Unfortunately, many injured workers do not fully understand the benefits available to them. Questions often arise about who pays the medical bills, how much an injured worker receives while out of work, whether an employee can choose a doctor, and whether additional compensation is available after medical treatment ends.
Understanding your rights under Delaware workers’ compensation law can help you make informed decisions and avoid mistakes that could affect your claim.
Depending on your injury and individual circumstances, Delaware workers’ compensation benefits may include medical treatment, wage-loss benefits, permanent impairment benefits, disfigurement benefits, and reimbursement for medical mileage.
If you suffer a compensable workplace injury, workers’ compensation may pay for reasonable and necessary medical treatment related to that injury.
Covered medical treatment can include:
One issue that sometimes causes confusion is the selection of a doctor. In Delaware, an injured employee generally has the right to select a certified health care provider authorized to provide workers’ compensation treatment. You are not necessarily required to treat with the physician preferred by your employer or its workers’ compensation insurance carrier.
The medical portion of a workers’ compensation claim can become disputed when an insurance carrier questions whether treatment is related to the work accident or whether additional treatment is reasonable and necessary.
A serious workplace injury may prevent you from returning to your regular job. If your doctor takes you completely out of work due to the work injury or your employer cannot accommodate your medical restrictions, you may be entitled to temporary total disability benefits.
Generally, temporary total disability benefits are calculated at 66⅔% of the injured worker’s average weekly wage, subject to the minimum and maximum compensation rates established under Delaware law.
Delaware also has a waiting period before you are eligible for wage benefits. Wage-loss compensation generally begins with the fourth day of incapacity. However, when the period of incapacity lasts seven days or more, including the day of injury, compensation may be payable beginning with the first day.
These wage-loss benefits can provide an important source of income while an injured employee is medically unable to return to work.
Not every work injury prevents an employee from working entirely.
For example, your doctor may release you to light-duty work with restrictions. Those restrictions might prevent you from performing your normal job, working overtime, lifting above a certain weight, or performing other duties you completed before the accident.
If your work-related injury causes you to earn less than you earned before the accident, you may qualify for temporary partial disability benefits.
Delaware law generally provides compensation based upon 66⅔% of the difference between the employee’s pre-injury wages and post-injury earning capacity, subject to the limitations established by Delaware workers’ compensation law.
Returning to work does not necessarily mean that your Delaware workers’ compensation claim is over.
Some workplace injuries result in permanent loss of function even after medical treatment has been completed. When that occurs, the injured employee may be entitled to permanent impairment benefits, sometimes referred to as permanency benefits.
A physician typically evaluates the injured worker and determines whether there is a percentage of permanent impairment associated with the work injury.
The value of a permanent impairment claim can depend upon several factors, including:
An employee may potentially receive permanent impairment benefits even if he or she has returned to full-time employment.
Certain workplace accidents and medical procedures can leave permanent scars or other changes to an injured employee’s appearance.
Delaware workers’ compensation law provides compensation for qualifying serious and permanent disfigurement.
Potential examples can include significant scarring resulting from an accident, burns, or surgery necessitated by a work injury.
Disfigurement benefits are important because they can represent an additional component of a workers’ compensation claim that an injured employee may otherwise overlook.
Another Delaware workers’ compensation benefit that is sometimes overlooked is medical mileage reimbursement.
An injured employee may be entitled to reimbursement for qualifying travel associated with medical treatment, medications, and certain medical supplies related to the workplace injury.
A few trips to the doctor may not seem significant, but mileage can accumulate quickly when an injured employee attends months of physical therapy, specialist appointments, diagnostic testing, and follow-up visits.
Injured workers should consider maintaining an accurate record of their medical travel throughout the claim.
A denial from an employer or workers’ compensation insurance carrier does not necessarily mean that you are not entitled to benefits.
Workers’ compensation disputes can involve questions such as:
When a dispute cannot be resolved, a petition may be filed with the Delaware Industrial Accident Board (IAB). The Industrial Accident Board hears workers’ compensation disputes and determines whether benefits should be awarded.
Having an experienced Delaware workers’ compensation attorney can be particularly important when a claim has been denied or an insurance carrier seeks to terminate existing benefits.
Workers’ compensation claims are subject to notice requirements and specific statute of limitations.
An employee who is injured at work should report the accident to his or her employer as soon as possible. Waiting to report a workplace accident can create unnecessary disputes and, depending upon the circumstances, may jeopardize the employee’s ability to recover benefits.
There are also deadlines for filing petitions with the Delaware Industrial Accident Board. The applicable deadline can depend upon the nature of the claim, whether workers’ compensation benefits have previously been paid, and other circumstances.
Because workers’ compensation deadlines can have significant consequences, an injured employee should not wait until a claim is denied to determine whether a deadline is approaching.
Not every workplace accident requires an attorney. However, workers’ compensation cases can become complicated quickly. Workers’ compensation carriers and adjusters represent your employer, not you!
You should consider speaking with a Delaware workers’ compensation lawyer if:
An attorney who regularly handles Delaware workers’ compensation cases can evaluate the claim, communicate with the employer and insurance carrier, obtain medical evidence, file the appropriate petitions, and represent the injured worker before the Delaware Industrial Accident Board.
Attorney Justin K. Weeks represents injured workers in Delaware workers’ compensation matters.
Before entering private practice, Justin served as a Deputy Attorney General for the State of Delaware and previously spent approximately 15 years in law enforcement. He has represented injured workers before the Delaware Industrial Accident Board and has successfully resolved workers’ compensation claims for injured Delaware employees. Justin has a passion for giving back and routinely represents first responders in navigating workplace injury claims.
Justin understands that a workplace injury is not simply an insurance claim. An injury can affect your ability to work, support your family, and plan for your future. His goal is to help injured workers understand the workers’ compensation process and pursue the benefits available to them under Delaware law.
If you were injured at work, you may have questions about medical treatment, lost wages, permanent impairment, or what the insurance company is required to pay.
You do not have to wait until your claim has been denied to learn about your rights.
If you have questions about a Delaware workers’ compensation claim, contact Justin K. Weeks, Esquire at Aleman & Associates LLC to discuss your case. Consultations are completely free, and there are no attorney’s fees or costs unless we successfully recover compensation on your behalf.
Disclaimer: This article is provided for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Every workers’ compensation claim is different and should be evaluated based upon its individual facts and circumstances. Prior results do not guarantee a similar outcome.
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