The Maryland WCC Form H-30R, Request for Modification (Rev. July 2005), is the form a party files with the Maryland Workers’ Compensation Commission to ask the Commission to reconsider, reopen, or modify a prior Order in a workers’ compensation claim. An injured worker uses it to prove their disability got worse and ask for more money, while an insurer uses it to argue the worker improved and ask the Commission to reduce the award.
This form is your second chance after a case has been decided and an Order has been issued. Maryland law gives you a window of five years from the date of your injury or from the last payment of compensation, whichever is later, to file. Miss that window and the door closes for good, so the date you put on this form can be worth tens of thousands of dollars. One key rule trips up almost everyone: the H-30R must be filed together with the Issues Form H-24R, and a filing that arrives without its companion form gets bounced back unscheduled.
Here is what you will learn in this guide:
- 📋 What the H-30R actually does and exactly who is allowed to file it
- 🗂️ Every document and number you must gather before you open the form
- ✍️ A line-by-line walkthrough of each box on the H-30R and the matching H-24R
- 👥 Three real-world examples that follow named filers from start to finish
- ⚠️ The most common mistakes that get a modification request denied or delayed
What the Form Is and Who Must File It
Form H-30R is the official Request for Modification used in the Maryland workers’ compensation system. The Maryland Workers’ Compensation Commission is the state agency that receives it, reviews it, and decides whether to change a prior award. The form exists because injuries are not frozen in time; a back injury that earned a 10% disability rating in 2022 can degenerate into a 25% disability by 2026, and the law lets you come back to ask for the difference. The legal authority for reopening and modifying awards comes from the Maryland Labor and Employment Article and the Commission’s procedural rules in COMAR Title 14.09.
The form is used by parties to a compensation claim, which means more than just the injured worker. A claimant files it to argue that their permanent disability increased or that they need additional temporary total disability benefits. An employer or insurer files the very same form to argue that the claimant’s disability decreased and that the weekly checks should stop or shrink. Attorneys for either side file it on their client’s behalf, and the Subsequent Injury Fund or Uninsured Employers’ Fund can also be parties.
The single most important rule about this form is that it never travels alone. The H-30R must be accompanied by the Issues Form H-24R, which is the document that actually puts your dispute on the hearing calendar. Think of the H-30R as the request and the H-24R as the ticket that gets you in front of a Commissioner. File one without the other and you have started a process that cannot finish.
Before You Start: Documents and Information You Need
Gather everything below before you open the form, because a missing claim number or stale medical report is the difference between a hearing date and a rejection letter. Filers who walk in unprepared often discover they cannot even complete Box 1.
- Your WCC claim number. This is the unique number the Commission assigned when your original claim was docketed; without it the Commission cannot match your request to your file, and the form is unprocessable.
- The date of your work injury or last compensation payment. You need this to prove you are inside the five-year reopening window, and getting it wrong can make a timely filing look late.
- A copy of the Order you want changed. The Commission needs to know which prior decision you are challenging, and quoting the wrong Order date sends reviewers to the wrong document.
- Updated medical records or a new impairment rating. A doctor must document that the condition has worsened (or improved, for insurers), and a request with no medical support almost always loses.
- The names and addresses of every party of record. You must serve a copy on the other side, and skipping a party can void the filing for lack of proper service.
- Your Social Security number. The Commission uses it to verify identity across its records, and a mismatch can trigger a hold on processing.
- The companion Issues Form H-24R. This is mandatory, not optional, and the H-30R will not be scheduled without it.
- Your attorney’s information, if represented. Represented parties must file through CompHub, and the attorney of record must be listed so notices reach the right inbox.
- A current mailing address and phone number. Every notice and hearing date is mailed to the address on file, and an outdated address means you may miss your own hearing.
Where to Get the Form and How to Access It
You can get Form H-30R directly from the Maryland Workers’ Compensation Commission forms page, where the Commission posts the current fillable PDF version. The form carries the revision stamp Rev. July 2005, so confirm that date appears on your copy before you fill it in; an older, retired version can be rejected on sight. The companion Issues Form H-24R is posted in the same place and must be downloaded at the same time.
