Blog

A work-related injury can disrupt your life. It can take a financial toll if you cannot work; it can cause frustration for your family; it can result in a great deal of physical and mental suffering for you. While workers’ compensation benefits may not remedy all these issues, they can provide vital support during a difficult time. Thus, learning that your employer or an insurance carrier has denied your claim can be devastating. However, in this situation, it is crucial not to lose hope. You have options and may still be able to collect these valuable benefits. Understanding the reason for the denial Before you decide how to proceed, you should understand why an Employer and its insurer denied your claim. Some of the most common reasons for denied workers’ compensation benefits include: A desire for the employer or its insurer to have more time to investigate the accident An effort by the employer or its insurer to pressure an injured worker to return to work A failure of communication between the employer and its insurer Failure to notify your Employer timely Failure to receive medical care shortly after the accident Although the above may be all reasons for a denial, none of the above are an actual bar to compensability of a Claim. Pursuing an Claim In order to challenge an employer and its insurer’s internal determination, an injured worker must properly file a Claim with the Worker’s Compensation Commission. Filing a Claim provides the framework and a place a redress for injured workers. Should an injured worker has a Claim filed, they have a right to request a hearing for the Worker’s Compensation Commission provide an Order compelling the Employer/Insurer to pay benefits. Since filing Claim opens the door to an injured worker’s rights, it is important that individual seek experienced and competent representation. Employer and insurer’s have representatives and attorneys that handle such claims every day. In order to level the playing field, injured workers must find their own representation to protect their rights.

Working two jobs at the same time is a reality for many people. According to the U.S. Census Bureau, nearly 13 million workers have more than one job. Even though it is common to hold two – or more – jobs, there are a few matters Maryland workers must be aware of when it comes to the risks they face as well as their entitlements to workers’ compensation benefits. Two critical things to note if you work multiple jobs There are many reasons individuals might hold two jobs, whether they are based on necessity or want. And, it is important to note that there is nothing wrong with working more than one job. Even so, there are two matters that workers must understand in these situations: Obtaining benefits can be complex: While working multiple jobs increases the risk of suffering a work injury, it also complicates workers’ entitlements to out-of-work benefits. The primary issue is that the worker’s protections under the law will only extend to one employer – where the work injury occurred. A worker is not entitled to temporary total disability benefits if they are placed out of work from one job, but are still able to work their second job. Although there is an argument to be made that a worker who works a second job may be entitled to temporary partial disability benefits if they cannot return to work for the first job, there is still room for dispute by the Employer/Insurer. Additionally, Worker’s Compensation protections do not extend to the other employer. For example, an employer cannot terminate a worker for reporting an injury they suffered on the job or filing a workers’ compensation claim. The same protections do not necessarily extend in terms of the other job the worker holds. They face a higher risk of injury: A 2014 study reported that multiple jobholders have an increased risk of suffering injuries both on the job and outside of work. This is unsurprising. After all, working two jobs can often leave workers fatigued and even put them at risk of seriously overexerting themselves, especially if they have shifts for both jobs in one day. And three things workers must do after an injury In the event that a multiple job holder does suffer a work-related injury, they must ensure that they: Inform their treating doctors of the multiple occupations and the physical requirements of each job. Inform both employers – and their workers’ compensation attorney – about the other job. Discuss with counsel the nature of any medical restrictions and the implications of returning to work with another employer during that time. Failing to take these steps could put one’s workers’ compensation benefits at risk. Holding two jobs does not mean that injured workers cannot seek the benefits they deserve or that they will automatically lose one job if they suffer an injury in the other; however, as outlined above the situations are very fact specific and can be complicated. Therefore, it is critical for workers to be aware of these issues and contact an experienced attorney in this area.

