Federal Workers Compensation

Division of Federal Employees’ Compensation (DFEC)

What our Program Does

The Division of Federal Employees’ Compensation adjudicates new claims for benefits and manages ongoing cases; pays medical expenses and compensation benefits to injured workers and survivors; and helps injured employees return to work when they are medically able to do so.

In FY 2012, 115,697 new cases were created. The program provided $3.025 billion in benefits to approximately 242,000 workers and survivors for work-related injuries or illnesses. Of these benefit payments, over $1.956 billion was for wage-loss compensation, $929 million for medical and rehabilitation services, and $140 million for death benefit payments to surviving dependents.

Where Benefits are Paid

Our program administers the FECA through 12 district offices and its National headquarters located in Washington, D.C. The 12 district offices and the areas covered by each district office are reflected in the following map.

Services our Customers can Expect

Prompt Adjudication. If you are an injured worker, you can expect timely adjudication of your compensation claim:

  1. For traumatic injuries, this means a decision within 45 days of receipt in all but the most complex cases.
  2. For simple occupational illness cases, a decision will be issued within 90 days of receipt.
  3. For most occupational illness cases, which require more extensive evidentiary development, a decision should be forthcoming within six months of receipt.
  4. For very complex occupational illness cases, a decision should be rendered within 10 months of receipt.

Prompt Payment of Medical Bills. Medical bills, whether submitted directly by the providers or as reimbursement requests by injured workers, are usually processed within 28 days of receipt. For any bill which is not payable, an Explanation of Benefits describing the reason for non-payment is issued to the party who submitted the bill.

Prompt Payment of Compensation. Injured workers can also expect prompt payment of claims for wage loss in accepted cases. Where medical evidence supports disability for work, compensation payments are usually made within 14 days of submittal to the district office by the employing agency.

Assistance in Returning to Work. The Federal Employees’ Compensation Act gives injured workers the right to reclaim their Federal jobs within one year of the onset of wage loss. We will do everything we can to help employees return to work during that time period, and, if necessary, beyond. Injured workers and employing agencies can expect timely case management services, which include the following:

  1. Assignment of a registered nurse if the injured employee cannot return to work soon after the injury. The nurse ensures that appropriate medical care is provided and assists the worker in returning to employment.
  2. Referral to a medical specialist for a second opinion examination where required by the worker’s medical condition or the program’s need for additional medical information.
  3. Referral for vocational rehabilitation services if the employee is unable to return to work at the employing agency or in his or her previous job category.

How the Program is Funded

Employing agencies are responsible for reimbursing the Division of Federal Employees’ Compensation for their workers’ compensation expenses. This reimbursement occurs once each year through the chargeback process.

The administrative cost of the services provided by the Division of Federal Employees’ Compensation is very low. Overhead is just 4% of benefits, and Federal workers’ compensation costs are only 1.8% of total Federal and Postal payrolls, compared to 2.3% for private insurance and state funds.

Also, because disputes in claims under the Federal Employees’ Compensation Act are resolved administratively, the Federal government avoids time-consuming and expensive litigation, which in some non-Federal workers’ compensation systems can account for as much as 46% of payout.

Maryland Workers Compensation Law

Maryland Workers Comp Quick Facts

The following represent the state of the law as of January 1, 2006. Please note that worker’s compensation law can be complex and these laws and policies are subject to amendment at any time. If you need help with a worker’s compensation issue, please consult a licensed attorney.

Is Worker’s Compensation Compulsory? Yes

Are Waivers Permitted? Yes

Numerical Exceptions: None.

Choice of Physician: Employee makes the initial choice of physician.

Waiting Period For Comp Benefits After Injury: 3 days

Compensation is retroactive if disability continues for what period of time from the date of injury? More than 14 days

Attorney Fees Permitted: Permanent Partial Disability: 20% of the first 75 weeks of compensation 15% of compensation due for weeks 76-195 10% of compensation due for weeks 196+ Cap is 20 times state aww for year of ai/od

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Injured Worker Forums

We offer a very popular injured worker forum, which includes a section specifically for injured Maryland workers. Share your experiences with other injured workers, and get their suggestions for improving your medical, personal and spiritual wellbeing.

Injured Worker Stories

Hundreds of injured workers have shared with us their experiences with the worker’s compensation system. Visit the collection of injured worker stories, including those by injured Maryland workers. Learn from workers who have been through this before you.

Injured Worker Links

We offer an extensive collection of workers compensation links to valuable online resources. Visit our links organized by stateby topic, and links to resources for Maryland injured workers.

Injured Worker Articles

Visit our growing collection of worker’s compensation articles, offering political advocacy and practical suggestions for those trying to find their way through the worker’s compensation system.

 

Ex-paraprofessional accused of workers’ compensation fraud

HENRY COUNTY, Ga. — A former Henry County Schools paraprofessional is accused of defrauding the Georgia State Board of Workers’ Compensation.

Warrants have been issued for 40-year-old Beth Ealey’s arrest. She faces 52 counts of unlawful receipt of workers’ compensation benefits.

