Maryland Workers Compensation Terms and Definitions
Accidental Injury (A/I) – injury arising out of and in the course of employment. You have been hurt at work while performing a work related task or you were in the position to be injured because of work obligations. There is much litigation over the specific language used in thestatutory code of Maryland. You do not necessarily have to be on the clock nor do you always have to be performing a job duty to have a qualifying workers compensation accidental injury.
Accident Leave– This is paid time off provided by an employer in the event an employee is injured. It can apply to work injuries or injuries outside of work. In some Maryland work injury cases leave is provided in lieu of temporary total disability payments. It is important to note that accident leave does not save an injured employee from the statute of limitations.
Accidental Injuries– injuries occurring while at the workplace. Claimants can be covered under Maryland workers compensation laws regardless of fault. If they are negligent it will not prevent the employee from receiving benefits.
Agreement of Final Compromise and Settlement (AFCS)– see also Settlement. This is the term used to describe a settlement in a Maryland workers compensation case. These documents, along with other forms required by Maryland laws will be drafted by the injured workers attorney.
American Medical Association- the largest association of Physicians in the United States comprised of MD, DO, medical students. As it applies to workers compensation, the AMA has drafted the 4th edition Guide to Impairment. This book is used by rating physicians to determine the injured workers impairment.
Arising out of employment– One of the most pronounced and complicated phrases within Maryland Workers Compensation laws. Workers Comp Lawyers regularly argue whether the injured workers injury arose out of his or her employment. A very simplified explanation: Was the injured worker working at the time of the accident.
Attorney Fees– Maryland Attorneys are paid on a contingency basis in workers compensation cases. This means that the hurt employee will only pay the attorney if he is successful in obtaining compensation for the injured worker, and out of that compensation the lawyer will be paid.
Assault– Assault incidents that result in a workers compensation claim may or may not be covered depending on a number of factors including the actions of the injured worker.
Auto Award– An auto award is an automatically generated award in each workers compensation claim that is not initially challenged by the Workers compensation Insurance company. The auto award is generated once the consideration date has passed. Many claimants or injured workers are confused by this award and see it as a final decision by the Maryland Workers Compensation Commission. This is not the case. The Work Comp Insurer will still have the option to challenge any medical treatment that is being recommended, diagnostics that are being prescribed, medications that are being prescribed, compensation payments and more. Also important to consider is the amount of money that is listed on the Auto Award is most often not accurate. The Auto Award should be looked at as a mere formality that really does not mean a whole lot.
Average Weekly Wage(AWW) – This is the figure used to determine the amount of compensation the injured employee is paid while out of work. This is determine by adding the 14 weeks of pay prior to the incident and dividing by 14 to determine the average amount of money the injured should receive per week. If however the injured worker is paid only twice a month the calculations will differ.
Award of Compensation– The award of compensation is the decision of the workers compensation Commissioner. This can be compared to a judge or jury verdict, however often in workers compensation there is not one final Award but many awards which may be regarding treatment, payments, mileage, vocational rehab, or other Issues that may arise.
Benefits– There are numerous benefits enjoyed by the injured employee in Maryland. To name a few: lifetime medical treatment as indicated by the extent of the employees injuries, Permanent Partial Disability, Temporary Total Disability, Vocational Rehabilitation, Mileage, prescriptions.
Back Pay- Also known as Temporary Total Disability, refers to wages that the injured worker is entitled to while he or she was held out of work by a treating physician. This could also apply to forward pay if the injured worker is expected to be held out of work for an extended period of time in the future. Discuss further with a Maryland workers compensation attorney.
Casual Employment– A defensive argument made to establish that the injured worker was not an employee and therefore not entitled to benefits. Argument consists of the nature of the work, duration of the employment, was the employment occasional, incidental or accidental, the work performed was or was not the norm for the employer. Emphasized in analysis is the scope and purpose of the employment and not duration and regularity.
Causal Connection– The question of whether the medical treatment sought is connected to/ caused by the incident. Example: An injured worker who needs an MRI to their knee but did not injure there knee in the accident would not be covered under Maryland workers compensation laws.
Causal Relationship– The question raised as to the possibility of the condition as it relates to the incident at work. For example, a Baltimore worker was stepping up on a curb and twisted their knee and felt a pop. Is it possible that that mechanism of injury could have caused a ligament to tear? Expert doctors opinions are often necessary to determine whether there is causal relationship between the incident and the injury.
