This article is meant to provide a brief overview of the process that happens when a claim is filed with the wcc in Maryland. It is not intended to apply to every single case.
Notify the Employer
When a work-related injury occurs, it is important for the injured employee to notify their employer immediately. Generally, an employee has ten days from the date of the injury to notify his or her employer that the injury occurred. Notice can be provided in writing, or otherwise. Examples of notice to the employer include being injured in the presence of a supervisor, having emergency response workers arrive on the scene, or simply by notifying your employer verbally that the injury occurred.
When an employer receives notice of an injury, an Employer’s First Report should be prepared by the employer or insurer. The Employer’s First Report is sent to the Commission if the work-related injury causes the employee to miss work for more than three days. It is important for the employer/insurer to file the Employer’s First Report because the filing of the Report starts the statute of limitations for filing the Employee’s Claim Form in cases where the employee loses more than three days of work as a result of the injury.
Filing a Comp Claim Online with the Maryland WCC
The Employee’s Claim Form can be self-prepared or prepared by the workers’ compensation attorney and submitted to the Commission. This Form must be filed within 2 years of the accident. The Employee’s Claim Form is filed online. Once it is filed electronically, the Claimant must sign the original Form. The original Claim Form, with signature, must be sent to the Workers’ Compensation Commission (WCC) within ten days of the electronic filing. Failure to provide the WCC with the signed original Claim Form could result in the Claimant’s case being dismissed.
Once the WCC receives the signed Claim Form, it takes approximately a week for the WCC to issue a claim number and for them to issue the Notice of Employee’s Claim. Once the WCC issues a claim number, the attorney must enter his or her appearance with the Commission. Filing of the Employee’s Claim Form on the employee’s behalf does not automatically enter counsel’s appearance. The Notice of Employee’s Claim is an important part of the claims process. This notifies the employer/insurer that a claim has been filed, and that they have until the “consideration date” to file any objections to the claim, which are called “issues.”
Issues and Work Related Injuries
When the Employee’s Claim Form is filed, the WCC establishes a consideration date, which notifies the employer that the Commission will pass an award based on the evidence in the claim. The employer may file “issues” or contest the case. The consideration date is approximately twenty-one days from the date the Notice of Employee’s Claim is mailed to all relevant parties. If the consideration date passes and no issues are filed, the WCC will most likely deems that the injury is work-related. If the insurer files issues, but those issues do not relate to causal connection, then the WCC will most likely issue an order finding that the injury was work-related.
The insurer may also file issues regarding temporary total disability (TTD) benefits if the employee is receiving sick pay or accident leave. If these issues are filed, then the WCC will issue an order stating that it is a work-related accident but that compensation has been deferred, which means that TTD is not an issue, but further compensation may be deemed appropriate at a later time.
Temporary Total Disability Benefits (TTD)
After the consideration date passes, it takes approximately two weeks for the WCC to issue an order as to causal connection and TTD. Once the WCC issues its order, and if TTD benefits are ordered, then it will take approximately two weeks for the Claimant to receive their check. All awards ordered by the WCC are paid by the insurer, not the WCC. The initial check that is issued will be a lump sum payment, which will include weekly payments dated from the date of accident to the WCC’s order. Thereafter, the Claimant should receive a weekly check from the insurer for the duration that the Claimant remains eligible for TTD, which means, the Claimant is still receiving treatment and has not returned to work.
Assuming that the causal connection of the injury is not contested, the Claimant will receive treatment for their injury, which will be paid for by the insurer, from the date of accident to the time the Claimant reaches Maximum Medical Improvement (MMI). A physician will decide when the Claimant has reached MMI, and thus, there is no prescribed time-frame for treatment, but rather, it’s a case by case issue.
Once the Claimant reaches MMI, it will be necessary for counsel to collect all of the relevant medical records associated with the work-related injury. The medical records must be sent to the rating physician, who bases his/her decision of the disability rating on a physical exam and review of the treatment records. The insurer and the claimant’s attorney will both schedule a rating appointment. The WCC generally will not hear a case regarding nature and extent until there are two rating reports.
MMI, Hearings, and Permanent Partial Disability (PPD)
Once the Claimant attends the rating appointments and the reports are received from the physician, counsel will request a hearing by filing “Issues” with the WCC. The “Issues” filed are for the nature and extent of disability to the specific body part injured. A hearing is usually scheduled by the WCC within a month of issues being filed, and the hearing will usually take place 3 months after issues are filed. At the hearing, counsel for the Claimant and the employer/insurer will present their respective cases to the Commissioner. The case, at this point, is about permanent partial disability of PPD. The Commissioner will issue an order approximately two weeks following the hearing date. At that time, if the Commission has ordered that the Claimant is entitled to further compensation, it will take approximately two to three weeks or more for the Claimant to receive their compensation from the insurer.