Maryland Workers’ Compensation Commission Annual Report 2013
Highlights and Process Improvements
The following forms have been revised and reprinted this year: Authorization for Release of Medical Information, Motion to Compel Medical Authorization, Response to Motion to Compel Medical Authorization, Subpoena, Objection to Subpoena of Medical Records, and Request to Implead a Party.
Now, the Commission will accept filing of insurance policies electronically, through the system for Electronic Rate and Form Filing. Paper submissions are still accepted, though the Commission prefers electronic submissions.
The Interpreter Program now only accepts three requests per attorney, per docket for their services.
Parties may now file Motions to Compel Medical Authorization Electronically. These motions compel parties to provide medical authorization. A party wanting to oppose a motion may file a response electronically, within seven days of receipt of the motion.
In an effort to reduce paper usage, the Appeal Department now sends only a transcript of the hearing to circuit court, rather than sending the entire case file.
In order to increase the security of the Worker’s Compensation Commission’s website, now parties involved in a claim may access their claim inquiry and corresponding documents by entering their claim number, while nonparties must enter more data in order to obtain information regarding the claim.
The Commission is now required to refer a case that has been established by a preponderance of evidence that a person knowingly affected or knowingly attempted to affect payment of compensation benefits, fees, or expenses under the Workers’ Compensation Act by fraudulent representation.
Graph Information Summaries
In 2013, the industries with the most workers filing for workers’ compensation are policemen/security. 2,445 workers from that industry have filed workers’ compensation claims, making up 10.5% of claims. Colleges and schools (including daycare) filed 7.4% of claims in 2013, followed by truck men with 4.7% of claims.
In 2013 the thorax (lower back) was the top body part that was disabled, and accounted for 27.9% of injuries. Most permanency awards were granted for 1-74 weeks for thorax injuries. Shoulders were the second body part most frequently injured in workers’ compensation claims, flowed by knees, the neck, and hands.
In 2013, approximately 7,369 injured persons under workers’ compensation were awarded 1-74 weeks of disability, making up 66.4% of cases. 3,447 people were awarded disability for 75-249 weeks, making up about 31.1% of the cases. 2.5% of people with workers’ compensation awards received permanency awards for greater than 249 weeks.
Permanent total awards increased 20.8% from 2012. Permanent partial disability awards decreased by 5.2%. Additionally, fatality decreased by 16.3%.
In 2013, 37.1% of claims were disputed, 25.3% were settled, 28% were deferred, and 2.6% were disallowed by the Commission.
In 2013, there was 1 fatality within the state government, and 12 within the local government. 25 workers from unclassified industries suffered fatal injuries, followed by 5 in the transportation, trades, and utilities industry, 4 in professional and business services, and 3 in the construction industry.
The age group for men with the highest amount of claims in 2013 was men 40-49 years old. They accounted for 16.7% of claims, followed by men 30-39 years of age with 14.6% of claims, and men 50-59 years old with 13.3% of claims. The highest age group of women in 2013 who made claims was those 50-59 years of age, making up 10.5% of claims, followed by women 40-49 years old, making up 10.4%, and women 30-39 who made 7% of claims.
Approximately 1,200 claimants brought appeals in 2013. 774 appeals were brought by the employer/insurer, 27 by the subsequent injury fund, and 13 by the uninsured employer’s fund.
The largest number of claims and appeals were brought in Baltimore County in 2013, which heard 4,004 claims, and 290 appeals. Baltimore City heard 3,601 claims and 228 appeals. Prince George’s County heard 3,009 claims and 386 appeals, followed by Montgomery County with 2,069 claims and 190, appeals, Anne Arundel County with 1,962 claims and 167 appeals, and Harford County with 996 claims and 75 appeals.
Interpreter requests fell in 2013, but the amount of interpreters provided increased. While 82.6% of interpreters requested were for Spanish speaking parties, interpreters are available for 38 languages.
45.1% of employees with workers’ compensation awards returned to the same employer, and kept their same job duties, while 17.3% of employees sought new employment. 12% of employees suffered from medical issues that prevented them from returning to employment at all.
The number of self-insured employees increased by about 8,000 in Maryland since 2012.
Maryland ranked 34 out of 51 for workers’ compensation premiums.