Claimant– This is the injured worker. The person who is claiming the benefits under the Maryland workers compensation statute.
Commission– See Maryland Workers Compensation Commission.
Commissioner– Workers compensation Commissioners are the judges for workers compensation cases. There is much confusion among injured workers who often believe the commissioners are somehow affiliated with the insurance companies. Despite this confusion it holds true that the Commissioners and the Workers Compensation staff are wholly independent.
Compensability– This is the initial determination made in a workers compensation case. Simply put- Is the incident in question a valid claim subject to Maryland laws? At this stage of the case the defense may argue there is no causal relationship, the incident did not arise out of employment, the employee was acting with willful misconduct, insurance fraud….
Consideration Date– The insurance company will have until this date to challenge your workman’s comp case on certain issues. Further explanation can be provided by an experienced workers compensation attorney.
Contested Case– This is decided at the relative beginning of every workers compensation case. A c40 will be mailed to the workers comp insurance adjuster which gives the adjuster the option to accept the case and begin paying for lost wages and medical treatment or challenge the case. He or she will decide whether they think the case is valid under Maryland Law. They can challenge the case on the basis of arthritic pre-existing injuries, whether the accidental injury actually occurred, whether the injures sustained are because of the accident or there is some other explanation, is the accident covered under Maryland Workers Compensation law, are they the correct insurance company.
Cost of Living Adjustment– In some cases the injured worker may qualify for an increase in the workers compensation benefits they are receiving.
Date of Disablement– When an employee suffers from an occupational disease it must be established when the injured workers disability began. It is somewhat of an arbitrary determination must legally be established. Determining this date often centers around the first time the worker felt pain, the first time the injured worker sought treatment, or the first time the injured worker was told by a physician that the occupational disease was related to work conditions.
Death Benefits– If an employee loses his life on the job family members may be entitled to death benefits under Maryland workmans’ comp laws. The key determination is whether or not the family member was dependent upon the deceased. Regardless of Dependency, the family is entitled to assistance with funeral expenses.
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Dependency– To establish dependency the family member, or in some instances friend, was financially relying on the deceased to some extent. The extent of dependency will be measured against total household income.
Defenses- Workers Comp insurers and their attorney will often argue there was not an incident at all, there was an incident but condition of the employee is not because of the incident (causal relationship), an accident occurred but the treatment needed is not a result of the accident (causal connection), willful misconduct, fraud, statute of limitations, notice, intervening or subsequent accident.
Depositions– If the workers compensation commission decision is appealed to the proper Circuit Court the parties are entitled to conduct discovery. A deposition is a form of discovery allowing the parties to question the opposing party under oath and in person at some mutually convenient location.
Disability Payments– Workers compensation disability payments are made in two instances. The first of which would include the period of time the injured employee is temporarily disabled from performing their job. This arises when a physician indicates that the hurt worker is not able to go to work. The second type of disability payments are made when the injured worker is receiving permanency payments because they have sustained a permanent injury. Although referred to as permanency payments, these are not workers comp payments that will continue indefinitely. Disability under a workers compensation claim is different than disability under social security and do, in a great majority of time, have a limited payment period. Unlike with social security disability payments workers comp payments often only last for a few years or less.
Discovery – Discovery is the right of each party in the legal process to have access to the other parties documents, to ask written questions of the other party and to perform depositions. The legal process of discovery allows the injured worker to “discover” what the other party knows or has in their possession.
Disfigurement– A form of compensation to which an injured worker is entitled if they suffered an injury at work and as a result have some form of scarring, mutilation, change in or alteration of appearance.
Dual Purpose Doctrine- An injured worker may still be entitled to Maryland workers compensation benefits even if they were working while also doing something for themselves. For instance a messenger that was sent to deliver an automotive part to a store but also purchased an item for him or herself while at the store.
Election of Remedies– For some accidents the injured has the option of selecting whether to bring a workers compensation claim or a personal injury lawsuit. In some scenarios the injured worker files a personal injury lawsuit but it is later determined that the only remedy that can be sought is a workers compensation claim. Workers compensation claims are ordinarily the injured workers sole remedy.
