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Michigan Workers’ Comp FAQ

Get the Answers from Skilled Worker's Comp Attorneys at Steele & Ferguson

At Steele & Ferguson, P.C., we understand that filing a workers’ compensation claim can be a daunting and confusing task. Instead of focusing on getting your health back, there are numerous processes and paperwork you need to take care of. As a firm founded out of a genuine desire to help the injured, we highly recommend that you arm yourself with information before embarking on the claims process. To get you started, we put together some answers to common worker's comp questions we have received from past clients. We hope this page is a helpful resource you when filing for your rightful benefits.

We recommend that you speak with a skilled workers' compensation attorney from our firm to receive assistance and proper guidance all throughout this tedious process.

For a FREE case evaluation, contact us at (888) 407-5820!
We are conveniently located in Flint and Saginaw.

This summary is only intended to provide general guidance. Every situation is different, laws change, and courts sometimes change their interpretations of the law. As a result, employees injured on the job are encouraged to consult an attorney for specific advice.

  • What is workers’ compensation?

    Workers' compensation is a system designed to provide the following for workers injured on the job:

    • Wage loss benefits
    • Medical expenses
    • Vocational rehabilitation

    It is basically a no-fault system that requires employers to make payment even if the employee was at fault for the injury, unless it results from intentional and willful misconduct. If an employee suffers a work-related injury, workers’ compensation is generally that employee’s only remedy against his or her employer for lost wages and medical expenses.

    The law generally forbids an employee who sustains an on-the-job injury from suing the employer (or a co-employee) for anything more, unless the injury is the result of an intentional act on the employer’s part, intended to injure the employee. The employee can sue any other party for damages caused by a work injury. For example, if a machine used on the job was negligently manufactured, the company that made it may be sued if it malfunctions on the job and causes an injury. In general, an employee must show that he or she is disabled as the result of a work related injury or illness. The degree of disability and the amount of required employment contribution to the injury or illness required may vary based upon the circumstances.

  • Who is covered by workers’ compensation?

    The Michigan workers’ compensation system covers every injury occurring in the state. Out-of-state injuries are also covered, if the contract of hire was entered into in Michigan or if the injured employee is a Michigan resident.

    • All private employers with three or more employees at any one time, or employing one or more workers for 35 or more hours per week are generally covered.
    • Employees of the federal government are not covered.
    • The Act covers employees, not independent contractors. The test for telling the difference focuses on the amount of employer control. The way the employer characterizes the relationship is not always the final word.
    • Volunteers are excluded from coverage.
  • What injuries are covered by workers' compensation?

    The injuries covered by workers' compensation depends on on when and how the injury occurred. For an injury to be covered by the workers’ compensation laws, the injury must arise “out of and in the course of employment.” It’s not enough that an injury occurs on the premises of the employer, unless there is some connection between the work being done and the injury. However, injuries sustained on the premises during a reasonable time before or after work are covered. Injuries during social or recreational activities are not covered.

    Injuries during the commute to and from work are generally not compensable, absent special circumstances. However, injuries during travel required by work are generally covered, if the employee has not strayed from the business purpose of the travel.

  • How much must the work injury contribute?

    An injury is generally compensable if it is caused by work. The aggravation of a previous injury or condition can also be covered, if a work injury caused a change in the underlying condition, rather than simply causing greater symptoms.

    The Act covers not just injuries, but also diseases and disorders caused or contributed to by work. Some types of claims involve their own specific standards. Mental disabilities and conditions of the aging process, including cardiovascular conditions and certain types of arthritis, are only compensable if they have been aggravated, accelerated, or contributed to by the employment in a significant manner. A mental disability must also result from actual events of employment, not an employee’s unfounded perceptions of those events.

    In short, this means that a claim cannot be based upon events imagined by the worker. However, the worker’s perception of events need not necessarily be accurate, as long as it is reasonable.

  • Do I qualify for disability benefits?

    In order to qualify for disability benefits, an employee must prove that he or she is disabled. While this seems simple enough, it is actually a very complicated matter. It involves not just the injured worker’s ability to return to his or her former job, but also the ability to perform any other suitable job.

    • If the employee can perform even a single job that is reasonably available and would pay maximum wages - the highest wage the employee would be able to earn - he or she is not disabled.
    • If the employee cannot perform any job that is reasonably available, regardless of the amount it pays, he or she is totally disabled.