Stan Bexley, director of the State Board of Workers’ Compensation Enforcement Division, said Ealey was injured in 2008 while employed by the Henry County School System. She told the district that she planned to resign and move to Florida.

In August 2012, Ealey accepted a teaching job in Putnam County, Fla., but did not tell Henry County that she was no longer disabled. She also did not tell the Putnam County School District that she claimed in Georgia to be totally disabled and was receiving benefits, according to Bexley.

Ealey reportedly received more than $8,000 in workers’ compensation while teaching in Florida. Bexley said the Henry County School System suspended her benefits upon learning she returned to work.

Bexley added that Ealey’s attorney is making arrangements for her to return to Henry County and turn herself in to police.

 

Read More Here

Local governments confront questionable claims

By Luke Broadwater and Scott Calvert, The Baltimore Sun8:50 p.m. EST, March 1, 2014
 Baltimore Workers Compensation

Police officers rushed into the downtown parking garage, weapons drawn.

As Detective Anthony Fata sat bleeding from a leg wound, officers scrambled around corners and up stairwells, frantically searching for a “junkie-looking black male.” The decorated 14-year veteran who’d made the emergency call — Signal 13: Officer Down — told of a violent struggle in which he was shot at close range. He also said that he had fallen down a flight of stairs while unloading his .40-caliber Glock, dislocating a shoulder

But within days of the fruitless search for an assailant, doubts arose about Fata’s version of events. And in the months that followed, it unraveled completely. After he sought workers’ compensation benefits worth about $78,000 for his injuries, prosecutors said he had actually shot himself, and he was convicted of perjury and fraud.

Fata’s conviction last year was an unusually high-profile example of abuse in Maryland’s workers’ compensation system, which made $395 million in awards in 2013. But state officials and other experts say the recurring problem helps drive up costs that Maryland taxpayers ultimately bear.

“Where there’s money, there’s going to be crime. And where there’s government money, it’s even more,” says Frank G. Scafidi, director of public affairs at the National Insurance Crime Bureau, which represents 1,100 insurance companies. “There are people who know how to game the system, and they’re good at it.”

A Baltimore Sun analysis of hundreds of documents obtained through Public Information Act requests, as well as court records, showed a number of claims that were found to be fraudulent.

For instance, in recent years, the state won a $42,000 theft case against a city Housing Authority employee who worked a second job while claiming to be unable to perform his city duties due to “feeling a pain in his elbow.” In another case, a state Developmental Disabilities Administration employee was caught “double-dipping” on a second job. And a city jail employee who claimed he couldn’t work because he’d injured his shoulder lifting equipment was caught moonlighting.

Carmine G. D’Alessandro, assistant vice president of legal services for Chesapeake Employers’ Insurance Co., which handles such claims for the state government and private companies, says claims officers frequently must beat back questionable cases. Usually, he says, claims officers are faced with exaggerations, rather than baldfaced lies.

“The general consensus is that only 5 to 10 percent are the bad apples,” he said. “Ninety percent are pure legit. It’s that 10 percent that muck it up. … When you’re embellishing to get more money, we just try to beat you back. Now, are those little white lies adding up? Of course, those are adding thousands of dollars to the system.”

Chesapeake Employers’ Insurance also scrutinizes doctors. A review of cases spurred an investigation by the state Board of Physicians that resulted in the revocation of an orthopedic surgeon’s license in February.

Local government officials are concerned about rising workers’ compensation costs — for example, claims and other program expenses such as attorney fees cost Baltimore $49 million last year, up from $44 million two years earlier. The system is designed to compensate government and corporate workers injured on the job for lost wages, medical expenses and any lasting disability, such as the partial or total loss of a body part.

Local officials say they vigorously fight claims they believe to be false. But they acknowledge that they have little power over payouts ordered in appeals to the state Workers’ Compensation Commission — or over Maryland law, which sets rates for awards.

“When somebody gets hurt on the job and things are legitimate, we want them taken care of,” said Douglas Kerr, the city’s risk manager. “If you’re going to play a game or try to work the system, our goal is to try to nip that in the bud and keep our costs down.”

Workers’ compensation payments can total tens of thousands of dollars. Under state law, employees who are too injured to work can receive two-thirds of their salaries, tax-free, up to $998 a week.

Read more: http://www.baltimoresun.com/news/maryland/sun-investigates/workers-compensation/bs-md-workers-comp-questionable-claims-20140301,0,453244.story#ixzz2ur4eB5vp

 

 

 

New firefighter benefits stoke workers’ comp debate

Mary McElroy gave 22 years to the Baltimore City Fire Department as a firefighter-paramedic. The job, she says, gave her breast cancer.
The state Workers’ Compensation Commission agreed, issuing an order last fall that requires the city to cover any cancer treatments she may need for the rest of her life. She could also get tens of thousands of dollars from the city for permanent physical damage attributed to the disease.
Now the city is challenging that award in Circuit Court, focusing on a recent change in state law that has made it easier for the 52-year-old McElroy and other Maryland firefighters to receive often-substantial workers’ compensation benefits.

