Workers Compensation Claims And Denials

Injured employees in Maryland rely on workers’ compensation to help them manage the physical, emotional, and financial consequences of a workplace injury. Unfortunately, not every injured worker receives the benefits they need. Workers’ compensation claims and denials are a common source of stress for employees who expected timely medical treatment and financial support, only to find their claims questioned or denied altogether. The result is often delayed care, mounting bills, and uncertainty about how to move forward. If you were injured while working and have questions about your rights, it is smart to talk to a workers’ compensation attorney as soon as possible. At Foran & Foran, P.A., our experienced Prince George’s County workers’ compensation attorneys understand how frustrating and overwhelming workers’ compensation claims and denials can be, and if you hire us, we can guide you through the process and advocate for the benefits you deserve.

The process for filing a workers’ compensation claim in Maryland begins when an employee suffers an injury or occupational illness arising out of and in the course of their employment. The injured worker must notify their employer as soon as possible, ideally within 10 days of the incident. The employee must also file a formal claim with the Maryland Workers’ Compensation Commission, typically within 60 days, although extensions may apply in certain circumstances. Once the claim is filed, the insurer will review the evidence and determine whether to accept or contest the claim.

Workers who successfully file a claim may be entitled to several categories of benefits. Medical benefits cover all necessary and reasonable treatment related to the injury, including surgeries, hospital visits, medications, rehabilitation, and assistive devices. Temporary total disability benefits are available for workers who are completely unable to work during their recovery, while temporary partial disability benefits are available when a worker can return to work at a reduced earning capacity. If a worker sustains a permanent injury, they may receive permanent partial or permanent total disability benefits, depending on the severity and impact of the condition. In some cases, vocational rehabilitation services are also provided to assist the worker in returning to the workforce.

Despite the protections offered under Maryland law, workers’ compensation claims are sometimes denied, leaving injured workers without the benefits they need during a critical time. Denials can occur for various reasons. A common basis for denial is a dispute over whether the injury actually occurred at work or in the course of employment. For example, if the injury happened while the worker was commuting or engaging in conduct deemed outside of their job duties, the claim may be contested. Another frequent cause of denial involves questions about the severity or legitimacy of the injury, particularly when there is insufficient medical documentation or conflicting opinions from providers.

Procedural issues can also lead to denials. If a worker fails to notify their employer promptly or misses the deadline to file a claim with the Commission, the claim may be rejected on technical grounds. In some cases, the insurance company may delay a decision, requesting additional medical evaluations or surveillance to challenge the worker’s credibility. Whatever the reason, a denial does not mean the end of the road for injured workers. Maryland law allows claimants to request a hearing before the Workers’ Compensation Commission to contest the denial. At this hearing, both parties may present evidence, including medical records and witness testimony, and the Commissioner will issue a decision. If the Commissioner’s ruling is unfavorable, the worker may request a rehearing or seek judicial review in the Maryland Circuit Court system.

It is highly advisable to have legal representation throughout the process of dealing with workers’ compensation claims and denials process. The rules governing evidence, deadlines, and procedural requirements are complex, and insurance companies typically have experienced attorneys defending their interests. An experienced workers’ compensation attorney can gather necessary medical documentation, challenge the basis of the denial, and advocate on the worker’s behalf to increase the chances of a successful outcome.

Dealing with workers’ compensation claims and denials can be frustrating and overwhelming, especially when you are trying to recover from a serious injury or illness. Whether you are filing a claim for the first time or appealing a denial, having knowledgeable legal counsel can make a critical difference. At Foran & Foran, P.A., our trusted Prince George’s County workers’ compensation attorneys take pride in helping injured workers secure the benefits they need to move forward, and if you hire us, we will advocate aggressively on your behalf. Our office is located in Greenbelt, Maryland, and we serve clients in Prince George’s County, Montgomery County, Charles County, and throughout the state. To schedule a free and confidential consultation, please contact us online or call (301) 441-2022.