How to Calculate Workers’ Comp Settlement in Maryland
In Maryland, the workers’ compensation system can give workers and their families critical support in tough times. Workers’ compensation benefits can cover all of a worker’s medical care from a job-related injury or illness. It can also cover wages that a worker loses from being unable to work as they did before the injury or illness — if they are able to work at all.
In many cases, workers receive their benefits through a settlement with their employer’s workers’ compensation insurance company. To understand the benefits available through a settlement, it’s important to know how a workers’ comp claim is calculated in Maryland. The value can depend on factors such as:
- Severity of your injury or illness
- Past and future medical expenses
- Impairment rating
- Vocational rehabilitation needs
Here, we look at those factors and explain how the workers’ compensation settlement process works in Maryland. To better understand the benefits that you may be entitled to receive in a full and fair workers’ comp settlement, contact Trollinger Law LLC today to speak with an experienced and dedicated Maryland workers’ compensation lawyer. We can provide a free consultation.
How Do Workers’ Comp Settlements Work?
Filing a claim with the Workers’ Compensation Commission starts the workers’ comp settlement process in Maryland. For this reason, you need to pay close attention to all reporting and filing deadlines that apply to your case. Some deadlines vary depending on whether you seek benefits for an accidental injury, occupational disease, or the work-related death of a loved one. Check out our section on the timeline in Maryland workers’ comp claims to learn more.
Within 21 days after a worker files a claim, the workers’ comp insurer must accept or contest the claim. An insurer sometimes accepts only part of a claim and challenges certain issues like future medical care or permanent disability benefits. The Commission will issue an award or put the claim in line for a hearing within 30 days after the claim is filed.
Even if the insurer denies a claim, wholly or partially, the worker and insurer can still resolve their contested issues by agreeing on certain parts by stipulation or through a settlement. A settlement can be reached, in fact, at any stage in a case, including before and after a hearing. The Commission must approve any stipulation or settlement before it can be enforceable.
Before accepting any stipulation or settlement offer from the workers’ comp insurer, you should consult with an attorney and understand the full benefits you are due. You should also know whether you are giving up the right to reopen your case in the future if your condition worsens.
What Should a Workers’ Comp Settlement Cover?
The severity of your job-related injury or illness plays a vital role in what should be covered in any workers’ comp settlement that you reach with an insurer. The severity determines the amount of your past and future medical expenses and the costs of training to work a different type of job. It also determines whether you are entitled to temporary or permanent disability benefits that, based on your impairment rating and other factors, may be total or partial.
All of those factors affect the total amount of a settlement and should be fully addressed in any settlement offer that an insurer makes to a worker. However, a settlement with a workers’ comp insurer cannot cover pain and suffering.
An insurer may challenge the severity of an injury. In some cases, an insurer may try to deny that an injury or illness arose from the worker’s job. It is important to work with a lawyer who will gather evidence and be ready to push back against those claims in settlement negotiations or a Commission hearing.
How Is a Workers’ Compensation Settlement Calculated?
The amount of a workers’ compensation settlement primarily depends on the type of benefits the worker needs to recover from their injury or illness and move forward in life, or what a family requires in the aftermath of losing a loved one. Those benefits, and how they are calculated, include:
- Medical benefits – All necessary and related medical care should be covered, including the need for emergency care, surgery, hospitalization, medication, crutches or other assistive devices, and any artificial limbs. The cost of transportation to and from medical care is also compensable.
- Vocational rehabilitation benefits – If a worker suffers from a disability that prevents them from returning to their old job, they can get up to 24 months of training and other services to help them work in a new job.
- Disability benefits – These benefits vary depending on the severity of the illness or injury that qualifies as a disability. They are based on a percentage of the worker’s average weekly wage, or what they earned, on average, in their previous 14 weeks of pay.
- Death benefits – If you qualify as a dependent, you may be eligible to recover benefits that cover funeral and burial costs up to $7,000, as well as benefits that cover a percentage of the deceased worker’s average weekly wage up to the maximum amount allowed by law.
The types of disability benefits provided through a workers’ comp settlement could include:
- Temporary total disability benefits (TTD) – When the disability prevents the worker from working at all for a temporary period, they could receive TTD. These benefits cover two-thirds of the average weekly wage, but they can’t exceed 100 percent of the state average weekly wage (see the Commission’s current maximum rate of benefits). Payments stop when a worker reaches maximum medical improvement (MMI).
- Temporary partial disability benefits (TPD) – These benefits are possible when the disability allows the worker to return to work in some capacity, but not at full speed, for a temporary stretch and keeps them from earning what they did before. TPD should cover 50 percent of the difference between the pre-injury average weekly wage and the worker’s gross earnings after they return to work. These benefits also stop when a worker reaches MMI.
When an employee reaches MMI, the worker must be evaluated by a doctor and given an impairment rating. This rating can be another issue that a workers’ comp insurer challenges and must be resolved before a settlement can be reached. The rating determines the type of permanent disability benefits the worker can receive. Those benefits include:
- Permanent total disability benefits (PTD) – Workers could qualify if the disability permanently prevents them from returning to work. PTD benefits are paid at the same rate as TTD benefits. If you have lost the use of both eyes, arms, hands, legs, or feet, or a combination of those parts, it would qualify as a total disability.
- Permanent partial disability benefits (PPD) – Permanent partial disability benefits apply when a disability allows the worker to return to work, but permanently keeps them from working the same type of job and earning what they did before. The calculation of these benefits involves the impairment rating, the date when the disability arose, which body part is affected, and which of three tiers the disability falls under based on the number of weeks of compensation. For instance, impairment of the thumb could have a maximum of 100 weeks of compensation, while an arm disability could be up to 300 weeks.
The rate of pay for PPD benefits follows a tier-based system. The tiers are:
- Tier 1 – For 1-74 weeks of compensation. The rate is 33 and 1/3 percent of the average weekly wage, with a cap on the amount based on when the disability arose. For example, if an injury occurred on or after January 1, 2000, and before January 1, 2009, the rate would be capped at $114.
- Tier 2 – For 75 or more weeks but less than 250 weeks of compensation. The rate is two-thirds of the average weekly wage but can’t go beyond one-third of the state average weekly wage.
- Tier 3 – For 250 weeks or more of compensation. The rate is two-thirds of the average weekly wage but can’t exceed 75 percent of the state average weekly wage. Also, the award is increased by one-third of the number of weeks.
Our Maryland Workers’ Compensation Attorneys Want to Help You
At Trollinger Law LLC, we can help you to assess the potential value of your workers’ compensation claim and take all of the steps to pursue a settlement that fully and fairly compensates you, protects your rights to reopen your case (if necessary), and ensures you get the medical care and vocational rehabilitation benefits you need. Contact us today to get started with a free consultation.