Read more: http://www.baltimoresun.com/news/maryland/sun-investigates/bs-md-workers-comp-presumptions-20140222,0,3182308.story#ixzz2uFSENWEP

Workers Compensation FAQ’s Part 2

Source of Information www.wcc.state.md.us

What should I do if a name is missing or appears incorrectly on the hearing notice?

  • Verify the correct forms were filed: form H-33R to implead a party, form C-24R to enter an appearance for a claimant’s attorney, form C-26R to enter an appearance for an employer/insurer attorney and form C-90R to correct information.
  • Verify the above forms were not filed after the date when the hearing notice was created.
  • If the problem is with an employer/insurer attorney name, verify the employer/insurer attorney’s entry of appearance was re-filed after any employer/insurance company related correction is filed.  If you can verify all of the above, then contact the WCC Claims Division via telephone: (410) 864-5100, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5100 when prompted or via email: info@wcc.state.md.us

When will my withdraw issues, continuance, and/or postponement request be acted upon?

  • If the request was filed 10 or more days prior to the hearing date, then you should receive a decision at least 5 days before the hearing date.  If the request was submitted over ten days ago and you have not received notice of a decision or if the hearing date is within a day or two, then contact the Hearing Division at 410-864-5186 or via email: wcchear@wcc.state.md.us  Online Services subscribers can inquire on filed requests’ via the web site. Learn more about WCC Online Services:WFMS Subscriber Services > How to Begin.

My attorney will not return my calls, but I need to talk to someone about my claim.

  • The Commission cannot provide legal advice, only general information.

How can I contact the Hearing Division?

  • Contact the Hearing Division at (410) 864-5306, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5306 when prompted or via email:wcchear@wcc.state.md.us

 

ADDRESS OR INFORMATION CHANGES

How do I change my/our address or contact information?

  • If you are a claimant or an attorney representing a claimant in a Workers’ Compensation case and wish to change a claimant’s address, please complete a “Claimant’s Request for Change of Address” form H-31R  This change must be submitted for each claim.
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  • If you are an attorney practicing before the Workers’ Compensation Commission who is subscribed to our WFMS Online Services you will change your address by updating your Online Services User Profile.  Do not submit a paper form for your information change; you will need to update any Employer Designee information via the Request for Employer Designee to Receive Notice of Employee Claims form as below.
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  • If you are an attorney practicing before the Workers’ Compensation Commission and wish to change your address, please complete an “Attorney Registration or Information Change” form.  This change affects the mailing address for all of your claims; you will need to update any Employer Designee information via the Request for Employer Designee to Receive Notice of Employee Claims form as below.
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  • If you are the Designee for an Employer please complete a new “Request for Employer Designee to Receive Notice of Employee Claims” form (H-23R) listing all of the employers. This change affects the mailing address for all of your claims for your registered employers only.
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  • If you are a WFMS Online Services subscriber other than Insurer you must also always keep your User Profile information current by updating it during a WFMS session.  Subscribed Insurers use the Insurer Designee update process below.
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  • If you are the Insurer Designee for an insurer or self-insured employer you must update your information by using the Personal Identification Number (PIN) assigned in your Insurer Designee mailing from the Commission.  This information must be current and correct, information is found on the Insurer Designee information page.
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  • If you are an employer wishing to change your address please complete an “Employer or Self Insured Employer Request for Change of Address” form (H-22R). This change affects the mailing address for all of your claims.
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  • If you are an insurer wishing to change your address please complete an “Insurer Request for Change of Address” form (H-13R). This change affects the mailing address for all of your claims.
ASSESSMENTS
How can I contact WCC with a question about annual insurer assessments, the annual Report of Payroll A-02 or a bill from the Commission?

  • Contact WCC Fiscal Services at (410) 864-5257, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5257 when prompted  or via email:Fiscal_A02@wcc.state.md.us.
MAIL SERVICES
How can I contact WCC with a question about mail service?

  • Contact WCC Mail Services at 410-864-5263 , outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5263 when prompted  or via email:wccmailserv@wcc.state.md.us
    Subscribed to Online Services?  Eligible subscribers can receive some correspondence electronically via our eNotice services (more information).

How do I know if something I mailed was received?

  • Please contact our Public Service Section. Our Mail Services Center does not record all individual incoming mail.  Only U.S. Postal Service Certified mail or others requiring a Mail Center staff signature are recorded.
PERSONNEL
How can I contact WCC with a question about career opportunities, internships or employee benefits?

  • Contact WCC Personnel at 410-864-5230, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5230 when prompted or via email:wccpers@wcc.state.md.us
    Current jobs available at the Commission can be found on our web page: Employment Opportunities
WEB SITE
How can I contact WCC with a technical question or problem using this web site?

How can I find more information about subscribing to Online Services?

TRANSCRIPTS Back to menu
How do I obtain a copy of my transcript from my workers’ compensation hearing?

