Our Legal and Claims professionals work hand-in-hand to successfully litigate numerous hearing cases in front of the Maryland Workers’ Compensation Commission (WCC). Our thorough case preparation and defense help to keep premium costs fair by limiting unnecessary and excessive awards/claim payments. Here are summaries of recent hearing cases in which the WCC ruled in favor of policyholders and Chesapeake Employers.
The issues in this case were whether the claimant sustained an occupational disease of adhesive capsulitis of the left shoulder (frozen shoulder) in the course of employment starting in October, 2010, as well as causal connection, temporary total disability (TTD) for a fixed period of time and temporary partial disability (TPD) from Nov 29, 2010 to present and continuing. Our legal and claims team worked closely in questioning the claimant’s credibility by eliciting on cross-examination and presentation of evidentiary medical exhibits that the claimant started having pain in their left arm/hand in 03/10 but did not seek any med treatment until 09/10. As a result of the lack of credibility and strong medical evidence the Workers’ Compensation Commission (WCC) ruled that the original WCC award be rescinded and annulled, that the claimant did not sustain an occupational disease to the left shoulder and that the disability of the claimant was not the result of the alleged occupational disease. The Commissioner denied the claim for TTD and TPD, ordering that the claim be disallowed.
The claimant was a public transit employee who was riding a bus after the claimant’s shift ended when the bus was involved in an accident. The claimant alleged that their psychological condition, which was pre-existing, was exacerbated and aggravated by the event. Our expert legal and claims team prepared their defense and argued that the claimant had a pre-existing psychological condition and that the claimant was exposed to no greater exposure than the public at large, therefore the condition was not compensable. The Commissioner ruled the psych complaints were not causally related to the 2010 accidental injury and did not cause an aggravation of a pre-existing condition.
In this case, our legal and claims professionals teamed up to defend this case on the issue of permanent total disability. The Commissioner ordered that the claimant was not permanently totally disabled, as there were extensive pre-existing conditions which contributed to the claimant’s disability. The Commissioner awarded 88% Permanent Partial Disability (PPD) with 55% attributable to the accident and 33% due to pre-existing conditions. By not finding the claimant permanently and totally disabled from the accident, Chesapeake Employers was able to contain the overall future costs associated with the claim.
Employer’s TIP:Remember, prompt and thorough investigation of the claim starts with you. Report injuries immediately. The more information Chesapeake Employers has to prepare for a possible hearing, the stronger our case. Please work with your claims adjuster by staying involved throughout the claims process.
Compensable Injury – An injury caused by an accident arising from the employment and in the course of the employee’s work. The employee is entitled to receive compensation.
Maximum Medical Improvement (MMI) – The point at which the condition of an injured person is stabilized. No further recovery or improvement is expected, even with additional medical intervention.
Temporary Total Disability (TTD) – A condition where an injured party is expected to recover, but is unable to work at all during the recovery period. Compensation is paid at 2/3 the average weekly wage, not to exceed the state maximum or go below minimum.
Temporary Partial Disability (TPD) – A condition where an injured party's capacity to work is temporarily impaired, but he or she is able to continue working in a reduced manner and is expected to make a full recovery. Compensation is paid at 50% of the difference between the average weekly wage and the present wage earning capacity not to exceed one-half of the state’s average weekly wage (TTD rate).
Permanent Partial Disability - A condition where the injured party's earning capacity is impaired for life, but he/she is able to work at any gainful employment for his/her remaining lifetime. Maximum permanency rates vary by weeks/length of the award and the affected body part(s).