking with others.
While you’re looking for work and working with a vocational counselor, you will receive temporary total benefits because you’re working with the vocational counselor. If you don’t cooperate with the vocational counselor, you won’t receive the benefits. If you refuse to go back to work you won’t receive this temporary total benefit. Then there are no benefits until you receive your permanent injury award which could take three to six months. It’s important that you successfully complete the vocational rehabilitation process so that a.), you can find a new career and b.), so that you can keep your benefits going. In fact I always tell clients that this is the most important part of your case. No matter what you ultimately get as far as the settlement at the end of the case it’s never as much as you can receive by obtaining a good paying job.This part of the case is the one that you should take the most seriously.
Permanent Injury Award
Finally, the next of the Maryland workers compensation benefits you are eligible for after you’ve completed your medical treatment, returned to work either with your old employer or through vocational rehabilitation, then we go to what’s called the permanent injury award part of the case. Under Maryland Worker’s Compensation there’s no settlement per se for pain and suffering. Instead there is a permanent injury award. If you have a permanent injury then you are entitled to an award from the Worker’s Compensation Commission.
Once your treatment’s over, your lawyer will typically send you to his doctor to get a rating. The doctor determines your permanent impairment based upon the AMA guidelines and Maryland has five other factors that a doctor has to look at in order to determine what your permanent impairment is. The doctors report is a rating. Then the insurance company obtains a rating from another doctor. Typically, the insurance company doctor’s rating is less than our doctor.
There’s basically two types of permanent injury awards. Scheduled member awards and non-scheduled member awards. Schedule members are typically the parts of the body that are on the outside of your body which would be like your eyes, your ears, your arms, your hands, your legs, your feet – they’re like the appendages to the outside of the body. In Scheduled member cases, you will testify what your complaints are and consider the disability evaluation rating from a doctor for each side, and then based on those ratings and your complaints, pass an award.
The Worker’s Comp. commission then issues an award. Each award is in percentage of disability. For scheduled member case like a hand, if you obtain an award of 10% of the hand, that is worth 25 weeks of benefits. The hand is worth 250 weeks of benefits if it’s 100% disabled, so 10% of the hand would be worth 25 weeks of benefits. Each week of benefit is paid at so much a week depending upon how much you are making at the time of the accident. If you’re making a lot of money so much a week is worth a lot more than if you are making very little money. If two people having the exact same injuries, however one’s a high wage earner and one’s a low wage earner, the high wage earner will receive more money for the same injury than the low wage earner.
The awards are backdated to the date you last missed time from work. Typically, when you receive the award, part of the award will be in a lump sum and then the balance of the award will be paid weekly. By way of example, if you were out of work for three months then you return to work and then it took another year to get you case in for hearing on a permanent injury award and the award is for 75 weeks of benefits, you would get the first 52 weeks in a lump sum because it’s been a year since your hearing and the rest of the award will be paid weekly, the other 25 weeks until the award is paid out.
The other type of permanency case is a non-schedule member. That would typically be the inside of the body. That would include your neck, back, head, and anything inside your body. In non-schedule member cases the commission is going to look at the ratings, listen to your complaints, but also consider how the injury affected your ability to earn a living, your loss of earning capacity. If for example, you have two similar back injuries, and in both cases the ratings are 15%, but in one case the client went back to work and in the other case the client can’t go back to the type of work he was doing before and now he’s making half for what he was making before. The client making half of what he was making before, will be awarded more money even though they had the exact same injuries and same treatment.
Re-Opening for Worsening of Condition
The last of the Maryland workers compensation benefits you are entitled to once you receive the permanent injury award, is that the case still stays open. If you have any other medical complaints, you have the lifetime medical, even after obtaining a permanent injury award. In addition, if you start missing time from work after obtaining your permanent injury award you can in theory go back and get paid for the time missed. Finally, if you are permanently worse you can re-open your case for an increased permanent disability award.
The right to receive money does have a limitation. If you ever go five years without receiving any money, your right to receive money will then close even though your medical stayed open. So let’s say you get a permanent injury award, it’s for 75 weeks, it pays out over 75 weeks and then six years passes you start missing time from work, once that five-year period had passed you will not receive any money. Your right to receive money ended and now you’re not get paid for that lost time.
So it’s important that you monitor if you’re having other problems and you try and not ever go five years without receiving any money. How do you do that? Your lawyer can send you back to the rating doctor to see if your permanent disability is worse and then schedule a new worsening of disability hearing. If you obtain a new worsening of disability award within that five-year period and get increased award or get paid for any new lost time, then a new five-year period starts from the date you last got paid in that reopening period. So in theory you can keep open the right to receive money for the rest your life as long as you never go five years without receiving money.
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