  • Copies of transcripts are available from the Court Reporting Division.  The Division requires all requests be made in writing and mailed to
    Maryland Workers’ Compensation Commission
    Attn: Court Reporting Division
    10 East Baltimore Street
    Baltimore, Maryland, 21202

Who is the WCC court reporter that reported (transcribed) my case?

  • If prior to requesting a transcript in writing you need specific information, such as the name of the court reporter who reported the hearing or the correct date of a hearing, you may contact the Division by phone, e-mail, or FAX.  Contact us via telephone (410) 864-5182, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5182 when prompted  or via email:  wcccourt@wcc.state.md.us.  Our FAX is (410) 864-5181 (no documents for filing in a WCC claim are accepted via FAX transmission).

An appeal has been filed in the Circuit Court.  What do I need to do to have the transcript prepared and forwarded to all parties and the Court?

  • After an appeal has been filed at the Circuit Court, the Court notifies the Commission that an appeal has been received.  Once the Commission receives the notice the reporter is put on notice by the Appeals Division that a transcript needs to be prepared.  To ensure timely preparation of the transcript it is recommended that the appealing party send a letter to the Court Reporting Division notifying the reporter that an appeal has been entered and that a transcript should be forwarded to the Court.

Why hasn’t the transcript been filed with the Circuit Court?

  • There are several reasons why a transcript has not been filed in an appellate case:
    • A reporter may not have received notice of the appeal
    • An extension may have been granted in the appeal giving extra time in which to file a transcript
    • The reporter may have sent an advance letter to appealing party and received no response
    • There may be an error in the claim number and/or a change of venue.
  • If there are any questions relating to why a transcript has not been forwarded to the Circuit Court you may contact the Court Reporting Division or the Appeals Division.

How long will it take to obtain a copy of a transcript?

  • Appeal transcripts are usually completed within 60 days of the first notice to the Commission by the Court that an appeal has been entered.  A party may request an extension of time up to an additional 60 days (120 days total) in which to file the transcript.  A transcript ordered for non-appeals are usually completed within 30 days of the request.  The reporters will strive to complete expedited and rush transcripts when requested.

For what length of time are transcripts available?

  • Currently, transcripts are available for up to 15 years from the date of the hearing.   Please allow extra time when ordering old transcripts.
SELF-INSURANCE (Insurance Compliance & Reporting) Back to menu
How can I contact WCC with a question about self-insurance requirements or insurer compliance reports?

  • Contact the Insurance Compliance & Reporting Division via telephone, (410) 864-5298, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5298 when prompted or via email: wccinsur@wcc.state.md.us.

How do I obtain a Certificate of Compliance for my business licensing requirements?

  • Contact the Certificate of Compliance Coordinator via telephone, (410) 864-5297, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5297 when prompted or via email: COC@wcc.state.md.us.
APPEALS (In the Circuit Court) Back to menu
How does a pro se claimant (claimant not represented by an attorney) get information on how to file a Circuit Court appeal of a Workers’ Compensation Commission decision?

  • Parties have thirty days from the date of mailing the order to file an appeal.  If unclear of the timeline of the Commission order, parties should contact the Appeal Division.  Parties should contact the Circuit Court in the jurisdiction where the appeal should be filed to request specific information on the procedures of filing the appeal.

How can I contact the WCC Appeals Division?

  • Contact the Appeals Division via telephone (410) 864-5320, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5320 when prompted or  via email: wccsupportserv@wcc.state.md.us
VOCATIONAL REHABILITATION Back to menu
Who may receive vocational rehabilitation services?

  • An injured worker may be qualified for vocational rehabilitation if the individual’s injury is severe enough to keep the individual from returning to his or her former occupation at the time of the injury.  The Commission publishes an informational brochure for interested parties seeking additional information regarding vocational rehabilitation benefits, the text and brochure are available as Questions and Answers About Vocational Rehabilitation on our web.

What happens if the injured worker disagrees with the vocational rehabilitation counselor’s decision regarding his or her vocational rehabilitation plan?

  • If a party disagrees on any aspect of the vocational rehabilitation plan, it is suggested that the disagreeing party should contact the opposing party and provide reasons for their disagreement; we encourage the parties to resolve these issues on their own.  If the issue/issues can not be resolved, parties should file vocational rehabilitation issues using form H24R. See our FORMS page at http://www.wcc.state.md.us/Adjud_Claims/Forms.html

Do vocational rehabilitation providers have guidelines, rules and regulations that they must follow when providing vocational rehabilitation services?

  • Yes, registered or certified Workers’ Compensation vocational rehabilitation providers must adhere to Maryland Workers’ Compensation Law LE§9-671 through 9-765 when providing vocational rehabilitation services.  COMAR 14.09.01.20 provide rules and regulations related to vocational rehabilitation contact with injured workers, the vocational rehabilitation hierarchy of services to follow  when providing vocational rehabilitation services, reporting requirements for vocational rehabilitation providers and ethical guidelines for vocational rehabilitation counselors and evaluators.  All rehabilitation providers must be either registered or certified through the Workers Compensation Commission Vocational Rehabilitation Unit.  See our Vocational Rehabilitation Certification and Registration information page.

