What is Workers’ Compensation?
Workers’ compensation, to put it simply, is a way for employers to compensate their injured workers without paying for litigation expenses. This system of compensation replaces the traditional method of personal injury lawsuits, which did not guarantee a worker compensation for his injury, and could cost an employer large amounts of money in attorneys’ fees and a potential settlement or award. Instead, an employer pays a premium for workers’ compensation insurance (or is self-insured), which will make the worker “whole again” if he is injured regardless of fault. Although, workers’ compensation only covers those who have been injured as a result of work that they are assigned to do at their job.
Does Michigan Require Employers to Have Workers’ Compensation Insurance?
Yes. In general, Michigan employers are required by law to provide workers’ compensation coverage for their employees. In fact, employers who fail to provide their employees with workers’ compensation coverage could face a personal injury lawsuit from the employee, a $1,000 fine, and potential jail time. However, there are exceptions to who is required to have coverage, including:
- Federal workers (including those who work on interstate railroads)
- Seamen and longshoremen are covered under different coverage laws
- Sole proprietors (people who own their own businesses) and do not have any employees
The rule that decides if workers’ compensation coverage is needed is; if an employer has three or more employees, or has one or more employee that works for at least 35 hours every week for 13 or more weeks, that employer is required to have coverage for his employees.
What Should I do if I’m Hurt at Work in Michigan?
- Report your injury to your employer.
It is important to report your injury to your supervisor in order to start the claims process early. Your notice should be given to your employer in writing. Your notice should have the date on which the injury occurred, and a brief description of what led to the injury. You will only have 90 days to report your injury to your employer before you risk losing your rights to compensation. Once your employer has received your notice, he should then fill out a Michigan Workers’ Compensation Agency (WCA) Form 100 (“Employer’s Basic Report of Injury”).
- Seek medical treatment.
Your employer has the right to dictate which doctor you visit for the first 10 days of your injury. This doctor should confirm the extent of your injuries and give you initial treatment. After the first 10 days, you are free to pick your own doctor to treat your work-related injury, but you must inform your employer that you are switching doctors first. You should expect to receive your first workers’ compensation benefits with about two weeks.
- If the injury is an emergency, go to the hospital first.
If the situation is an emergency when you are injured at work, skip the first step and seek medical attention as soon as possible. Everyone in the claims process will understand that you immediate well-being takes priority. Tell all of the doctors, nurses, and emergency medical technicians that you were injured while at work. After the situation is no longer an emergency, go back to step one.
What Kinds of Benefits does Michigan Workers’ Compensation Provide?
Under the Michigan Workers’ Disability Compensation Act, each worker is entitled to compensation should they receive an injury because of their work. These forms of compensation or “benefits” include:
- Medical Benefits
Injured workers will not be charged for any reasonable and necessary medical treatments. Usually, medical providers send bills directly to a worker’s employer, or the employer’s insurance carrier for payment. Any medical bills that are related to your work-related injury will be covered by your employer or his insurer for as long as you live.
- Lost Wage Benefits
If you have suffered an injury that stops or reduces your income, you can receive compensation that replaces your lost wage. This benefit, in most cases, will be equal to 80 percent of the after-tax income you made before you were injured. However, you cannot receive more than 90 percent of the state’s average weekly wage. These benefits will last for the rest of your life, or until your wages are restored to their formal rate. If you receive additional benefits from your employer (like pension payments), or are receiving social security payments, your rate of compensation will drop by five percent every year when you turn 65 years old. This rate drop will stop when you turn 75, at which point you will only receive 50 percent of your original compensation from then on.
- Specific Loss Benefits
Should you lose complete function of a specific body part (this includes amputation) you will be compensated for a set number of weeks, regardless of whether or not you fully recover your prior wages. The specific body parts that you can be compensated for, and for how long, are:
- Thumb — 65 weeks
- 1st (index) finger — 38 weeks
- 2nd (middle) finger — 33 weeks
- 3rd (ring) finger — 22 weeks
- 4th (pinky) finger — 16 weeks
- Great toe — 33 weeks
- Other toes — 11 weeks
- Hand — 215 weeks
- Arm — 269 weeks
- Foot — 162 weeks
- Leg — 215 weeks
- Eye — 162 weeks
- Total and Permanent Disability Benefits
Some injuries are considered to be “total and permanent” under law. These benefits are calculated the same way as other wage loss benefits, but be paid in full won’t be decreased or “coordinated” for as long as you live. Additionally, the amount of compensation you receive cannot be less than 25 percent of the state’s average weekly wage (specific loss benefits follow this rule also). In order to considered totally and permanently disabled you must suffer from:
- Loss of use in both legs or both feet at or above the ankle.
- Loss of use in both arms or both hands at or above the wrist.
- Complete and permanent blindness in both eyes
- Any combination of the above injuries (for example, loss of use of an arm and leg).
- Incurable insanity or imbecility.
It is important to note that you cannot be compensated for the first week of your injury, unless your injury lasts longer than two weeks. Also, the rate that you are compensated for with wage loss benefits is based your average weekly wage from before your injury. This is based off a 52 week period before your injury, and will use the average of 39 of your highest paid weeks within this period to calculate average weekly wage.
What Should I do if My Claim is Denied?
In the state of Michigan, about three-fourths of all claims are voluntarily accepted by insurers. However, cases do arise in which an insurance carrier will reject a claim. These cases are usually caused because of a lack of evidence that a worker’s injury was work-related.
However, no matter what the cause of the claim rejection is, it would be wise to retain a Michigan workers’ compensation attorney. The claim filing process is complicated, and requires in-depth legal knowledge to fully understand. It is your right to retain an attorney to help you in the claims process of your case at any time. An experienced workers’ compensation attorney will help smooth over any problems that pop up when you are seeking compensation. Additionally, if your case is appealed, your attorney should be willing and able to represent you legally at the hearing. If your claim is appealed, the insurer will have an attorney to represent it in the appeals process. So protect your rights, and retain an experienced workers’ compensation attorney.