Since the early 1900’s, every State has had some form of protection for employees who are hurt while working.  The old system requiring lawsuits against employers just wasn’t effective. Negligence by the employer was often difficult if not impossible to prove and the legal process was very time consuming and expensive, with no benefits paid to injured workers during the process. This is why the States passed workers’ compensation laws, providing a statutory solution to the problem.  Workers’ compensation was a new kind of insurance which all employers were required to obtain to protect their employees.

Covered Injuries
: Not all injuries are covered by the Workers’ Compensation Law even if the injury happened “on the job.” In Maryland, in order for an injury to be covered,  the harm suffered by the employee must have been caused by an “accidental personal injury arising out of and in the course of employment.” Those words from the Maryland statute are VERY important. Just because a person is hurt “while working,” “on the job” or “at work” may not be enough for the insurance to apply. Additionally, if you can prove that you have an occupational disease you may be entitled to Workers’ Compensation benefits.

Employees Only:  
In determining whether an injury falls under the coverage of workers’ compensation the first thing to understand is that this law protects only employees. The Workers’ Compensation statute provides legal guidance on who is a covered employee and employer. A genuine employer-employee relationship must exist. Some businesses are set up in such a way that some persons don’t actually work for the business but work with it as independent contractors. Other businesses don’t have any employees because they are a sole-proprietorship or partnership.  Persons in these categories, if they want workers’ compensation insurance, may elect to be covered and can obtain the necessary insurance. There is a statutory procedure for electing coverage.

Accidental Personal Injury & Occupational Diseases: 
If there is an employer-employee relationship between the worker and their company, the next factor considered is if the injury was an accident. An accidental injury is one that happens ‘by chance or without design, taking place unexpectedly or unintentionally.”

Exceptions to the accident requirement are occupational diseases. These are illnesses caused by the nature of the circumstances surrounding the worker’s job. For example, asbestosis is a disease that may have been caused by a worker’s job of removing asbestos from buildings. Some forms of skin, eye or lung disease may have been caused by long term exposure to chemical solvents or other solutions used on the job. Conditions such as these may result in the employee’s being covered by workers’ compensation even though there was no 

specific “accident;” they are covered as occupational diseases.

Arising Out of Employment: 
For a compensable accidental injury claim, the injury must “arise out of the employment”. If the conditions under which the work is required to be performed by the employer causes the worker’s injury, it is said to “arise out of” the employment. The focus of this factor is on the exposure of the employee to risk or danger because of the job requirements. For example, if a person must work in an environment that is usually wet and slippery–for instance, a car wash facility or a water amusement ride at an entertainment park–then a slip-and-fall injury experienced by that worker could be said to arise out of the person’s employment.

Arising in the Course of Employment: 
For a compensable accidental injury claim, the injury must also “be in the course of employment.” “In the course of employment” is a slightly different factor. Here the attention centers on the time, place and circumstances of the injury. If the injury occurs during the period of time when an employee was at work, the employer’s place of business or such other location as may have been designated by the employer, and while the employee was performing their job duties or something related to them when the injury took place, the injury is said to have arisen in the course of that person’s employment.

If all of the above factors are satisfied -and that’s not always easy to determine initially- a worker’s injury will generally be covered by workers’ compensation insurance. Frequently, an investigation of the claim is necessary. If a worker believes they have sustained a compensable injury, an Employee Claim may be filed with the Workers’ Compensation Commission to receive a determination regarding the type and amount of any benefits to which the worker may be entitled. Initial determinations that may have been made by insurance carriers are not binding on the Commission.

The legislature of each State determines the type and amount of benefits which are payable under workers’ compensation insurance, just as the various States differ in determining what kinds of injuries are compensable and which are not. Based upon the laws enacted in each State the insurance companies who provide this type of insurance coverage consider the probabilities of injury for different occupational categories and set their premium rates accordingly. This is the amount charged to employers for their workers’ compensation insurance. The Workers’ Compensation Commission does not establish rates of premiums, nor does the Commission itself provide insurance coverage. Workers’ compensation payments are not taxable to the employee as income.