Our Michigan workers compensation lawyers help workers injured at the workplace and in the course of their employment.
On the job injuries are often very serious can lead to permanent disability. Employers frequently dispute legitimate claims and force injured workers to hire an attorney to file a work comp claim.
Workers’ compensation is the system created by Michigan statute to provide wage replacement, medical, and rehabilitation benefits to workers who suffer a work-related injury. Claims are made against the employer, but it is typically an insurance company that pays the required benefits.
Both workers and employers are governed by the Workers’ Disability Compensation Act, which was first adopted in 1912 and is meant to provide compensation to workers who suffer an injury on the job, as well as to protect employers’ liability. Essentially, the mission of the Workers’ Compensation Agency is to efficiently administer the Act and provide prompt, courteous and impartial service to all customers.
If you were injured while at work or have sustained an occupational illness, consider contacting a Michigan workers’ compensation lawyer to discuss the possibility of seeking recovery for your injuries.
A successful claim for benefits may help to alleviate your financial stress so that you can focus on your recovery. By enlisting the help of a tenacious and experienced attorney, you could rest assured that a legal professional is by your side through each step.
Why You Need a Michigan Workers Compensation Lawyer
After many work injuries, your employer and workers compensation insurance company may pay your medical bills and lost wages. At some point, you can eventually expect a change in the situation. Typically, there will be an abrupt cutoff of your benefits or you will be sent to a company doctor or clinic for a medical exam.
These medical exams, called an independent medical examinations or IME, are supposed to be a fair and unbiased assessment of your work related injury. However, these are really just “paid for doctors” who are hired to recommend a termination or reduction in your benefits. The doctor usually determines that you can have a full return to work or that you can return with restrictions, even if your own treating doctor still has you completely disabled. When this report is sent to the claims adjuster it usually signifies a change in your status.
Once you learn that your benefits are terminated or reduced, you can file a Petition with the workers compensation bureau and demand a hearing. While many injured workers handle it on their own, they soon realize that they are up against an insurance company lawyer. These lawyers are hired to support the company’s decision to cut off your benefit payments.
An experienced workers compensation lawyer fights these cases everyday for workers injured on the job or during the course of employment. Our law firm has handled these cases since 1969 and have a great track record of success in winning cases. We often win settlements for unpaid benefits and work to reinstate benefits going into the future.
What Qualifies as Workers Compensation Injury?
Most injuries that occur on the job are covered by workers’ compensation insurance. This includes job accidents and illnesses caused by exposure to work activities, materials, and equipment.
It is not required that the injury occur at the business, factory, plant, or workplace. Rather, it must simply be a work-related injury. So, if a person is travelling for work and is injured in another city it is still an injury that qualifies for workers compensation benefits. The same is true if a person is injured making deliveries at a customer location or providing services at a business.
In addition, exposure to chemicals and toxic substances that cause illness also qualify as a workers compensation injury. These often occur because the employer failed to provide proper personal protection equipment, like clothing, gloves, and masks. An occupational physician can evaluate the workplace exposure and determine if a condition was a job-related injury.
What Injuries do not Qualify for Workers Compensation Benefits?
The fact that a person is hurt or becomes ill while working or at the job site does not along mean that benefits are due. The injury itself must be caused by a work-related activity or function.
For example, the following situations do not trigger workers compensation benefits.
- Stress or other psychiatric disorders, unless specifically related to work.
- Self-inflicted injuries
- Injuries caused by fighting or horseplay are generally not covered.
- Injuries that happen when commuting, unless travelling for work. Simply driving to and home from work is not enough.
- Injuries incurred while committing a crime, while under the influence of drugs or alcohol, or while violating company policies.
Employers and insurance companies often argue that a claimant does not qualify benefits as the basis for refusing to pay. A workers compensation lawyer will evaluate the cause of your injury to determine whether you qualify. If so, we will file a claim for you and fight for every penny that you are owed.
How Accidents Happen at Work
People may expect injuries at work to only happen on construction sites, railways, and other occupations with a higher risk for dangerous accidents. However, an on-the-job injury can happen virtually anywhere in Michigan and range from mild to severe.
- Trip and falls.
- Overexertion from lifting, lowering, and carrying items.
- Repetitive motion stress.
- Chemical exposure.
- Accidents involving dangerous tools.
- Falling objects, such as merchandise, tools, or debris.
- Crashes with trucks, forklifts, or other vehicles and machinery.
- Workplace fires and electrocution.
The pie chart below shows the distribution of work injury sources in 2017 in Michigan. Ground surfaces are responsible for the most injuries, while injuries from other workers are the next most responsible culprit.
- Floors, walkways, other ground surfaces: 21%
- Person, injured or ill worker: 17%
- Vehicles: 11%
- Parts and materials: 11%
- Containers: 11%
- Person, other than injured or ill workers: 9%
- Machinery: 7%
- Handtools: 4%
- Furniture, fixtures: 4%
- Ladders: 3%
- Chemical, chemical products: 2%
Common Workplace Injuries
No matter the occupation, a workplace incident could result in severe trauma.
