Important Timing Requirements for Workers’ Compensation Claims
The Maryland Workers’ Compensation Act (“the Act”) has a number of requirements that must be met in order for an injured worker to proceed with his or her claim. The particular requirements that would be applicable in your case depend on whether the claim involves an accidental personal injury, hernia, occupational disease, and/or death.
The Act requires injured workers to (1) notify their employers of an accident or disablement, as well (2) file an application for benefits with the Workers’ Compensation Commission (“the WCC”). These two mandates carry different time requirements.
Accidental Personal Injury
An injured employee must notify his or her employee within 10 days from the date of injury. However, notice must only be given if an accidental personal injury is compensable; hence notice need not be given if the resulting disability causes any less than 4 days away from the job. Notice to the employer may be done orally or in writing. If it is done in writing the notice must include the Claimant’s name and address, as well as the time, place, cause and nature of the injury. It must also be signed by the Claimant or his/her representative.
That said, even if the notice requirement has not been met, an injured workers’ claim may possibly go forward. The WCC has the authority to excuse the notice requirement in the Act if there is sufficient reason why timely notice was not given, or if the employer/insurer has not been prejudiced by the employee’s failure to give timely notice. In fact, there is a presumption that the employer/insurer has not suffered prejudice, with the burden of proving otherwise on the employer/insurer. Consult an attorney if there is a notice issue in your comp case.
In addition to the notice that must be provided to the employer, an injured worker is also required to file a claim with the WCC within 60 days from the date of injury. The application for benefits must contain an authorization for the release of pertinent medical records. If an injured worker has been examined by a doctor of his or her choice, the application must also include a copy of the physician’s report.
The Act requires that the claim be filed within 60 days from the date of accident rather than from the date of disablement. However, in cases of latent injury—i.e. where an employee does not realize that he/she has suffered a compensable injury on the date of accident—the 60 day clock does not begin to run until the injury becomes “reasonably apparent.”
Similar to the notice requirement, the WCC may excuse the failure to timely file an application for benefits if there is a sufficient reason and/or lack of prejudice. That said, the WCC has no such power if the claim is filed outside of 2 years from the date of injury.
An injured worker who becomes disabled as a result of an occupational disease must notify his or her employer in writing within one year from the date that the employee knows or has reason to believe that he or she has an occupational disease. Similar to notice for an accidental injury, the WCC may excuse the failure to timely notify an employer if there is a sufficient reason and/or lack of prejudice.
The application for benefits as a result of an occupational disease must be filed with the WCC within two years, or in the case of pulmonary dust disease within 3 years, from the date of disablement, or alternatively, from the date that the injured worker had actual knowledge that the disablement was caused by the employment. The claim must be accompanied by an authorization for the release of pertinent medical records.
Obviously, in cases of death resulting from an accidental personal injury or occupational disease, the injured worker is unable to personally notify the employer or file with the WCC an application for benefits. Nevertheless, the dependents of the employee who seek death benefits are also expected to abide by the Act’s timing requirements.
For cases of death due to an accidental personal injury, the employer must be notified within 30 days after the date of death. This may be done orally or in writing. In contrast, the employer must be notified in writing within one year after a death that results from an occupational disease.
A claim for death benefits as a result of an accidental injury must be filed with the WCC within 18 months from the date of death. Additionally, the death must have occurred within 7 years from the date of injury. In contrast, a claim for death benefits as a result of an occupational disease must be filed within two years, or in the case of pulmonary dust disease within 3 years, from the date of death, or alternatively, from the date that the injured worker or his/her dependents had actual knowledge that the disablement was caused by the employment.
The application for benefits must be submitted with proof of death, as well as a certificate from the treating physician, if any. The claim form must also be accompanied by an authorization for the release of pertinent medical records. Furthermore, unlike cases of disablement due to accidental injury where the WCC has the discretion to excuse non-compliance with certain timing requirements, the same is not true for death benefits. The claim must be submitted within the requisite period of limitations.
The Act mandates that employers notify the WCC whenever an accidental personal injury results in a disability for more than 3 days. Specifically, an employer must notify the WCC within 10 days after receiving oral or written notice of a disability or death that resulted from an accidental injury. If an employer fails to make such a report, the timeframe for which an injured worker may file an application for benefits is tolled and does not begin to run until the report is filed.
Similarly, if an employer/insurer makes a misrepresentation that misleads an employee and results in the employee missing the time that is allowed to file a claim, the period of limitations is also tolled. The same is true for occupational disease claims.
With respect to occupational disease, the Act mandates that an employer notify the WCC “promptly” upon receipt of notice that an employee has been disabled. Unlike accidental injuries, however, failure to file the report does not toll the period of limitations in which a claim can be filed.
It is a criminal offense for an employer to fail to file an accident report with the WCC. It is also a crime for an employer to fire an employee simply because a workers’ compensation claim has been filed.
Talk to an attorney if any of the above applies to your comp claim, or simply for assistance in getting your case off the ground.