    Finally, if an injured employee could still perform work suitable to his or her qualifications and training, but not at maximum wages, he or she would be partially disabled. It does not necessarily matter whether a partially disabled employee is actually working, because employers are given a credit for the amount the employee has the capacity to earn. However, a partially disabled individual who establishes a good-faith but unsuccessful effort to find work may still be entitled to full benefits. For that reason, it is very important that injured workers continue to look for work within their capacity to perform following an injury, not only in the fields in which they previously worked but also in other area in which they could use their education, experience, training, and skills. Workers should keep detailed written records of their job search, in case they have to prove in court that they have made reasonable efforts to find post-injury work.

  • How much does workers comp pay?

    An injured worker does not receive wage loss benefits until he or she has been disabled for at least one week. Injured workers generally receive 80% of the after-tax value of their wage loss, subject to a maximum benefit level that is adjusted every year.The benefit rate is fixed as of the date of injury, and is not adjusted in later years.

    If an employee has additional jobs at the time of injury, the earnings from all employers may be added to calculate an average weekly salary or wage if both jobs are covered by workers’ compensation. The worker’s benefits are then based upon the total from all of their employment. Discontinued fringe benefits, including such things as health insurance, employer contributions to a pension plan, and vacation and holiday pay, may also be included in determining the injured worker’s average weekly wage, but only to a limited extent.

    An injured worker who has found work after an injury, or who is able to earn wages even if not actually working, will receive 80% of the difference between his or her after-tax average weekly wage at the time of the injury and his or her subsequent earnings or earning capacity (without regard to tax consequences). Again, it is critical that partially disabled individuals regularly and diligently seek work, to prove that they are not able to obtain work within their capacity to perform. Benefits continue as long as the worker is disabled.

  • How is workers' comp affected if the injured worker receives other benefits?

    If an injured worker receives other benefits paid for by the employer, including group disability insurance benefits, wage continuation payments, or a pension, his or her workers’ compensation rate will be reduced by the after-tax value of the other benefits. Workers’ compensation benefits are also reduced by 50% of social security old-age benefits, but are not affected by disability benefits. Unemployment compensation benefits will also reduce workers’ compensation benefits. Alternatively, an employer may reduce benefits by 5% per year, beginning upon the worker’s 65th birthday and continuing until benefits have been reduced by 50%.

  • What else does workers’ compensation cover?

    In addition to weekly wage loss benefits, workers' compensation covers:

    • Hospital services, including surgical and medical care and treatment
    • Dental services
    • Hearing apparatus
    • Crutches
    • Nursing care
    • Chiropractic treatments

    An injured worker is entitled to necessary and reasonable medical care for as long as it is needed. It does not matter whether the injury is disabling, since medical expenses must be paid for even nondisabling but work-related injuries. The employer has a right to control treatment, including the choice of a treating doctor, during the first 28 days after the injury. After that, the employee can choose his or her own treater, but should give the employer written notice of the intent to treat with that doctor before starting care. If an injured party refuses treatment or does not follow their medical provider’s advice, he or she may lose their rights to continued benefits if the treatment is not unduly dangerous or painful and offers a reasonable prospect of relief.

    An injured worker also has a right to vocational rehabilitation, and an employer also has a right to ask that the worker participate in such a program. If the employee refuses to cooperate, his or her benefits may be suspended.

  • What about returning to work after injury? Can the employer require the injured employee to return to work?

    If an injured employee receives an offer to return to work within his or her capacity to perform, which poses no clear threat to his or her health and is within a reasonable distance from home, the worker must accept the job or face the suspension of weekly benefits during the period of refusal.

  • What if the work injury causes the employee’s death?

    The death of an injured worker ends the right to workers’ compensation benefits. However, if the worker whose death is caused by a work injury leaves behind a dependent or dependents, a claim for death benefits may be made.

    • Children under the age of 16 are automatically presumed to have been dependent, if they lived with the employee at the time of death.
    • All others, including a surviving spouse, must prove that they were dependents.
    • If there are no dependents, no weekly benefits are payable.

    Death benefits are paid at 80% of the after-tax value of the wages the deceased worker was receiving on the date of injury or death, but no more than the maximum benefit and no less than a minimum benefit that applies only in death cases.

    • If there are whole dependents, they will share equally in the death benefit and those who were only partially dependent will receive nothing.
    • If no one was wholly dependent, then those who may have been partially dependent will split the benefit, based upon the extent of their dependency.

    Death benefits are generally paid for a total of 500 weeks, reduced by any benefits paid before the worker died. Children under the age of 16 at the time of their parent’s death may receive further benefits as late as age 21. The dependency of a surviving spouse, and the right to further benefits, ends upon remarriage or death. In addition to weekly benefits, a deceased worker’s estate may receive a burial allowance of up to $6,000 and the expenses of the deceased employee’s last illness.

  • What other types of claims are available?

