Workers' Compensation for Public Safety Employees

WORKERS COMPENSATION FOR PUBLIC SAFETY EMPLOYEES reprinted and amended from warnkenlaw.com with permission.

WHO IS PUBLIC SAFETY?

Public safety is police officers, firefighters, paramedics, and other first responders. Other types of law enforcement, cops, and prison officers sometimes qualify.

In public safety, job related injuries are commonplace. In fact, according to the Maryland Workers’ Compensation Commission, police officers filed the most claims for workers’ comp benefits in 2009. Firefighters (listed by the WCC as firemen) were the seventh most injured on the job profession.

A lot of public safety employees, however, minimize their own injuries and ignore their rights. They don’t file claims as quickly as they should, don’t file for permanent partial disability, or don’t file a workers’ comp claim period. All of these courses are wrong. It is your right as an injured employee, to file for workers’ compensation. Failure to file a claim or pursue a claim to its fullest extent can result in later complications or a complete lack of consideration or recovery for an injury. While nothing substitutes for a good workers’ comp lawyer, all public safety employees should know their rights in Workers’ Compensation.

WORKERS’ COMPENSATION BENEFITS

Temporary Total Disability Benefits

Temporary total disability (TTD) benefit payments make up for time missed from work. The WCC benefit, which is not taxed, is “capped” at two-thirds of the employee’s average weekly wage (AWW), not to exceed 100% of the state average weekly wage (SAWW). This benefit is paid, without time limitation, until the employee is able to return to work. The employee’s AWW is usually calculated based on the last 13 pay periods prior to the injury.

Medical Expenses

Typically, all expenses resulting from medical treatment for injuries compensable under workers’ compensation are covered. Most health care providers will not accept third-party coverage for work related injuries, such as Blue Cross/Blue Shield and other HMO’s, when the treatment is for a work-related injury. Additionally, in the event that health insurance pays for medical treatment arising from a compensable injury, the insurer may seek subrogation from the Workers’ Compensation insurer. Consequently, it is important that employees suffering from a work related injury seek legal advice and file the necessary paperwork to avoid needless complication in resolving payment for medical expenses.

Permanent Partial Disability Benefits

Maximum Medical Improvement (MMI) is the point at which, in the opinion of the treating physician, further treatment will not improve the injured employee’s medical condition. At that time, the extent of permanent partial disability (PPD), if any, must be determined by two physicians – the worker’s physician and the insurer’s physician. Most injuries, especially back, lumbar, or orthopedic injuries, cause some permanency. The injured employee’s attorney coordinates a “rating” with a reputable physician, after which employer’s workers’ compensation insurer likewise coordinates a “rating.” The claimant’s “rating” is almost always higher than the insurer’s rating. Typically, the insurer and the claimant’s attorney negotiate a midpoint rating. Cases may be settled or stipulated. If a case is settled, the insurer usually pays a higher disability amount because the case is closed and the injured worker may not reopen the claim or seek compensation for future treatment. Conversely, if there is a stipulation, the permanency award offered is usually less, but the claim remains open for five years after final payment. If the condition worsens and requires more medical treatment, the insurer remains liable. Each year, the State establishes a statewide AWW. Weekly compensation, which is usually paid in a lump sum award, may not exceed the statewide AWW for the year of the injury. The WCA establishes the number of compensable weeks, depending on the injured body part. Compensable weeks range from 500 weeks for a head or back injury to 25 for the little finger. The number of compensable weeks is calculated by multiplying the allowable weeks for that body part times the percentage of disability. For example, if the injured employee suffered a compensable back injury, which has been determined to be a 10% PPD, the benefit is 500 (the number of compensable weeks) x 10%, i.e., 0.10 (percentage of PPD) = 50 weeks. The WCA sets three weekly compensation tiers. For injuries resulting in less than 75 weeks of compensable disability (minor-tier), the claimant receives one-third of the AWW, times the number of compensable weeks, not to exceed one-third of the SAWW. For injuries resulting in 75 to 249 compensable weeks (mid-tier), the claimant receives two-thirds of the AWW, times the number of compensable weeks, not to exceed 50% of the SAWW. Public safety employees are always bumped up to the mid-tier.

Other Benefits

Temporary partial disability benefits and permanent total disability benefits are also available as applicable. TTD and PPD are simply more common and, therefore, discussed more in depth above. Also, death benefits are available to surviving dependents as well.

SPECIAL PROVISIONS FOR PUBLIC SAFETY EMPLOYEES

Public safety employees, receive significant additional consideration for injuries falling within the mid-tier of compensable injuries under the WCA. For example, if a civilian worker has a 10% disability, because of a back injury, the employee is entitled to 500 (the number of compensable weeks) X .10 (percentage of PPD) = 50 weeks. Based on the minor tier AWW ($114), the total benefit is $5,700. If a law enforcement officer suffers a similar injury, the officer is compensated based on the mid-tier, which is 500 x .10 = 50 weeks x $257 = $12,850.

Additionally, the prevalence of hypertension and heart disease amongst public safety personnel led to the creation of legislatively created presumptions in favor of employees who suffer from such conditions. Specifically, the WCA provides that hypertension and heart disease, among law enforcement officers, fire fighters, and paramedics, are presumed to be job-related, with the burden on the employer to prove the contrary. Moreover, due to certain restrictions placed on employers, it is exceedingly difficult to disprove the presumption of job-relatedness for such conditions.

Conclusion

Despite the job-related hazards, public safety employees injured on the job are often hesitant to file a workers’ comp claim. This may come from a grin and bear attitude or it may come from loyalty to the organization. Sometimes they believe that injury and stress are just a part of the job. Injury and stress are part of the job. It’s why Maryland General Assembly amended the WCA in favor of public safety employees. The best way to get the appropriate benefits is to retain a competent workers’ compensation attorney.