Emergency Hearing– A Maryland Workers Compensation Attorney can request an emergency hearing before the workers comp commission in the event there is a dire medical question issue that needs immediate attention, or in the event the injured worker is financial strained. In order to obtain an emergency hearing there ordinarily needs to be a medical report indicate treatment needs to be authorized very quickly, or evidence substantiating the financial dire the employee is suffering such as gas and electric shut off notices, late mortgage or rent bills, or utilities bills.
Escrow– An account where funds are held safely until the requisite time of disbursement. Some workers comp settlements require funds to be placed in an escrow account and on a regular occurrence be sent to the injured worker.
Estoppel– A defense to a defense. Argument made that the defense is invalid because of some wrongdoing or fraud on behalf of the employer. A common example: The employer argues that the statute of limitations has run and the injured maryland worker can no longer claim work comp benefits. Facts show the employer told the injured employee that he has nothing to worry about and the claim has been filed with the workers compensation commission. The injured worker can then have his comp attorney argue that the Employer is “estopped” from raising the statute of limitations defense.
Fire Fighters- Fire Fighters are provided extra benefits under Work Comp Laws and to obtain all benefits they should be represented by a qualified Maryland Workers Compensation Attorney. As public safety employees Fire Fighters enjoy the right of a presumption for certain occupational diseases like cancers, and hypertension. Fire Fighters also enjoy the right of second tier permanent partial disability payments regardless of the percentage awarded by the Commissioner.
Forms- Maryland workers comp practice consists largely of formatted forms that can be filled in and submitted to the workers comp commission. The forms make workers comp law appear simplified however it is often understood as one of the more complex areas of law because of the many intricacies in the labor and employment article.
Fraud- Wrongfully obtaining legal benefits.
Frivolous Issues- Issues can be filed by any party involved in a Maryland workers compensation claim. These issues must be legally substantiated. If the Maryland Workers Compensation Attorney is successful in arguing the issues are frivolous then the attorney and injured worker may recovers cost, fees, and penalties.
Functional Capacity Evaluation (FCE)– A functional capacity evaluation is a day long, or half day long evaluation performed by a medical doctor or physical therapist to determine the physical capabilities of the injured worker. If it is unknown what the injured worker can physically tolerate or if there is no clear picture as to what the injured worker can tolerate than a FCE will be necessary. For further explanation and what to expect go here.
General Contractor- If the defense is able to prove that the injured worker was a contractor and not an employee they may succeed in defeating the workers compensation claim. Simply stating that the worker was a contractor will not be enough to determine if the law sees him or her as a contractor. Factors to be considered are the amount of control over the worker the employer has, whether the worker uses their own tools, whether the worker controls his own schedule, works at his own pace, works hours he designates, how the worker is paid (hourly, salary, installments), other workers performing the same duties, other workers relationship with the employer.
Going and Coming rule- Employee who are injured while traveling to and from work are typically not entitled to recover workers compensation benefits however there are numerous exceptions to this rule that can result in compensation for the injured worker if a qualified Maryland workers compensation attorney is involved.
Hearings- The procedures that occur at the Maryland Workers Compensation Commission are referred to as hearings. They are not trials. A common misconception among injured workers is the expectation that the case will be finalized at the first hearing as would be the case in a civil trial. Often, the injured worker will be required to go to numerous hearings before any case is finalized.
Illegal Aliens- Those injured on the job that are considered to be in the country illegal, or those who are not citizens are still considered eligible for workers compensation benefits. However, vocational rehabilitation benefits must be limited to only those legally eligible to work in the United States.
Impleader- The procedural action of bringing in, or involving another party to the Maryland workers compensation case. This often involves bringing in the Subsequent Injury Fund or the Uninsured Employers Fund.
Indemnity- Referring to monies recovered in a the work comp case. The forms of compensation considered indemnity money include permanent partial disability, vocations rehab payments, temporary total disability payments, permanent total disability payments. Temporary partial disability payments.
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Independent Contractor- See General Contractor
Independent Medical Evaluation (IME); Also DME or Dependent Medical Evaluation
The insurance company will schedule you for an appointment with a physician of their choosing for a second opinion. This doctor is hand selected by the insurance company and paid by the insurance company to offer an opinion as to the medical treatment that your treating physician is providing. These evaluations are also referred to as Dependent Medical Evaluation, second opinions, ratings. If an IME has been scheduled there is a good possibility that your treatment or your case is coming to a standstill. This is the time to hire an attorney if you have not already done so.
