Baltimore Business Guide: Worker's Compensation Claims - What to Expect and How to Prevent Them

Baltimore Business Guide: Worker's Compensation Claims - What to Expect and How to Prevent Them

| April 17, 2024

Worker's compensation (WC) insurance protects your employees in case of work-related injuries or illnesses. But even with WC in place, a workplace injury can be a stressful experience for both the employee and the employer. This blog post from American Insurance will guide Baltimore business owners through the WC claim process and explore strategies to minimize workplace accidents.

What Happens When an Employee Files a Worker's Compensation Claim in Baltimore?

If an employee suffers a work-related injury or illness, they are entitled to file a WC claim. Here's a breakdown of the typical process, outlining key Maryland time limits:

  • Employee Reports the Injury: The first step is for the employee to report the injury or illness to their supervisor as soon as possible, ideally on the same day it occurs. Maryland law requires reporting within seven days of the incident. Failure to report promptly can impact the validity of the claim.

  • Medical Treatment: The employee will likely seek medical attention. It's crucial to ensure they receive proper treatment authorized by the WC insurance carrier. Your insurance company will likely have a network of preferred medical providers to ensure treatment aligns with WC guidelines.

  • Claim Filing: The employee will file a formal WC claim with your insurance company, typically within two years of the injury date. You, the employer, will also need to file a report with your insurer within ten days of receiving notice of the claim. This report should include details about the accident, the injured employee, and any witnesses.

  • Investigation: The insurance company will investigate the claim to determine its validity and establish the extent of the employee's injuries. This may involve reviewing medical records, interviewing the employee and witnesses (within 28 days of receiving the claim), and visiting the workplace to assess potential hazards. Your cooperation during the investigation is crucial.

  • Claim Decision: The insurance company will then decide whether to approve or deny the claim. You will be notified of the decision within 14 days of the completion of the investigation. If approved, the employee will receive benefits outlined in their WC policy, including medical expense coverage and lost wage replacement.

  • Dispute Resolution: If the claim is denied, the employee has the right to appeal the decision through the Maryland Workers' Compensation Commission within one year of the denial. The Commission will conduct a hearing and issue a final decision.

How Does a WC Claim Affect Your Business?

A WC claim can impact your business in a few ways:

  • Increased Insurance Costs: Even if the claim is approved, filing a WC claim can lead to higher premiums in the future. Insurance companies consider your claims history, including the frequency and severity of claims, when calculating your WC rates.

  • Decreased Productivity: Workplace injuries can disrupt your workflow, especially if a key employee is unable to work. Depending on the severity of the injury, absences can range from a few days to permanent disability.

  • Potential Legal Issues: In some cases, employees may file lawsuits against their employers for negligence, even if they have received WC benefits. This is especially true if the injury was caused by a deliberate violation of safety standards. Having a strong safety program and clear documentation of your efforts to maintain a safe work environment can help minimize this risk.

Minimizing the Risk of WC Claims in Your Baltimore Business

Here are some proactive steps you can take to reduce the likelihood of workplace injuries and WC claims:

  • Implement a Safety Program: Develop a comprehensive safety program that outlines safe work practices, hazard identification and mitigation procedures, and regular safety training for employees.

  • Tailor Your Program: Make sure your safety program is specific to your industry and the types of work performed by your employees. For instance, a construction company will have different safety protocols compared to an office environment.

  • Maintain a Safe Work Environment: Regularly inspect your workplace for potential hazards and take steps to correct them promptly. This includes ensuring proper ventilation, maintaining clear walkways, and providing appropriate personal protective equipment (PPE) for employees. Conduct regular safety inspections and keep a record of your findings and any corrective actions taken.

  • Invest in Employee Training: Provide ongoing training to employees on specific job safety procedures, proper lifting techniques, and how to identify and report potential hazards. Training should be conducted in a language understood by your employees.

  • Promote a Culture of Safety: Encourage open communication about safety concerns and empower employees to stop work if they feel unsafe. Recognize employees who demonstrate safe work practices and hold regular safety meetings to discuss potential hazards and best practices.

By prioritizing workplace safety, you can create a healthier and more productive environment for your employees while minimizing the risk of costly WC claims.

Finding a WC Insurance Partner in Baltimore

American Insurance is committed to helping Baltimore businesses navigate the complexities of worker's compensation insurance. We can help you design a WC policy that meets your specific needs, implement risk management strategies, and ensure a smooth claims process. Contact us today for a free consultation and peace of mind!