The number of licensed insurers writing workers’ compensation insurance increased from 634 to 658 in 2013. Additionally, insurer assessment costs have increased from $110,175,781,742 in 2012 to $113,830,536,789 in 2013.
Legislation
SB65/Chapter 16: Claim Processing-Electronic Delivery of Decisions
This bill now allows copies of decisions to be sent electronically to parties or their attorneys.
SB139/Chapter 18: Health Care Practitioners- Prescription Drug of Device Dispensing-Medical Facilities or Clinics that Specialize in Treatment Reimbursable Through Workers’ Compensation Insurance
This bill repeals an exception from the requirement that one must be licensed by the Board of Pharmacy before he or she can practice pharmacy in the State. This rule requires a dentist physician, or podiatrist who dispenses a prescription for treatment of a patient at a facility that specializes in treatment of medical cases reimbursable through workers’ compensation insurance to obtain a dispensing permit and meet other requirements.
SB313/Ch. 225, HB370/Ch. 226: Workers’ Compensation- Anne Arundel County Deputy Sheriff
This bill alters the definition of “public safety employee” to include deputy sheriffs in order to establish eligibility for enhanced workers’ compensation benefits for a compensable permanent partial disability of less than a certain number of weeks.
HB1330/Ch.676: Workers’ Compensation- Insurance Coverage- Employer Compliance
This bills changes the requirement for employers securing compensation for certain employees, and clarifies the Commission’s authority to require employees to secure compensation for covered employees. The requirement directs employers to attend hearings under specific circumstances and further establishes penalties for employers that fail to secure compensation for their covered employees.
Regulatory Updates
14.09.06: Local Office Requirements for Insurers- Appeal
This regulation removed COMAR 14.09.06.05B, which required an appellant’s attorney to send a copy of a petition for judicial review to the Attorney General representing the Commission if the appeal is for attorney’s fees.
14.09.01: Attorney’s Fee and Medical Evaluation Fee-Application or Petition for Approval
This regulation amended and recodified COMAR 14.09.06.05B.
14.09.01 Average Weekly Wage
This regulation established a procedure and timeline for determining average weekly wage.
Appellate Opinions
Andrew P. Swedo, Jr. v. W.R. Grace & Co., et al., 211 Md.App. 391 (2013). Labor and Employment Article, § 9-633 requires a dollar credit to be utilized where an award of permanent partial disability compensation was modified on appeal.
Washington Metropolitan Area Transit Authority v. Robert M. Washington, 210 Md.App. 439 (2013) held that profits derived from a business should not be considered as earnings and cannot be accepted as a measure of loss of earning power unless they are the main result of the claimant’s personal management and endeavors.
Felix L. Johnson, Jr., Deceased v. Mayor and City Council of Baltimore, 430 Md. 368 (2013) held that the workers’ compensation benefits includes payment of dual pension and workers’ compensation benefits to dependents of a deceased claimant.
McLaughlin v. Gill Simpson Electric, et al., 206 Md.App. 242 (2012) held that the withdrawal of issues filed with the Petition to Reopen constitutes a withdrawal of a petition.
(No information available for 2012 FY annual report)
Maryland Workers’ Compensation Commission Annual Report 2011
Summary
Highlights and Process Improvements:
The Subsequent Injury Fund Assessment (LE § 9-806) & the Uninsured Employers’ Fund Assessment (LE § 9-1007) are billed by two separate funds as of July 1, 2011. Employers/ Insurers are required to pay the assessments to the two funds within thirty days of their respective invoices.
In the IT Division new and improved software applications have led to improvements in Claims Administration efficiencies. Data sharing with other agencies has proven to achieve significant process improvements. There has also been improved business analysis/ intelligence of diverse data/ source utilizing SQL Server Reporting Services.
Graph Information Summaries:
Filed claims are up 1.6% from 23,003 to 23,366.
Policemen- Security had the most claims. The top 5 industries for filed claims are Policemen – Security, Truckmen N.O.C., Colleges or Schools including day care, Building Raising or Moving – Construction and Hospitals – all other employees. These five industries account for 33.3% of all claims with 7,774 claims total.
The Thorax – Lower (Back) was the most often disabled body part involved in 25.4% of disabilities. Most permanency awards in 2011 were for 1-74 weeks. Shoulder injuries were the only category that had more permanency awards that lasted from 74–249 weeks.
