Every day, employees are at risk of suffering various work-related injuries. However, a government-mandated system referred to as workers’ compensation protects employees who get injured in accidents arising out of or in the course of employment. According to federal and state laws related to workers’ compensation, employers are required to provide monetary awards for employees who are injured while on the clock in a bid to eliminate the need for litigation.
While the workers’ compensation system might seem straightforward, claims are not always smooth sailing. In the event of an occupational injury or disease, employees are entitled to receiving wage replacement benefits, medical treatment, vocational rehabilitation, and other benefits. However, employers may raise various disputes in an attempt to deny your claim and you risk losing the benefits you’re entitled to. This is where a Parkville workers’ compensation lawyer can help you get the compensation you deserve.
Filing your workers’ compensation claim alone may not be the best thing for you. Seeking the legal assistance of an experienced Parkville personal injury lawyer can help you avoid the denial of your claim. At Pinder Plotkin Legal Team, we are dedicated to representing injured employees whose workers’ compensation claim has been denied. We understand the agony that comes with getting injured on the job and missing out on the benefits you much deserve. Reach out to us today at (410) 525-5337 to learn more about your legal rights in a workers’ compensation claim.
Causes of Workers’ Compensation Disputes
In Maryland workers’ compensation claims, employers may cite various reasons for the denial of your claim. Some of the most common reasons for disputes in these claims include:
In order to file a workers’ compensation claim in Maryland, you must be an employee and not an independent contractor. An independent contractor refers to a worker contracted to complete work for another person through their own means and free from the control of that person. In Maryland, business owners, volunteers, railroad employees, federal employees, and longshoremen are not covered by workers’ compensation. It follows that they aren’t eligible to file a workers’ compensation claim in case of a work-related injury.
Outside Scope of Employment
Some work-related accidents or illnesses may not be covered by workers’ compensation. Employees are only entitled to workers’ compensation benefits for an injury that arises out of and in the course of employment. That means that the injury or occupational disease must have occurred due to the conditions of the employer regarding how to do the job or when the employee is performing their job duties.
Lack of Causation
Your workers’ compensation can be dismissed if there is no legal causation. There must be a work connection for you to be eligible to receive workers’ compensation benefits. You have to prove that your injury is “causally related” to your job, which means that it happened solely due to your job.
For instance, if you are operating machinery and a heavy load falls on you and breaks your leg, you can argue that you suffered the injury while doing your job. However, proving causation may get complex if it established that there are other factors that may have contributed to the accident that caused your injury. An experienced Parkville workers’ compensation lawyer can help you prove causation in the event of an injury and protect your right to receive workers’ compensation benefits.
Workers’ compensation insurers may deny your workers’ compensation claim if you fail to report your injury immediately. The assumption made is that if you don’t report the incident immediately, you weren’t really hurt. In Maryland, employees are supposed to report an accident in writing within 10 days of its occurrence.
Employees have 2 years from the date of the accident (in the case of a work-related accident) and 1 year following the discovery of an occupational disease to file a workers’ compensation claim. Failure to do so, they lose their right to receive workers’ compensation benefits.
In some instances, employees can legitimately get injured while at work but delay filing their workers’ compensation. By the time they get around filing the claim, they get fired or laid off. Such claims that are filed after one has been fired or laid off are mostly considered revenge claims and can easily be denied.
While injured employees are not legally obligated to provide insurers with a recorded statement regarding the work-related accident, failure to do so only sends a negative message to the workers’ compensation insurer. Such claims may also be denied if the accident was unwitnessed. To avoid such a scenario, it is important that you provide the insurer with as much information about the accident as possible, including a recorded statement and medical reports.
What to Do If Your Workers’ Comp Claim Is Denied in Maryland
If your employer or their insurer denies your claim, you will get a Notice of Dispute from the Workers’ Compensation Commission of Maryland indicating that your claim has been denied. When your claim is denied or believe that you haven’t been awarded all the benefits you’re entitled to, you have the right to do the following:
Request a Hearing Before the Industrial Commission
Employees who have had their claim denied or are not satisfied with the benefits awarded have 30 days to fill and submit an Issues Form to the Industrial Commission. The form should be filled with the specific issue you believe was wrongly decided and sent to the Commission at the right address, and to your employer and their insurer as well.
Contact an Attorney
A Parkville workers’ compensation lawyer comes in handy in the event your claim is denied or whenever you feel that your average weekly wage was incorrectly calculated. Your lawyer will look at the possible reasons for the denial of your claim and help build a strong case according to the facts of your case. With their experience, a Parkville workers’ compensation lawyer can ensure that you receive the benefits you deserve and that these benefits are calculated correctly.
Types of Workers’ Compensation Disputes
Employers and insurers may cite various reasons to justify the denial of your workers’ compensation claim. The most common disputes in these claims include:
Generally, these are disputes that arise when your employer or their insurer have questions regarding the injury or illness that led to the filing of the claim. Specifically, employers will often dispute your claim if they believe that you had suffered the injury before or it was an aggravation of an underlying condition.
If your employer believes that you had an underlying condition, or that other factors contributed to your occupational illness, then they might dispute your claim on these medical grounds. In such cases, a workers’ compensation can advise on what to do to prove that the injury or disease was a result of a work-related accident.
Employers and insurers may also raise disputes if you fail to adhere to the rules that govern workers’ compensation claims. In Maryland, such disputes may come about if you file your workers’ compensation claim after the deadline has lapsed. Another common claim dispute is about whether the injury was work-related.
Your employer might say that you weren’t on your job, or that you were involved in misconduct at the time of the accident and might end up denying your claim. Your workers’ compensation lawyer can help you gather sufficient evidence to support your claim and help you receive the workers’ compensation benefits you’re entitled to.
Workers’ Compensation Dispute and Appeals Process in Maryland
Whenever your workers’ compensation claim is denied, you have 30 days to fill and submit an Issues Fill to request a hearing from the Industrial Commission. This is after receiving a Notice of Dispute indicating that your claim has been denied. The hearing will often involve medical examination for the employee to establish the severity of their injury.
The Workers’ Compensation Commission will make a decision within 30 days from the date of the hearing. If you are not satisfied with the Commission’s decision, you have a right to request a rehearing, which should be done not later than 15 days from the date of the Commission’s decision. If your request for a rehearing is denial, you can appeal to the Circuit Court. You can also appeal if you’re granted a rehearing and lose.
Contact Our Parkville Workers’ Compensation Lawyers Today
Workers’ compensation is a government-mandated insurance system that requires all employers to allocate benefits to employees who may be injured or get sick while on the job. This system seeks to award monetary benefits to employees, who, in turn, are required to give up the right to take legal action against their employer.
However, disputes are common and workers’ compensation claims can get complex. Mostly these disputes will be due to medical reasons or questions about whether you are eligible to receive the workers’ compensation benefits. In Maryland, employees have the right to request a hearing before the Industrial Commission and also appeal its decision if they are not satisfied.
To help you navigate the complex field of workers’ compensation, working with a qualified and experienced workers’ compensation lawyer is your best option. If your claim has been denied by your employer or their insurer, reach out to us for legal assistance at (410) 525-5337. The workers’ compensation lawyer at Pinder Plotkin will help assess your case and help you throughout the appeal process.