Having recently been asked for advice by a lawyer interested in buying a workers’ compensation law firm representing injured workers, I thought it important to lay out the different stages of a workers’ compensation case for his consideration.  One can’t simply ask, how many workers’ compensation cases do you have, and understand the ramifications of the answer.  There are different stages of workers’ compensation cases in Maryland.  Each means different issues, obligations, and work to the claimant’s lawyer.

This page is meant to be a very brief overview from the attorney’s perspective when analyzing a group of workers’ comp cases.

First – A Few Basics

You have two years from the time of the injury to file an accidental injury Maryland workers’ compensation claim.  It’s important to understand that “file” means filing the claim with the Maryland Workers’ Compensation Commission (“WCC”), not the insurance company. Note, occupational disease claims are more the same than different, but are nonetheless slightly different for our purposes here.

There are four major types of benefits in workers’ compensation in Maryland.  These include wage replacement (TTD or TPD), medical benefits, vocational benefits, and indemnity benefits (PPD or PTD).  There are articles on this site about more in depth on each of these.  (Importantly and in particular, see: Maryland PPD).

A crucial thing to understand about workers’ comp: medical benefits causally related to the compensable injury are covered for life.  For the life of the claimant.  Forever.  But the claimant cannot get indemnity benefits (disability payments) more than five years after the last compensation was paid.

Attorneys fees in Maryland workers’ comp are up to 20% of only the permanency compensation.  Attorneys do not get fees on wage replacement (TTD or TPD) unless the attorney wins a contested hearing on the issue of wage replacement.  In such a circumstance, the attorney receives 10%.  In both circumstances, the attorney gets no fee unless he or she is successful.

Stages of a Workers’ Compensation Case – Considerations for Lawyers

An attorney looking at cases in progress and determining how much work vs. how much fee will later be earned needs to know some basic points and needs to ask some important questions.

1 – The Case Has Not Yet Gone to Permanency

First, understand that the attorney only gets a fee on the indemnity benefits, commonly permanent partial disability.  That phase only happens after a claimant has reached maximum medical improvement.  Once MMI is reached, that’s when a disability assessment can happen and those benefits can be applied for.  This is sometimes referred to as “going for permanency” or “moving forward on permanency.”

Therefore, cases that have never had permanency are one category of files in a comp lawyer’s book.  These can be anything from an original claim needs to be filed, on up to PPD ratings have already been done, PPD issues have been filed, and the lawyer and claimant are awaiting a hearing with the WCC.

2 – The Case Has Gone to Permanency, But There Could Still Be Additional Compensation

A second category of files are those in which PPD has been paid, but those files have reopened for further medical treatment within the five years since last indemnity.  This group of files may or may not produce additional permanency/indemnity benefits, but you still represent the claimant in the quest for medical treatment.

Category 2B is the above (within 5 years since last indemnity) except the file is dormant.  The claim has not reopened for medical.

3 – The Case Will Be Medical Only

A third category of files are those that have reopened for medical treatment but are past five years since the last indemnity payments.  Therefore, these files will not produce a future fee for the workers’ comp lawyer, but the lawyer still pursues the medical benefits for the claimant.  This can also happen on occasion where the claimant has fully and finally settled all indemnity with “open meds.”

Category 3B is the above (more than 5 years since last indemnity) except the file is dormant.  The claim is not reopened for medical.

4 – Permanent Total Disability

A fourth category is the already awarded permanent total disability case.  Here, the claimant has been awarded the max indemnity benefit available and the attorney has gotten all the fee there is to be earned.  However, there are ongoing medical issues that need to be resolved and sometimes litigated.  This is similar, albeit slightly different, to category three.

The vast majority of the money for the claimant and their attorney, is in the first category.

Get your question answered.