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Injured workers should know workers comp procedures, policies, and legal rights!

Many people are first exposed to the Maryland workers compensation system later in their lives and at that point being unfamiliar with the process is much more concerning and perhaps troubling.  There are a handful of scenarios for which the injured worker needs to know about workers comp.  It is important the employee is prepared for these possibilities because if it happens when they least expect it a rash decision could be made that could damage the workers comp case.

Below is a list of 12 important facts and circumstances the injured worker should know about workers comp:

  1. The injured worker should know about PROPERLY filing the workers comp claim

In order to be protected by Maryland workman’s compensation laws a claim must be filed with the Workers Compensation Commission.  It is not enough to file a claim with the insurance company.  To make sure this is done properly consult a Maryland Workman’s Compensation Attorney rehearsed in workers comp laws.  If there is reluctance to consult an attorney make sure to contact the Maryland Workers Compensation Commission to confirm your claim has been filed.  Do not trust what the adjuster/ case manager says about a “claim” being filed.  It is possible that a claim is filed with the adjuster but not with the Commission.  The injured worker should know about workers comp claim filing.  File with the Commission!

  1. Injured workers should know about Independent Medical Evaluations

An independent Medical Evaluation (IME)/ Second Opinion is not in the interest of the injured worker.  The injured worker must attend this appointment however under no circumstances must the injured worker accept the IME doctors opinion.  Also referred to as second opinions, these are used by the insurance company to deny treatment and save money.  Before attending an IME or “second opinion” the injured worker should know workers comp second opinions may not be a true second opinion.

At some point the adjuster may schedule the injured worker for a Second Opinion or an Independent Medical Evaluation.  This is never good news.  These are scheduled only for the adjusters benefit and the injured worker should known workers comp IME doctors are not going to view the case the same as a treating physician.  The injured worker is obligated to attend the IME however they are not obligated to go out of their way to obtain medical films or records, nor are they obligated to attend an IME that has been scheduled for a time that is unreasonable.

The injured worker should know workers comp IME’s and “second opinions” are usually so the insurance company can begin building their case against the injured worker for the purpose of denying treatment or benefits.  IME’s are the Maryland insurance adjusters evidence and support for their arguments going forward.  If an IME is schedule the injured worker should know workers comp benefits may be very shortly terminated.

Temporary Total Disability benefits are paid to injured Maryland employees while they are unable to work according to a doctors orders.  IME’s are also used by the workers compensation insurance company to deny payment of lost wages or temporary total disability.  Often a treating physician will hold the injured worker out of work so that the injured can get the rest and treatment necessary for optimal recovery.  If the out of work period lasts for an extended period of time then the adjuster may schedule an IME and request the IME physician comment on the injured employees work capacity.  Sometimes all the medical treatment is approved but the adjuster focuses her time and energy on the indemnity portion of the case and is simply not willing to pay the Maryland injured worker.  In order for the adjuster to form her argument against paying temporary total benefits she will schedule an IME.  If the IME doctor does not indicate the worker can work full duty, they often indicate that the injured worker is able to work light duty.

The injured worker should know workers comp may offer light duty work and it may be in the best interest of the employee to attempt the light duty.  This is something that should be discussed with a good Maryland workers compensation attorney before deciding because it is often a complicated decision which must be made after only considering all outcomes.

  1. Injured workers should know Workers Comp Adjusters role and purpose in the case

Workman’s compensation adjusters have a job and a supervisor just like the injured worker.  The adjuster’s job is to save money and expedite the claims process.  This means they do not have the injured workers interests in mind all the time.  Their focus is to save for the employer- they do this with denials of medical treatment, refusal to pay lost wages, influencing choice of treating doctor, and involving a nurse case manager to expedite treatment.

Overall workers compensation adjusters are good people but they are on the other side of the phone looking out for the insurance companies interests.  He or she may speak like they care about the injured worker, and they usually do but at the end of the day they have a job to do.  He or she may come across as nice, polite, and caring, and they usually are.  The injured worker should know workers comp adjusters are paid to save money.  This can be done while being caring, polite, and nice.  In the end, the adjusters ultimate decision is based on how to save the injured workers employer and the insurance company money.

  1. Injured workers need to know workers comp allows them as choice of doctor

Workers injured in Maryland have an absolute right to treat with a physician of their choosing.  With the exception of an Independent Medical Evaluation, workers comp insurance companies can not force the injured worker to treat with a specific doctor.  Those injured at work should not be influenced to pick a doctor on the adjusters “list” as these doctors made the “list” for a reason.

It is important for injured worker to know that workers comp can have the employer require the employee to see the employers doctors but this is part of the relationship between the employer and the employee.  This is not part of the relationship between the employee and workman’s comp.  There is overlap and potential confusion between Maryland Labor and Employment laws and Workers’ Compensation Laws.  For clarification a free consultation with a qualified and experienced Maryland workers compensation attorney should be obtained.

For a no cost consultation with Baltimore Workers Comp Attorney call Andrew M. Rodabaugh today Call Us, Click to email or simply fill out the form at the bottom of this page!

  1. The injured worker should know workers comp accidents should be reported ASAP!

The first step an employee should take after being injured on the job is to notify a co-worker or a supervisor, preferably both.  Maryland law requires the injured employee to give notice.  In some circumstances it is not possible to give notice the same day or even the same week as the injury.  This is ordinarily ok but notice must be given as soon as possible.  Employees need to know workers comp accidents are to be reported as soon as the incident occurs otherwise complications begin to arise.

