Visitor Question

Auto insurance vs Workers’ comp?

Submitted By: Anonymous (Maryland)

I was rear ended while driving the company van while at work. I filed a Worker’s Comp claim and a third party claim against the at-fault driver’s insurance company. I have not received any money from either company.

I used my PIP from my car insurance to pay for my medical bills. My PIP paid $2451.19 towards my medical bills and $48.81 towards my lost wages.

I have one medical bill in the amount of $276.00 that has not been paid.

Workers’ Comp has paid about $2582.00 towards medical bills and has a lien against the third party claim for that amount.

The last time I talked to the third party insurance company (MAIF), they were trying to negate a large portion of the medical bills for one reason or another. However, Workers’ Comp has a lien against these same bills. I have the medical bills to be around $8676.00.

Here are my questions:

1. How do I know if I am entitled to medical disability payments from Workers’ Comp?

2. Am I entitled to be reimbursed for the cost of the medical bills that were paid by my PIP?

3. Am I entitled to be reimbursed for the lost wages that were paid by my PIP? If so at what percent?

4. Which claim should I settle first and why?

5. If Workers’ Comp pays the outstanding bill in the amount of $276.00, will I owe Workers’ Comp $276.00 from my settlement?

Thank you.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Anonymous,

According to Maryland’s Workers Compensation Commission, disability benefits break down as follows:

Temporary Partial Disability Benefits:

These are benefits to which an injured employee may be entitled during the process of recovery when the worker during a temporary period is NOT totally disabled. They are intended to be temporary and generally apply when the worker can only perform limited or part-time duties at a reduced income level. That is, when their wage earning capacity is lower.

The employer or its insurer pays the covered employee compensation that equals 50% of the difference between the average weekly wage of the covered employee and the wage earning capacity of the covered employee in the same or other employment while temporarily partially disabled, subject to a maximum payment of 50% of the State average weekly wage.

Permanent Total Disability Benefits

Some injuries are so serious that a worker is permanently, totally disabled. Absent conclusive proof to the contrary, in Maryland the loss or loss of use of any of the following constitutes a permanent total disability: both arms, both eyes, both feet, both hands, both legs; or a combination of any two of the following: an arm, eye, foot, hand or leg.

Whether or not you can be reimbursed for the cost of medical bills paid by your PIP will depend on your division of benefits set out by your employer’s worker’s compensation insurance company. The two insurance companies will handle it. Worker’s comp may legally request reimbursement for monies paid out in your behalf.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,

Published: December 6, 2016

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