Medical Benefits Under Workers’ Compensation in Maryland

While workers’ compensation provides important coverage for work-related injuries and illnesses, it’s important to note that there are certain injuries that may not be covered under this system. Each state may have its own specific guidelines and limitations on the types of injuries that qualify for workers’ compensation benefits. Some injuries that occur outside the scope of employment or result from non-work-related activities may not be eligible for coverage.

It is helpful for Maryland workers to familiarize themselves with the provisions and exclusions of our state’s workers’ compensation laws to understand the extent of coverage available for their specific circumstances. It is important to consult with a Maryland workers’ compensation attorney who can provide valuable guidance and assistance in navigating the complexities of the legal system and understanding the scope of coverage for different types of injuries.

Who does workers’ compensation cover?

The coverage provided by Workers’ Compensation Law may not extend to all injuries that occur during the course of employment. In Maryland, for an injury to be eligible for coverage, it must meet the criteria of being an “accidental personal injury arising out of and in the course of employment,” as per Maryland’s Workers’ Compensation Law. Furthermore, individuals who can establish that they have contracted an occupational disease may also be eligible for workers’ compensation benefits.

Merely sustaining an injury while working or being on the job may not automatically qualify you for insurance benefits. It is important to understand the nuances of the law and consult with professionals knowledgeable in workers’ compensation to determine the applicability of coverage for different types of injuries.

What does workers’ compensation cover?

Under Workers’ Compensation in Maryland, injured workers are entitled to various medical benefits to cover the costs of necessary medical treatment and care related to their work-related injury or illness.

The benefits covered by workers’ compensation includes:

• Medical treatment. Workers’ compensation provides coverage for all reasonable and necessary medical treatment and care related to the work injury. This includes doctor visits, hospital stays, surgeries, medications, physical therapy, chiropractic care, and other necessary treatments.
• Diagnostic tests. The cost of diagnostic tests, such as X-rays, MRIs, CT scans, and laboratory tests, necessary for diagnosing and evaluating the work-related condition, is typically covered.
• Rehabilitation services. Workers’ compensation may cover rehabilitation services, including occupational therapy and vocational rehabilitation, to help injured workers regain their functional abilities and return to work.
• Prosthetic devices and mobility aids. If an injury results in the need for prosthetic devices (such as artificial limbs) or mobility aids (such as crutches, wheelchairs, or walkers), the costs of these devices may be covered.
• Prescription medications. The cost of prescription medications related to the work injury or illness is generally covered under workers’ compensation.

It’s important to note that medical benefits under workers’ compensation are aimed at providing necessary and reasonable treatment to restore the worker’s health and facilitate their return to work. To access these benefits, injured workers should promptly report their work-related injury or illness, seek medical attention from an authorized healthcare provider, and follow the prescribed treatment plan. Consulting with an experienced workers’ compensation attorney can help ensure that you receive the full range of medical benefits you are entitled to under Maryland law.

What types of injuries are not covered by workers’ compensation?

Workers’ compensation insurance generally provides coverage for incidents that occur within the scope of employment or with employer permission outside of the workplace. However, there are certain circumstances where claims for injured employees may not be covered.

Such circumstances include:

• Driving to/from work. Injuries sustained during the commute to or from work are typically not covered by workers’ compensation, with certain exceptions.
• Inebriation or intentional injurious acts. Intoxication or engaging in intentional acts that solely cause the injury are also generally not covered.
• Roughhousing. Horseplay in the workplace is typically excluded unless the injured employee was not directly involved.
• Intentionally causing workplace injuries. Workers’ compensation insurance does not provide coverage for workplace injuries or illnesses that are intentionally caused by the worker. In such cases, where an employee intentionally inflicts harm upon themselves, the injuries or illnesses would not be eligible for benefits under a workers’ compensation insurance policy.
• Engaging in illegal activities. If you are injured at work during a criminal act, you will not be covered by workers’ compensation.
• Breaking policy. Violations of company policies, procedures, and protocols may result in a denial of workers’ compensation benefits.
• Fired. Once an employee has been terminated or laid off, they are generally no longer covered under workers’ compensation insurance, unless the injury occurred prior to their termination.

How can a Maryland workers’ compensation attorney help me?

An attorney specializing in workers’ compensation can guide you through the process, ensuring your coverage under the system. They will help you understand your rights and obligations, assist with filing the initial claim, and handle any potential appeals. Their experience and knowledge in workers’ compensation laws allows them to build a strong case on your behalf, gathering evidence and documentation to support your claim and increase the likelihood of approval.

In cases where your claim is disputed or denied, an attorney acts as your advocate. They negotiate with insurance companies, represent your interests during settlement discussions, attend hearings before the Workers’ Compensation Commission, and can navigate legal proceedings if necessary. Their goal is to maximize your benefits by securing fair compensation for medical expenses, lost wages, rehabilitation costs, and disability compensation, addressing both your immediate and long-term needs.

At Plaxen Adler Muncy, P.A., you can work with a knowledgeable workers’ compensation lawyer, who can help you confidently navigate the complexities of the process and improve your chances of obtaining the coverage and benefits you deserve for your workplace injuries. We will provide support and knowledge to the table, so that your rights are protected. Our goal is to maximize your compensation. If you were injured at work, and have concerns about your workers’ compensation coverage, call us at one of our many Maryland offices to schedule a free consultation. You can also use our contact form.