What To Do If Your Workers’ Compensation Claim is Denied in Delaware

Claim Denied

After suffering a devastating injury on the job, having your workers’ compensation claim denied is an incredibly stressful and disheartening experience. It’s essential to understand your options and take steps to appeal the denial.

Proudly serving the people of Dover, Wilmington, Newark, and across Delaware, the knowledgeable workers’ compensation team at Rhoades & Morrow have dedicated their entire practice to fighting for just compensation for injured citizens of Delaware. We are ready to fight relentlessly in appealing the denial of your rightful workers’ compensation benefits

What Circumstances Qualify for Workers’ Compensation Benefits in Delaware?

It’s essential to understand the criteria for qualifying for workers’ compensation benefits in Delaware. Some basic eligibility requirements include:

  • The injury occurred at the workplace or while performing work-related duties.
  • You have complied with your employer’s policy to report the workplace injury.
  • You were not under the influence of alcohol and drugs at the time of the injury.
  • You do not have a pre-existing medical condition directly contradicting the injury which is the subject of your claim.

Why Would an Employer Deny My Claim?

There are many reasons why an employer would reject an employee’s claim for workers’ compensation benefits in Delaware. Some more common reasons include:

  1. The employee was under the influence of alcohol or drugs when the injury was sustained.
  2. The employee did not follow the proper reporting protocol following the injury.
  3. A pre-existing medical condition accounted for the injury.
  4. The injury occurred outside work hours or outside the scope of the employee’s duties.
  5. The employee attempted to misrepresent unrelated injuries as work-related.
  6. The injury doesn’t impede the employee from doing their job.
  7. You refuse to submit to a drug test.
  8. You refuse to comply with the employer’s designated provider’s treatment plan.
  9. The injury or illness is not covered by your employer’s workers’ compensation insurance.
  10. You did not make your claim in the appropriate timeframe.

How To Handle a Denied Workers’ Compensation Claim

If you suffered a work-related accident and were injured as a result only to find your Delaware workers’ compensation denied, it’s essential to understand how to proceed.

Firstly, you must identify the reason for denying your claim. You can’t develop a strategy to address the denial if you don’t know why your claim was denied. 

Secondly, you need to remedy the grounds for denial. You must address the reason your claim was denied directly, and an experienced Delaware workers’ compensation attorney can help you gather critical evidence to support your side of the story. This includes but is not limited to medical evidence, testimony from an expert in the field, and statements from witnesses. You need evidence that contradicts the employer’s reasoning for denying the claim, as well as evidence to counter the employer’s objections during the appeals process.

Thirdly, you should file an appeal. Upon receiving the claim denial letter, you have the right to file an appeal of the decision. The denial letter should contain detailed instructions on how to initiate the appeals process. In Delaware, there’s a ticking clock governing the appeals process, so it’s important to act quickly.

Lastly, you should consider hiring an attorney. An experienced workers’ compensation attorney knows how to navigate the complex world of workers’ compensation claim denials and appeals. They will guide you through the process, help you gather evidence, and come up with an effective appeal strategy to present to the employer and the workers’ compensation insurance company.

Rhoades & Morrow: Experienced Workers’ Compensation Lawyers Fighting Relentlessly to Uphold Your Rights

If you or a loved one have suffered an injury at the workplace, you deserve to see your rightful workers’ compensation benefits. If your workers’ compensation claim was denied in Delaware, it’s crucial you act fast to secure the benefits you rightfully deserve. Don’t let your employer diminish your pain and limit the benefits you’re rightfully owed. Trust a law firm, backed by decades of experience in the field, with the mission of fighting for the rights of injured Delaware workers. The skilled and seasoned team at Rhoades & Morrow has offices in Wilmington, Newark, Milford, and Lewes, and proudly serves clients across Delaware. We offer free and confidential initial consultations. Call us at (302)-427-9500 or fill out our online form today.


Delaware Injury Lawyers

R & M Lawyers
Rhoades & Morrow

Our attorneys provide exceptional legal service with a personal touch. Since our founding in 1990, we have helped thousands of Delaware citizens obtain full and just compensation for personal injury claims. We have gained an excellent reputation as the “go to” law firm. Let us put our decades of experience to work for you.

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