Commonly Used Defenses to Maryland Workers’ Compensation Claims

When workers’ compensation insurance works the right way, it provides medical coverage and lost wages to an employee who is injured on the job. However, there are often many obstacles that arise in the course of an employee being injured on the job and successfully receiving the care and expenses they are entitled to. One of these obstacles can be employer interference or a toxic company culture, which can make it feel unsafe or impossible to file a claim without losing your job or the respect of your co-workers. Even once a claim has been made though, there’s still another obstacle: getting the insurance company to actually pay it. Workers’ compensation insurance companies often deny claims the first time they are submitted without even thoroughly reviewing them, in hopes that the employee will give up and drop the claim, letting them off the hook for paying it. Getting an experienced Maryland worker’s compensation lawyer, is one way to make sure they take your claim seriously.

Workers’ Compensation Claim Investigation

When you file a workers’ compensation claim, the insurance company conducts an investigation to determine whether it meets the criteria to be covered (and if there’s any way to avoid covering it).

Requirements for Workers’ Compensation Coverage

In order to be covered, the injury must have occurred in the course of your employment and the injury must arise out of your employment. It’s not enough to be at work when you were injured, you must also have been completing a task necessary for work. (There are many circumstances however, where an injury away from the workplace still qualifies for workers’ compensation benefits). For instance, if you pulled a muscle while rough-housing with co-workers at a manufacturing plant, that may not be covered, because it’s not your job to rough-house. However, if in the same situation, you pulled a muscle while unloading boxes, that injury would be covered because you were injured while completing a task necessary for work. (Even if you pull a muscle while rough housing, you may have a covered claim -regardless of how or where your injury takes place, if there is a connection to your employment, you should consult with a workers’ compensation attorney to determine if you are eligible for workers’ compensation benefits.

Additionally, the injured party must be an employee in order to be entitled to workers’ compensation benefits. If the individual is an independent contractor, they will not qualify for these benefits. However, it’s important to note that many businesses routinely misclassify employees as independent contractors in an effort to avoid having to provide them with benefits and overtime pay. This practice is illegal, and if you suspect that you have been misclassified in an attempt to avoid providing you with coverage or benefits for an injury, it’s important to speak to an experienced Maryland Workers’ Compensation Attorney today.

Common Defenses

• Failure to notify employer. Maryland state law requires that in most circumstances, an employee must notify their employer of a work-related injury within 10 days.
• The injury was self-inflicted as part of an attempt to file a fraudulent claim.
• The injury was not related to employment.
• Intentional carelessness and/or rough-housing.
• Cause of injury cannot be determined.

Schedule a Consultation

A Maryland workers’ compensation lawyer can help you prepare for and overcome any defenses the insurance company will throw your way, and help you get the compensation you’re entitled to. The attorneys at Berman | Sobin | Gross LLP, are ready to fight for you. Schedule a free consultation today.