How to Determine If You Remain Eligible for Workers’ Comp Benefits When Your Doctor Releases You to Return to Work

According to a recent report from the Workers Compensation Research Institute (WCRI), the average cost of workers’ compensation claims in Delaware has increased at an annual rate of roughly 3% since 2019. Additionally, the average duration of temporary disability leaves has increased.

These statistics highlight the fact that workers’ compensation claims are getting more costly for both employers and employees. As a result, some employees may find themselves being pressured into returning to work before they are ready to do so. Let’s take a closer look at how choosing to return to work—even with permission from a doctor—can impact your ability to collect workers’ compensation in the state of Delaware.

How do workers’ compensation claims work in Delaware?

The Delaware Legislature created and oversees the Workers’ Compensation program to provide benefits to employees who are injured at work. Under Delaware’s system, any employer with one or more employee is required to maintain workers’ compensation insurance that can cover employees’ medical care, temporary disability payments, and compensation for any permanent injuries they may suffer on the job.

In our state, the general protocols for filing workers’ compensation claims are as follows:

1. Immediately notify your employer (ideally in writing) of any injuries you suffer on the job and request medical care.
2. If your injury will keep you from returning to work for longer than 3 days, inform your employer of your intent to collect disability-related compensation.
3. If your employer does not agree to compensate you for your injuries, you may file a petition with the Office of Workers’ Compensation for a hearing before the Industrial Accident Board to argue for benefits in your case.

Generally speaking, employers and/or their insurance carriers are on the hook for any reasonable and necessary medical care or hospitalization related to a work injury. Additionally, employees are eligible for total disability benefits beginning on the 4th day of lost work. However, if an employee’s disability leave extends beyond 7 days, their entire period of absence will become compensable under the law.

What happens when I return to work?

Employees may also be eligible for partial disability benefits if they return to work part-time or at a lower hourly rate than their pre-injury wage. However, if the employee’s injuries did not result in a reduction in their earning capacity, meaning that you can work full-time and at the same rate as your pre-injury wage, you may have your workers’ compensation benefits terminated.

Doctors often play a crucial role in determining if and when an employee should return to work on a full-time basis. As part of your medical evaluation and treatment, the physician you see may recommend that you:

• Return to work with no restrictions.
• Return to work in a reduced capacity, i.e., part-time or in a different, less demanding position.
• Refrain from returning to work for an additional length of time.

Just because your doctor clears you to return to work in some capacity does not automatically mean your benefits will be terminated.

My doctor released me, but I’m still not ready…

If you receive a full-duty work release from a medical provider but feel you are still not well enough to return to work, you may still have some options available to you. First, you’ll want to consult with an experienced workers’ compensation attorney who understands the complex nature of work-related injuries. A reliable lawyer can advise you of your options and help you argue for why your doctor’s determination may have been faulty.

In order to push back against an erroneous full-duty work release, you and your attorney will need to gather compelling evidence suggesting that your provider was mistaken or ill-informed. Sometimes, this requires that the injured party obtain a third-party medical evaluation disputing the other provider’s findings, though some cases can be resolved through the introduction of new or clarifying evidence or documentation.

Am I covered for more doctor’s visits after I return to work?

Here’s the thing: Many injuries require ongoing medical care that might not be covered if you return to work full-time. Medical appointments you attend after a full-duty work release may not qualify for workers’ compensation benefits because returning to your former employment at the same or higher wage indicates that your earning capacity has not been impaired for workers’ compensation purposes.

In order to push back against this contingency, an injured worker would have to demonstrate that their earning capacity has, in fact, been impaired in some way as a result of their injuries. Obviously, this is hard to prove if you are back to working the same hours for the same money as before your injury. This is yet another reason why it’s important to work with an experienced legal professional while navigating the workers’ compensation system. Employers and their insurers may not be keen on paying out the full value of a worker’s claim, so it’s easy for injured employees to find themselves being manipulated or taken advantage of in the absence of competent legal support.

Next steps

Workers’ compensation claims often yield major questions and can be a significant source of confusion for injured employees and their loved ones. While we all hope for a full and swift recovery after a workplace accident, being released to return to work too soon can result in additional uncovered expenses and negatively impact an injured worker’s recovery process.

At Silverman, McDonald & Friedman, we believe that workers have a right to physical and financial safety at work. When this safety is compromised, our team is standing by to step in and fight for the full value of compensation afforded to you under Delaware law. Employers and insurers don’t want to see you collect the full scope of benefits you are owed and may subsequently encourage you to return to work before you are truly ready to do so.

If you find yourself in the uncomfortable position of needing additional support after receiving a full-duty work release from your doctor, our team might be able to offer you additional clarity and support to help you access the resources you need to make a full recovery. Give us a call today or fill out our contact form to schedule a free consultation with a member of our team, and let’s make sure your rights and well-being are being properly safeguarded throughout the workers’ comp process.