How you access and submit the form depends on whether you have a lawyer. Under COMAR 14.09.02.02, a party represented by counsel must file electronically through CompHub, the Commission’s online portal. An unrepresented worker may file through CompHub or on paper. Every party involved in a claim, including employers, insurers, and third-party administrators, must register with CompHub to participate.
CompHub launched as the Commission’s redesigned filing system and is now the main channel for most filings. To use it, you create an account, verify your identity, and locate your existing claim by claim number. Once inside the claim, you select the modification filing, attach your supporting PDFs, and certify the submission electronically. If you are filing on paper, you print the form, fill it by hand or type, and mail or fax it to the Commission’s office in Baltimore.
Step-by-Step: How to Fill Out Form H-30R Line by Line
The H-30R is a short form, but every box carries weight, and a blank or wrong entry can sink the whole request. Work through each field in the order it appears, and remember that the H-24R must be completed alongside it. Below, sample entries that show what you actually write on the form are shown in italics.
Box 1: WCC Claim Number
This box asks for the claim number the Commission gave your case when it was first opened. You write the number exactly as it appears on your original award or any Commission notice, including all letters and digits, with no extra spaces. For example, Darnell Brooks writes B123456 in the claim number box, copying it straight from his most recent Order. If you have more than one claim from different injuries, use the number for the specific claim you want modified, not a newer or older one.
A common edge case is the worker who has lost every piece of paper and cannot find the number; in that situation you can look it up through the CompHub Claim Inquiry using your last name plus your Social Security number or date of birth. The most common mistake here is transposing two digits, which routes your request to the wrong file or to no file at all, and the Commission cannot schedule a hearing it cannot match. A frequent misconception is that the claim number is the same as your Social Security number; it is not, and entering your SSN in this box exposes private data and still fails to identify the claim.
Box 2: Claimant Name and Address
This box asks for the injured worker’s full legal name and current mailing address, even when the insurer is the one filing. You write the name in the order First, Middle, Last, and use the address where the worker wants every hearing notice mailed. For example, Maria Lopez writes MARIA T. LOPEZ, 412 OAK STREET, HAGERSTOWN, MD 21740 in the claimant block. Use the worker’s legal name as it appears on the original claim, not a nickname or a new married name unless the claim was amended.
A common edge case is the worker who moved after the original award; if the address changed, the correct fix is to file a separate Claimant’s Request for Change of Address (Form H-31R), not to quietly change it here and assume the system updates everywhere. The most common mistake is listing an old address, because the Commission mails the hearing date to whatever address is on file, and a worker who misses the hearing can lose by default. A frequent misconception is that the address on this form changes the address on the whole claim; it does not, so the change-of-address form still matters.
Box 3: Employer and Insurer Information
This box asks you to identify the employer and the workers’ compensation insurer named in the claim. You write the employer’s legal business name and the insurer’s name as they appear in the Commission’s records, which you can confirm through CompHub. For example, Carlos Mendez lists EMPLOYER: RIVERSIDE LOGISTICS LLC and INSURER: CHESAPEAKE MUTUAL INS. CO. exactly as shown on his award. Matching the names to the official record matters because the Commission and CompHub key parties by these exact entities.
A common edge case is the self-insured employer, where there is no separate insurance company; in that situation you name the self-insured employer in both roles or follow the CompHub prompt for self-insured parties. The most common mistake is guessing at the insurer’s name or using the third-party administrator’s name instead, which can leave the actual party on the hook unserved and delay the hearing. A frequent misconception is that the employer is no longer a party once an insurer is involved; both remain parties of record and both must be served.
Box 4: The Order or Award Being Modified
This box asks which prior decision you want the Commission to reconsider, reopen, or modify. You write the date of the Order and briefly identify it, such as the award of permanent partial disability you are challenging. For example, Janet Powell writes ORDER DATED 03/18/2022 AWARDING 10% PPD TO THE BACK so the Commission knows exactly which ruling is in dispute. Pull this date straight from the Order itself rather than from memory.
A common edge case is a claim with several Orders over the years; you identify the specific Order whose result you want changed, usually the one that set the disability percentage. The most common mistake is leaving this box vague or blank, which forces the Commission to guess and can get the request returned for clarification. A frequent misconception is that you can use this form to fix a typo or clerical error in an Order; you cannot, because a document correction is handled on Form C-90R, not the H-30R.
