The basics of determining the value of a Maryland workers compensation claim
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Determining the value of a workers’ compensation claim is not an easy task and there are a multitude of factors that go into this analysis. What is important to understand is that the final compensation (see permanency vs settlement) to be paid is based on remaining issues that the injured worker has after they are discharged from their treating physician. If the Maryland injured worker has recovered 100% and has no remaining physical issues then the value of their case is essentially zero. If the injured worker is part of the majority and has some remaining issues then under Maryland law they are entitled to at least some compensation. The law does not provide compensation for the pain, suffering, aggravation, and inconvenience that was brought about by the work injury. In some scenarios a qualified Maryland workers compensation attorney can obtain a settlement even when there is no remaining issues.
Percentages and Ratings
Once the injured worker is discharged from care he or she will be sent to a rating doctor for an independent medical evaluation by their Maryland workers comp attorney. The injured workers’ attorney will send him or her to a carefully selected orthopedic surgeon or internal medicine doctor for an evaluation and determination of the nature and extent of the injury. The doctor will indicate in writing the percentage impairment he believes the worker has sustained as a result of the injury. The doctor will indicate the percentage impairment for each injured body part. For example if the worker broke his wrist and sprained his ankle the doctor would indicate x% impairment to the ankle and x% impairment to the wrist. The insurance company will likely also have the injured worker scheduled for a rating. These ratings will be placed into an algebraic equation for a very rough determination of the amount of compensation expected.
The problem most often arising- the insurance company doctor issues a low % impairment and the claimants’ doctor issues a high percentage impairment thus creating a conflict which will often lead to a hearing before the Maryland workers compensation commission. The workers compensation commission will decide the percentage impairment after the parties put on their case.
Percentages and Weeks of Payment
The impairment percentage will be broken down into a certain amount of weeks of payment. The Maryland Legislature has determined that each body part is worth a certain number weeks of payment.
Shoulder- 500 weeks
Knee/leg- 300 weeks
Back/neck- 500 weeks
Arm – 300 weeks
Hand – 250 weeks
Foot – 250 weeks
Fingers, toes, vary by each digit.
The Tier System
Maryland law provides a tier system which determines the rate of compensation to be paid for the permanency award to the injured employee. There are multiple tiers however most cases will fall within the first or second tier payment rates and only these first two tiers will be discuss herein. A permanency award will fall within the first tier rate if 74 weeks or less is awarded. The award will fall within the second tier if 75 weeks or more is awarded. The pay rates for first and second tier differ greatly and are increased every year.
Year Tier 1/Tier 2
For any rating you would take the percentage awarded and multiply it by total weeks for body part. You will then multiply that number by the applicable tier rate. For example an injured shoulder is rated by the claimants doctor at 14% for an injury in 2016. 14% x 500= 70 weeks. 70 x 172 (first tier rate for 2016)= 12,040. Note that the average weekly wage can have a significant effect on these calculations so the Tier rates may not necessarily be accurate for any particular case.
Other Considerations and Valuation
When evaluating a case for settlement or permanency there are a number of other factors to consider and the calculations are simply a starting point for the Maryland workers comp attorney. The amount of treatment the injured worker received under the Maryland workers compensation policy should also be considered. Cases involving surgery, pain management, injections, or extensive treatment are generally going to be considered of higher value. If the worker is no longer able to perform the same job duties, or has sustained a loss in earning capacity the value of a case may also be considered a bit higher. Also, when considering settlement over permanency the motivation of the Workers Compensation Insurer must also be contemplated. The greater the exposure to expenses the higher the value. A qualified Maryland Workers Compensation attorney can help maximize settlement or permanency recovery with concise legal arguments considering industrial loss, future medical expenses, vocation rehabilitation exposure, and threats of reopening. In the majority of cases a represented workers compensation Claimant will recover significantly more by hiring a lawyer than handling a case on their own.
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