Does the injured worker get to choose his/her own vocational rehabilitation provider?

  • Generally, the employer/ insurer selects the initial vocational rehabilitation provider; however, if there is a disagreement with the choice of the provider and parties can not agree, the injured worker (or claimant’s attorney) can file issues regarding the choice of a provider.  Please see the Issues Form H24R on our Forms and Instructions page.

How can I contact the WCC Vocational Rehabilitation Division?

  • Contact the Vocational Rehabilitation Division via telephone (410) 864-5320, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5320 when prompted or via email: wccsupportserv@wcc.state.md.us
MEDICAL Back to menu
What happens when an injured worker cannot find a medical provider in their area to provide medical treatment?

  • In Maryland, medical providers can be selected by the (injured worker) claimant; however, if they cannot find a medical provider in their area who is willing to provide medical treatment (who is willing to accept the rules of the Medical Fee Guide), it is often suggested that parties should consider contacting the employer/insurer for suggestions for medical providers in their area (the insurer is most likely to have data listing participating medical providers in the various regions of the State, based on their payment records).

Are there timelines in which an employer/insurer has to pay or provide justification for denying a medical claim?

  • Maryland Workers’ Compensation Medical Fee Guide (MFG) regulations define the submission of bills from the medical provider to the employer/insurer, the forms required, timeliness for payment of medical claims and penalties for untimely reimbursement. This is specified in the Medical Fee Guide regulations text posted to our Medical Fee Guide information page.

How does a provider find the values for treatment/procedures performed to bill the employer/insurer?

  • This information and resources are posted to the Medical Fee Guide information page.

Do medical providers need to register or be certified by the WCC to treat the injured worker in Maryland?

  • No, medical providers are not required to be registered or certified by the WCC.

Where is the MD WCC pharmacy/Rx, dental and prosthetics/DME fee schedule?  How do I price for these items under your regulations?

  • The MD WCC MFG has never priced durable medical equipment (DME), prescriptions/pharmaceuticals (Rx) or dental procedures; however, medical providers should bill what is usual and customary: “An insurance carrier may base the assigned value on nationally recognized and published relative value studies, or on the values assigned for services involving similar work and resources.”  Providers are supposed to have one price for all patients regardless of what they get paid by different payers. If there is a disagreement in the payment, the bill should be submitted to the Commission for review via the Claim for Medical Services, form C-51.

Does your fee schedule (MFG) require NCCI edits for billing?  What about other CMS policies not listed in your MFG regulations?

  • The MFG does not require NCCI edits for billing and generally does not require many CMS policies that are not referenced in our MFG regulations.

How can I contact the WCC Medical Division?

  • Contact the Medical Division via telephone (410) 864-5320, outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5320 when prompted or  via email: wccsupportserv@wcc.state.md.us

Workers Compensation FAQ’s Part 1

 

Source of Information www.wcc.state.md.us

CLAIMS
Please note that the U.S. Department of Labor Office of Workers’ Compensation Programs OWCP administers four major programs including: the Energy Employees Occupational Illness Compensation Program, the Federal Employees’ Compensation Program, the Longshore and Harbor Workers’ Compensation Program and the Black Lung Benefits Program.  The OWCP provides wage replacement benefits, medical treatment, vocational rehabilitation and other benefits to federal workers or their dependents who are injured at work or acquire an occupational disease,  Go to their web site for information if your are covered under these programs. CLICK HERE http://www.dol.gov/owcpHow long will it take for my claim form to be processed?

  • When the claim form is fully completed with no information missing, it takes us approximately 2 to 3 business days from the date we receive the form to process the claim. An incomplete form may be returned for missing information such as: claimant signatures, employer information or other required information.

I received my document back for missing information. Can I call and give you the missing information?

  • No, we can not alter any document by inserting information for you.  Please complete the form as indicated in the form’s instructions or accompanying notice sent with the returned form and mail the form back to the Commission.  Any questions regarding any WCC form’s requirements can be answered by an MD WCC Public Service representative via telephone during normal business hours (Monday through Friday, 8:00 a.m. – 4:30 p.m. excluding State holidays) (410) 864-5100, outside Baltimore Metro area toll free: 1 (800) 492- 0479, Maryland Relay for the hearing impaired Dial 711 in Maryland or (800) 735-2258 .

What is the status of my claim?

  • You may obtain claim status information in various ways:
    • You can check your claim status online via our Public Claim Data Inquiry.
    • By telephone, you can access claim information from our automated Voice Response System at any time or speak to a Public Service representative during normal business hours.  Our telephone numbers are: (410) 864-5100.
      Outside Baltimore Metro area toll free: 1 (800) 492- 0479, Maryland Relay for the hearing impaired Dial 711 in Maryland or (800) 735-2258

When will my order go out and when will I receive my check?

  • The issuance of an Order depends upon the Commissioner handling the claim. They may have several requests ahead of yours.  When the Order is issued, it enters our digital document management process and is mailed the same day to parties in the claim, including the employer and their insurer.  All parties must comply with the Order. If wage replacement or other benefits are to be paid, the employer or their insurer will pay the benefits. The benefit checks are not issued by the Commission.

