7 Basic Rights of Recovery: Delaware Workers’ Compensation Laws Explained
Workers’ compensation laws ensure the payment of fixed monetary benefits to employees who are injured on the job – and in some cases, to the dependents of those employees.
Claimants can recover under workers’ compensation laws for such things as:
nursing home care
lump sums of money (if the claimant has a permanent impairment or permanent disfigurement)
This blog will focus on and provide a brief synopsis of the 7 basic rights of recovery under Delaware workers’ compensation laws.
1. Medical Expenses
If you are injured in the course and scope of your employment, you are entitled to medical expenses for the rest of your life as long as the medical treatment is reasonable, necessary, and related to the work injury and provided that one bill is paid by workers’ compensation every 5 years.
In 2008, Delaware passed a law to regulate the reasonableness and necessity of medical treatment. All medical treatment is evaluated based on strict guidelines (created by the Health Care Advisory Panel), along with a utilization review process, to determine whether the medical treatment is reasonable and necessary.
2. Temporary Total Disability (total lost wages)
If you are unable to work at all and are declared totally disabled from all employment by your medical provider, you are entitled to two-thirds of your average weekly wage up to a maximum amount of $689.45 per week based on an average weekly wage of $1,034.18. There is no limit to the amount of time you are entitled to receive temporary total disability benefits.
3. Temporary Partial Disability (partial lost wages)
If you are capable of working, but your work injury limits what jobs you are able to perform, you may be entitled to temporary partial disability benefits. The workers’ compensation carrier must pay two-thirds of the difference between what you were earning at the time of the work accident and what you are earning now, up to a maximum amount of $689.45 per week based on an average weekly wage of $1,034.18. Temporary partial disability benefits are limited to a total of 300 weeks (almost 6 years).
4. Permanent Partial Impairment
Although workers’ compensation does not compensate an injured worker for pain and suffering, permanent partial disability benefits is the workers’ compensation alternative to a lump sum of money if you have incurred a permanent injury within the course and scope of your employment. This lump sum recovery is based on a simple formula:
(percentage of impairment) x (statutory number of weeks per body part) x (workers’ compensation rate)
Your lawyer can explain in greater detail how those calculations are determined.
Any scar and/or disfigurement that is visible when properly clothed can be awarded money as well. A certain amount of weeks is determined based on the size, location and visibility of the scar and this number of weeks is multiplied by your workers’ compensation rate to determine the amount of lump sum recovery for disfigurement.
You are entitled to recover 40 cents per mile for round trip mileage for healthcare and prescriptions.
7. Death Benefits
If an injury within the course and scope of employment results in your death, benefits are payable to your dependents. Children who are deemed to be dependents remain so until the age of 18 years or if a full-time student, until the age of 25 years. The workers’ compensation carrier is responsible to pay up to $3,500 in funeral expenses.
Employer Acknowledgement of Work-Related Injury
In order for a claimant to receive the above workers’ compensation rights, the employer must acknowledge the work-related injury within two years from the date of the work accident (two year statute of limitations). If the employer refuses to acknowledge the work related injury, then a petition must be filed with the Industrial Accident Board (IAB) to force the employer to acknowledge the work injury. If the IAB determines that the alleged work injury is a compensable work injury (claimant sustained injuries within the course and scope of the employment), then the claimant is entitled to receive the above benefits.
Once an employer acknowledges the work injury (or is forced to acknowledge the work injury following the IAB decision), there is no longer a two year statute of limitations. Instead, a five year statute of limitations applies, whereby the claimant is entitled to the above listed benefits as long as the workers’ compensation insurance company pays a benefit (wage, check, medical bill, etc.) at least one time every five years.
In addition to the above workers’ compensation benefits, a claimant may decide (but cannot be forced by the workers’ compensation carrier) to give up all of the above listed benefits for one lump sum of money called a commutation. While commutations can put large amounts of money in a claimant’s pockets, they are risky because all of the above benefits are given up. In addition, the IAB must approve of every commutation to make sure the claimant is not being taken advantage of by unfairly giving up all of the workers’ compensation rights.
Kimmel Carter highly recommends that you obtain an experience attorney if you are injured on the job. The lawyers at Kimmel Carter have more than 210 combined years of experience in workers’ compensation law, and we are here to make sure you receive all of the benefits you deserve in your time of need.