For more on notifying an employer about an accident at work click this link.

  1. Advise the Doctor so they know workers comp is involved

Doctors have certain billing requirements they must follow in order to properly administer medical care.  If the injury occurred on the job then they must bill workers’ compensation insurance and not health insurance.  If there is improper billing the injured worker should know workers comp may not pay and the injured worker may end up paying unnecessary medical bills.  Not only is it important the physician bills properly, but it is also important the injured workers complaints are documented as arising from the work accident.  If there is no mention of a work accident in the medical records of the physicians then the Maryland workers compensation claim will likely fail.  Often the injured worker attempts to avoid using Maryland workman’s comp for one reason or another.  They report to the doctor that it is not a workman’s comp claim.  This is not a good idea and the injured worker should know workers comp benefits may be lost if they later decide to seek those benefits.

  1. Keep track of out of pocket expenses and know workers comp may reimburse those expenses

Expenses for the injured worker can quickly add up and become overwhelming.  Co-pays, transportation costs, double billing, and prescriptions often put severe financial distress on the injured employee.  Fortunate enough for the injured worker, Maryland law provides reimbursement for these expenses.  In order to be fully reimbursed the injured worker must provide proof that they have paid for these things.  For every expense those hurt on the job should obtain a receipt.  A Maryland workers compensation attorney can help obtain these benefits if workers comp is refusing to pay.

  1. It is important to know workers comp will only pay lost wages if an out of work note is provided

Lost wage payment or Temporary Total Disability (TTD) is one of the most coveted benefits among injured Maryland workers.  Without injured employees would be forced to go to work out of fear of losing their personal belongings.  Even when TTD payments begin there is always a good chance that they will be terminated at any given time.  The injured worker can help themselves by making sure the obtain a work status note from their doctor every time they attend an appointment.  Without a doctors note know workers comp will not pay lost wages.  If the next doctor’s appointment is more than a month out then it is a good idea for the injured worker to arrange for an updated work status note in the interim.  Some workers compensation adjusters will not accept a work note that holds an injured employee out of work for more than a month.

  1. Communicate with Employer

Employers are skeptical of the workers’ compensation process because they do not understand the process and can be left in the dark as to the status of the claim.  It can often be helpful for the injured worker to provide regular updates to the employer as to their expected return to work date and medical treatment status.  It is also important the employer knows workers comp procedures but they are often uninformed or misinformed.  BEFORE DISCUSSING WITH EMPLOYER CONSULT A WORKERS COMPENSATION ATTORNEY.

  1. Consult a Maryland Workers Compensation Attorney

As a workers compensation attorney it only seems natural that I say this.  The truth is, injured workers have the option to consult attorneys for free.  They can get advise, obtain a better understanding, and be advised as to what to look out for or expect from the workers compensation insurer.  Each year thousands of injured Maryland workers fail to file a claim with the workers compensation commission and eventually the statute of limitations runs leaving them without legal recourse.  This is something that can be prevented if they had just obtained a free consultation from a qualified Maryland workmans comp attorney.  Injured workers should know workers comp procedures can be complicated but a proper claim filing can save them from losing benefits and possibly thousands of dollars in compensation.  Injured workers should not be afraid to obtain free legal help.  Attorney’s realize, and if they do not shame on them, that providing free legal advise is part of the job.

      11. Employees need to know workers comp may deny medical treatment

At some point medical treatment may be cut of by the workers compensation adjuster.  This could come unexpectedly often occurring when the injured worker was thinking the case was moving along just fine.  If treatment is denied it usually indicates that the adjuster is reviewing the case expenses and the natural progression of the treatment and is now ready to start putting up a fight.   This is not the end-all-be-all of the case and what the adjuster does and says is certainly not law.  This is the time to lawyer up and call a qualified Maryland workers comp attorney.  If the injured worker is serious about getting the treatment being prescribed a lawyer can help and they should know workers comp adjusters are not the ultimate decision makers.

    12. Health Insurance versus Workers Comp Insurance

The most common sense resolution often enters the mind of the injured worker when the workers compensation insurer denies treatment- Why can’t I just use my health insurance for treatment?  It is sometimes the better alternative if the health insurer is willing to pay; however this decision should not be made lightly as there are certain repercussions that may arise. If there is a work injury the health insurer only willingly pays after the treatment has been ordered “not related” by the Maryland Workers Compensation Commission or if they have received an official denial from the workers comp insurer.  This means the injured worker may have to wait until a hearing is requested and takes place at the Commission, often a lengthy period of time.

A person that is injured at work, and is covered under the Maryland Workers Compensation article is obligated to use workers compensation rather than their health insurance.  The injured worker should know workers comp is an arduous process which can place a great deal of burden on them.  A treatment regime that would take three or four under health insurance could possibly take a year or longer if the workers compensation insurer fights the treatment.

Unfortunately, if the injured workers health insurance will not pay for the treatment then the injured worker is forced to go through some hoops to get the treatment authorized under the workers compensation policy.

For a free consultation call workers compensation and personal injury attorney Andrew M. Rodabaugh now at  Call Us, Click to email  or Fill out the Form below!


Mr. Rodabaugh was a professional and courteous attorney who had my best interest in mind when handling my case.  I would highly recommend him to anyone in need of Workers Comp. Counsel.
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David B.


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