I sent in my Settlement (Stipulation, Lump Sum Request, etc.), but it’s not been processed. Where is it?

  • These documents must be reviewed before they are scanned and enter our document management process. Check again in a week; if your document has not been processed, contact the WCC Public Service Division via telephone: (410) 864-5100, outside Baltimore Metro area toll free (800) 492-0479, Maryland Relay for the hearing impaired Dial 711 in Maryland or (800) 735-2258 or via email: info@wcc.state.md.us. We will be happy to research the document’s status for you.

My claim’s settlement has been signed, when will I receive a payment?

  • The Commission does not make payments, although Commission orders may direct the claimant’s Employer and/or Insurer to make payments. The employer or its insurer shall begin paying compensation to the covered employee within 15 days after the later of the date: an award is made or payment of an award is due.
    If you have a question about payment status and you are represented by counsel, contact your attorney. If you have a question about payment status and you are not represented by counsel, contact the Insurance Adjuster handling your claim.  If you do not have their contact information, please see the Insurer Designee list posted on our web.
HEARINGS Back to menu
What information is included on a hearing notice?

  •  All parties in the Workers’ Compensation Commission’s claim data (see below).
  •  Date, time and location of the hearing.
  •  When a case is set on a special issue, such as a rehearing or lump sum settlement, it will be noted above the hearing date on the left side of the hearing notice.

How can I tell the roles of all of the parties listed on the hearing notice?

  • The order in which the parties are listed on the hearing notice document is significant. Begin by reading from left to right, line by line as shown in the following example:

 

 

 

 

 

 

 

Maryland’s Workers Compensation law

Extremely useful workers compensation resource, directly form the State of Maryland

 

Since the early 1900’s, every State has had some form of protection for employees who are hurt while working.  The old system requiring lawsuits against employers just wasn’t effective. Negligence by the employer was often difficult if not impossible to prove and the legal process was very time consuming and expensive, with no benefits paid to injured workers during the process. This is why the States passed workers’ compensation laws, providing a statutory solution to the problem.  Workers’ compensation was a new kind of insurance which all employers were required to obtain to protect their employees.

Covered Injuries

Not all injuries are covered by the Workers’ Compensation Law even if the injury happened “on the job.” In Maryland, in order for an injury to be covered,  the harm suffered by the employee must have been caused by an “accidental personal injury arising out of and in the course of employment.” Those words from the Maryland statute are VERY important. Just because a person is hurt “while working,” “on the job” or “at work” may not be enough for the insurance to apply. Additionally, if you can prove that you have an occupational disease you may be entitled to Workers’ Compensation benefits.

Employees Only  

In determining whether an injury falls under the coverage of workers’ compensation the first thing to understand is that this law protects only employees. The Workers’ Compensation statute provides legal guidance on who is a covered employee and employer. A genuine employer-employee relationship must exist. Some businesses are set up in such a way that some persons don’t actually work for the business but work with it as independent contractors. Other businesses don’t have any employees because they are a sole-proprietorship or partnership.  Persons in these categories, if they want workers’ compensation insurance, may elect to be covered and can obtain the necessary insurance. There is a statutory procedure for electing coverage.

Accidental Personal Injury & Occupational Diseases

If there is an employer-employee relationship between the worker and their company, the next factor considered is if the injury was an accident. An accident is when a sudden unusual or extraordinary event causes an unexpected result. The unexpected result is a bodily injury; that must be caused by an unexpected or unusual event. Injuries that do not fit into this category may very well be covered by general health insurance but may not be compensable under the Maryland Workers’ Compensation Act.
Exceptions to the accident requirement are occupational diseases. These are illnesses caused by the nature of the circumstances surrounding the worker’s job. For example, asbestosis is a disease that may have been caused by a worker’s job of removing asbestos from buildings. Some forms of skin, eye or lung disease may have been caused by long term exposure to chemical solvents or other solutions used on the job. Conditions such as these may result in the employee’s being covered by workers’ compensation even though there was no specific “accident;” they are covered as occupational diseases.

Arising Out of Employment  

For a compensable accidental injury claim, the injury must “arise out of the employment”. If the conditions under which the work is required to be performed by the employer causes the worker’s injury, it is said to “arise out of” the employment. The focus of this factor is on the exposure of the employee to risk or danger because of the job requirements. For example, if a person must work in an environment that is usually wet and slippery–for instance, a car wash facility or a water amusement ride at an entertainment park–then a slip-and-fall injury experienced by that worker could be said to arise out of the person’s employment.

Arising in the Course of Employment 

For a compensable accidental injury claim, the injury must also “be in the course of employment.” “In the course of employment” is a slightly different factor. Here the attention centers on the time, place and circumstances of the injury. If the injury occurs during the period of time when an employee was at work, the employer’s place of business or such other location as may have been designated by the employer, and while the employee was performing their job duties or something related to them when the injury took place, the injury is said to have arisen in the course of that person’s employment.

