[Video] What is workers' compensation?
There are seven main rights under workers' compensation and we are going to assume that the work injury has already been accepted and that your injury was within the course and scope of your employment.
The first right are medical expenses. When you are injured in a work accident, the medical bills are paid by the insurance company for workers' compensation.
Medical bills have to be reasonable, necessary and causally related to the work accident. They also have to be treated, if it's with a doctor in Delaware, by a certified workers' compensation doctor. Workers' compensation should cover your medical expenses as long as they are within the workers' compensation guidelines.
That pays two-thirds of your gross wages. If you look back at the 26 weeks before you were injured at the job, we average out those 26 weeks and that's your average weekly wage. If you multiply that by two-thirds, that's your workers' compensation rate. This is the rate that you are paid weekly if you are unable to work at all. All workers' comp benefits are tax free.
Your third right under workers' compensation is temporary partial disability benefits. If you can return to work but cannot work as many hours or have to find a job because of your restrictions, which does not pay as much, you are entitled to two-thirds of the difference.
So you would take that average weekly wage for the 26 weeks before you were injured and you take the new job that you are now working in, or possibly the same job with less hours, and you look at the difference between what you were making to what you are making now and you multiply that by two-thirds.
There is a cap of 300 weeks of temporary partial disability benefits over your lifetime.
The fourth benefit is called permanent partial disability or PPD. You may also hear the term permanency or permanent impairment. We have to wait until you are at maximum medical improvement -- usually at least one year after the work accident, or one year after if you have any surgery as a result of the work accident.
Then we have a doctor rate you for permanent impairment. A doctor will give you a permanency rating. We pay a doctor to give that rating, we then file a petition with the board and we claim permanent partial disability.
A multiplier is used to determine the amount of money paid for permanent partial disability. Each body part is worth a different amount of weeks. So we take those weeks and we multiply those weeks by a percentage of impairment you have for the injured body part and we multiply that by your workers' compensation rate (That's that average weekly wage times two-thirds). And we come up with a number for permanent partial disability.
Your fifth benefit under workers' comp is disfigurement. If you have any scarring as a result of a surgery that took place or possibly of have an altered gait -- you walk with a limp becauseof a leg injury or a back injury. We can get you disfigurement benefits as well.
Your sixth benefit is mileage. When you go to and from you medical providers – the pharmacy, the doctors you see, physical therapy -- You are entitled to 40 cents per mile.
The last benefit is death benefits, which will be explained in an upcoming video.