Industrial Loss- If an injured worker sustains a loss of earning capacity they have suffered an industrial loss which may increase the amount of the compensation awarded by the workers comp commissioner. The term industrial loss is also referred to when an employee injured more than one body part and the impairment is combined by the commissioner.
Insurer- Each employer in Maryland and most of the states in the United states are required to have a workers compensation insurance policy. The Insurer is the one who provides the insurance policy to the employer with the understanding that if a claim for benefits arises the Insurer will be responsible to represent and litigate the workmans’ comp claim. The insurer will “step into the Employers shoes” or Indemnify the employer as to any medical or money payments that are owed to the claimant.
Very often injured employees refer to workers comp. For example- workers comp is not paying for my medical treatment. It is important to know that when used in this instance the injured worker is most likely referring to the Insurer /Workers Compensation Insurer and not the Maryland Workers Compensation Commission. Much confusion arises because of the noun “workers comp.”
Intoxication- Even if intoxicated at the time of the accident an injured employee may still be able to recover certain, if not all, benefits under Maryland workers compensation laws.
Issues- Issues is the operative word for filing for a hearing. Akin to filing a “mini-lawsuit” when issues are filed a hearing will be scheduled with the commission. The hearing could be to determine a number of issues including but not limited to medical treatment, payments, counseling, payment of bills, authorization for medical treatment, or reimbursements.
Issues2 – You may hear your attorney say that he or she is going to file issues. One set of issues will most often not finalize your case completely. In more complicated cases it may become necessary to file issues multiple time a year for the life of a claim.
Job Security– see job security and employment relationship
Jury Trial- If an injured worker feels that the Maryland Workers Compensation Commissioner made the wrong decision they may appeal the decision to the proper Circuit Court and request a jury trial.
Jurisdiction– Like any government body acting as a judicial body such as courts or administrative hearing officers, the Workers Compensation Commission is subject to certain rules of jurisdiction. They are deemed to have sole jurisdiction in the initial decisions of the workers compensation issues. However this jurisdiction becomes limited when a decision is appealed to the next highest court which is the Circuit Court.
Liberal Construction– Often quoted by the injured workers attorney before the commission, “the workers compensation act is to be construed liberally in favor of the employee injured in Maryland.”
Light Duty– At some point the treating physician will indicate that the patient who was injured at work may return to work with some restrictions. This may include limiting the amount of hours they work, or the tasks they are able to perform. In most situations the injured worker is obligated to return to work in the capacity in which the doctor ordered if the employer is able to accommodate the restrictions.
Loss of earning capacity– If an injured worker suffers from a loss of earning capacity they may be entitled to Industrial loss benefits. It will be up to the Maryland workers compensation attorney to prove that the injured worker is no longer able to make the same wages he or she once made.
Lunch Injuries– In many scenarios one who is injured on the job while on lunch break, heading to a break, or returning from a break will be entitled to compensation under Maryland workers compensation laws. An experienced Maryland workmans’ comp attorney can get these benefits for the employee!
Lump Sum- refers to a settlement or permanency money that is issued in one payment rather than installments.
Maximum Medical Improvement (MMI)– at a certain point the injured workers treating physician will state that there is nothing more he can do for the hurt employee. The physician may even use there term maximum medical improvement. This means that the injured worker has received all the possible medical treatment available and the injured worker is essentially as good as he is going to get from the medical treatment available. See below for a rating explanation.
Medical Expenses- A benefit the worker injured in Maryland enjoys under law. Payment for medical treatment, diagnostics, medication, mileage and parking for doctors visits (yes mileage is considered medical). In a few instances obtaining help from a spouse or close loved one qualified as medical treatment and the spouse was able to be compensated.
Medical Set Aside- (MSA) When a workers compensation case is settled anywhere in the county, and the injured worker is covered or expected to soon be covered under medicare an MSA is needed. A MSA is a projection of the cost of future medical treatment. The cost projection is performed by a specialized and independent company for the purposes of estimating the future medical costs. It is submitted to the Center for Medicare Services for approval or denial. Once the MSA is approved the case can be submitted to the workers compensation commission for approval. An MSA will most often be advisable when the injured worker is on medicare in order to settle the case completely.
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!
Mental Treatment- Mental treatment can be covered if the treatment needed is a result of the work injury. This would qualify as a complicated medical question and demands the opinion of a mental health expert.
