If you’re injured on the job, it is imperative you hire an experienced workers’ compensation lawyer. For most of us, we spend much of our lives in the workplace. And while most of the work environments are relatively safe and employees work for decades without a mishap, there are some environments where thousands of injuries occur almost every day. Workplace accidents are actually the second most common cause of injuries in the country.

If you or a loved one was injured in their workplace, you may be entitled to workers’ compensation benefits from your employer or their insurance company. Unfortunately, the process isn’t always straightforward.

Fortunately, the Bel Air personal injury lawyers at Pinder Plotkin has extensive experience representing both plaintiffs and defendants in such cases. We are well aware of how insurance companies operate and the tricks they use to avoid paying compensation to the injured victims. Get in touch with us today at (410) 593-1883 for a free case evaluation.

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Common Causes of Workers Compensation Disputes

To obtain workers’ compensation benefits, you have to file a claim with your employer or their insurance company. But there is no guarantee that your claim will be honored. In fact, many claims end up being denied for a variety of reasons. In many cases, the employer or their insurance company will try to deny a claim from a victim, or significantly undervalued claims to ensure they only pay as little amounts as possible as compensation.

Some of the common reasons why workers compensation claims are denied include:

Employment Status

If your employer had classified you as an independent contractor, you might be ineligible for workers’ compensation. If this is the case, contact an experienced workers’ compensation lawyer to advise you with legal options. For instance, you can appeal such a denial based on incorrect classification.

Keep in mind that in some cases, employees that were legitimately injured while at work delay filing their workers’ compensation claim, and by the time they file their claim, they get laid off or fired. An attorney can help either way.

Outside the Scope of Employment

Your employer may argue that your injuries were not caused by any workplace-related activities. In such a case, you may be required to prove that your injury was related to your scope of employment.

Missed Deadlines

Many workplace compensation insurers are not fond of cases where the accident goes unreported immediately. They usually assume that if you fail to report the incident immediately, you were not really hurt. Don’t forget that the law also requires you to report work-related injuries within a given timeframe. So, don’t wait and report any accident as soon as possible.

Lack of Causation

The insurance company may claim that you don’t have adequate proof to show that you got the injury from the workplace. Some insurers may demand independent medical examinations, and it’s always wise to have a workers’ compensation lawyer by your side before you agree to some of these terms.

Presence of Illegal Drugs or Alcohol

If you go to the emergency room after an accident in the workplace and the records end up showing illegal drugs in your system, the insurer will most likely deny your claim.

Workers Compensation claims can be denied for a variety of reasons

What to do if Your Workers Comp Claim is Denied in Maryland

Request a Hearing from the Industrial Commission

In case your employer or their insurance company chooses to deny your initial workers’ compensation claim, your first step in appealing a denied claim would be submitting a form to the Maryland Workers’ Compensation Commission.

The Commission will essentially provide your employer with a notice of your claim along with an opportunity to object. In case your employer objects to your claim, you will be sent a notice of dispute from the commission to indicate that your claim was denied in part or in whole.

Once you receive a notice of dispute, you have the right to request a hearing before a commissioner. You can request a hearing by timely submitting an Issues Form, as outlined in a section below.

Contact a Workers’ Compensation Lawyer

If you’re eligible for workers’ compensation benefits, you should pursue them. A workers compensation lawyer can help you file your claim and appeals in a timely manner. They can also help you persuade the commissioner that you’re entitled to the benefits you’re claiming. An experienced and skilled workers compensation lawyer will provide you with guidance and advice at every step of the way.

Appealing a claim can be complicated. You will need to know the rules and procedures associated with every stage. As such, an appeal is something you don’t want to handle on your own. Contact a Bel Air workers compensation lawyer today.

Types of Workers’ Compensation Disputes

Medical Disputes

These are disputes involving the medical facts and opinion in relation to the treatment of the injured employee. While working with an attorney can help to speed up and resolve medical disputes, the outcome of these kinds of disputes almost always rely on the willingness of the doctor to cooperate. Examples of medical disputes include:

  • Denied therapy
  • Denied surgery
  • Denial of medical products or supplies like TENS units, braces, and other devices
  • Denial of services like home-based healthcare and assisted living arrangements

Claims Disputes

Many disputes related to the claim may arise during the life of a normal claim. Some examples of claims disputes include:

  • Compensability: Disputes about whether or not the illness or injury suffered by the employee meet the requirements to be eligible for workers compensation
  • Disability: Disputes on whether or not the victim actually suffered a loss of income as a direct result of the work-related illness or injury. These disputes will also include questions about when the disability started and ended
  • The extent of injury: These relate to whether or not workplace-related injuries include other parts of the body or health systems. For instance, when a worker falls and injures their shoulder and back, the insurer may only agree to cover the shoulder injury.
  • Average weekly wage: These are disagreements about how much money the injured victim should receive as workers’ compensation.

Entitlement to supplemental income benefits: Injured employees who receive an impairment rating of 15% or higher, the carrier may challenge their entitlement to these benefits. This is especially true if the carrier denies that the victim had made a good faith effort in finding a job in the qualifying period.

Workers’ Compensation Dispute and Appeals Process in Maryland

In case an injured employee is unhappy with the decision made by the Commission, perhaps due to an award of insufficient benefits, there’s an appeal process for that. This appeals process has three main steps as outlined below:

Requesting a Hearing

To request the first hearing, the injured employee will first have to complete and submit an Issues form to the Commission. They will then choose the relevant issues on that form, such as the calculation of average weekly wages and the nature of the injury. The injured worker must then send the completed form to both the Commission and to the employer or their insurance company.

The Commissioner will then chair your hearing and listen to both sides (you and your employer). They will then make a decision on whether you’re eligible for any compensation benefits. In case you are dissatisfied with the judgment made by the commissioner, you can request another hearing. You are required to ask for the hearing within 15 days of the decision, usually by making a written request.

Request a Rehearing

Keep in mind that a new hearing won’t be automatic. The Commission will decide whether to grant you one or not. Note that it can be quite difficult to get a rehearing. In fact, rehearings are only granted in case you have new evidence or the commissioner made any legal error.

In case the Commissioner denies your request for a rehearing, you may file an appeal with the Maryland courts. This also applies if you lose at the rehearing. In either case, your next step will be to appeal with the Maryland courts.

File a Court Appeal

You are given 30 days from the date of the decision to appeal to the Circuit Court nearest to your location. When in the Circuit Court, the presumption is that the Commission made the right decision.

The Circuit court will either choose to agree or disagree with the decision made by the Commission. It may also disagree with the Commission in whole or in part. In some cases, the Circuit court may even send the dispute back to the Commission for additional proceedings.

You need to prove why their decision was incorrect. In case you end up losing your case at the Circuit Court, you can also appeal to the Maryland Court of Special Appeals.

A workers compensation claim denial can be appealed

Contact a Bel Air Workers Compensation Lawyer Today

Time is of the essence when filing workers’ compensation claims in Maryland. Get in touch with the Pinder Plotkin Legal Team in Bel Air, Maryland today to discuss your case and learn how we can help you get justice and protect your rights.

Our team of workers comp lawyers handles these claims on a contingency fee basis, meaning we won’t charge you anything unless we recover compensation on your behalf. Plus, we provide a free consultation to all our clients.

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