Q: How much is my Comp Claim Worth?

A:

Injured employees are entitled to Maryland workers’ compensation benefits for “temporary” or “permanent” disabilities that are either “partial” or “total” in nature.  The amount that your workers’ compensation claim is worth depends on the severity of your disability and your average weekly wage.

How do I calculate my Average Weekly Wage?

In addition to the severity of the disability, another important concept in MD comp law is the average weekly wage (“AWW”). This is important to injured workers for two reasons.

First, an employee’s disability benefits are based specifically on that individual’s personal AWW.  This calculation is based on the 14 weeks of pay the employee earned prior to the date of injury, or in cases of occupational disease, the date of last injurious exposure (save your paystubs!).  It is important to note that AWW is not calculated from the date of disablement, which in some cases may be later than the date of injury/exposure.  AWW accounts for gross wages (including overtime), vacation pay, commissions, tips, and certain other monetary perks.  In some cases, Workers’ Compensation Commissioners may even consider whether, under the facts of a given case, it is probable that an employee’s wages would increase “under normal circumstances,” for purposes of calculating a Claimant’s AWW.

Second, an employee’s individual award may not exceed a predetermined percentage of the State average weekly wage for the same year in which the injury occurred. The predetermined percentage of the State average differs depending on what kind of disability is at issue in any given case. For example, a temporary partial disability award is capped at 50% of the State AWW, whereas an award for permanent total disability is capped at 100% of the State AWW for the year in which the injury occurred.

How much is my temporary disability claim worth?

When an employee is recovering from a work-related injury he or she may be entitled to temporary disability benefits.  There are two different types of temporary disability – temporary total and temporary partial.

If an injured worker is completely unable to work, he or she may collect temporary total disability. If the employee is able to work in some limited capacity, temporary partial disability may be warranted. Temporary disability benefits may continue indefinitely, but will terminate when the employee is able to return to work at a pre-injury wage level, or when “maximum medical improvement” is reached.

Temporary Total Disability (“TTD”) equates to two-thirds of the employee’s average weekly wage, but may not exceed the State average weekly wage for that same time period (i.e. the year in which the injury occurred). If the TTD lasts for 14 days or less, the employee is not compensated for the first three days of disability. On the other hand, if the employee’s TTD lasts more than 14 days, compensation is due for the entire length of the disability.

Temporary Partial Disability (“TPD”) is available to employees who may only be able to work on a part-time basis as a result of a compensable injury, or who are able to work but for less pay. A TPD award equates to 50% of the difference between an employee’s present and pre-injury wages, and may not exceed 50% of the state average weekly wage for the year of the injury.

How much is my permanent disability claim worth?

There are two types of permanent disability awards in Maryland, permanent total and permanent partial.

When a treating physician finds that an injured employee has reached maximum medical improvement temporary disability terminates, but a permanent award may then be warranted. Typically, an employee will be given a “permanency rating” by both the insurance company’s doctor and the doctor brought in by the attorney representing the injured worker. The rating given by the insurance company’s doctor is always the lesser of the two. Sometimes, the two sides will agree on a settlement, or alternatively, the final permanency rating is made by a judge or commissioner.

Permanent Total Disability

Workers’ compensation awards for permanent total disability (“PTD”) are paid in addition to and consecutively with compensation for a temporary total disability. Specifically, PTD is due when an injured employee is wholly unable to work in any kind of reasonable employment. In other words, a Claimant may not be entitled to PTD even if he or she is permanently unable to work in their previous job or career field, so long as other reasonable employment is possible.

If PTD is at issue, the Workers’ Compensation Commission considers the facts of the case and makes a determination. The burden is on the Claimant to prove his or her entitlement to PTD. However, there exists a presumption of PTD in cases where there is a loss of both hands, both feet, both arms, both legs, or any combination thereof. In such a case, the burden of proof shifts to the employer to disprove PTD entitlement.

As is the case with all workers’ compensation benefits, relevant to the calculation of an individual award is the employee’s average weekly wage and the State average weekly wage for the year in which the injury occurred. A PTD award equates to two-thirds of the employee’s average weekly wage, so long as it does not exceed 100% of the State average weekly wage for the year in which the injury occurred. A Claimant may collect PTD for the entire time that he or she is permanently totally disabled, provided said payment does not exceed $45,000.

Permanent Partial Disability

Workers’ Compensation awards for permanent partial disability (“PPD”) are based on precise rates of compensation that are predetermined by law and based on the loss of use of a specific body part. For example, the loss of use of a hand is worth 250 weeks of compensation, compared to the loss of an arm which is worth 300 weeks. These numbers reflect a 100% loss, and thus individual awards are often reduced accordingly.

Put into context, assume that an employee’s permanency rating reflects a 10% loss of use of the arm. The employee would be entitled to 30 weeks of PPD, because 10% of 300 is 30.

Next, assume that an employee has sustained a 50% loss of his or her hand. The employee would be entitled to 125 weeks of compensation, because 50% of 250 is 125.

Moreover, as is the case with all workers’ compensation benefits, relevant to the calculation of an individual award is the employee’s average weekly wage and the State average weekly wage for the year in which the injury occurred. Unlike other types of workers’ compensation benefits, however, permanent partial disability is governed by a three “tier” system. Specifically, a PPD award equates to a percentage of the employee’s average weekly wage, with said percentage being based on the particular compensation “tier” for which the injury qualifies.

A tier one award is due when, based upon a permanency rating, an injured worker is entitled to less than 75 weeks of permanent partial disability. A tier one award is only worth one-third of the individual’s average weekly wage, multiplied by the number of total weeks of compensation that the employee is due to receive. However, an individual award under tier one may not exceed a percentage of the State average weekly wage for that same period.  Put into context, in the above-example where the employee has suffered a 10% loss of the arm—i.e. 30 weeks of compensation—the PPD award would be at the tier one rate (because it is under 75 weeks of compensation).

A tier two award is due when an injured worker is entitled to PPD for a period of time ranging from 75 to 249 weeks of compensation. A tier two award is worth two-thirds of the employee’s average weekly wage, not to exceed one-third of the state average.

A tier three award is referred to as “serious disability” and is warranted when an employee is due at least 250 weeks of PPD. A tier three award equates to two-thirds of the employee’s average weekly wage, and is capped at 75% of the state average.

Serious Disability is particularly beneficial to injured workers because it provides an additional one-third of the total amount of weeks of compensation that an employee is due. For example, if a permanency rating reflects that an injured worker is due 300 weeks of compensation, then the actual PPD award would be for a total of 400 weeks of compensation—i.e. one-third of 300 is 100, and 100+300=400.

PPD for Public Safety Employees

There are no tier one PPD awards for public safety employees, even if the total amount due is less than 75 weeks. Rather, such compensation is always at least at a tier two rate. A public safety employee within the meaning of the Workers’ Compensation Act includes certain types of law enforcement officers, firefighters, paramedics, etc.

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