Chapter 06. Payment of Awards and Assessments and Termination of Benefits
Regulation .01 Payment Prior to Filing of Claim.LinkCopy Citation
A.
If a covered employee or dependent has not filed a claim with the Commission for the death or disability of the covered employee, an employer or insurer may not pay, in whole or in part, any compensation under Labor and Employment Article, Title 9, Annotated Code of Maryland.
B.
If a covered employee or dependent has not filed a claim with the Commission for the death or disability of the covered employee, an employer or insurer may pay or contest charges for medical and other services under Labor and Employment Article, Title 9, Subtitle 6, Part IX or Part XIII, Annotated Code of Maryland.
C.
An employer or insurer shall pay uncontested medical charges promptly after receipt.
Regulation .02 Claims for Medical Expenses; Notice; Penalty.LinkCopy Citation
A.
Notice. Within 5 days after receipt of an order of the Commission on a claim for payment for medical services, the claimant shall serve a copy of the order on the provider of the medical services for which payment was granted or denied.
B.
Penalty for Late Payment for Treatment or Services.
(1)
The Commission may assess against an employer or insurer a fine not to exceed 20 percent of any fee approved but not timely paid pursuant to Labor and Employment Article, §9-664, Annotated Code of Maryland.
(2)
The Commission shall determine the amount of the fine on a case-by-case basis.
Regulation .03 Payment of Assessments.LinkCopy Citation
A.
Time for Payment. Assessments payable for the SIF and the UEF shall be paid within 30 days after the date of the award of compensation or approval of a settlement.
B.
Assessments shall be paid in accordance with Labor and Employment Article, §§9-806, 9-1007, and 9-1008, Annotated Code of Maryland, as ordered by the Commission.
Regulation .04 Termination of Temporary Total Disability and Medical Benefits.LinkCopy Citation
A.
Termination of Monetary Benefits Requiring Notice.
(1)
Prior to terminating payment of temporary total disability benefits, an insurer shall give written notice to the claimant by:
(a)
Completing the insurer’s termination of temporary total disability benefits form; and
(b)
Sending a copy of the form to the claimant, counsel and to the Commission.
(2)
The insurer’s termination of temporary total disability benefits form may be used to provide notice to the claimant of the termination of disability benefits when:
(a)
The employee is working for another employer other than the employer where the accident or occupational disease occurred;
(b)
No medical evidence supports continued payment;
(c)
The employee failed to appear for a medical evaluation requested by the employer/insurer;
(d)
A physician other than the employee's chosen treating physician has determined that the employee has reached maximum medical improvement; or
(e)
Otherwise supported by law.
B.
Termination of Monetary Benefits — No Notice Required. An insurer may terminate payment of temporary total disability benefits without providing written notice, pursuant to Labor & Employment Article, §9-733(a), Annotated Code of Maryland, if:
(1)
The employee has returned to his or her current employment;
(2)
A treating physician chosen by the employee has advised that the employee has reached maximum medical improvement; or
(3)
The termination is made after the termination date contained in an order of the Commission.
C.
Termination of Medical Benefits.
(1)
Prior to terminating the payment of medical benefits, an insurer shall give written notice to the claimant and the claimant's treating physician or health care provider of the date that benefits will be terminated.
(2)
Written notice of the date that medical benefits will be terminated shall include a statement that the claimant has the right to request a hearing before the Commission on the issue of termination.
(3)
A copy of the termination notice provided to the claimant shall be filed with the Commission.
Chapter annotations
Authority: Labor and Employment Article, §§9-309, 9-605, 9-713, 9-727—9-731, Annotated Code of Maryland
History: Effective date: May 28, 2001 (28:10 Md. R. 949)
History: Regulation .01 amended effective September 2, 2002 (29:17 Md. R. 1382)
History: Regulation .01B amended effective November 26, 2001 (28:23 Md. R. 2055); April 11, 2005 (32:7 Md. R. 683)
History: Regulation .02 amended effective September 2, 2002 (29:17 Md. R. 1382); April 11, 2005 (32:7 Md. R. 683)
History: Regulation .02C repealed effective November 26, 2001 (28:23 Md. R. 2055)
History: Regulation .05 amended effective July 4, 2005 (32:13 Md. R. 1116); July 23, 2012 (39:14 Md. R. 839)
History: Regulations .01—.03, recodified from Regulations .09, .22, and .21 in COMAR 14.09.01, Procedural Regulations, to COMAR 14.09.06, Payment of Awards and Assessments and Termination of Benefits, and amended effective March 3, 2014 (41:4 Md. R. 303)
History: Regulation .04 adopted effective March 3, 2014 (41:4 Md. R. 303)
History: Regulation .04A amended effective October 18, 2021 (48:21 Md. R. 890)