Modified Award- For multiple reasons a workers compensation award can be modified and reissued. Examples: there was an inadvertent mistake by the Workers Compensation Commission, the award was reversed on appeal, mistaken facts by counsel, or if post hearing agreements were made by the attorneys.
Motion- A motion is a request by any party involved in the particular case. Ordinarily motions are only raised in appealed cases.
Motion for Rehearing- If there is newly discovered evidence or strong legal grounds discovered after a hearing an aggrieved party can request the same issues be heard again.
Nature and Extent- This is the formal language used when issues are filed to obtain a permanent partial disability award. The purpose of the hearing is to determine the nature of a claimants disability and to what extent that disability effects the injured worker.
Notice- 1. A hearing notice will be sent to all parties involved in the workers compensation case. On this notice the location of the hearing will be listed, the time, and date, along with the parties involved. 2. Notice of the injured or occupational disease must be given to the employer. When a person is injured on the job in Maryland they must provide notice orally or written to the employer or employers agent within 10 days of the injury date. For occupational illness cases the employee must provide notice within one year of the date they know or should know they have an occupational disease. Notice requirements can be flexible and the right Maryland workers compensation attorney can recover compensation despite the employees failure to give notice.
Nursing Expenses– An injured worker may be entitled to home nursing care provided by a professional. In some cases the injured workers family or friends may be entitled to compensation if they have dedicated their time to helping and treating the injured.
Order– The formal decision of a judicial body.
Occupational Disease– Illness or disease that developed because of the exposure to a physical, biological, or chemical hazard inherent in the nature of the workers employment.
Penalties– See Frivolous Issues
Permanent Partial Disability(PPD, Permanency) – There will come a time when you have plateaued with treatment and your physician has no other recommendations. If you continue to have restrictions, complaints, or difficulty on a physical level then you will be entitled to compensation. You will be evaluated by a doctor who will help your attorney determine you permanent impairment.
Permanent Total Disability- In the most severe of injury cases an employee hurt at work in Maryland may be awarded Perm Total benefits. This is an award of lifetime compensation benefits and medical treatment. In order to qualify for permanent total disability payments the injured Maryland worker may not be able to work in almost any capacity. If the claimant can only perform services so limited by quantity, dependability or quality that no stable market exist then he or she may be considered permanently and totally disabled under Maryland Workers Comp.
Platelet Rich Plasma Injections- Platelet activation plays a key role in the process of wound and soft tissue healing. The use of platelet rich plasma (PRP), a portion of the patient’s own blood having a platelet concentration above baseline, to promote healing of injured tendons, ligaments, muscles, and joints, can be applied to various musculoskeletal problems. Hospital for Special Surgery
Pre-existing condition– At almost every hearing docket these words can be expected to be uttered from the defense attorney. Synonymous in the legal community with arthritis and degeneration Maryland workers comp attorney on the defense side will argue that the need for treatment, right to compensation, or causal relationship is diminished or removed because of pre-existing conditions.
Presumption– Public safety employees enjoy a presumption under the law that certain medical conditions are related to work. These often include High blood pressure, cancers, and heart diseases. Practically speaking the presumption means their burden to prove the disorder was from work is reduced.
Presumption2 or Presumption of Correctness– Once a party is successful at the commission hearing they receive a windfall in the event an appeal is taken. The Circuit Court is obligated by law to presume that the commissioner was correct. This forces the appealing party to put on evidence to support their case even if they did not have the burden of doing so at the Commission hearing.
Prior Injuries– Hand in hand with Pre-existing conditions. Prior injuries to the same body part that was injured in the work accident may reduce the possibility of success at the hearing.
Quantum Meruit- Latin for what one has earned. In a legal setting a person is entitled to paid for the work they have done. The amount deserved. Often applicable in cases where a Maryland workers Compensation Attorney is discharged by their client and then goes on to hire another comp attorney. The prior attorney is entitled to be paid for the work they have done.
Rate of Benefits- Workers comp benefits are calculated according to the code of regulations the commission has drafted. When calculating temporary total benefits the employee is paid 2/3 of their gross weekly wages tax free. This benefit rate is capped at 100% of the state average weekly wage which ordinarily increases annually. For permanent partial disability payments- second tier rates are paid at 2/3 of the injured Maryland workers average weekly wage. This benefit rate is not to exceed 1/3 of the state average weekly wage. For first tier permanent partial disability benefits the rate is 1/3 of the injured employees’ average weekly wage.