Box 5: Grounds for Modification (Increase or Decrease)
This is the heart of the form, and it asks why the prior award should change. You state whether the claimant’s permanent disability has increased or decreased, or whether the claimant is entitled to additional temporary total benefits, and you describe the worsening or improvement in plain terms. For example, Darnell Brooks writes: CLAIMANT’S LUMBAR CONDITION HAS WORSENED SINCE THE 2022 AWARD; NEW MRI AND IMPAIRMENT RATING ATTACHED SHOWING INCREASE FROM 10% TO 25% PPD. Be specific about the body part and the change.
A common edge case is the insurer filing to reduce an award; the insurer writes that the claimant’s disability has decreased and attaches medical evidence of improvement or a return to full duty. The most common mistake is asking for modification with no medical proof, because the law requires a doctor to document that the condition changed, and a bare assertion gets denied. A frequent misconception is that you can reopen simply because you are unhappy with the original percentage; only a genuine change in condition, not regret, supports a modification.
Box 6: Date of Injury and Last Compensation Payment
This box anchors your filing inside the legal time limit, so it asks for the date of the work injury and the date compensation was last paid. You write both dates in MM/DD/YYYY format, drawn from your records and payment history. For example, Maria Lopez writes INJURY DATE 06/01/2021 and LAST PAYMENT 09/15/2022, which shows her filing is well within the window. These two dates let the Commission confirm you still have the right to reopen.
A common edge case is a worker who received several types of benefits; use the date of the last compensation payment of any kind, since the five-year clock runs from injury or last payment, whichever is later. The most common mistake is using the injury date when the last-payment date would have kept the filing alive, which can make a timely request look barred. A frequent misconception is that the five years runs only from the injury date; the later of the two dates controls, and that often buys a worker extra time.
Box 7: Signature, Date, and Certification of Service
The final box asks the filing party or attorney to sign, date, and certify that a copy was served on every other party. You sign your legal name, enter the date you sign in MM/DD/YYYY format, and list who you served and how. For example, Carlos Mendez signs Carlos Mendez, dates it 06/04/2026, and certifies he mailed a copy to the insurer and its attorney. The signature makes the filing official and the certification proves the other side got notice.
A common edge case is an unrepresented worker who is unsure who to serve; you serve every party of record, which includes the employer, the insurer, and any attorney listed on the claim. The most common mistake is signing but skipping the certification of service, which can void the filing because a copy must be served on the other parties. A frequent misconception is that filing with the Commission automatically notifies everyone else; it does not, and the burden to serve the other side falls on you.
Completing the Companion Issues Form H-24R
Because the H-30R cannot be scheduled alone, you fill out the Issues Form H-24R at the same time to put your dispute on the hearing calendar. This form asks for the same identifying information, the claim number, the parties, and then a checklist of issues you want the Commission to decide. You check the issues that match your modification, such as “nature and extent of permanent disability” or “worsening of condition,” and you specify the body part involved.
The H-24R is used to request or initiate a hearing after the consideration date, and it must specify the exact issues to be resolved. The most common mistake on the H-24R is leaving the issues vague, because the Commission will only hear the issues you actually check, and an unchecked issue is an issue you cannot argue at the hearing. The misconception to avoid is thinking the H-30R already lists your issues; the H-24R is the controlling document for what gets heard, so list every issue you want decided.
Three Filled-Out Examples Using Real Scenarios
The three fact patterns below show how different filers complete the H-30R and H-24R from start to finish. Each follows one named person through the most important sections of the form.
Scenario 1 — Darnell Brooks, injured worker reopening for a worsening back. Darnell hurt his lower back in 2021, received a 10% PPD award in 2022, and now his condition has degenerated. He files the H-30R to ask for an increase.