It is common for workers and their families to come across many terms and concepts that they are not familiar with in the process of seeking or reviewing their workers’ compensation benefits. One of the terms that is frequently heard in these cases is “maximum medical improvement” (MMI). Understanding the basics of these terms can help injured workers better comprehend how their benefits work as well as their rights under Maryland law. So, what does MMI mean? When an injured worker reaches the maximum medical improvement, they have essentially recovered to the fullest extent. This can generally mean one of two things: The worker healed fully and reached their pre-injury status; or, The worker is not fully healed, but further medical treatment will not improve their condition When an injured worker reaches MMI, the following should ultimately be determined: The worker’s capabilities Any work restrictions Any permanent impairment (to be conducted based on Maryland law.) For example, suffering a fall on a construction site could result in a broken arm. After the injured worker receives medical care, there may come a point where additional surgery or physical therapy may not improve the worker’s condition. At that juncture, the worker has reached MMI. How does reaching MMI affect workers’ compensation benefits? When workers reach MMI, they will generally stop receiving the temporary total disability benefits they earned while seeking treatment as it will end the treatment or “healing” period. However, that does not mean they cannot receive other benefits. If an injured worker can still not return to their old employment, they may be entitled to Vocational Rehabilitation. Once the injured worker has reached MMI, returned to either their old employment or found new employment, they may be entitled to compensation for any permanent injury that resulted from the work-place accident. The circumstance the finding of MMI is most contested is when a treating physician indicates that an injured worker requires more treatment – and not at MMI – and when an independent medical examiner on behalf of the Employer/Insurer feels otherwise and opines that the injured worker requires no additional treatment – MMI. When this circumstance arises, it is critical for an injured worker to have counsel to help explain the circumstances and options the injured worker has. Most importantly, should additional treatment be necessary, despite the Employer/Insurer’s view, an attorney can request a hearing and seek a finding by the Worker’s Compensation Commission that additional medical remains necessary.

Falling from even a short distance on the job can put workers at risk of suffering a serious injury. And according to the National Safety Council, falls in the workplace are one of the top accidents that keep individuals out of work while they recover. Work injuries like this are unexpected and can lead to a considerable amount of stress and many questions. It takes time to heal, but many Maryland workers might wonder: when can I go back to work? How long will it take to heal from fall injuries? The time it takes to heal after a serious fall depends on multiple variables.  Most importantly there is no one-size-fits-all understanding in medicine as to a healing period, as each individual heals at their own speed. However, a general understanding of healing time is best determined by the type of specific injury a worker experiences. Soft tissue injuries that do not include broken bones or torn ligaments could take between one and four weeks to heal A broken hip bone could take between six months and one year to heal Broken or bruised ribs could take three to six weeks for recovery Spinal or back injuries, in particular, can be more volatile – and life-changing. However, if they are not serious, these injuries can take roughly six months to regain full mobility. Concussions are also especially common injuries that result from a fall. It could take roughly two weeks to heal, but recovery is also dependent on rest and the individual’s circumstances. All of these injuries addressed here are some of the most common after a fall. Depending on the number of injuries a worker suffers in the event of a fall, a full recovery could take several weeks, if not months. However, all injuries should still be evaluated on a case by case basis, and speaking with a physician is the best source to discuss recovery time. So, when can workers return to work? The answer to that question is not so simple. A return to work depends on the limitations of the injured worker as well as the nature of the employment a worker is returning to. Desk jobs and clerical work are less physically demanding, so workers may be able to return to work in a shorter time period. Conversely, a worker may have to remain out of work for a longer period, even if the injury is less severe, if the worker has a very physically demanding job, such as construction. If recommended by a physician, some workers may be provided light duty restrictions while still under medical care. Should an employer be able to provide accommodations, an injured worker could return to work while also receiving ongoing medical treatment. In other circumstances either a medical provider or employer may require an injured worker to reach a full recovery before they return to work. Regardless, the many variables in these cases can make the timeline of recovery uncertain. This is why it is critical for injured workers to seek counsel when injured on the job. Worker’s Compensation benefits and laws were established to protect the injured worker. Returning to work too soon may result in further injury. Obtaining appropriate coverage and understanding a worker’s rights are essential to help cover medical bills for treating these injuries and financially supporting the family while workers recover from the accident.

Serious work injuries can keep one out of work for a long time while they recover. This time is necessary for workers to rest and heal. Even so, many injured workers worry: how will they support their family if they cannot work? Thankfully, the answer to that question involves an injured worker’s entitlement to collect workers’ compensation benefits after an injury. But how much can injured workers expect to receive? Under Maryland law, while a worker is out of work or their employer is unable to accommodate work restrictions during a healing period, an injured worker is entitled to Temporary Total Disability benefits. These benefits are two-thirds of the injured worker’s average weekly wage, tax-free. Each year there is a State cap to weekly benefits. In 2020 maximum benefit was $1,080.00 per week. In determining a worker’s Average Weekly Wage, a specific calculation is required: How much the worker was earning in the 14 weeks before the injury; Lodging Per diem pay Schedule bonuses Tips the worker earned, if applicable If the worker started employment recently prior to the accident, the anticipated or contracted wage. This is merely a brief overview of the factors considered to calculate these lost wage benefits. But it is critical to know that there are guidelines provided under Maryland law (Maryland Code, Labor & Employment §9-602). These guidelines can be complex to understand, and can be applied differently depending on the circumstances. It is often beneficial for workers to consult an experienced workers’ compensation attorney to fully understand the financial compensation they can obtain.