Rating– A rating appointment is set up by your attorney with a carefully selected medical evaluator. The rating will help your attorney determine the value of your case. This will be reflected by a percentage of impairment. You will also be required to attend a rating appointment for the insurance company.
Rehearing- See Motion for Rehearing.
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!
Reopening- Once the injured worker has obtained permanent partial disability benefits they have a vested interest in reopening their case. In order to reopen a claim for further benefits the condition of the employee must have worsened since the time of the initial permanent partial hearing. To reopen for medical benefits the nature and extent of the permanent impairment must so justify. An injured worker has 5 years from the date of the issuance of the last temporary total or permanent partial payment. It is good practice to retain a copy of the last check received by the workers comp insurer.
Return to work- An injured worker is obligated by law to return to work if the treating physician so indicates. Whether it be in a light duty or full duty capacity. If the employer is not able to accomodate light duty restriction then the employee shall be entitled to continuing temporary total disability benefits so long as justified by law.
Room and Board- If an employee is provided room and board as a condition of employment then the average weekly wage calculations should take this into consideration.
Scope of Employment– See general contractor.
Sanctions- See Frivolous proceedings
Settlement- There are various types of settlement available to an injured worker. Settlement should not be confused with obtaining a permanent partial disability award. Settlements types include closing the case out completely, closing only the indemnity portion of a case, closing only the medical portion of a case, closing the indemnity and creating a fund to which the injured Maryland worker can withdraw money out of for the purpose of medical treatment.
Serious Disability- Injuries of a certain level of severity may entitle the employee to “extra” permanent partial disability payments. To qualify for serious disability the impairment award must be in the amount of 250 weeks or greater. If the 250 week threshold is met then the injured worker is entitled to an additional 1/3 weeks at the serious disability rate. For example: In 2016 the serious disability rate is 2/3 of the workers average weekly wage, But not to exceed 75% of the state average weekly wage. If an injured worker making 1,000 a week gets an award of 250 weeks they will be entitled to an additional 82.5 weeks (1/3 of 250) for a total 332.5 weeks at the rate of $660.00. Total compensation payout is 332.5 x $660.00 = $219,450.
Social Security Disability Payments– An injured worker is not entitled to collect workers compensation benefits in addition to social security benefits. Which ever amount is greater the employee will receive. Unfortunately it is not unusual for an injured worker to eventually resort to social security. See Other Disability Payments
State Average Weekly Wage- By January 1st of each year the Department of Labor Licensing and Regulation shall advise the Maryland Workers Compensation Commission as to the State average weekly wage. The state average weekly wage is used to set Maryland’s maximum compensation rates.
Statute of Limitations- Maryland Workers Compensation statute of limitations can be confusing because, unlike an auto accident case, there are many deadlines to be considered. It can be argued that the Notice provision is a mini statute of limitations. 10 days for accidental injuries and 1 year for occupational diseases. An Employee involved in an accidental injury will have 2 years to file their claim with the workers compensation commission. If they do not file, barring an estoppel, the claim will be forever barred. The injured worker will also have a five year statute of limitations which requires them to reopen their case for further indemnity payments or they shall forever lose their right to indemnity.
Stipulations– Agreements by both the defense attorney and Workers Compensation Attorney that are submitted to the Commissioner as not being in dispute. These can be factual or legal stipulations. Often used when there is no true justification for arguing over the fact or law. Stipulations can also come in the form of an agreement as to the permanent impairment the injured worker has. For example if the insurance doctor provides a 10% impairment and the injured workers doctor provides an 11% impairment, parties would likely stipulate to a 10.5% because the .5% simply would not justify the time and expense to litigate.
Subcontractor– See General Contractor
Subpoenas- Issued upon a person to produce themselves or documents. A subpoena can be issued for a person to come to a hearing and testify, to a physician to produce medical records, or to some other facility to produce documents.
Subrogation- If the injured worker is able to obtain compensation and benefits from the workers compensation insurer but also a liable third party then, under Maryland workers compensation laws the workers comp insurer has a right to be paid back from the third party benefits. Workers Compensation insurers will place a lien on any third party benefits received.