| Form Section | What Darnell Enters |
|---|---|
| Box 1: WCC Claim Number | B123456 |
| Box 2: Claimant Name and Address | DARNELL BROOKS, 88 ELM ROAD, BALTIMORE, MD 21215 |
| Box 3: Employer and Insurer | EMPLOYER: APEX WAREHOUSE INC.; INSURER: KEYSTONE COMP INS. CO. |
| Box 4: Order Being Modified | ORDER DATED 02/10/2022 AWARDING 10% PPD TO THE BACK |
| Box 5: Grounds | DISABILITY INCREASED; LUMBAR CONDITION WORSENED, NEW RATING 25% PPD |
| Box 6: Injury / Last Payment | INJURY 04/12/2021; LAST PAYMENT 05/30/2022 |
| Box 7: Signature and Service | Darnell Brooks, 06/04/2026, served insurer and counsel by mail |
| H-24R Issues Checked | Nature and extent of permanent disability; worsening of condition |
Scenario 2 — Keystone Comp Ins. Co., insurer seeking a reduction. The insurer believes Maria Lopez recovered and returned to full duty, so it files the H-30R to ask the Commission to reduce her ongoing award.
| Form Section | What the Insurer Enters |
|---|---|
| Box 1: WCC Claim Number | W654321 |
| Box 2: Claimant Name and Address | MARIA T. LOPEZ, 412 OAK STREET, HAGERSTOWN, MD 21740 |
| Box 3: Employer and Insurer | EMPLOYER: RIVERSIDE LOGISTICS LLC; INSURER: KEYSTONE COMP INS. CO. |
| Box 4: Order Being Modified | ORDER DATED 01/05/2024 AWARDING ONGOING TTD |
| Box 5: Grounds | DISABILITY DECREASED; CLAIMANT RETURNED TO FULL DUTY, IME ATTACHED |
| Box 6: Injury / Last Payment | INJURY 06/01/2021; LAST PAYMENT 02/15/2026 |
| Box 7: Signature and Service | Adjuster signature, 06/04/2026, served claimant and counsel |
| H-24R Issues Checked | Nature and extent of disability; entitlement to ongoing benefits |
Scenario 3 — Janet Powell, claimant requesting reconsideration of a recent award. Janet thinks the Commission’s recent Order overlooked part of her medical evidence and files to have it reopened and modified.
| Form Section | What Janet Enters |
|---|---|
| Box 1: WCC Claim Number | P778899 |
| Box 2: Claimant Name and Address | JANET POWELL, 19 PINE COURT, ROCKVILLE, MD 20850 |
| Box 3: Employer and Insurer | EMPLOYER: METRO CLEANING CO.; INSURER: BAY STATE INS. CO. |
| Box 4: Order Being Modified | ORDER DATED 04/22/2026 AWARDING 8% PPD TO THE SHOULDER |
| Box 5: Grounds | DISABILITY INCREASED; SECOND RATING SHOWS 18% PPD TO SHOULDER |
| Box 6: Injury / Last Payment | INJURY 09/03/2023; LAST PAYMENT 05/01/2026 |
| Box 7: Signature and Service | Janet Powell, 06/04/2026, served employer and insurer by mail |
| H-24R Issues Checked | Nature and extent of permanent disability |
A fourth filer, Aisha Carter, a home health aide reopening a knee claim, and a fifth, Marcus Reed, a warehouse worker adding a worsening-of-condition issue, would follow the same path, proving the form works the same way no matter the body part.
How to File the Completed Form
Maryland gives you more than one way to submit the H-30R and its H-24R, and the right channel depends on whether you have an attorney. Keep proof of whatever method you use, because a filing you cannot prove is a filing the Commission may say it never received.
- CompHub online portal. Represented parties must file through CompHub, and unrepresented workers may use it too. There is no filing fee for a modification request. You attach your PDFs, certify electronically, and the system date-stamps your submission as your proof of filing.
- By mail. Unrepresented workers may mail the forms to the Commission at 10 East Baltimore Street, Baltimore, Maryland 21202. There is no fee. Send it certified mail with return receipt so the green card serves as your proof of filing and the postmark anchors your date.
- By fax. The Commission accepts faxed filings for some documents from unrepresented filers; keep the fax confirmation sheet as proof. Confirm the current fax number on the Commission’s contact page before sending, and follow up by phone if you get no acknowledgment.
- In person. You may hand-deliver the forms to the Commission’s Baltimore office during business hours and ask for a date-stamped copy as your receipt. This is the surest way to confirm the Commission has your filing on the date you intended.
For technical help with CompHub, the Commission directs filers to comphubsupport@wcc.state.md.us, and for claim-process questions it lists 410-368-0992. Processing times vary, but once the Commission accepts the H-30R with its H-24R, it sets the matter for a hearing and mails a hearing notice to every party of record.
