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Navigating the Worker’s Comp Process

Posted on 07/17/23 by admin in Workers' Compensation

Worker’s Compensation is a vital part of the benefits endowed to the American worker. It’s also a vital part of our practice here at Malloy Law. We pride ourselves on advocacy for injured workers, as our team helps honest hardworking people make ends meet while recuperating from on-the-job injuries. But oftentimes we receive questions from our worker’s compensation clients, unclear on the minutiae of the process and how exactly they’ll receive their benefits. We’d like to dispel some of this confusion today with a roundup of the worker’s comp process and what exactly our clients can expect.

worker's comp process

Understanding Worker’s Compensation

Worker’s compensation, also known as worker’s comp or workman’s compensation, is a program of insurance coverage which provides benefits to employees who suffer from a work-related injury or illness. When such an injury or illness occurs, the worker’s comp insurance policy held by their employer pays the injured employee for their lost wages and medical bills. While most states mandate employers obtain and maintain worker’ comp insurance and accompanying procedures, the state guidelines for what exactly these policies must contain can vary wildly. Employees should consult their state’s Department of Labor or equivalent agency to learn the specifics of their state worker’s comp laws.

Navigating the Worker’s Comp Process

So let’s navigate the worker’s comp process “tip to tail” so to speak. Worker’s comp places a responsibility on the employee to report any injury in a timely manner to be eligible for benefits. Remember, this insurance policy is meant to cover injuries or sicknesses originating in the workplace. The quicker an injured worker reports their ailment, the harder it is for the employer or insurance company to dispute that the injury indeed occurred in the workplace. Prompt reporting of any eligible condition is the first step to any successful worker’s comp claim.

A Note on Eligibility

But what exactly is an eligible condition? Well, there are the obvious ones. Broken bones or severe burns or lacerations are classic workplace injuries, especially in construction or industrial concerns. But worker’s comp will also generally cover:

  • Carpal tunnel
  • Back injuries caused by long-term repetitive movements
  • Injury to the lungs, from superheated or toxic gasses
  • Slip and falls in the workplace
  • Car accidents while driving for your employer.

worker's comp claim

However, there are also injuries that will be ineligible for worker’s comp, in almost all instances.

  • Injuries incurred while under the influence of alcohol or psychoactive drugs (cannabis, cocaine, etc.)
  • Self-inflicted injuries
  • Injury incurred while in violation of the law or company safety policy or guidelines

One particular gray area in our home state of Maryland is the so-called “going and coming” rule. While we’ve recently covered this quirk of Maryland worker’s comp on our blog, we can summarize it briefly here. This rule specifics when and if injuries suffered by workers’ commuting to or from the workplace can be eligible for compensation.

Continuing the Process

After reporting their injury to the relevant authorities at their place of employment, the injured worker will receive paperwork to file a claim with their employer’s insurance company. When this paperwork is returned, the employer will file a claim, notify the Operational Safety and Health Administration (OSHA), and potentially report the incident to the state worker’s compensation board or agency. If the insurance company and employer agree that the injury in question was sustained in the workplace, the employee will begin to receive benefits from the insurance company. However, if either the employer or the insurance company disagree with the employee’s assessment of their injury, it could hold up benefits or even wall them off entirely. The injured employee may appeal this decision to the relevant authorities.

Workplace Injury

How Malloy Law Can Help

If you find yourself seriously injured while conducting your duties in the workplace, you may quickly become overwhelmed. Lost wages, medical bills, and a long and winding road to recovery. You don’t have to face these challenges down alone. Malloy Law Offices is proud to employ some of Maryland’s worker’s compensation specialists. Our experienced and diverse team can guide your claim to the best possible outcome and advocate aggressively for your best interests. Don’t delay, contact Malloy Law to schedule a free consultation.