Frequently Asked Questions
About Worker's Compensation
Who is covered by Worker’s 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 under Worker’s Compensation?
Most on-the-job injuries are covered by worker’s compensation. Even if an injury was not caused at work, but was significantly aggravated by employment, you are still entitled to worker’s compensation. Back, knee and wrist injuries are covered; however, people have also received benefits for psychiatric problems, arthritic conditions or in some situations, heart attacks.
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.
The Worker’s Compensation 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.
What benefits am I entitled to under Worker’s Compensation?
Worker’s Compensation is designed to provide the following benefits for workers injured on the job:
- Wage loss benefits
- Medical expenses
- Vocational rehabilitation
Worker’s Compensation pays for weekly benefits while you are off work, medical benefits related to your condition and vocational rehabilitation benefits.
Weekly benefits continue while you are not working and may continue for years.
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 non-disabling 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 doctors 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.
Medical benefits include payment of doctor visits, prescriptions, surgeries and medical appliances. Under this provision, family members or others can collect payment for services an employee can no longer do for himself, such as preparing meals or getting dressed.
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.
Also, an injured worker must show that they are looking for work. We recommend you submit 5 job applications a week, and keep track of such applications in a job log. Failure to do this can result in the reduction of benefits.
If I am injured at work, am I entitled to Social Security benefits?
Many injured workers are also entitled to either Social Security Disability (SSD) or Supplemental Security Income (SSI). If you are receiving regular Social Security benefits, and you aren't yet at your full retirement age, you might be entitled to Social Security benefits, which could increase your monthly benefits.
In order to qualify for Social Security 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 any job he or she has done in the past, and the ability to perform any suitable job. As the injured worker gets older, it is generally easier to obtain benefits.
If you think you may be entitled to Social Security Disability or Social Security Income, and have been turned down for benefits or just have questions related to your benefits, please give us a call and schedule an appointment to discuss your case.
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, benefits are then based upon the total earnings from all 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). It is important 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.
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. Please contact our office for additional details on work related death benefits.
Do I need a lawyer?
Our consultation is Free and our job is to help you determine if you have a legal issue. If your concern deals with Worker’s Compensation, Social Security claims, a personal injury we can help you determine if you have a case and how you should proceed. We will answer your questions and provide guidance during your free, no-obligation consultation.
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:
- 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.
What if My Claim is Denied?
If the workers compensation 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 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.
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 benefit from legal representation when filing a formal claim, even though this is not required.
If your claim has been denied, please contact our office for a FREE Case Review so we can advise you as to your next steps.
How is a workers' compensation attorney paid?
We work on a contingent fee, meaning that we 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 me?
Michigan workers compensation cases can be very complicated and an experienced local attorney, who provides personal representation can be a tremendous help. We can help obtain records from your employers and your doctors, and make sure that they are presented to the court in a way to ensure that they are accepted and fully considered.
We work to 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 the benefits you’re entitled to, and that you don’t get taken advantage of by your employer or their insurance company. Please give us a call to schedule your FREE case review and advise.