Subsequent Injury Fund- Injuries of a certain level of severity may entitle the employee to “extra” benefits. The Subsequent Injury Fund (SIF) is provided by state law and insurers must contribute money to the fund on each permanent partial award issued. The Fund holds these monies for operating costs and potential future indemnity payments. If a Maryland Employees injuries result in an impairment award of 125 weeks or greater they may collect benefits from the SIF. However, the injured worker must also have pre-existing conditions, the combined effect would also amount to 125 weeks. The award issued by the commission must reflect a 125 week impairment due to the workers comp accident and 125 weeks due to the pre-existing condition. If either threshold is not met the SIF will not be required to pay.
Temporary Total Disability(TTD)– Using the Average Weekly Wage you are entitled to two thirds (2/3) of your weekly pay while being held out of work by a doctors note. This is most often not taxed.
Temporary Partial Disability (TPD)– When you miss time from work each day but do not miss an entire day of work you are entitled to this form of compensation. This is calculated by determine fifty percent (50%) of the difference between your daily wages before the accident and your wages now. If you typically make $125 daily but you are now making $75 you would be entitled to $25 of TPD.
Termination of Benefits- A Maryland workers compensation adjuster may terminate indemnity payments or medical treatment by filing a “termination of benefits” form. They may also file and argue that the injured workers impairment has improved and they are therefore not entitled to continuing payments of the previous impairment award.
Time Limitations- See Statute of Limitations. or Further reading on deadlines.
Thomas Doctrine- If a pre-existing condition worsens after the date of the workers compensation accident, the pre-existing condition is not compensable. Neither SIF nor the workers comp insurance company will be required to compensate for worsening pre-existing conditions.
Uninsured Employers Fund- The Uninsured Employers Fund (UEF) is provided by state law and insurers must contribute money to the fund on each permanent partial award issued. The Fund holds these monies for operating costs and potential future liabilities. Employers are required to have workers compensation insurance however occasionally a worker is injured in Maryland and their employer has no workers comp. In the event this occurs, the UEF can be implead into a case and act as the employers insurer. If found liable, the UEF would be required to provide all the benefits that an ordinary workers comp insurer would have to pay.
Vocational Rehabilitation (Voc Rehab)– If you are no longer able to perform your work duties and the employer does not have an accommodation available you will be a candidate for Voc Rehab. A mutually agreeable counselor will be selected by your attorney and the insurance representative to counsel you in finding different employment. While searching for employment the insurance company will be responsible to pay you Temporary Total Disability benefits. In certain circumstances educational courses and certifications may be available.
Volunteer Employment- Because workers compensation indemnity payments are based on the workers average weekly wage logic would lead us to think that a volunteer worker would not be paid in the event they were hurt on the job. Maryland law provides that the volunteer worker is to be paid based on the wages they earn at other employment. For example, volunteer firefighters often have other employment which provides their income. If hurt on the job while acting as a volunteer then they would indeed receive benefits according to their income.
Willful Misconduct- This is a defense raised by the insurance company when they are contesting a case. Common examples include getting injured while fighting, getting injured when intoxicated on the job. Operative language is that the employee intentionally placed himself in a position where he would likely be injured. In the event willful misconduct is raised as a defense against an intoxicated employee, there is a presumption that the injury was not solely and primarily caused by the intoxication and that the employee did not intend to injure himself.
Withdrawal- Both issues and claims can be withdrawn from the commission effectively cancelling any need for a hearing.
Workers’ Compensation Commission (WCC) – This is the administrative agency provided the authority by the state executive branch to oversee and administer the functions of the workers compensation system. Hearing, filings, and state regulations fall within the purview of the WCC’s responsibility. See more about the Commission here.
Work Comp/Workmans’ Comp/Workers Comp/Workers Compensation- In a great majority of cases these are the terms used by the injured employee when talking about the workers compensation insurance company. When discussing “work comp” care must be used to make sure that all parties know exactly who they are talking about. There is a great misconception that “work comp” is the Workers Compensation Commission.
Understanding why workers comp came about is an entirely different discussion not suited for a simple definition.
Work Hardening- Work hardening is an aggressive course of physical therapy that is usually attended to daily for anywhere from two weeks to two months. The purpose of the program is to increase an injured workers physical capabilities hopefully to the point they were prior to the injury but at least to the point that they will be physically suited to meet the requirements of more occupations.
Wrongful Discharge- Under Maryland Workers Compensation laws an employer may not terminate an employee based on filing a claim. The employer is not liable for a wrongful discharge if it is justified by truancy or lateness, or inability to perform the duties required by the job position.