Determining the Validity of a Worker’s Compensation Claim in Glen Burnie
If you have sustained an injury or occupational illness while on the job in Glen Burnie, you are entitled to pursue compensation through the state workers’ compensation system. While you have the right to pursue benefits, there is no guarantee that your claim would be accepted. In fact, many exceptions allow insurance companies to deny benefit claims.
Determining the validity of a worker’s compensation claim in Glen Burnie could provide you with an idea of whether you might be entitled to benefits. An experienced workers’ compensation attorney could help evaluate your injury claim.
Grounds for Denying a Claim
There are multiple reasons available for an insurance company to deny a workers’ compensation claim. However, most denials center on four primary arguments:
- Insufficient documentation
- Insufficient notice
- Independent contractor status
- Non-covered injury
Could Insufficient Documentation Cause a Rejection of Benefits?
Arguably the most common grounds for denial, insufficient documentation denials could cause a worker to not receive benefits for his or her injuries. In many cases, an insurance company only needs a small amount of additional documentation to make its decision.
What Happens If a Worker Fails to Give Adequate Notice?
A worker must provide their employer or supervisor with notice of their injury within ten days. This notice can be written or oral. While it is important to comply with this deadline, courts often allow a claim that violated the notice requirement so long as the employer was not prejudiced.
Independent Contractor Status
Workers’ compensation claims are reserved for employees. While these employees could be full-time or part-time, the insurance does not apply to independent contracts. The court ultimately determines whether a claimant is an employee or qualifies as a contractor.
Certain injuries are not covered under workers’ compensation claims. A pre-existing condition is not in itself covered, but an aggravation of a pre-existing condition is compensable to the extent of the aggravation.
Injuries that result from horseplay are also barred. While these injuries might occur at work, they do not qualify as occurring within the scope of employment.
Injuries caused by a worker’s intoxication are also not covered, at least not in full.
The Right to Appeal a Denial
Having the backing of an experienced Glen Burnie workers’ compensation attorney is beneficial when determining how viable a claim is. However, the importance of an attorney’s role only increases after the initial denial of a claim.
Fortunately, the denial of a claim by an insurance company does not end a worker’s chances of obtaining benefits. An employee has the fight to appeal the denial and even request a hearing. However, from this point forward, the process becomes more and more like a complex trial. The first step following a denial is to request a hearing with the Maryland Workers’ Compensation Commission. At this hearing, an attorney could advocate on behalf of an injured worker to have the denial overturned.
If the worker is unhappy with the decision at the hearing, they have up to 30 days to appeal the issue to circuit court. If the Notice of Appeal is not timely filed, the court will not consider the case, and the original denial will stand. At the Circuit Court level, both sides have the opportunity to plead their case at a hearing. However, the court will presume that the decision made by the Commission was correct.
If a worker loses on appeal, they still have one final avenue to fight back. An appeal from the Circuit Court to the Maryland Court of Special Appeals is possible. However, the process is complex and is best handled by an experienced Glen Burnie workers’ compensation attorney.
Seek Help With Determining the Validity of a Workers’ Compensation Claim in Glen Burnie
An experienced lawyer could help you in determining the validity of a workers’ compensation claim in Glen Burnie. During a consultation with a prospective lawyer, you have the opportunity to ask questions about your lawyer’s experience or the strength of your claim.
There are several important deadlines for every claim for benefits. To ensure you comply with all of them, contact a Glen Burnie workers’ compensation lawyer right away.