What Happens After You File
Once the Commission accepts your H-30R and H-24R, it places the modification request on the hearing docket and mails a hearing notice to all parties. That notice lists the date, time, and location of the hearing and any special issue the case is set on. From this point the matter moves toward a contested hearing, where each side presents medical evidence and testimony.
At the hearing, a Commissioner weighs the medical proof of worsening or improvement and decides whether to change the prior award. The worker who reopened for a worsening back must prove the change with current medical evidence, while the insurer seeking a reduction must prove improvement the same way. After the hearing, the Commission issues a new Order that either increases, decreases, or leaves the award unchanged.
If you disagree with the new decision, you have options that run on tight clocks. You may file a Request for Rehearing on Form H-27R within 15 days based on an error of law or mistake of fact. You may also appeal to the circuit court within 30 days of the decision. Both deadlines are firm, and missing them generally ends your ability to challenge the result.
Mistakes to Avoid When Filling Out the Form
Each error below has sunk real modification requests, so read them as a checklist before you submit. The consequence beside each one shows exactly what goes wrong.
- Filing the H-30R without the H-24R. The request never reaches the hearing calendar and sits unprocessed.
- Filing after the five-year window closed. The Commission lacks authority to reopen and denies the request outright.
- Leaving Box 5 with no medical evidence. The Commission has no basis to find a change and denies the modification.
- Transposing digits in the claim number. The filing routes to the wrong file or none, and no hearing gets scheduled.
- Using an outdated claimant address. The hearing notice goes to the old address and the filer misses the hearing.
- Naming the wrong insurer or only the administrator. The actual party goes unserved and the hearing is delayed.
- Skipping the certification of service. The filing can be voided because the other parties never got proper notice.
- Trying to fix a clerical typo with the H-30R. The form cannot correct documents, so the request is returned and a C-90R is needed instead.
- Identifying the wrong Order in Box 4. Reviewers look at the wrong decision and the request stalls for clarification.
- Listing vague issues on the H-24R. Unchecked issues cannot be argued, narrowing what the Commissioner will hear.
- Forgetting to sign and date Box 7. An unsigned form is incomplete and the Commission will not act on it.
- Assuming filing notifies the other side. Without your own service, the filing can be rejected for lack of notice.
Do’s and Don’ts
These quick rules keep your filing clean and on schedule.
- Do attach the H-24R every time, because the H-30R cannot be scheduled without it.
- Do attach current medical evidence, because the law requires proof the condition changed.
- Do confirm you are inside the five-year window, because the deadline is jurisdictional and unforgiving.
- Do use the exact claim number from your Order, because the Commission matches filings by that number.
- Do keep proof of filing and service, because you may need to prove both later.
- Do verify you have the Rev. July 2005 version, because an old form can be rejected.
- Don’t use this form to fix typos, because that is the C-90R’s job.
- Don’t leave the grounds box vague, because vague grounds invite denial.
- Don’t guess at party names, because a wrong name leaves a party unserved.
- Don’t rely on memory for dates, because a wrong date can bar a timely claim.
- Don’t assume the Commission serves the other side, because service is your job.
- Don’t miss the 15-day rehearing or 30-day appeal deadlines, because they are firm.
Pros and Cons of Filing on Your Own vs. With Help
Many workers can file the H-30R themselves, but a modification fight often turns on medical evidence, where experience matters. Weigh the trade-offs below.
| Filing on Your Own (Pro Se) | Filing With an Attorney |
|---|---|
| Pro: No attorney fee comes out of your award, so you keep more of any increase. | Pro: A lawyer knows what medical proof actually persuades a Commissioner, which can raise your percentage. |
| Pro: You control the timing and can file the moment your doctor documents a change. | Pro: Counsel must file through CompHub and handles the technical steps for you. |
| Pro: Simple, clearly worsened cases can succeed without help. | Pro: An attorney spots the later last-payment date that keeps a filing inside the five-year window. |
| Pro: You learn your own claim inside and out. | Pro: Counsel handles service, deadlines, and the rehearing or appeal clock. |
| Pro: No need to share your award with anyone. | Pro: A lawyer can cross-examine the insurer’s medical expert at the hearing. |
| Con: One missed rule, like the H-24R requirement, can derail the whole request. | Con: Attorney fees, set by the Commission, reduce the net award. |
| Con: You face the insurer’s medical expert without your own. | Con: You give up some control over strategy and timing. |
| Con: Easy to miss the later last-payment date and look time-barred. | Con: Finding the right workers’ compensation lawyer takes effort. |
| Con: Service and certification errors can void the filing. | Con: Communication delays can slow the process. |
| Con: No guidance on framing the medical worsening persuasively. | Con: Not every small case justifies the cost of help. |
Related Forms and How They Differ
Several Commission forms sit near the H-30R, and using the wrong one wastes weeks. The table below shows how the closest cousins differ.
