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Maximum Medical Improvement in Maryland Workers’ Compensation Cases

parking-lot-1092981-mIn a recent case, the Maryland Court of Special Appeals considered whether a claimant who had reached maximum medical improvement could receive temporary total disability benefits under the Workers’ Compensation Act. The case arose when a 68-year-old claimant working at a CVS pharmacy fell on ice outside her workplace. She hurt her mid and lower back because of the fall.

She filed for temporary total benefits through CVS’s insurer and began medical treatment. A neurosurgeon’s examination found that she had a medical condition called kyphosoliosis, a pre-existing S curve in her mid and lower back. She also had a fracture to the spine as a result of the accident. Fragments of her spine had entered the spinal canal.

Her neurosurgeon recommended a fracture repair and he referred her to an orthopedic surgeon for further evaluation. After talking to the orthopedic surgeon, she decided against the surgery.

The insurer stopped making temporary total disability benefit payments when it found out she decided not to have the surgery. She filed issues with the Maryland Workers’ Compensation Commission asking it to order vocational rehabilitation and reinstate her temporary total disability payments.

The insurer’s orthopedic surgeon examined her and found that she wasn’t able to go back to full-time work, but could work four hours per day at a sedentary job. He found she had reached maximum medical improvement — she could not improve any more without surgery.

The Commission found that the claimant was at maximum medical improvement and denied temporary total disability. It also found that she was entitled to 60 days of vocational rehabilitation and compensation for the vocational rehabilitation benefits at the temporary total disability rate during the 60-day period.

The claimant asked the Circuit Court to review the case. She also filed for summary judgment, asking for a modification of existing workers’ compensation law. She didn’t dispute the finding of maximum medical improvement and she admitted that case law supported the insurer’s position on terminating the temporary disability benefits because she had reached maximum improvement. However, she argued that she deserved summary judgment because the Legislature didn’t intend that maximum medical improvement meant that temporary total disability benefits would be terminated.

The circuit court denied the motion and case proceeded to trial. At trial, a videotaped deposition of experts from both sides was presented that showed that both of them believed she had reached maximum medical improvement, although they disagreed as to when. The claimant testified that she continued to see a doctor for pain medication therapy until 2011 and that she had looked for jobs as suggested by one of the doctors. Nonetheless, she remained unemployed.

The employer/insurer made a motion for judgment, which was denied. The jury found the employee had reached maximum medical improvement, she was temporarily and totally disabled, and that she would remain so until she found a job. The employer asked the court to grant it judgment notwithstanding the verdict or a new trial.

The trial judge granted the motion for judgment notwithstanding the verdict, ruling that the claimant was not entitled to temporary total disability payments. The employee appealed.

The appellate court explained that temporary total disability is intended to cover a healing period. An injury is not temporary once the injured worker is as healed as he or she is going to get. The test for permanent total disability was whether, at the time the employee had reached maximum medical improvement, there was a market for the type of job for which she was qualified. She would be eligible to receive permanent total disability benefits if she couldn’t work in a job for which a reasonable stable market existed. In this case, there was a stable market, but the claimant had simply not been able to find a job. She had reached maximum medical improvement and was no longer entitled to temporary total disability benefits.

If you have been hurt at work, you should report the injury to your employer and consult with an experienced Maryland workers’ compensation attorney as soon as possible. Contact the attorneys of Steinhardt, Siskind and Associates at (866) 902-4111 or via our online form.

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