Fatality awards rose from 2010 to 2011 as were permanent partial disability awards but permanent total disability awards fell.
Disputed claims fell from 7,957 to 7,632.
Actual fatalities were down in both the Government and Private Sectors with only two industry groupings in the private sector reporting an increase.
The age group among males with the most claims was 40–49 year olds with 4,123 claims filed. Among females the age group with the most claims was also 40-49 year olds with 2,414 claims filed.
Claimants were the most likely source of appeals with 989 filed, up from last year’s 856 filed. The employer/ insurer filed 811 claims.
Baltimore County had both the most claims and the most appeals and both were the highest they’ve been in the last two years. Baltimore City had the second highest amount of claims and Prince George’s County had the second highest number of appeals. The six major metro areas of Maryland, Baltimore County, Prince George’s, Montgomery County, Anne Arundel, Harford, and Baltimore City, are the source of 66.7% of claims and 77.1% of appeals.
Interpreter requests fell. A majority of the interpreter requests were for a Spanish/ English interpreter.
The number of covered self-insured employees went down from 429,600 to 422,500.
No new Workers’ Compensation Premium Ranking. Maryland’s 2010 ranking was 42nd out of 51.
The number of licensed insurers writing workers’ compensation insurance rose between 2010 and 2011 but not as high as the 651 from 2009.
Insurer assessment and the Commission’s expenses were up from 2010.
Legislation Update:
HB244/ Ch. 584: Extends the presumption of a compensable occupational disease under workers’ compensation law to include Anne Arundel County deputy sheriffs who suffer from heart disease or hypertension resulting in partial or total disability or death under specified circumstances; requiring that workers’ compensation benefits received under the Act are in addition to certain retirement benefits, subject to a specified adjustment.
SB568/ Ch. 256 & HB392/Ch. 257: Altering the venue available to individuals & employers appealing a decision of the Workers’ Compensation Commission.
SB212/Ch. 435 & HB417/ Ch. 436: Provides that specified death benefit provision of the workers’ compensation law apply only to specified covered employees of a municipal corporation or a county, and their dependants; altering the authority of the Workers’ Compensation Commission to make specified determinations of dependency; altering the provisions relating to calculation of death benefits for individuals who are wholly or partly dependent; providing for the amount of death benefits to specified dependents.
SB269/Ch. 45 & HB453/Ch. 46: Worker’s Compensation Commission now has jurisdiction over a request for approval of a proposed settlement of all or part of a claim when an appeal of a Commission order is pending.
SB693/Ch. 276 & HB598/Ch. 132: Employees of the Injured Workers’ Insurance Fund are not subject to specific laws, regulations or executive orders governing State employees compensation; and repeals a requirement that the Fund’s Board set compensation for its employees in accordance with the State pay plan.
SB1/Ch. 5: Joint Committee on Workers’ Compensation Benefit and Insurance Oversight now includes a member that is a representative from a self-insured local government entity.
Regulation Update:
14.09.02.01: requires the Commission to adopt regulations to establish guidelines governing the investment of surplus monies in equities by a governmental self-insurance group. Effective: 3/7/11
14.09.01.06: employee’s weekly wage is no longer a mandatory element required to process a claim form for workers’ compensation benefits. Effective: 3/21/11
14.09.01.05: Commission’s regulation now conforms with statutory requirements related to the filing of notices of cancellation of insurance. Effective: 5/16/11
Appellate Opinions:
Jeffrey Lecronier v. United Parcel Service, 196 Md. App. 131 (2011). Venue can be based on a residence or the place where the individual regularly conducted business or is employed.
Pro-Football, Inc. v. Tupa, 197 Md. App. 463 (2011). For a claimant covered by Md. Code Ann. Lab. & Empl. § 9-203, Maryland has jurisdiction over the individual’s workers’ compensation claim and a forum selection clause in the employment contract, requiring him to file his workers’ compensation claim in Virginia, contravened Maryland’s public policy- Compensation may not be denied because of the degree of risk associated with the employment.
Sanchez v. Potomac Abatement, Inc., 198 Md. App. 436 (2011). Md. Code Ann. Lab. Empl. § 9-742 does not deprive the Commission of jurisdiction while a previous award is on appeal, and the agency retains jurisdiction if the new claim is properly authorized under § 9-736(b).
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