Work-related injuries can cause a considerable amount of physical and financial stress in a worker’s life. Thankfully, if a worker suffers an injury on the job, they are often eligible to recover workers’ compensation benefits. However, workers should take some time to understand certain aspects of the law that regulates their benefits – particularly, the phrasing that covered injuries must “arise out of and in the course of employment.” What does this entail? Maryland law defines a work injury as an accidental injury “that arises out of and in the course of employment.” (Maryland Code, Labor and Employment §9-101). Many people might interpret this phrase to include any injury that workers might suffer on the job. However, “on the job” and “arising out of and in the course of employment” do not often have the same meaning. The phrase included in our state’s statute has a specific context. According to the Maryland Workers’ Compensation Commission, a few factors may determine a finding that an accident was in the course of employment: The incident occurred when the worker was completing work tasks and duties The incident stemmed from regular duties of employment The incident occurred when the employer required the worker to complete a certain task The incident occurred during the worker’s work hours or shift The incident occurred in the workplace or another work location recognized by the employer While it is true that these four factors do often mean that the injury occurred on the job, it is critical for workers to understand these particular factors. Claims are interpreted on a case by case basis, so every accident set of facts should be evaluated on an individual basis. This definition can create a challenge for some injured workers The elements of what makes up a work injury can make it challenging for some workers to connect their injury to their work in the first place. And, it might be more difficult to prove the four factors listed above for long-term injuries, such as: An injury that developed over time An illness connected to work Hearing loss connected to their work That is not to say these injuries are not compensable. Maryland law includes many presumptions for certain injuries – including cancers and hearing loss – to help injured workers avoid such challenges. Even so, injured workers must understand their eligibility to obtain workers’ compensation benefits, so they can protect their rights.  As a result, injured workers will benefit from seeking advice from experienced attorneys.

In some cases, returning to work might become a complex ordeal for workers who sustained a temporary total disability. For example, a worker might not be completely recovered from an injury, but their physician might clear them to return to work with light-duty restrictions. There are a lot of details involved in the process of returning to work and obtaining light-duty restrictions. Workers should consult experienced attorneys to learn more about these details and their benefits, however here are some essential things that injured workers should know. What are light-duty restrictions? Some workers are often able to return to work, even if they are still in the process of recovery. Light or modified duty restrictions essentially provide recovering workers with work that is less taxing, both mentally and physically – if their employer has such work available. Physicians recommend the restrictions workers should adhere to, such as not lifting anything over 50 pounds, or even working with sedentary restrictions after a severe back injury. What other details should workers know? In the cases where employers have an offer of light-duty work available, there are a few things that workers should know: Injured workers should explain in detail the nature and requirements of their employment to their physician, in order for a physician to provide the most appropriate restrictions. The restrictions must be made in writing and provide a timeframe for the duration of said restrictions. Upon receiving a modified duty note from a physician, the injured worker should provide the note to their employer and inquire if any positions are available. Even if any injured worker believes an employer does not have light duty, the injured worker still has the responsibility of contacting their employer to inquire about accommodations. If an Employer is unable or unwilling to accommodate an injured worker, that injured may be entitled to ongoing benefits while they remain out of work recovering to full duty. Additionally, should an employer provide accommodations, but the injured worker earns less than their pre-accident wage, the injured workers may be entitled to Temporary Partial Disability, which is one-half the difference between their prior wage and the current light-duty wage. (Maryland Code, Labor & Employment §9-615). Injured workers must continue to receive light duty notes from their physicians until their physician releases them to full duty. Failure to provide an updated note may permit an employer to rescind the provided accommodations without penalty. As demonstrated, there are a lot of different scenarios that may play out when an injured worker is able to return to work in a modified capacity.  There is no one size, fits all approach. Therefore, it is critical for an injured worker to understand their rights and options under the law. Furthermore, employers and their insurance representatives may pressure workers to return to work full duty or in a less than modified capacity.  Such situations can be dangerous to an injured worker’s health and recovery.  Ultimately, when faced with the decision to return to work, it is important for individuals to have experienced representation that will look out for their best interest, rather than the bottom of line of an employer or insurance company.

