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How Will My Claim Proceed?

A workers' compensation claim is initiated by filing a claim with the Maryland Workers' Compensation Commission.   About a week after the claim is filed, you will receive a claim form back in the mail. If the insurance company wants to fight your case they will do so by filing issues and you will receive a Notice of Issues Filed. A hearing will take approximately four months to be held. You will receive notice of the hearing three to eight weeks before the hearing.

If you do not receive a Notice of Issues Filed, you will receive an Award of Compensation or a Compensation Deferred and Average Weekly Wage Award in the mail about one week after the consideration date listed on the claim form. Both forms mean that your claim has been accepted as covered under the law

If you are in need of medical care other than an initial emergency room visit, the medical provider will want an authorization from the adjuster representing the employer/ insurer. Usually, medical reports are required from the medical providers unless the treatment requested is immediately after the injury was incurred. Furthermore, requests for expensive tests and/or surgery are usually met with a request for reports and possibly a medical exam.

It is your responsibility to keep track of mileage for reimbursement and prescription and parking receipts for reimbursements. We ask that you mail them to us once very three months or so. We will need the original receipts. As for mileage, we ask you to keep a three column list which lists the day you went, where you went, and the roundtrip mileage. The amount you will be reimbursed will depend on the year you incurred the cost.

If you are unable to work because of your injury, it is important that your physician support you. Always leave their offices with a slip indicating your present work status if you are unable to return to work. Send that slip to us immediately. If your employer offers you light or restricted duty, you must inform us at once. Depending on the offer and your physician's restrictions, you may or may not be required to attempt to return to work.

When you are finished with treatment, you should notify us immediately (as you should if your condition worsens).   If you are feeling no further medical problems we will discuss with you whether or not a settlement should be attempted or the file closed.   If:

  • You are still experiencing any medical problems;
  • You have reached maximum medical improvement;
  • You have returned to work; and
  • It has been more than six months from the injury

we will request a hearing and/or have you evaluated for permanent disability.   If you have not yet returned to work we may begin the vocational rehabilitation process.

There are many occasions during the course of a claim where there are delays caused by the adjuster for the employer/insurer.   The delays may come because they have not yet received medical reports, inefficiency or lack of caring by them, or because of a dispute as to what they should pay or approve.   Many times we can solve these problems through contact and providing them with documents they request.   Unfortunately, there are times when a hearing is required.   If this is the case, hearings, as mentioned earlier, often take up to four months to be held and another three weeks for a decision to be received.   This is often a difficult and frustrating time for injured employees.  

If any party is not happy with a Commissioner's decision they can appeal it. Appeals take over a year to resolve. Any benefits that are ordered, other than bills for medical treatment received prior to the hearing, must be paid by the employer/insurer. Appeals generally require the testimony of doctors. Usually the appeal is tried in front of a jury. While the case is on appeal, the right to go back to the Workers' Compensation Commission to claim additional benefits is limited.

A case can take well over a year to resolve, if it involves permanent disability, even if it is relatively minor. Serious injuries can take many years to resolve, depending on the amount and nature of the treatment, the injured workers' employability, and how obstructive the employer/insurer are. Although a Workers' Compensation claim can be frustrating to pursue for the injured worker, it quite often is the difference between financial disaster and survival.