By: Eric M. Doroshow, Esquire
In the over 21 years I have been handling Workers' Compensation claims , I learned that there is a lot of misinformation about the rights of the consumer. This article discusses the most common misconceptions about Delaware’s Workers' Compensation Laws.
1. I HAVE TO GO TO THE BOSS’S DOCTOR.
Delaware law permits an injured worker hurt on the job to use a doctor of his or her choice for treatment. There is no requirement that you receive treatment from the boss’s doctor. The Workers' Compensation law also provides for payment of reasonable and necessary treatment expenses, including chiropractic fees.
2. I DON’T NEED A LAWYER TO HELP ME GET BENEFITS.
Although this is technically correct, it is a bad idea to "go it alone". Insurance adjusters and their attorneys receive years of training to help protect the insurance companies. You need similar expertise on your side. Never sign any agreements until you see a lawyer: if you do, you could cause great damage to your case. In many cases, a lawyer will simplify the process and speed up benefits. Lawyers often negotiate with the insurance companies to make sure that lost wage checks are promptly sent. Normally attorneys will charge based on a percentage of benefits they collect. Therefore, attorneys typically don’t get paid unless they are successful in collecting benefits for you.
3. THE INSURANCE ADJUSTER HAS THE FINAL SAY IN DETERMINING MY LOSS
Not necessarily. The Workers' Compensation law provides payment based on a "average" weekly wage. An attorney can help determine whether the insurance company is paying the proper amount. Often the wage rate suggested by the insurance company is wrong and it needs to be corrected before signing any papers.
4. WORKERS COMP WILL ONLY PAY FOR MEDICAL BILLS AND MY LOST WAGES
This is incorrect. Workers' Compensation laws provide additional lump sum benefits called permanent partial disability. Usually about a year after the accident or surgery, a doctor can certify the percentage of permanent disability. The Workers' Compensation law has a formula to translate that percentage into a lump sum benefit for you. An attorney can help you secure this benefit which the insurance company will often not tell you about.
5. THEY WILL NOT PAY FOR MY MILEAGE BACK AND FORTH TO THE DOCTOR
The insurance company is required to pay .40 cents per mile to the injured worker for mileage incurred for treatment from doctors and therapy (as of 07/01/06). Keep track of your mileage on a mileage log. You can print mileage logs by clicking here.
6. MY DOCTOR PUT ME ON LIGHT DUTY; THEREFORE, I DO NOT HAVE TO LOOK FOR WORK
The workers' compensation law requires that once you have been released to return to work (even for light duty), you must begin a good faith job search. You must start by going back to your old employer to see if there is a light duty position available. Failure to do this could jeopardize your future benefits.
7. I GOT HURT ON THE JOB AND MY EMPLOYER WON’T TAKE ME BACK. I GOT OFFERED A JOB AT A REDUCED SALARY FROM ANOTHER EMPLOYER BUT I DON’T HAVE TO TAKE IT
The law requires that you take any job within your restrictions. However, you may be eligible for a loss of earning capacity claim called partial disability which is typically two-thirds of the lost earning capacity. Thus, you could be working as well as securing reduced worker's compensation benefits.
8. MY WORKERS' COMPENSATION BENEFITS AUTOMATICALLY STOP AFTER TWO YEARS
Incorrect. As long as the medical bills or other benefits are paid every five years, the benefits can continue indefinitely.
9. IF A PRIVATE INVESTIGATOR IS WATCHING ME CAN I TELL HIM TO LEAVE?
As long as he or she is not breaching the peace, the investigator can follow you and photograph you. Many insurance companies are now hiring private investigators to videotape workers' compensation claimants.
10. I CAN SUE MY BOSS FOR HIS NEGLIGENCE
Delaware Law does not permit you to make a claim against your boss. Under the current law, you are limited to making a claims for the above Workers' Compensation benefits only. However, if a third party caused your injury (like a negligent driver while you were at work), you can sue this person for your pain and suffering.