It is a frightening time when you are hurt in an accident at work. It is even more traumatic when your injuries prevent you from returning to work. You have financial commitments that you need to make, and those could be increasing with new medical bills. Fortunately, it is not as dire as it might appear, as there are options for you that will help you cope.
All businesses with employees, except agricultural businesses, in Delaware are required to carry Workers’ Compensation. This is a no-fault insurance that will not only cover your medical expenses but will also pay a portion of the salary you are not collecting while you are missing work.
Not all businesses or insurance companies will easily pay what they owe. They may try to dissuade you from filing for Workers’ Compensation or deny your claim. That can be discouraging, but when you hire a lawyer, they will confront the insurance company or your company and compel them to fulfill their obligations.
What Benefits Are Available Through Workers’ Compensation?
Every business in the state is required to carry this insurance. While it is a national program, it is managed individually by each state. Therefore, there are certain variations of the program from state-to-state in terms of the benefits and the qualifications. The benefits of the insurance include:
- Medical expenses: When you are hurt in a workplace accident, Worker’s Compensation will cover all your associated medical expenses, including treatment, medications, and mileage reimbursement. The state also allows you to use your own doctor for your treatment, although your company may require you to obtain a second opinion from an unaffiliated doctor. Keep a copy of your receipts and doctor notes for your claim.
- Lost wages: You may be unable to return to work immediately after your workplace injury. It could be a severe financial hit if that is your primary source of income. However, Workers’ Compensation will recoup a portion of those losses. It will pay just under 67 percent of your gross weekly wages. If your company is paying you a reduced salary, Workers’ Compensation will reimburse you two-thirds of the difference between your pre-injury wage and post-injury wage.
- Long-term disability: If you suffer a long-term disability or disfigurement, you are entitled to compensation in a lump-sum payment or recurring payments.
- Death benefits: If a person dies due to an injury they sustained at work, then the surviving family member can receive compensation to cover related expenses, such as funeral costs, through Workers’ Compensation.
These benefits are designed to protect you and your family from financial hardship should you get hurt while working. If you feel that you are not receiving the full amount of your entitled benefits, speak with a lawyer who can help you.
How Do I File for Workers’ Compensation Benefits?
When you are hurt at work, it is imperative you act quickly to file for your Worker’s Compensation benefits, otherwise you might lose the opportunity. If you sustain a major injury at work and require medical attention, you should go immediately. As stated, Delaware law allows you to choose your own doctor for this process.
Once you have sought out medical attention or if you believe your injuries do not warrant an immediate trip to the doctor, then report the accident to your manager. They will have a standard form for you to fill out. You must submit it within 90 days of the work-related injury. If you contracted an occupational illness due to conditions at work, you have a six-month window from the day you learned your illness was related to work.
Once you file a report, your manager has 10 days to file the First Report of Injury with the Delaware Office of Workers’ Compensation. The manager will then inform their insurance company about the situation, and the insurance company will move forward with approving or denying the claim.
If approved, there might be some negotiations between you and the insurance company over the final compensation amount. It is advisable that before you get to this part that you hire a lawyer who can help with negotiations.
Once the two sides agree on a number, the agreement is finalized and sent to the Delaware Office of Worker’s Compensation. Upon receipt of the final agreement, you will begin receiving your checks at the agreed-upon schedule.
What Happens if My Worker’s Compensation Is Denied?
There are a couple of legitimate reasons why an insurance company could reject your Worker’s Compensation claim, such as if you were acting irresponsibly during your accident, like operating a machine while intoxicated. You must be injured while either on premises or engaged in a work-related activity.
There are instances when an insurance company will attempt to reject a claim when they do not have cause. You may also have a difficult time coming to an agreement with the insurance company on an amount for the final compensation. If that occurs, you can file an appeal with the Industrial Accident Board.
To do that, you must file a Petition to Determine Compensation Due with the Delaware Office of Workers’ Compensation. You need to submit this paperwork within two years of the job-related injury, or you can file within a year of the date you found out your illness was caused by work conditions.
The next step is a hearing before the Delaware Industrial Accident Board, which will then accept or deny the claim. If you wish to appeal that decision, your next step is to file an appeal with the Superior Court within 30 days of the previous decision. If you fail to get the decision you are seeking, your final step is to file an appeal with the State Supreme Court within 30 days.
Wilmington Workers’ Compensation Lawyers at Rhoades & Morrow Will Protect Your Rights if You Have a Work Injury
If you have been hurt at work and you are unable to return to your job, Worker’s Compensation should help defray your lost salary. If your company or their insurance is threatening to deny your claim, our Wilmington Workers’ Compensation lawyers at Rhoades & Morrow can represent your interests. Call us at (302) 427-9500 or contact us online to schedule a free consultation. Located in Wilmington, Bear, and Milford, Delaware, we serve clients in Middletown, Dover, Milford, Lewes, Rehoboth, Elsmere, and Seaford.
