Personal Injury
A 200-week difference. That is what is at stake when a Maryland workers' compensation claim for a shoulder injury gets classified the wrong way.
I see this play out constantly in my practice. An injured worker has shoulder surgery, starts receiving benefits, and assumes everything is being handled fairly. But behind the scenes, the insurance company's attorney is already working to categorize that shoulder injury as an "arm" or "upper extremity" case — which caps permanent partial disability benefits at 300 weeks. If that same injury is properly classified as an "Other Cases" claim, the maximum jumps to 500 weeks.
The difference is not academic. It can mean thousands of dollars in benefits that an injured worker never receives — simply because of how the claim was labeled.
Maryland's Workers' Compensation Act divides permanent partial disability injuries into two categories. The first is "scheduled" injuries — specific body parts listed in the statute with a fixed maximum number of weeks of benefits. An arm, for example, is capped at 300 weeks. A hand is 250 weeks. A leg is 300 weeks.
The second category is called "Other Cases." These are injuries to body parts that are not listed on the schedule — things like the back, neck, chest, and shoulder. For Other Cases injuries, the Maryland Workers' Compensation Commission evaluates the percentage of impairment to the worker's body as a whole, and the maximum is 500 weeks.
Here is the critical point: the shoulder is not listed on the statutory schedule. It should fall squarely under Other Cases. But in nearly every shoulder case I handle — especially when surgery is involved and the claim becomes more valuable — defense counsel argues that the shoulder is really just part of the arm or upper extremity, and therefore should be capped at 300 weeks.
This is one of the most consequential fights in Maryland workers' compensation law, and most injured workers have no idea it is happening.
Let me put this in concrete terms. Say a worker receives a 20% permanent partial disability rating for a shoulder injury. Under an Other Cases classification, that worker's benefits are calculated against 500 weeks — so 20% of 500 equals 100 weeks of benefits. Under a scheduled arm classification, it is 20% of 300 weeks — only 60 weeks.
That is 40 additional weeks of compensation at stake, multiplied by the worker's weekly benefit rate. Depending on the rate, that gap can easily represent $15,000 to $25,000 or more. For a worker recovering from shoulder surgery and dealing with lasting limitations, that money matters enormously.
The leading authority on this issue is Getson v. WM Bancorp, a 1997 decision by the Maryland Court of Appeals. In that case, the claimant injured her right shoulder after slipping on ice in her employer's parking lot. She fractured her humeral head, underwent surgery, and returned to work with permanent limitations. The Workers' Compensation Commission classified her injury under Other Cases and awarded benefits based on a 30% loss of industrial use of the body.
The employer appealed, arguing that the shoulder injury was really an injury to the arm and should be classified as a scheduled member under the statute. The Court of Appeals disagreed. It held that a shoulder injury is properly classified as an Other Cases impairment under § 9-627(k) of the Labor and Employment Article — not as a scheduled arm injury.
The Court also addressed an important nuance: the American Medical Association's Guides to the Evaluation of Permanent Impairment, which doctors use to assess disability ratings, do not override the statutory framework. In other words, even if a doctor expresses an impairment rating using "upper extremity" terminology from the AMA Guides, that does not change how the injury should be classified under Maryland law.
Getson should have settled this debate. But in practice, it has not. Defense counsel continues to push the upper extremity argument in case after case. And the outcome often depends on the specific medical evidence — which is exactly where the battle gets complicated.
In my experience, the insurance company's attorney has an almost automatic obligation to argue that a shoulder injury is an upper extremity case rather than a whole-person, Other Cases claim. The more valuable the claim — particularly after surgery — the harder they push.
The most effective tool they have is the language in your medical records.
If your treating physician or an independent medical examiner describes your impairment as an "upper extremity" impairment rather than a "shoulder" impairment, defense counsel will seize on that language. They will argue to the Commission that the doctor's own terminology proves this is a scheduled arm case, not an Other Cases claim. And sometimes, that argument works — even though Getson says the AMA Guides' terminology should not control the classification.
This is why the details of your medical records matter so much. How a doctor phrases an impairment rating can shift the entire trajectory of your claim.
There is another issue I want injured workers to understand. In some cases, the insurance company will set you up with a particular treating doctor or send you for an independent medical examination with a physician they have selected. These doctors may not be acting in your best interest. The way they document your injury — including whether they use "shoulder" or "upper extremity" language — can directly affect the value of your claim.
I am not saying every insurer-selected doctor is biased. But I am saying that you should talk to an attorney before accepting the insurance company's choice of doctor, before attending an IME without understanding what is at stake, and certainly before accepting any settlement offer.
If you have suffered a shoulder injury at work in Maryland, here is what I want you to know.
First, classification matters — and it is decided early. Whether your claim is treated as an arm case or an Other Cases claim will shape the maximum benefits available to you. This is not something to sort out after you have already accepted a settlement.
Second, pay attention to how your injury is described in your medical records. If your doctor is using "upper extremity" language instead of "shoulder," that could create problems down the road. An experienced workers' compensation attorney can help you understand what your records say and how to address any issues before they become ammunition for the other side.
Third, do not accept a settlement offer without having an attorney review the classification of your injury. The insurance company is not going to volunteer that your claim might be worth 200 more weeks of benefits under a different classification. That is your attorney's job.
Every shoulder case is different. The specific facts, the medical evidence, the testimony at the hearing — all of it matters. But the starting point is always the same: understanding what your claim is actually worth before you agree to anything.
If you have been injured at work and you are dealing with a shoulder claim in Maryland, I would be glad to review your situation. Contact me at SG Legal Group — I can help you understand your options and make sure your injury is classified the way the law intends.
Disclaimer: The information provided in this article is for general informational purposes only and does not constitute legal advice. Laws and regulations are subject to change, and individual circumstances vary. For advice specific to your situation, please consult with a qualified attorney.
Ioana David, Esq.
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