Ex-Redskins Punter Tom Tupa just won his Maryland Workers’ Compensation case in the Court of Appeals (Washington Redskins v. Tupa). There were two issues here:
First, the Redskins tried to argue that Tupa’s preseason injury during warm-ups at FedEx field did not qualify as an accidental injury. The rule in workers’ compensation cases is that an employer (and the employer’s insurance company) are on the hook if an employee suffers an accidental injury while in the course of their employment. Tupa was working at the time–he was warming up. Tupa was accidentally injured. The Redskins tried to argue that these types of injuries are expected in football, so it wasn’t really accidental. The Court of Appeals called the Redskins’ argument “conspicuously wrong.” It doesn’t get much more wrong than that–it’s a nice way of calling it a dumb argument (to be fair, the employer/insurer’s argument was based on an old court opinion, but the workers’ compensation rules had been very much modified since that time).
The bigger issue was whether Tupa’s contract with the Redskins, which had something called a forum-selection clause, took away Tupa’s right to redress with the Maryland Workers’ Compensation Commission. In the contract, Tupa agreed to be bound by Virginia’s workers’ compensation laws. Maryland’s laws are more pro-claimant, so Tupa obviously wanted to fight his case in Maryland after his injury. The choice isn’t random–FedEx Field is located in Prince George’s County, and the Redskins are incorporated in Maryland. However, there are connections to Virginia, as well–the Redskins’ headquarters and practice facility are located there.
The problem with the forum-selection clause is that it is contrary to Maryland law. The rules on Maryland workers’ compensation make those provisions unenforceable:
§ 9-104. Agreements.
(a) Exemption from duty; waiver of right. –
(1) Except as otherwise provided in this title, a covered employee or an employer of a covered employee may not by agreement, rule or regulation:
(i) exempt the covered employee or the employer from a duty of the covered employee or the employer under this title; or
(ii) waive a right of the covered employee or the employer under this title.
(2) An agreement, rule, or regulation that violates paragraph (1) of this subsection is void to the extent of the violation.
Maryland is obviously concerned about employees waiving their rights to workers’ compensation benefits. Because of that concern, Tom Tupas will be entitled to extremely important benefits, including lifetime medical care for his work-related injuries.
If you were injured on the job, you may be entitled to medical care paid by your employer, as well as compensation for any permanent disability. Call us anytime at 443.850.4426, or through our online contact form. There are no consultation fees, hourly rates, or retainer fees; and you pay us nothing unless we win your claim. For more information on Baltimore workers’ compensation claims, click through the following links:
The title of this post is lifted straight from KevinMD.com’s blog post of the same name. It’s a mysterious title, and makes workers’ compensation treatment sound like something done in a back alley with rusty equipment by failing medical students. The point of Dr. Schumann’s post is really to explain that workers’ compensation is confusing for doctors.
Primary care doctors typically have no specialized training in conducting disability evaluations, and even less understanding of the byzantine world of workers’ compensation.
On this point, I wholeheartedly agree. Workers’ compensation is anything but a logical process–sure, it has its own internal logic, but to an outsider, the whole process is just wacky. Even lawyers seem to understand, if not accept, the internal contradictions. Much electronic ink has been spilled on some lawyer listserves that I monitor over whether an injury qualifies as a foot injury or a leg injury, because the classification will result in a wholly different amount of money to the injured claimant.
Workers’ compensation seems to take the battle of the experts to extremes–in getting a final rating from the Commission, lawyers must put forward the reports of their experts, who are expected to follow very specific guidelines. Not just any doctor can do it; and not just any doctor knows how to do it. The result is that the Commission gets reports from the same doctors time and time again. I’m not saying that those doctors are fudging their results, or that they don’t believe in their reports, but I will say that there are probably claimant or insurer/employer biases and prejudices that influence the reports. Show me an expert, and I’ll tell you what he’s going to say. 95% of the time, I’d be right. This makes the world of workers’ compensation seem like a game. That’s unfortunate, because it’s a game with serious consequences to the injured claimants, and also to their employers and the insurance companies. But it’s the only system that we’ve got.
The second point is that those doctors and clinics who specialize in workers’ compensation medicine often mark-up drugs that they “sell” to the injured worker. Of course, the workers’ compensation insurer is the party expected to foot the bill. The analysis by Dr. Schumann is that those clinics have an incentive to mark-up the cost of those drugs. They probably do. The other side of the analysis, though, is that not all workers’ compensation claims are viable–the doctors sometimes shell out time and money and prescriptions, and never get reimbursed because a claim is denied or a workers’ compensation case fails. The prices of other products must be raised to compensate for those losses. In 2011, 32.7% of the 23,336 claims were disputed. Less than 60% of claims yielded an award of temporary total disability (basically, payment of wages for time lost because of the injury). I haven’t found statistics to show what percentage of those claims are disputed and lost by the claimant, but that it an important number to determining whether the profit made by doctors who peddle drugs is obscene, outrageous, or just modest.
