Experienced Maryland Attorneys Help When Your Workers' Compensation Claim is Denied

Learn more about the Workers' Comp hearing process

Maryland workers injured on the job are typically protected by the State’s workers' compensation laws. Most employers are required by law to protect their workers by taking out workers' compensation insurance, so their employees are taken care of financially if they become injured or sick while performing their duties. When everything goes according to plan, this system fairly compensates the worker.

When you're hurt on the job, you're entitled to workers' compensation benefits. However, sometimes the insurance company will wrongly deny your claim. But just because your initial claim was denied doesn't mean it's over and you have no recourse. With the help of an experienced workers' compensation lawyer, you still have a chance to get approved for these benefits. The team at Plaxen Adler Muncy, P.A. will file issues, secure a hearing, and be by your side during the entire process in order to get the benefits you’re owed.

Worker's compensation law in Maryland

The purpose of the Maryland's Workers' Compensation Act is to provide financial relief to injured workers. It gives those workers and their dependents no-fault benefits to make up for lost time from work when they're injured on the job. “No-fault” means that the worker isn't required to prove that anyone was negligent.

Benefits offered include medical treatment costs, loss of wages, and also vocational rehabilitation, which can help you find more suitable work. Wage replacement is calculated at two-thirds of your weekly wage. If your injuries are permanent in nature, you are entitled to additional money. You can also choose your own doctor for treatment. In exchange, you don't sue the employer for negligence. (However, in Maryland, it's possible to bring a negligence claim against a co-worker or a third party if they are responsible for your injury.)

Workers’ compensation covers injuries or occupational diseases that happen while on the job. It's important an employee report his or her injury and get medical attention within required time limits, or he or she can lose the chance to file a workers' compensation claim.

Types of benefits

Once a claim is filed, the types of compensation you may be eligible to receive include:

• Temporary total disability benefits, which are available until you go back to work.
• Temporary partial disability benefits, which are available to workers who now must work part-time or in a limited capacity.
• Permanent partial disability benefits, which last for a fixed time – even if you go back to work
• Permanent total disability benefits, for workers who are left totally or permanently disabled.
• Death benefits, awarded after a worker dies to his or her spouse or dependents, and which include funeral expenses and a percentage of the employee’s earnings.
• Medical benefits, which cover the costs associated with treatments.

Reasons why your workers' compensation claim could be denied

Sometimes, after filing your workers' compensation claim, you may find it denied. There are several possible reasons for a claim denial, including:

• Missing the deadline to file the claim
• Your employer states the injury or illness didn't occur on the job
• There is a mistake on the claim form, either by the employee or the employer
• You weren't an employee at the time of your workplace injury
• The necessary medical records or paperwork weren't given to the insurer

Your workers' compensation claim can also be denied if your employer states:

• You weren’t using or wearing proper safety equipment at the time of the accident
• You intentionally injured yourself
• You were under the influence of alcohol or drugs when the accident occurred

If your claim is denied, you can request a hearing and then file an appeal with the help of your workers' compensation attorney.

How to file a workers' compensation claim

If you receive notice that your workers' compensation claim was denied—or you believe your claim is being underpaid— you should contact us immediately. It's your right to request a hearing, and we will represent you at that hearing.

How do I request a hearing?

You and your employer each have the right to request a hearing, by submitting an Issues Form, before the Maryland Workers' Compensation Commission to resolve any issues with your claim. Typically, this hearing takes place within three months. At the hearing, the Commissioner listens to your account of how your workplace injury or sickness occurred, and you may show any evidence supporting your claim. Evidence is usually documents like medical reports or written testimony from witnesses. Your employer has the right to have an attorney from their insurance company question you, and can supply their own evidence and testimony.

You'll receive a decision within 30 days of the hearing. If you (or your employer) disagree with the decision, you can request a re-hearing. However, you must make this request within 15 days of the Commission's decision. It's important to note that re-hearings are infrequently granted, and usually only in cases where a technical error occurred or if there was new evidence not available at the first hearing.

How can I appeal to the Circuit Court?

If you disagree with the outcome of the hearing or re-hearing, you may file a Notice of Appeal with your local Circuit Court within 30 days of the Commission's decision. Appeals are more formal than the hearings, and rules must be followed to the letter. A Petition for Review must be filed in the appropriate circuit court. Additionally, the party who is making the appeal must arrange to have the hearing transcript transcribed and to make sure that the entire record is transmitted within 60 days.

Because you are the one appealing the case, the burden of proof falls on you, so your evidence must be thorough and compelling. You'll need testimony from a medical expert, usually in person or via video. The appeals process is where your workers' compensation attorney can help you the most.

Once your appeal goes to the Circuit Court, it's subject to the same procedures as any other lawsuit. Before the case goes to trial, there's a period of discovery. This is the formal process of exchanging information between the parties about the witnesses and evidence they’ll present at trial. Then, the judge or jury, based on the evidence submitted and testimony from witnesses and experts, will decide if the Commission's decision was correct or incorrect.

What if the insurance company doesn't pay?

One of the hardest things that happens in workers’ compensation cases is when someone's unable to work because of their work injury, their doctor agrees they aren't able to work, yet the workers’ compensation insurance company's refusing to pay them. That puts people in a terrible situation where they can't provide from themselves and their families.

One of the things you need to do when that happens is to call us right away, because we will take the insurance company to a hearing and demand that you be paid while you're out of work, so you can provide for yourself and your family while you're trying to recover from your injury.

Talk to our Maryland workers' compensation lawyers about your hearing or appeal

If your workers' compensation claim was denied, the process doesn’t have to be over. The attorneys at Plaxen Adler Muncy, P.A. have more than 35 years of experience in dealing with Maryland workers' compensation claims, and can help you navigate through the maze of paperwork and filing deadlines. To learn more, or to schedule a free consultation, please call 410-730-7737 or fill out our contact form.