Workers’ Compensation Denials and Appeals Process in Delaware

At Silverman, McDonald & Friedman, we represent clients who have been injured or are suffering from an occupational disease in Wilmington, Newark and Seaford. We guide them all the way through the process of getting a claim approved to returning to work. You are welcome to contact today us to find out more about your rights, and what you may be entitled to collect from workers’ compensation.

The Delaware Workers’ Compensation program was designed to provide benefits such as partial wage replacement disability payments, coverage for injury-related medical expenses and other benefits such as lump sum payments for loss of use of certain parts of the body. The workers’ compensation system is a no-fault system that does not require the injured worker to prove their employer’s negligence in order to win their claim.

Let’s say you suffered a workplace injury and you have filed a worker’s compensation claim, but you are surprised and disappointed to discover that your claim was denied. If an injured worker files a claim which is subsequently denied, they have the right to file an appeal.

Why was your claim denied?

There are several reasons for the denial of a workers’ compensation claim. A few common reasons for denials include the following:

• You missed the filing deadline for your claim. In Delaware, a worker has 90 days from the date of the injury to notify their employer notice of the injury. For most injuries, workers have up to two years to file a claim, but they must have given their employer notice of the injury within the 90-day deadline.
• The injury did not occur in the workplace, or in the course of performing your regular work tasks.
• Your injury was not serious enough to require medical treatment or time lost at work.
• Your employer thinks that the injury was preexisting rather than being a new, workplace injury.
• Your injury may have been caused because of your failure to use a safety device that was available at the time of your accident.
• You were intoxicated or under the influence of drugs when the injury occurred.

Your employer’s workers’ compensation insurer may deny your claim for many reasons and not all of them will be legitimate. Sometimes they deny a claim the first time in hopes that the claimant will not pursue an appeal. When you have sustained a serious workplace injury that requires you to lose time at work, or if you have been diagnosed with an occupational disease and your workers’ compensation claim has been denied you should never just give up after an initial denial of your claim.

The workers’ compensation appeals process in Delaware

The first thing you want to do is find out why your claim was denied. If you possibly made a mistake on your application, or if there was some other kind of error that caused the denial, you may be able to work it out without going through the formal hearing process. However, if it is not possible to work out any misunderstanding and they stand by the denial, then your workers’ compensation attorney will guide you through the process of filing a petition for a hearing. You will receive a notice with your hearing date and then the initial steps will include preparing a pre-trial memorandum and then appearing at the hearing. If the Industrial Review Board denies your appeal, there is yet another level of appeal to the Delaware Superior Court which must be filed within 30 days of your denial from the IRB.

Given the fact that the process for filing a workers’ compensation appeal is an adversarial process, you would do well to contact an experienced Delaware workers’ compensation attorney to discuss your case. They offer a free initial consultation where you can discuss the background of your case and then the lawyer will advise you based on the facts of your case.

Getting injured on the job can be frustrating and you may not be sure what your rights are. If you have any questions about your rights or if you become involved in a dispute over your workers’ compensation benefits, you are welcome to give us a call at 302-314-5533 or fill out our quick contact form. At the law firm of Silverman, McDonald & Friedman, we listen to you, and we offer legal guidance and support. Please feel free to contact us to schedule a free consultation with a workers’ compensation lawyer in Newark, Seaford or Wilmington. We are on your side.