Following significant work-place injuries, employees and their families often wonder what benefits may collect. There are a few types of benefits injured workers are entitled to, but one specific question is whether the injured worker can recover both workers’ compensation benefits and Social Security Disability Insurance (SSDI) benefits? Is this possible? The short answer is yes – it is possible for injured workers to collect both workers’ compensation benefits and SSDI benefits at the same time in certain cases. However, these are two complex systems, and individuals must make sure they qualify for both of them separately, as they are a part of separate systems. If person receives benefits from one system, it does not entitle them to benefits from the other system. How do workers know if they qualify? Workers’ compensation: Maryland law governs workers’ compensation benefits. And according to state law, injured workers qualify to collect workers’ compensation if they suffered an accidental injury or occupational disease that arose out of and in the course of their work (Maryland Code, Labor & Employment §9-501). SSDI: In contrast, Federal law governs the parameters of receiving SSDI benefits. To obtain SSDI benefits, individuals must have a qualifying disability based on the Social Security Administration’s (SSA) guidelines. This disability does not necessarily have to be work-related, but it must prevent individuals from returning to work. As prerequisite, an individual must be out of work for an entire year or be placed out for of work for the foreseeable year in order to qualify for benefits. The age of an individual and prior occupation has a significant relation to being awarded benefits. A younger person with an advanced education or specialized skill has higher burden to show they are unable to return to the workforce. In contrast, a worker of advanced age with a limited skillset may only need to prove they cannot return to their former employment in order to receive benefits. Even though individuals can obtain both workers’ compensation and SSDI benefits, there is a limit to how much they can collect. According to the SSA, the total amount of benefits individuals recover cannot exceed 80% of their earnings before the injury or disability. When could you collect both? Take the example of a workplace accident leading a worker to suffer a fall. In many cases, a fall can lead to serious physical injuries as well as a severe traumatic brain injury (TBI). If the injury is work-related, then individuals can pursue workers’ compensation benefits to cover their medical costs and lost wages. However, a TBI can have a long-lasting, permanent impact on individuals. If the TBI leads to permanent disability and prevents individuals from returning to work, then they can also pursue SSDI benefits. These are both very complex systems to understand and navigate – especially in such a challenging situation. In these cases, individuals should consider consulting an experienced attorney.

Individuals rely on their knees more than they think. As the largest and most complex joint in the body, the knee is what allows us to move in many different ways, whether standing, walking or lifting. This heavy reliance on the knee is also why suffering a knee injury on the job can quickly put workers out of commission. If a knee injury keeps them out of work, the first worry on anyone’s mind is the effect on their income and will medical care be covered. Are knee injuries covered under workers’ compensation? Yes, workers who suffer a knee injury on the job are entitled to collect workers’ compensation (Maryland Code, Labor & Employment §9-501). As with all workers’ compensation cases, workers must be able to connect the injury to their work. It must arise out of their employment duties. Some knee injuries happen very suddenly, and workers can easily trace them back to a single incident. Other injuries might be the result of repetitive motion and stress on the joints, which, in some cases, can make it harder to trace back to one’s work. What are common occupational knee injuries? To understand the potential challenges of connecting one’s knee injury to work, here is a brief look at a few common examples of knee injuries: Dislocation: A worker might suffer a knee dislocation from a fall to a lower level or from lifting heavy objects incorrectly. It takes time and rest to heal from a dislocation, but it is often easy to determine what caused the injury at work. Anterior Cruciate Ligament (ACL) injuries: This is another common injury, though it often requires more treatment than a dislocation. Even so, a torn ACL often stems from a sudden stop, such as a fall or a pivot on one leg. These injuries leave lasting damage, but workers can often connect the injury to a single incident on the job. Osteoarthritis: Osteoarthritis in the knee can significantly impact one’s ability to move and stand – and even continue working. In extreme cases, individuals often must obtain a total knee replacement to regain movement. Arthritis is a disease linked to aging, but certain repetitive movements related to work activities or a single impact can aggravate and speed up the disease. Even so, if there is enough evidence that one’s duties at work aggravated or caused the osteoarthritis, workers can collect workers’ compensation benefits. Workers in many fields, from construction workers to cleaning service workers, face a high risk of suffering a wide range of knee injuries. In these cases, it is often in a worker’s best interest to consult an experienced workers’ compensation attorney to guide them through the process of recovering compensation and protecting their rights.