If all of the above factors are satisfied -and that’s not always easy to determine initially- a worker’s injury will generally be covered by workers’ compensation insurance. Frequently, an investigation of the claim is necessary. If a worker believes they have sustained a compensable injury, an Employee Claim may be filed with the Workers’ Compensation Commission to receive a determination regarding the type and amount of any benefits to which the worker may be entitled. Initial determinations that may have been made by insurance carriers are not binding on the Commission.

The legislature of each State determines the type and amount of benefits which are payable under workers’ compensation insurance, just as the various States differ in determining what kinds of injuries are compensable and which are not. Based upon the laws enacted in each State the insurance companies who provide this type of insurance coverage consider the probabilities of injury for different occupational categories and set their premium rates accordingly. This is the amount charged to employers for their workers’ compensation insurance. The Workers’ Compensation Commission does not establish rates of premiums, nor does the Commission itself provide insurance coverage. Workers’ compensation payments are not taxable to the employee as income.

The Maryland Workers’ Compensation Act provides for the following benefits in appropriate cases:

Temporary Total Disability Benefits: 

This is the period of time frequently referred to as the “healing period”. If an employee’s injury has resulted in a disability that prevents the person from returning to work at all -that is, the person is completely disabled for all work purposes- then the employee may receive temporary total disability payments. If the period of disability is fourteen (14) days or less then the compensation benefit payments may not be allowed for the first three (3) days of disablement except for payments for hospital, nursing or other medical services, funeral expenses or medicine. If the period of temporary disability lasts for more than fourteen (14) days, then the compensation is allowed from the date of disability.

Temporary Partial Disability Benefits: 

These are benefits to which an injured employee may be entitled during the process of recovery when the worker during a temporary period is NOT totally disabled. They are intended to be temporary and generally apply when the worker can only perform limited or part-time duties at a reduced income level. That is, when their wage earning capacity is lower. The employer or its insurer pays the covered employee compensation that equals 50% of the difference between the average weekly wage of the covered employee and the wage earning capacity of the covered employee in the same or other employment while temporarily partially disabled, subject to a maximum payment of 50% of the State average weekly wage.

Generally, if a covered employee is temporarily totally disabled due to an accidental injury or an occupational disease the employer or its insurer shall pay to the covered employee compensation that equals two-thirds of the average weekly wage on the covered employee, up to a maximum of the average Maryland weekly wage. The “average Maryland weekly wage” is calculated every year by the Department of Labor, Licensing and Regulation (DLLR) and provided to the Commission for use in its calculations. In no case are the benefits to covered employees less than $50.00 (fifty dollars) per week, regardless of the individual’s average weekly wage.

Temporary total disability benefits are intended to replace the income being lost, at least in part, during the interval when the injured employee can’t work at all. The benefit is terminated when, during the process of treatment and recovery, the point is reached where the worker is no longer totally disabled -that is, they can return to work in some capacity- or if a medical determination is made that the injured worker has reached maximum medical improvement, even if the person has not fully recovered to their pre-injury condition.

Permanent Total Disability Benefits  

Some injuries are so serious that a worker is permanently, totally disabled. Absent conclusive proof to the contrary, in Maryland the loss or loss of use of any of the following constitutes a permanent total disability: both arms, both eyes, both feet, both hands, both legs; or a combination of any two of the following: an arm, eye, foot, hand or leg.

Permanent Partial Disability Benefits

Injuries that are not so serious as to leave a worker permanently, totally disabled may nonetheless result in some permanent impairment. This is called permanent partial disability.

Generally, a covered employee who is entitled to compensation under the Workers’ Compensation Act shall receive a minimum weekly compensation of $50.00 for permanent partial disability unless that employee’s average weekly wage was less than $50.00. If the worker’s average weekly wage was less than $50.00, they will receive compensation that equals their average weekly wage at the time of the accidental injury or the last injurious exposure to the hazards of their occupational disease.

Benefit payments for permanent partial disability continue for a period of weeks established by the statute; a period that varies according to the body part injured and the severity of the injury. For example, the total loss of a thumb or the use of the thumb results in payments for 100 weeks. The total loss or loss of use of the 4th finger (also called the little finger) results in payments for 25 weeks. When the period allowed by a Workers’ Compensation Commission finding and prescribed by the law has run, the compensation payments cease.

If a covered employee has an accidental injury or an occupational disease that results is a permanent total disability, the employer or its insurer shall pay to the covered employee compensation that equals to two-thirds of the average weekly wage of the covered employee, subject to a maximum payment equal to the State average weekly wage. No payment for permanent disability shall be less than $25.00.

Benefits paid for permanent total disability are subject to an annual cost of living adjustment not to exceed 5% as determined by the Department of Labor, Licensing and Regulation. These benefits are reduced in the case of workers who are also entitled to Federal Social Security Disability Benefits to the extent necessary to avoid a diminution of the Federal benefits. 

