Workers’ Compensation Benefits and Unemployment Compensation Benefits … Are Injured Workers Entitled to Both?

By Keri L. Morris-Johnston, Esq.*

Is a claimant entitled to workers’ compensation benefits when her doctor verbally tells her that she is unable to work? Only if there is evidence to show that her no-work status was actually discussed with her and that it is supported in the medical records. If an injured worker in Delaware is instructed by her treating physician that she is not to perform any work, the injured worker will be deemed totally disabled during the period of the doctor’s order. This rule (Wendy’s rule) presumes that the doctor is acting in good faith when he issues the no-work status. The burden of proof is on the injured worker. The worker must be able to show that the treating doctor actually issued a no-work opinion and that the no-work status is supported in the medical records.

In the case of Munsell Harmon v. F&H Everett & Associates., 83 A.3d 737 (Del. 2013), the Delaware Supreme Court addressed the issue of no-work instructions verbally given to the injured worker by his doctor. The injured worker in the Harmon case testified that her doctor advised her that she was unable to work for several, lengthy periods of time. The doctor testified that he verbally informed the claimant that she was unable to work. However, the medical records did not support the doctor’s testimony regarding the alleged no-work status. As a result, the Industrial Accident Board awarded only a portion of the claimed periods of total disability. The Board simply did not find the treating doctor’s testimony credible.

In Munsell Harmon, the Delaware Supreme Court decided whether the Industrial Accident Board abused its discretion in finding that the injured worker was not entitled to total disability benefits for the entire period of time she was deemed “totally disabled” by her medical doctor, since injured workers are permitted to rely on their treating doctors’ no-work opinions. The Supreme Court found that the Board did not abuse its discretion and affirmed the Board’s award.

The Delaware Workers’ Compensation Act requires that treating doctors complete forms to address the work abilities of injured workers. As per the statute, doctors must complete the form at every office visit. Carriers should monitor medical records to determine if there is any change in work status.

What happens when an injured worker collects unemployment compensation benefits for the same period for which he or she seeks total disability benefits? Should the injured party be entitled to unemployment benefits and workers’ compensation benefits for the same period of time? The answer to this question is no.

In Munsell Harmon, the Delaware Supreme Court was also faced with the question of whether workers’ compensation benefits should be offset by the amount an injured worker receives through the state’s unemployment compensation system. The Supreme Court noted that several Delaware courts’ decisions found that workers’ compensation benefits should be reduced by the amount of any unemployment benefits received by the injured worker. The court noted that, although the Workers’ Compensation Act contemplates full compensation, the Act was never intended to allow for double recovery to the injured party.

Munsell Harmon indicates that it is important to gather as much information as possible when investigating a claim for total or partial disability benefits. Workers’ compensation carriers should make certain that the injured worker’s treating doctor has provided written work restrictions or a clear total disability status. Carriers should also determine if the injured party has received, applied for and/or will receive unemployment compensation benefits. The Delaware Supreme Court has made it clear that workers’ compensation should be offset by the receipt of unemployment benefits.

* Keri is a shareholder who works in our Wilmington, Delaware office. She can be reached at 302.552.4372 or klmorris@mdwcg.com.

Defense Digest, Vol. 20, No. 3, September 2014

Defense Digest is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2014 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. This article may not be reprinted without the express written permission of our firm.