When injured workers pursue workers’ compensation benefits, their employer’s insurance company may question the extent of their injuries. In these cases, insurance companies often arrange an independent medical evaluation (IME). This is a common issue that injured workers come across. Therefore, here is some essential information they should know about an IME, so they can protect their rights to collect the workers’ compensation they deserve. What is an IME? An IME is a medical ev aluation not performed for the purposes of medical care or treatment. The primary purpose of the evaluation is to generate a report for the requesting party, the Employer and its Insurer. During the IME, the doctor will: Assess the claimed injuries; Evaluate whether these injuries are related to the work accident; and Determine if the treatment either being received or recommended is medically necessary. It is important to note that the doctors receiving such referrals from insurance carriers often work very closely with the same insurance company or their representing attorney. Even though an insurance company may claim that the IME is a “second opinion,” such an evaluation is often used support an insurance carrier’s position to deny medical treatment or reduce compensation for permanent injuries. Although injured workers may not desire to attend an IME, the Maryland Workers’ Compensation Act generally requires attendance; otherwise, an insurance carrier will have a right to suspend benefits (Maryland Code, Labor & Employment §9-720). How can workers prepare for an IME? If workers must attend an IME, they should speak with an experienced workers’ compensation attorney beforehand. That way, they can understand their rights as well as how they can protect them during the IME. Insurance carriers will often require non-represented injured workers to provide medical documentation of their injuries. However, this is not required, and it is of benefit to have an attorney who can gather such information on behalf of the injured worker. Furthermore, once the evaluation is completed, the IME physician will not provide a summary of his or her opinion to the injured worker. Instead, a report with the doctor’s medical analysis and opinion will be provided to the insurance carrier’s review. All in all, an IME is often a very significant appointment following a work-place accident. Preparing and participating in the evaluation may be confusing and daunting, and the ultimate opinion may be difficult to understand for a non-medical professional and, quite frankly, detrimental to a Claim. As a result, it is critical for injured workers to seek an experienced attorney to assist in such a potential turning point in a Claim.

When does workers’ compensation eligibility go into effect? This is a common worry that some workers might have. It may take a few months for other employment benefits to take effect after their first day on the job. So, does the same go for workers’ compensation benefits? Time on the job does not impact eligibility for benefits Even though it might be a common worry, there is no base for it. If the injury occurs in the course of employment to benefit the employer’s interest, the duration of employment does not impact the compensability of a Claim. If the employee was involved in a “training” or “probation” period deemed by the employer, an injured worker still remains eligible for Worker’s Compensation coverage. Common defenses may include that short-term employment indicated that the worker was an independent contractor, rather than an employee. However, the determination of an independent contractor is a multi-prong test that goes beyond only the duration of employment. But the risk of injury is high for new employees Even so, newly hired workers must be aware that even though starting a new job may not affect their eligibility to collect workers compensation, it does increase their risk of an injury. The high risk of injury for new-hires makes sense – after all, new employees often have limited experience. Additionally, many workers report that they do not receive proper safety training when they begin a new job. There are several reasons for this, from reduced staff to a necessity for high-speed work. A 2016 report found that: 40% of injured workers were on the job for less than a year; One in eight work injuries each year occur on the first day of work; and New employees are five times more likely to suffer a work injury than other employees. New workers may face a higher risk of injury, but they can take measures to ensure that they receive the proper training to succeed and stay safe in the workplace. Should a new employee that experiences an on-the-job injury, they should speak with an experienced attorney to discuss their rights.

May is Mental Health Awareness Month. Movements like this have been instrumental in decreasing the stigma surrounding mental health issues and mental illnesses over the years. And yet, mental health is often overlooked because these conditions are often invisible. They may not be taken as seriously as physical injuries, but workers in the healthcare field should ensure they pay careful attention to their mental health, so they can avoid an even more serious condition or injury – specifically post-traumatic stress disorder (PTSD). Healthcare workers especially susceptible to PTSD Healthcare workers at all levels face significant stress with each shift they work, and there is no questioning why nursing and healthcare jobs are some of the most stressful jobs. Workers in this field frequently deal with: Moral distress; Human suffering; Traumatic situations; and Violence and death. Because of this, a 2019 study in The New York Times reported that one in four nurses suffer symptoms of PTSD. And the risk of PTSD in the healthcare field is only increasing with the current situation. Does workers’ compensation cover PTSD? PTSD is a very real risk for many workers on the job, but can healthcare workers recover workers’ compensation benefits? Maryland law and precedent allow workers to recover compensation for PTSD if it resulted from the worker’s employment and necessitated a health care professional place limitations on the work or completely out of work. Compensability is often very fact specific, whether a worker has one particularly traumatic experience or if it is cumulative in nature. Even though it is generally a compensable injury, many employer and their insurance carriers deny such claims. Workers should consult an experienced workers’ compensation attorney if they suffer PTSD related to their work, so they can recover the benefits they need. What can healthcare workers do? Healthcare workers must prioritize their mental health. Mental health is just as important as physical health. Therefore, all healthcare workers should ensure that they: Address feelings of stress, anxiety and depression as soon as possible; Educate themselves about the symptoms of PTSD and related conditions; and Seek out mental health care services at work or outside of work, if necessary. Most importantly, healthcare workers must ensure they find time to rest. Resting and taking measures to be mindful and calm can be incredibly helpful to help workers not only be aware of their mental health, but to take care of it as well.