Maryland Workers Comp Claims: Eligibility, Filing, and Appeals
Find out if you're eligible for workers' comp benefits in Maryland.
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In Maryland, a worker who is injured at work may be eligible for workers’ compensation benefits, including coverage of related medical expenses. However, unlike in some other states, not all injuries that occur on the job are "compensable" (covered). To be covered, an injury or illness must have been “an accidental personal injury arising out of and in the course of employment.”
Types of Covered Injuries
An injury must satisfy three criteria to be compensable:
- result from an accident
- arise out of the course of employment, and
- arise in the course of employment.
What Is an Accident?
The Maryland Workers’ Compensation Act defines an accident as an unusual, extraordinary event that occurs suddenly and creates an unanticipated result (the injury or illness). There are a couple of exceptions to the rule that an injury must have been caused by an accident. Hernias are compensable even if they were cause by on-the-job strain rather than an accident.
Likewise, occupational diseases are covered even though they are not necessarily caused by “accidents.” An occupational disease is one that is caused by conditions at the workplace, such as exposure to chemicals or asbestos. All other injuries and illnesses may be eligible only for ordinary health insurance coverage.
What Does “Arise Out of the Course of Employment” Mean?
Only injuries that result from "some obligation, condition, or incident of the employment" are compensable. Accidental injuries that are related to the performance of job duties or working conditions are said to "arise out of" employment. For example, if an employee at a car wash slips and falls, this is an accident arising out of employment that will be covered.
What Does “Arise In the Course of Employment” Mean?
Injuries that arise “in the course of employment” occur when the employee is at the normally designated workplace or another location where the employee was required to perform duties. This factor has more to do with timing and location than the "out of the course" factor. These injuries must have occurred while the employee was performing their job duties or was taking actions directly related to their job. This factor is not always obvious or easy to prove, so the assistance of an attorney may be necessary.
What to Do When you are Injured
Report your injury to your employer, file a claim, and seek medical treatment. In Maryland, an employee has the right to choose the doctor who will provide medical treatment. If you are found eligible for benefits, retroactive payment of medical expenses will be available.
File a Claim
You can file a claim online at the Maryland Workers' Compensation Commission (WCC) website.
You cannot print the online form then complete it and submit it. If you want to complete a paper form, you must send an email to firstname.lastname@example.org, request a claim form, and provide your mailing address. You can also ask your employer for a claim form. Please note, however, that handwritten claims will not be accepted.
In addition to the claim form, you also must submit a signed Authorization for Release of Medical Information form.
After submitting a completed claim form and medical release form, it will only take a few days for your claim to be processed. You can check the status of your claim on the Public Claim Data Inquiry website.
The WCC's address is:
Maryland Workers' Compensation Commission10 East Baltimore StreetBaltimore, Maryland 21202-1641
Email address: email@example.com
You can contact the Commission by phone at (410) 864-5100 or (800) 492-0479 (outside metro Baltimore).Dial 711 for the Maryland Relay for hearing impaired.
Types of Medical Benefits
Various types of medical service are covered by workers’ compensation, including:
- medical treatment and surgery
- hospitalization and nursing care
- medical equipment such as crutches, and
- prosthetic devices.
Medical services will be covered for you as long as is necessary to treat the work-related injury or illness.
Temporary Total Disability Benefits
An eligible employee who is totally unable to work on a temporary basis is entitled to compensation to help make up for the wages being lost. This compensation will be two-thirds of the employee’s average weekly wage but cannot exceed the State Average Weekly Wage, which for 2014 is $998. Employees will receive a minimum of $50 per week regardless of how low their average weekly wage may be.
Once a doctor decides that an employee is no longer totally disabled but can work, even if only in a limited way, this benefit will cease. Likewise, once a doctor finds that an employee has reached the total medical improvement, this benefit will also cease, even though the employee may not have been restored to the condition they were in preceding the injury.
Temporary Partial Disability Benefits
If an employee is limited to part-time hours or cannot perform all of their duties, temporary partial disability benefits can compensate the employee for the temporary loss of income. The employee receives half of the difference between their average weekly earnings and their temporary reduced earnings. This payment cannot exceed half of the State Average Weekly Wage, which for 2014 is $499.
Permanent Partial Disability Benefits
Employees who have permanent impairments that don’t make them totally disabled and unable to work are still entitled to extra benefits for those impairments.
The amount of benefits a worker is entitled to receive for a permanent partial disability is set by statute. For example, a permanent disability to a toe entitles a worker to 10 weeks of benefits at a rate of one third of the workers' average weekly wage, not to exceed 16.7% of the State Average Weekly Wage. For 2014, this would mean no more than $166. An injury to a thumb entitles a worker to compensation for 100 weeks at a rate of two-thirds the workers average weekly wage not to exceed one third of the State Average Weekly Wage. For 2014 this would mean no more than $332 per week. A permanent partial injury to a hand, foot or eye entitles a worker for compensation for 250 weeks at a rate of two-thirds of the workers average weekly wage, not to exceed $749.00 for 2014. In no case shall an employee receive less than $50 per week for a permanent partial disability.
Permanent Total Disability Benefits
In some cases, an injury or illness may lead to permanent and total disability. Typically, the loss or loss of use of the following will be presumed to be a permanent and total disability:
- both hands
- both arms
- both feet
- both eyes
- both legs, or
- a loss of any two.
For these and other permanent and total disabilities, an employee will receive two-thirds of their average weekly pay, not to exceed the State Average Weekly Wage, which for 2014 is $998. All employees are eligible for at least a minimum payment of $25 per week.
If Your Claim is Denied
If you receive a letter called a Notice of Dispute telling you that your benefits claim has been denied, or if you don't believe you are receiving all the benefits you are entitled to, you have the right to request a hearing before the Workers’ Compensation Commission. You will have to submit an Issues Form to request a hearing. For more information, see our article on appealing a workers' comp denial in Maryland.