Md. Code Regs. 14.09.01.01

Current through Register Vol. 51, No. 18, September 6, 2024

Section 14.09.01.01 - Definitions

A. In this subtitle, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Affidavit" means a written statement the contents of which are affirmed under the penalties of perjury to be true.

(2) "Automatic award" means the order finding the claim compensable when:

(a) The employer or insurer files no response to an employee's claim form by the consideration date in accordance with Labor and Employment Article, § 9-713, Annotated Code of Maryland;

(b) The employer or insurer files a response that the claim does not involve lost time; or

(c) The employer or insurer files a response that the employer or insurer does not contest the claim.

(3) "Certified mail" means mail deposited with the United States Postal Service, postage prepaid and return receipt requested.

(4) "Claimant" means a person filing a workers' compensation claim and includes:

(a) A covered employee;

(b) A dependent of a deceased covered employee; or

(c) An individual authorized to act on behalf of a dependent of a deceased covered employee.

(5) "Commission" means either the Workers' Compensation Commission or its designee.

(6) "CompHub" means the Commission's online system designed to facilitate the filing and adjudication of workers' compensation claims, and to provide other services related to workers' compensation benefits.

(7) "Consideration date" means the day by which the employer or its insurer must begin paying temporary total disability benefits, or file with the Commission any issue to contest the claim in accordance with Labor and Employment Article, § 9-713, Annotated Code of Maryland.

(8) "Contact information" means the name of a person submitting a document or of a person on whose behalf a document is being submitted, telephone numbers, personal or business addresses, email addresses, employer identification and address, or similar facts that make it possible for another to contact a person who is named in a document.

(9) "Disputed workers' compensation claim" means a:

(a) Newly filed claim from the date it is filed until the employer or insurer commences paying the claim or until the consideration date has expired;

(b) New claim in which issues have been filed;

(c) Pending claim in which one or more issues have been filed; or

(d) Claim that is pending on appeal.

(10) File.

(a) "File" means to submit to the Commission a written claim, motion, request, or other document for action by the Commission.

(b) "File" does not include a submission rejected by the Commission.

(11) "Final award" means the award of compensation determined by the Commission after exhaustion of all applicable appeals, regardless of whether the award is increased or decreased as a result of any appeal.

(12) "Formal set-aside allocation" means a document reflecting a comprehensive analysis and projection of future injury-related medical needs and associated costs.

(13) "Healthcare provider delegate" means administrative or support staff designated by a health care provider to have access to basic claim information for the purpose of obtaining settlement, claim and hearing status information.

(14) "Individual" means a human being.

(15) "Insurer" means:

(a) A stock corporation or mutual association that is authorized under the Insurance Article, Annotated Code of Maryland, to provide workers' compensation insurance in the State;

(b) The Chesapeake Employers' Insurance Company authorized under Insurance Article, Title 24, Subtitle 3, Annotated Code of Maryland;

(c) A governmental self-insurance group that meets the requirements of Labor and Employment Article, § 9-404, Annotated Code of Maryland;

(d) A self-insurance group of private employers that meets the requirements of Insurance Article, §§25-301-25-308, Annotated Code of Maryland; or

(e) An individual employer that self-insures in accordance with Labor and Employment Article, § 9-405, Annotated Code of Maryland.

(16) "Insurer delegate" means administrative or support staff, designated by an insurer, to have access to all claim documents in all claims in which the insurer is a party for the purpose of filing documents and managing claims.

(17) "Non-compromise case" means a case in which the employer/insurer has not contested liability or in which the Commission has found liability and in which the settlement compensates the claimant for anticipated future medical expenses.

(18) "Paper" means a document filed with the Commission, whether in physical paper form or electronic form or format.

(19) "Person" means:

(a) An individual;

(b) A general or limited partnership;

(c) A joint stock company;

(d) An unincorporated association or society;

(e) A municipal or other corporation;

(f) An incorporated association;

(g) A limited liability partnership;

(h) A limited liability company;

(i) The State, its agencies or political subdivisions; or

(j) A governmental entity.

(20) "Proxy" means administrative or support staff, designated by an attorney, to have access to all claim documents in all claims in which the attorney has entered the attorney's appearance for the purpose of filing documents and managing claims.

(21) "Role" means the functionality and type of account for which a user is authorized in CompHub and includes the following and their delegates and proxies:

(a) Attorney;

(b) Claimant;

(c) Employer;

(d) Insurer;

(e) Healthcare provider or practitioner; and

(f) Vocational rehabilitation provider or practitioner.

(22) "Signature" includes electronic signature pursuant to Commercial Law Article, § 21-101(i), Annotated Code of Maryland.

(23) "State average weekly wage" means the State average weekly wage in effect on the date of the accident or date of disablement.

(24) "Subpoena" means a written order directed to a person and requiring attendance at a particular time and place to take the action specified.

(25) "Subscriber" means an authorized user in CompHub having the access applicable to the role for which the user is authorized.

(26) "Subsequent Injury Fund" or "SIF" means the statutorily created entity, funded by assessments on workers' compensation awards and settlements, that may be a party to a claim and which pays benefits attributable to a compensable injury to previously injured body parts.

(27) "Undisputed workers' compensation claim" means a claim in which all issues have been:

(a) Withdrawn;

(b) Resolved by a decision of the commission that is not appealed; or

(c) Resolved on appeal.

(28) "Uninsured Employers' Fund" or "UEF" means the statutorily created entity, funded by assessments on workers' compensation awards and settlements, that may be a party to a claim and which pays workers compensation awards made against an uninsured employer.

Md. Code Regs. 14.09.01.01

Regulations.01 repealed effective October 1, 1991 (18:11 Md. R. 1187)
Regulations.01 adopted effective October 1, 1991 (18:11 Md. R. 1187)
Regulation .01 amended effective May 28, 2001 (28:10 Md. R. 949); September 2, 2002 (29:17 Md. R. 1382)
Regulation .01B amended effective April 11, 2005 (32:7 Md. R. 683)
Regulation .01B amended as an emergency provision effective January 4, 2010 (37:3 Md. R. 173); emergency status extended at 37:15 Md. R. 997
Regulation .01B amended effective November 28, 2011 (38:24 Md. R. 1503); amended effective 45:5 Md. R. 287, eff. 3/12/2018; amended effective 47:17 Md. R. 797, eff. 8/24/2020; amended effective 48:20 Md. R. 890, eff. 10/18/2021