Medical/Hospitalization Benefits

In addition to the various types of disability benefits to which an injured worker may be entitled, if a covered employee has suffered an accidental injury, compensable hernia or occupational disease, the employer or its insurer promptly shall provide to the covered employee, as the Commission may require-
Medical, surgical or other attendance or treatment:
Hospital and Nursing Services
Medicine
Crutches and other apparatus
Artificial arms, feet, hands, legs and other prosthetic appliances

The entitlement to these services may continue indefinitely or for whatever period is required by the nature of the accidental injury, compensable hernia or occupational disease if there is evidence to establish that the need for these services is reasonable, necessary and causally related to the accidental injury or occupational disease.

Wage Reimbursement Benefits

In addition to any other compensation paid to a covered employee entitled to compensation under the Workers’ Compensation Act, the employer or its insurer is required to reimburse the covered employee for lost wages due to time spent being examined by a physician or other examiner at the request of the employer or its insurer and time spent attending and traveling to and from a Commission hearing scheduled as a result of a continuance caused by action of the employer or its insurer, if the claimant is otherwise entitled to compensation benefits.

Vocational Rehabilitation Benefits

When a covered employee is disabled from performing work for which they were previously qualified as the result of an accidental injury or an occupational disease, the covered employee is entitled to vocational rehabilitation services.  Training may last up to 24 (twenty four) months and other services may include:

Coordination of medical services, vocational assessment, vocational evaluation, vocational counseling, vocational rehabilitation plan development, vocational rehabilitation plan monitoring, vocational rehabilitation training, job development, job placement.

Individuals having questions relating to vocational rehabilitation may call the Commission’s Vocational Rehabilitation Office at (410) 864-5320.

Death and Funeral Benefits Page  (Updated October 2011)
Payment of Benefits

The Workers’ Compensation Commission does not itself make benefit payments to injured workers. The Commission’s role is to process and adjudicate claims. Once appropriate determinations have been made in specific cases, it is the responsibility of the insurance carriers and self-insured employers to make timely benefit payments to injured workers as required by the Commission’s awards and orders.

Filing a Claim
Any worker who believes that they have suffered an injury covered under the Workers’ Compensation Act may file an Employee’s Claim with the Workers’ Compensation Commission.  Certain time limits on filing apply.

The WCC Employee Claim Form can be accessed and completed online; you must print, sign and mail the submitted form to the WCC.
Click Here for more information.


Printed Employee Claim forms may be obtained from your employer or by contacting us:  
Maryland Workers’ Compensation Commission
10 East Baltimore Street
Baltimore, Maryland  21202-1641

 

(410) 864-5100
Outside Baltimore Metro Area Toll Free 1 (800) 492-0479

Maryland Relay for the hearing impaired Dial 711 in Maryland or 1-800-735-225

for Legal guidance and advice from a competent lawyer. The Maryland Workers’ Compensation Act may be found in the Labor and Employment  Article, Title 9, Annotated Code of Maryland.

What to do after a car accident, State Farm

This is a great resources provide by State Farm 

RESOURCES

What to Do After an Auto Accident

Auto accidents are unexpected and stressful. Even the most careful drivers may be involved. If you are in an accident, State Farm® is committed to helping restore your peace of mind as soon as possible. If you have recently been involved in an accident, begin reporting a claim.

Be Prepared

 

  • Carry a set of cones, warning triangles, or emergency flares in your trunk to help alert traffic.
  • It also helps to have a pen and a card with any relevant medical information for you and your family.

 

Immediately After an Accident

 

  • Take a deep breath and stay calm.
  • Check for injuries; call an ambulance when in doubt.
  • If accident is minor, move cars to a safe place, out of traffic.
  • Turn on your vehicle’s hazard lights and use cones, warning triangles or flares for safety.
  • Call the police, even if the accident is minor.
  • Notify your insurance agent immediately.

 

Other Important Tips

 

  • Do not sign any document unless it’s for the police or your insurance agent.
  • Make immediate notes about the accident, including specific damages to all vehicles involved, witness information, etc.
  • If the name on an auto registration is different than the driver, jot down the relationship.
  • Be polite, but don’t tell anyone the accident was your fault, even if you think it was.
  • State only the facts, and limit your discussion of the accident to the police and your insurance agent.
  • If possible, don’t leave the accident scene before the police and other drivers do.

Car Accidents In Baltimore, Maryland

 

Here is a brief list of things you must do following an accident to ensure a smooth handling of your case:

 

1: Immediately seek medical attention if you are injured. If you do not have a Doctor of your own, I can help arrange an appointment for you.

2: Make sure the police are at the scene in order to document the accident; ask them to file a police report.

3: Exchange ALL information with the other driver. In particular, ask to copy the information on their driver’s license and copy their insurance information.

4: Take down the names and numbers of any witnesses to the accident. Often, an independent witness will the the “key” to the case.

5: Take photos of the scene of the accident and of all the cars involved.

NEVER:

I repeat, NEVER provide a statement, written or oral, to an Insurance Company without first consulting a qualified Maryland Attorney.

 

Need a Personal Injury Lawyer in Baltimore, Maryland?

Call or TEXT Now: 410-279-2348