The other part to this equation is that people injured on the job often have no place to go–if they need medication, their insurance will often not pay for it when they determine that it was the result of an accident. Many injured workers are uninsured. Of course, they are happy to get the care and medicine that their doctors recommend. If it comes with a higher price tag, so be it.
It’s not a perfect system, but it’s the game they have to play.
Many of my Baltimore workers’ compensation calls are from people who have never been through the process, before. All litigation can be complicated, but workers’ compensation has unique jargon that makes it especially difficult for people to understand. Here are some key terms, descriptions and concepts:
Workers’ Compensation Claim: a workers’ compensation claim is any claim by made an injured worker to his/her employer’s insurance company. Claims can be informal, consisting of internal company paperwork; or they can be formal, including a claim through the Workers’ Compensation Commission.
Workers Compensation Commission (WCC): This is the Maryland entity that will process and hear workers’ compensation claims. The WCC is like a court, and the commissioners are like judges. The only way to get a claim in front of the WCC is to file a formal Employee Claim Form (click here for information on hard copy blue forms, or here for information about electronic filing).
Fault: In order to get workers’ compensation benefits in Maryland, the employee does not have to prove that the employer was at fault. Fault is not important in these claims—the worker’s injury could be because of the employee’s own clumsiness, or the actions of another employee, or because of pure accident, and the employer is responsible as long as the injury was in the course and scope of employment (meaning, that the injury happened while on the job and working in furtherance of that job).
Statute of Limitations: The employer must file a formal claim with the Workers’ Compensation Commission within two years after the date of the accident. There is a lot of case law discussing when a worker must give notice to an employer—it’s always best to notify the employer of an accident immediately after the accident.
Temporary Total Disability (TT or TTD): When injured on the job, an employee who cannot return to work for a certain amount of time may be entitled to TT benefits. This is basically meant to help the worker by providing some money early on—generally, this amounts to two-thirds of the employee’s average weekly wage (AWW).
Average Weekly Wage (AWW): Average Weekly Wage is used to calculate wage- and salary-type benefits like Temporary Total Disability. To calculate the AWW, you must usually add all benefits (wages, bonuses, tips, etc…) for the fourteen weeks immediately prior to the injury, and divide that number by fourteen.
Medical Benefits: One major benefit of workers’ compensation is the payment of medical expenses. If the employer is responsible for the injury, then it must pay for all necessary and related medical expenses. Employees can choose their own doctors—they don’t have to see a doctor picked by the employer (and, there are many reasons not to see a doctor picked by the employer).
Hearing: If the employer doesn’t believe that it is responsible for a claim, or if it contests any part of a claim (the amount of temporary total benefits, medical treatment, etc…), then either party may request a Hearing. Each side will present evidence during a hearing, and a commissioner will render an opinion, usually within a couple of weeks.
Third-Party Claim: Some on-the-job injuries are caused by other people or entities. For example, a driving salesman may get into an auto accident while on-the-job. He may pursue a claim through Workers’ Compensation, and he may also pursue a third-party claim against the negligent driver. There is some interplay between the two cases, but there are two avenues of recovery.
A high school principal landed in hot water last week after it was revealed that she friended hundreds of students using false pretenses. After creating a fake Facebook profile for Suzy Harriston and friending over 300 users, a former high school quarterback posted:
Whoever is friends with Suzy Harriston on Facebook needs to drop them. It is the Clayton Principal.
Good advice for anyone. Principal Louise Losos was placed on a leave of absence, then resigned with a severance package of $140,000.
In this day and age of social media, we recommend that our clients clean out their friend lists, and not accept new friend requests from anyone that they do not know. It is important to avoid posting anything about the legal claim, whether medical malpractice, automobile accident, or workers’ compensation, on electronic social networking sites. You should be aware that insurance company adjusters or private investigators may examine these posting, especially if there are no privacy settings enabled, to determine ways to undermine your claim.
For More Information
Head on over to our Maryland Car Accident Lawyers Blog for a post about last week’s workers’ compensation opinion, WMATA v. Williams. Click here for more information on workers’ compensation cases in Timonium and Maryland.