Workers Comp for Public Safety
WORKERS COMPENSATION LAW FOR LAW ENFORCEMENT OFFICERS:
An introduction to your rights under Maryland’s Workers’ Compensation Act
By: James M. Nichols, Esquire, Byron Warnken, Esquire & David Nowak, Esquire
In law enforcement, on the job injuries are a fact of life. Many officers, however, minimize their own injuries and ignore their legal rights, which often results in unnecessary complications later in life. While no article can substitute for the considered advice of a good lawyer, it is imperative that all employees understand their basic rights and obligations under the Workers’ Compensation Act (WCA). Consequently, this article seeks to provide a general overview of the workers’ compensation process so that employees are equipped to protect their rights in the event of an injury.
WHAT DOES WORKERS’ COMPENSATION PAY FOR AND HOW AWARDS ARE CALCULATED.
Temporary Total Disability Benefits
If a temporary total disability (TTD) lasts no more than 14 days, WCC benefits may not commence until three calendar days after the start of the disability, except for payments for hospital, nursing, medical services, medicine, and funeral expenses. If a TTD lasts more than 14 days, compensation is permitted from the start of the disability. 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 14 pay periods prior to the injury.
Sick leave (SL), if available, may be taken at the full rate of pay – and not two-thirds. Whether to use SL or administrative leave (AL) is determined on a case-by-case basis. Occasionally, SL, minus withholding taxes, is fairly close to the two-thirds, non-taxable, AL benefits. To qualify for AL benefits, the officer generally must apply internally.
Typically, all expenses resulting from medical treatment for job-related injuries are compensable under the WCA. Moreover, most health care providers will not accept third-party coverage, 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. Police officers are compensated at the rate determined in the mid-tier.
For injuries resulting in at least 250 compensable weeks, it is considered a serious disability, and the number of compensable weeks is increased by one-third and the claimant receives two-thirds of the AWW for the increased number of compensable weeks, not to exceed 75% of the SAWW.
SPECIAL PROVISIONS FOR LAW ENFORCEMENT OFFICERS
Police officers, as well as other 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. This is a significant difference.
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.
Law enforcement officers are exposed to dangers and physical demands that are unique in the workplace. Despite the job-related hazards, law enforcement officers injured on the job are sometimes hesitant to file a WCC claim, in part, out of loyalty to their agency. Moreover, they are sometimes hesitant to file a WCC claim because they believe that injury and stress are simply part of the job. The fact that injury and stress are part of the job, as a law enforcement officer, is the very reason why the Maryland General Assembly amended the WCA in favor of law enforcement personnel. Therefore, if a police officer, firefighter, paramedic, or correctional officer is injured in a work-related incident, or suffers from an occupational disease caused by the workplace, he or she should protect all rights before the WCC. The best way to accomplish that is to retain a competent workers’ compensation attorney.
About Warnken, LLC:
During the last two decades, Warnken, LLC, has represented numerous law enforcement officers and public safety employees in workers’ compensation matters. As with all legal matters, it is important to remember that the skill and experience of an attorney can be invaluable when attempting to preserve your rights. Insurers are represented by skilled legal counsel who act to protect the interests of the insurance company. Consequently, employees should think twice before attempting to represent themselves in any workers compensation matter. Warnken, LLC may be reached at 443-921-1100