    Some types of injuries or disabilities are treated differently from others. For example, if the worker suffers a “specific loss” - the loss of a digit, limb, or eye, taking into account any joint replacement or similar medical procedure – he or she is paid wage loss benefits for a specified number of weeks. These benefits are payable whether or not the employee is disabled or off work, and even if the worker is receiving other types of benefits. The number of weeks depends upon the severity of the loss and the digit or extremity involved. The benefit paid is the same as for a normal disability, although there is a minimum benefit rate that applies to this type of benefit.

    If an injury causes the loss of two members (hands, arms, legs, or feet), both eyes, or one member and one eye, or the industrial use of those members, the worker is considered to have suffered total and permanent disability. A worker who is incurably insane may also be totally and permanently disabled. These workers are paid benefits for 800 weeks, even if they are working and earning wages or receiving other benefits. The minimum benefit rate also applies. After the 800 weeks, totally and permanently disabled workers may still receive benefits, but only if they are still unable to work. In addition, they may be eligible for annual increases in the amount of benefits, if wages in the state have risen during the prior year.

  • How does an injured worker make a claim?

    Most employers have workers’ compensation insurance to cover work-related injuries. Larger companies may be “self-insured,” which means that they are big enough that the state trusts they can pay claims without going out of business and leaving injured workers without benefits. The injured worker injury should immediately notify his or her employer, generally starting with a supervisor, the medical department, or the human resources department. The employee should make it clear that:

    1. A work-related injury has occurred.
    2. That he or she is requesting medical treatment and/or wage loss benefits.

    The employer should then either make the claim on behalf of the employee, or provide him or her with contact information for their workers’ compensation carrier. In most cases, the employee must make a claim within one year of the injury, although there are exceptions to that general rule. Benefits are often paid voluntarily after the preliminary claim, without the need for anything more.

    If the claim is denied, the injured employee will have to file an application with the Workers’ Compensation Agency. Following the filing of a formal application, the case will be sent to the Board of Magistrates. Medical and other information will be exchanged between the employer and the employee, and testimony will be taken from doctors and vocational experts, usually by deposition. At some point, the case will likely be sent to mediation, where the parties informally present their positions before a workers’ compensation magistrate or other person in an attempt to resolve the claim.

    During mediation or at any other point in the proceedings, the parties can reach a settlement, a compromise that allows the parties to avoid the uncertain result of a magistrate’s decision. If the case is settled, the employer (or its workers’ compensation insurer) agrees to pay a single lump sum to the employee in exchange for a release from any further liability. Sometimes medical expenses are excepted from the terms of a settlement.

    If mediation does not resolve the claim, the case will have a formal hearing before a different magistrate. Claimants who do not have legal representation are generally, and understandably, unfamiliar with court procedures and are at a disadvantage dealing with attorneys hired by their employers or their insurance companies who are familiar with those procedures. As a result, injured workers are well-advised to seek legal representation when filing a formal claim, even though this is not required.

    If a magistrate holds a hearing, he or she will listen to “live” testimony in court, from the injured worker and anyone else with information concerning the case. The magistrate will then review the depositions and medical records, before rendering a written decision as to whether the claim is compensable. Any party disagreeing with the decision may file an appeal with the Appellate Commission. However, the Commission has limited review powers, and does not simply start from scratch when reviewing the case. Instead, it begins with the magistrate’s findings, and must adopt them if they are supported by sufficient evidence, even if the evidence would also support a different result. Further appeals are available to the Court of Appeals and Supreme Court, but those courts have an even more limited review standard. Once a final decision is reached, it is binding on all the parties.

  • How is a workers' compensation attorney paid?

    Our workers' compensation attorneys generally work on a contingent fee, meaning that they will not be paid if no recovery is made (unless the parties agree in advance to a minimum fee of $500). The percentage is governed by law, and can range from a minimum of 10% of a settlement to as much as 30% if benefits are paid according to a final decision. No fees are charged on future benefits. The injured employee may also be required to pay the expenses of bringing the claim, which are typically deducted from any recovery made.

  • How can our workers' compensation attorneys help you?

    Workers’ compensation cases in Flint, MI can be very complicated and an experienced local attorney can be of great help. Our lawyers can help obtain records from your employers and your doctors, and make sure that they are presented to the court in the proper way to ensure that they are accepted and considered. Our workers' compensation lawyers can also protect your rights during a hearing, and make sure necessary questions are asked of doctors and other experts during their testimony. In addition, a lawyer can direct a magistrate to laws that may help your case, to make sure that your claim is presented in the best possible light.

    We are happy to sit down with you and discuss your case at no cost. We can make sure that you receive everything you’re entitled to, and that you don’t get taken advantage of by your employer or its insurance company. Please call us for a free, private consultation.

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