I was injured on the job and am going through workers comp but… who or what is workers comp?
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To better understand Maryland workers compensation it is important to understand the people involved and what role they play in the work injury process.
If the injured worker is on the sideline of a discussion it is important to know when they are being referred to in the discussion. The hurt employee is formally referred to as the Claimant in the Maryland workers compensation case. A good way to remember this is that the workers compensation Claimant is the one who is claiming the benefits available under workers compensation laws. If the work comp case is ever appealed to a higher court the Claimant may also be referred to as the plaintiff, appellant, appellee, or simply by name.
Claimant’s counsel, Claimant’s attorney, or counsel is the attorney that is representing the injured employee/ Claimant. Contact an experienced and qualified Maryland workers compensation attorney .
Across the aisle and on the other side is the workers compensation defense. This most often includes the workers compensation insurer, the employer, the defense attorney, the insurance adjuster. Understanding the defense is paramount to understanding the Maryland workmans comp process and why you are where you are in the work compensation process. The workers compensation insurer is the insurance company that provides the employers workers compensation policy. Quite often the workers compensation insurance company is referred to by the injured worker and the public as workers comp, work comp, workmans comp, or some similar term. While the terminology is similar it can create confusion when discussing the case. It is best to refer to the workers compensation insurer as the insurer or the workers compensation insurance company. The relationship between a workers comp insurer and the employer can be compared to an auto insurance company and a driver.
On occasion workers compensation case the employer and insurer will be the same person. This is the case when the injured employees’ employer has opted to insure themselves rather than pay for an insurance policy with a workers compensation insurer. This is an option under Maryland workers compensation laws. Often government municipalities or larger companies such as Johns Hopkins are self insured.
The defense attorney is more often than not paid by the workers compensation insurance company to provide legal guidance and representation. They are the one who will be at any Maryland Workers Compensation Commission hearing and will be arguing against the interests of the injured worker. There are workers compensation defense attorneys that are actual employees of the workers compensation insurer and there are defense attorneys that are hired on a contractual basis. Knowing the relationship between the workers comp defense attorney and the work comp insurance company can be very advantageous for the claimant when it comes time for settlement discussions or negotiations as there are certain financial considerations that may play a part in settlement authority. An experienced Maryland workmans comp lawyer should be able to help with identifying the agreement between employers and insurers.
A workers compensation insurance adjuster is most likely the first person an injured worker will speak with that has practical knowledge of the workers compensation process. The adjuster works for the compensation insurance company and manages workers compensation claims in an effort to minimize expenses while providing some benefits to the injured worker. The workmans comp adjuster is the decision maker and carries the authority to approve or deny all the medical treatment and all the compensation payments in the workers compensation claim. As an aside: If there is any person involved in the workers comp process that is worth being nice to it is the work comp adjuster as he or she has the power to make the case move very smooth or extremely rough. The adjuster is often called a case worker by the injured worker.
A Nurse Case Manager is sometimes hired by the workers comp adjuster in order to facilitate medical treatment and keep the case moving forward. A great majority of Nurse Case Managers (NCM) are effective and helpful in the workers comp case however there are some scenarios that should raise concern. If the Nurse Case Manager is an employee of the workers comp insurance company then they are likely to be greatly influenced. NCM’s are paid by the adjuster so they may be considering the adjusters interests as well as the injured workers interest. Nurse Case Managers that are employees of the work comp insurance company not only consider the injured workers interests but also often the insurance companies interest as they are employed by the insurance company. To be clear, the insurance companies interest is to save money and this can happen by the injured worker being pushed quickly through treatment and being returned back to work. A NCM may have their own interest of job security effect the way they manage the injured workers case. Quite often a Nurse Case Manager will attempt to influence a Physicians decision to return the hurt worker back to work sooner than the Physician has planned.
The Maryland Workers Compensation Commission is the administrative agency that handles the processing of all workers compensation cases that are officially filed with them. To be protected by the workers comp laws an injured Maryland worker must file a claim with the Commission as well as the workers comp insurer. Failure to file a claim with the Workers Compensation Commission can prove to be devastating to ones rights to full benefits under Maryland workers comp laws.
The Workers Compensation Commissioners are the judges for Maryland workers compensation cases at the administrative level. They have the legal power to force the workers Compensation Insurer to pay for medical treatment, provide lost wage payments, or provide other benefits which Maryland law bestows upon the injured worker. They are appointed by the governor to a 12 year term. There are currently 10 Commissioners including one Chairman who oversees the administration of the Commission.