Please note that you are not eligible for this benefit until one year after the date of injury or one year after the date of surgery, whichever is later.
We are frequently asked how much this benefit will be. To summarize, Delaware law clearly defines exactly how the monetary amount must be determined. There are three parts to the formula:
Which body part was injured—Delaware statute defines the “value” of each area of the body according to the importance of the body part to normal daily functioning, with a maximum of 300. For example, the spine is assigned a value of 300, an arm or a leg is worth 250, a hand is 220, and so on. In other words, the less crucial the body part, the lower the “value” it is assigned.
Your Average Weekly Wage at the time of your injury—for injuries occurring after January 17, 2007, statutes mandate that your average weekly wage (AWW) is the average of your pay for the 26 weeks immediately prior to the injury. Two thirds of this amount is your compensation rate (CR), with a minimum and maximum that are determined by the state.
Your Permanency Rating—this is the percentage assigned by the doctor during your permanency evaluation. It represents the percentage of function you have lost in the injured body part. The doctor determines this number according to the specific guidelines published by the American Medical Association. Doctors can differ on this to some extent, though.
The final calculation is as follows:
(Compensation Rate) x (Perm Rating %) x (Body Part Value)
For example, John Doe has a compensation rate of $400.00, sustained an injury to his lumbar spine, and has a 10% permanency rating. Thus, his benefit would be:
$400 x 300 x 10%, or 400 x 300 x 0.10=$12,000.00.
Please remember that these numbers will be reduced by the amount of legal costs and fees.
It is likely that the insurance company will have their own doctor examine you, and it is likely his or her opinion would be lower than our doctor’s opinion. After their doctor examines you, we will likely get an offer from the insurance company. Depending on this offer, and with your permission, we’ll seek to resolve your claim somewhere between the two ratings. If we do that, a hearing will not be necessary and some of the costs could be reduced or eliminated. If we can’t resolve the claim, we’ll proceed to a hearing before the Industrial Accident Board.