How do I Appeal a Maryland Workers’ Compensation Denial?

After sustaining injuries at work an employee has the right to file for a workers’ compensation claim. However, at times the claim can get denied. If the applicant feels that their claim was denied due to an error, they can appeal the validity of the denied claim. A person who is interested in filing an appeal for a denied workers’ compensation claim in Maryland should engage a proficient, skilled and experienced workers’ compensation lawyer from the law firm of Pinder Plotkin. An attorney from the firm can help them recover the full benefits they deserve for injuries received in the line of duty.
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Top Reasons Why A Workers’ Compensation Claim May Be Denied

The Commission for Workers’ Compensation usually accepts claims that are in line with the acceptable injuries which are sustained while a person is working and as they are carrying out their assigned duties in their line of work. A compensation claim can get denied if the applicant is deemed to be an independent contractor instead of an employee or if the claim filed does not meet the three-part statutory definition as given by the commission. It is important to note that though a compensation claim may be approved, the benefits that the applicant will receive may be cut. For example, the insurer of the employer may feel that the applicant had pre-existing injuries to a certain body part prior to the accident or that the applicant was not injured to the level contained in a compensation claim. Other things that are taken into account include; the permanency of an injury, the scope of treatment received by the applicant as well as other issues and details in the filing of a compensation claim. However, when deciding whether to deny a claim in the initial stages, assessors usually look at whether the claim fits within the statutory definitions and whether the applicant is an independent contractor or an employee.

What Process Is Followed When Determining If the Claim Applicant Is an Independent Contractor?

There are certain factors that are assessed in order to determine if the applicant of a compensation claim is an employee or independent contractor. It all boils down to the level of control that a supervisor has over an applicant of a claim. For example, if the person has regular work hours say from 8am to 4pm, they are heavily supervised when performing their duties, a supervisor can tell a person what to do in certain stages of their work and the person is paid with a W2 form, then that person is an employee. If a person does their work without much supervision from a superior, they do not work according to a specific schedule and they receive a 1099, then that person is deemed to be an independent contractor. An independent contractor does not have any entitlement to the rights and emoluments received by employees.

What Is the Process of Filing an Appeal for a Denied Workers’ Compensation Claim?

When filing an appeal for a worker’ compensation claim that has been denied, the attorney will file a case highlighting the issues that do not augur well with the applicant of the claim such as the nature and extent of permanent injuries, the number of benefits to be received and other issues that often depend on the nature of the claim at hand. On filing the case, the attorney will request for a hearing to deliberate on the issues raised by the applicant. A commissioner will then hear the issues raised by the applicant and make a decision on the issues raised. If the applicant is not satisfied with the decision of the commissioner, their lawyer can then move ahead and file an appeal with the appropriate circuit court in Maryland. The court where the appeal will be filed will depend on where the incident occurred. The lawyer will represent the applicant in the Circuit Court and even in higher courts such as the Court of Special Appeals and finally to the Court of Appeals until all legal channels are exhausted.

How Is a Notice for an Appeal on a Denied Workers’ Compensation Claim Filed?

The applicant of a claim through their lawyer can either ask for a reconsideration or file a notice of appeal in the appropriate circuit court. To file a notice of appeal, the applicant must know the reasons why their initial claim got denied in the first place. Knowing the reasons for denial is important as it helps the applicant decide if they want to appeal the whole claim or only part of the claim. On deciding the type of appeal to be filed, the applicant through their lawyer usually has to compile a strong appeal case and provide evidence showing that their claim got denied incorrectly.

What Are the Most Integral Processes in Filing a Workers’ Compensation Appeal?

When filing for a workers’ compensation claim appeal in Maryland, it is important that the applicant follows the guidelines for workers’ compensation. This is to avoid queries and hitches that can prevent the applicant from getting compensated for injuries received in the course of work. To avoid any hitches in the appeals process, the applicant should ensure that they:
  • Report their injury to the employer as soon as an incident occurs
  • Keep track of everything following an incident (This should include keeping all the requisite documentation)
  • Get all the requisite treatment and follow through on all recommendations made by doctors
  • Show up to all appointments with medical practitioners

Looking for Assurance That Future Medical Treatment Will Not Be Denied? Contact Our Workers’ Compensation Lawyers!

To ensure that you are not denied compensation for any future medical treatment, it is imperative that the applicant of a compensation claim follows the treatment plan provided by their doctor. If a person is deemed to be non-compliant then the insurer to the employer will not pay for the treatment or approve a compensation payout. Additionally, it is important that a claimant considers any possible future treatment costs before accepting to receive full compensation for injuries sustained in the course of work. If you intend on appealing a denied workers’ compensation claim in Maryland, it is best that you consult and engage the highly knowledgeable workers’ compensation lawyers at Pinder Plotkin as they will guide you through every step of the complicated appeal process with a view of ensuring that you get exactly what you deserve.
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