| Form | What It Does |
|---|---|
| H-30R Request for Modification | Reopens, reconsiders, or modifies an Order when disability increased or decreased. |
| H-27R Request for Rehearing | Challenges a recent decision within 15 days based on legal error or mistake of fact. |
| C-90R Request for Document Correction | Fixes an undisputed factual or clerical error in a filed document, not a substantive change. |
| H-24R Issues Form | Lists the issues and puts the dispute on the hearing calendar; required with the H-30R. |
| C-3 Claim Amendment | Adds or removes a body part from an existing claim rather than changing an award amount. |
FAQs
Do I need to file Form H-24R with my H-30R?
Yes. The H-30R must be accompanied by the Issues Form H-24R, which puts your dispute on the hearing calendar. Filing the H-30R alone leaves it unscheduled.
Can an insurer use the H-30R to reduce my benefits?
Yes. Either party may file it, and an insurer uses it to argue your disability decreased and ask the Commission to lower or stop your award.
Is there a deadline to file the H-30R?
Yes. You generally have five years from the date of injury or from the last compensation payment, whichever is later, to file a modification request.
Do I write my old address or current address in Box 2?
Yes, write your current mailing address, because the Commission mails every hearing notice there, and an old address means you may miss your hearing.
Should I put my Social Security number in the claim number box?
No. Box 1 takes the WCC claim number, not your Social Security number, and entering the SSN there fails to identify the claim.
Do I need medical evidence to reopen my claim?
Yes. A doctor must document that your condition worsened (or improved, for insurers), because the Commission will not modify an award without medical proof.
Can I use the H-30R to fix a typo in my Order?
No. Clerical or factual errors are corrected on Form C-90R; the H-30R is only for reconsidering, reopening, or modifying the substance of an award.
Is there a filing fee for the H-30R?
No. The Commission does not charge a fee to file a Request for Modification through CompHub, by mail, by fax, or in person.
Do I list the injury date or the last-payment date in Box 6?
Yes, list both, because the five-year clock runs from whichever date is later, and the later date often keeps your filing timely.
Must I file through CompHub if I have a lawyer?
Yes. Under COMAR 14.09, a party represented by counsel must file electronically through CompHub; unrepresented workers may use CompHub or paper.
Do I have to serve the other parties myself?
Yes. You must serve a copy on every party of record and certify service in Box 7, because filing with the Commission does not notify the other side.
Can I appeal if the Commission denies my modification?
Yes. You may request a rehearing on Form H-27R within 15 days or appeal to the circuit court within 30 days of the decision.
Which version of the form should I use?
Yes, use the version stamped Rev. July 2005, the current H-30R, because an outdated edition can be rejected when you submit it.
Can I add a new body part with the H-30R?
No. A new body part is added through a Claim Amendment on Form C-3; the H-30R changes the extent of disability on body parts already in the claim.
Related reading
- How to Fill Out California WCAB Request for Increased Permanent Disability + FAQs
- How to Fill Out the New Jersey Division of Workers’ Comp Application for Review or Modification of Formal Award (WC-368) + FAQs
- How to Fill Out the Maryland WCC Employee Claim Form (C-1) (w/ Examples) + FAQs
- How to Fill Out the Maryland WCC First Report of Injury (Form 1A-1) — With Examples + FAQs
- Maryland WCC Issues / Request for Hearing Form (H24R) Instructions + FAQs
- How to Fill Out a Maryland WCC Settlement Agreement (w/Examples) + FAQs
- How to Fill Out California WCAB DWC-AD 1 (w/Examples) + FAQs