Michigan Workers’ Comp: Frequently Asked Questions
Our firm has more than 30 years of experience in matters of Michigan workers’ compensation. If you or a loved one has been injured on the job, our workers’ comp attorneys can help you get the benefits you need and deserve.
You undoubtedly have a lot of questions after a work injury or illness, and we have provided some answers below. Note: This summary is only intended to provide general guidance. Every situation is different, laws change, and courts sometimes change their interpretations of the law. That is why people 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 people who have suffered work-related injuries or illnesses:
Workers’ comp is a no-fault system that requires employers to cover the costs of work-related injuries. By “no-fault” we mean that you don’t have to prove that your employer did anything wrong in order for you to get workers’ compensation benefits. The fact that you were injured on the job should be enough for you to file a claim.
Typically, the employer’s workers’ compensation insurance is responsible for providing workers’ comp benefits. However, insurance companies routinely try to reduce or altogether deny workers’ compensation benefits, even when injured people have a legitimate claim. That is why you need a workers’ comp attorney from Steele & Ferguson, P.C., on your side from day one — to fight to get you the benefits you need.
What do workers’ compensation attorneys do?
Who is covered by workers’ compensation in Michigan?
The Michigan workers’ compensation system covers injuries illnesses that happen 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.
Other important notes about workers’ comp coverage in Michigan:
- All private employers with three or more employees, or employing one or more workers for 35 or more hours per week, are generally covered.
- Employees of the federal government are not covered.
- Workers’ compensation is generally available to employees, not independent contractors. The test for telling the difference between employee and independent contractor focuses on the amount of control the employer has over the worker’s actions on the job. The way the employer characterizes the relationship is not always the final word.
- Volunteers are generally excluded from workers’ comp coverage.
What injuries are covered by workers’ compensation in Michigan?
For an injury to be covered by workers’ compensation, the injury must arise “out of and in the course of employment.” It is not enough that an injury occurs on the premises of the employer. There must be a connection between the work being done and the injury.
However, injuries suffered on the work premises during a reasonable time before or after work are generally covered.
Injuries during the commute to and from work are generally not compensable, unless there are 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.
Our firm serves clients who have suffered all types of work-related injuries, including cumulative stress injuries, back injuries, head injuries, joint injuries, shoulder injuries, knee injuries and joint injuries.
What types of employers may be excluded from having to purchases workers’ comp insurance?
Employers in Michigan may be excluded from having to purchasing workers’ compensation insurance only under specific circumstances, such as:
- If the business is a sole proprietorship and all employees are either the spouse, children or parent of the sole proprietor
- If the business is a partnership and all employees are partners
- If the business is a stock corporation and all employees are corporate officers and own 10% or more stock in the corporation
- If the business is a limited liability corporation and all employees are members and managers, and own 10% or more interest in the business
Employers may submit an exclusion form only if all employees can be excluded and the business does not use subcontractors in its operation.
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 may also be covered, if a work injury caused a change in the underlying condition, rather than simply causing greater symptoms.
Workers’ compensation covers not just injuries, but also diseases and disorders caused or contributed to by work.
Some types of claims involve their own specific standards. For example, 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 unproven perceptions of those events.
How much does workers’ compensation pay in Michigan?
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 certain 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).
Note: 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.
Is there a waiting period for workers’ compensation benefits in Michigan?
There is a seven-day waiting period for wage loss benefits in Michigan. In other words, your injury or illness must keep you from earning wages for at least seven consecutive days (including weekends and holidays) before you may begin to collect wage loss benefits.
You may receive payment for your first week of disability if your wage loss lasts for more than 14 days.
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, the employee’s 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
- 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 to participate in such a program. If the employee refuses to cooperate, his or her benefits may be suspended.
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 workers’ compensation claims are available in Michigan?
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 do you file a worker’s compensation claim?
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:
- A work-related injury has occurred
- 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.
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.
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.
My employer threatened to fire me for filing for workers’ compensation. Can I sue my employer?
In most cases, yes. The Michigan Workers’ Disability Compensation Act prohibits employers from retaliating against employees for filing for workers’ compensation after suffering a work-related injury. If your employer has obstructed your workers’ compensation claim process in bad faith, ridiculed you, threatened you, demoted you, cut your pay, or taken any other type of adverse action against you in relation to your injuries, consult with an attorney immediately.
Contact Steele & Ferguson, P.C.
For a free consultation regarding your workers’ compensation case, please call our Michigan workers’ comp attorneys at 888-471-2002 or complete our contact form. Our main office is in Flint, and we represent injured workers and their families throughout Michigan.