While some accidents, such as a minor fall, may only result in cuts and bruises, others could lead to any number of damages and occupational illnesses. These include, but are not limited to:
- Arm and wrist injuries
- Carpal Tunnel Syndrome, from repetitive movement
- Knee damage
- Herniated discs and bulging discs
- Broken bones and fractures
- Post-traumatic stress disorder
- Toxic diseases — such as mesothelioma and silicosis
- Burn injuries
- Spinal cord damage
- Brain trauma
The pie chart below shows the distribution of injury and illness types experienced while working in Michigan in 2017. The most significant source comes from sprains, strains, and tears. Bruises are responsible for 10% of injuries, while more serious injuries, like heat burns and amputations, are only responsible for a combined 3% of all injuries.
- Sprains, strains, tears: 43%
- Soreness, pain: 14%
- Fractures: 14%
- Cuts, lacerations, punctures: 13%
- Bruise, contusions: 10%
- Multiple traumatic injuries: 2%
- Heat (thermal) burns: 2%
- Carpal tunnel syndrome: 1%
- Amputations: 1%
What should I do after being Injured on the Job?
While seeking medical attention is paramount for any person injured on the job, it is also essential that they report their injuries to their employer as soon as possible after the incident. This is important because it might essentially initiate the start of a workers’ compensation claim, as well as diminish the opportunity for an employer to claim the injury was sustained somewhere else outside of work.
Even when an injury or occupational illness is discovered outside of work, an employer should still report their condition to their employer.
Furthermore, a condition should still be reported upon its discovery, even if the full extent of its damages is unknown.
During any step of this process, the aid of a well-versed Michigan workers’ compensation lawyer may also help an injured worker, especially as they seek recovery.
What Benefits do I get through Workers’ Compensation?
Essentially, workers’ compensation is an insurance program established to provide wage replacement, medical expenses, and rehabilitation benefits to an employee who was injured at work. While these claims are technically made against an employer, it is their insurance company that typically pays the required benefits.
Full and part-time employees may be covered under this system. In general, all employees are covered for on-the-job injuries. However, some of the major exceptions to this coverage include:
- Employees of the federal government, such as postal workers (but such workers may be covered by the Federal Employment Compensation Act).
- Some agricultural workers.
- Employees of companies who employ a very small number of people.
- Independent contractors.
Disputes very frequently arise over whether medical treatment is reasonable and necessary, or over whether the injured person is an employee or an independent contractor. The outcomes of these disputes can have significant consequences for someone who is injured at work.
For example, if it is decided that a medical expense is not reasonable, the cost of its treatment will no longer be covered, which means the injured person will have to pay for the treatment out of their own pocket. If the injury is a serious one, this can cost many thousands of dollars over a person’s lifetime.
To take another example, quite often, employers attempt to argue that the injured person is an employee in order to bring them within the scope of the workers’ compensation law.
The reason an employer might do this is so it will be cheaper for them to pay the wage loss benefits and medical expenses than it would be to face a lawsuit for these and other damages — such as pain and suffering, or punitive damages that workers’ comp would not pay.
Furthermore, there have even been instances in which an injured person’s job title was “independent contractor,” but the employer nonetheless argued that the person was an “employee.” Because of these nuances, having a seasoned Michigan lawyer who is familiar with each component of the workers’ compensation system could be critical for an injured worker.
Who Pays my Medical Bills After a Work Injury?
A worker who suffers a work-related injury is entitled to reasonable and necessary medical care for work-related injuries or diseases. This includes payment of expenses for all medical treatment, including surgery, physical therapy, rehabilitation, and hospital services.
Employers or their insurance carriers are required by law to provide these services and benefits must be paid as long as the treatment is related to a worksite injury.
State law does not require prior authorization from the employer or insurance company for medical services. However, it does allow the employer to direct the care for the first 28 days of medical care.
Many large employers have company clinics and doctors that will see and treat the injured worker and refer to an outside specialist if necessary. After the four-week period, the employee may choose their own treating physician.
Typically, the doctors and other medical providers send their bills directly to the employer or its insurance carrier. There is a specified fee schedule for services and doctors and hospitals are not permitted to charge more than the set fees. If they do charge higher fees, the insurance company will only pay according to the fee schedule.
A worker who incurs out of pocket expenses is entitled to reimbursement.
Many times, the employer will unlawfully refuse to pay for necessary medical care and treatment, while other times, the company doctor or an insurance medical examiner (IME doctor) will give an opinion that an injury is not work-related or that medical treatment is no longer necessary and medical benefits will be terminated.
How Long do I Have to be Off Work to Receive Benefits?
You must wait for a seven-day period to be eligible for wage-loss benefits after your injury.
If you are disabled from work after seven days, you are entitled to receive your benefits starting on the eighth day.
If you continue off work for 14 days or more, you should receive your wages for the first seven-day period.
How Much Do I Get Paid for my Lost Wages?
Wage loss benefits are calculated through an average weekly wage system.
After an injury is sustained, a worker must wait seven days before they can become eligible for wage loss. However, if they are unable to work for 14 days or longer, they should receive retrospective wages for the first seven days they missed.
A worker who suffers on the job injury is normally entitled to eighty (80%) percent of the after-tax value of his other wage loss. This is the case whether the worker is “totally” or “partially” disabled.
The amount of wages is calculated based upon the average weekly wage, which is essentially the highest amount of wages in the 39 of the last 52 weeks before the injury.
If the employee worked less than 39 weeks during the year before an accident, the wage loss amount is determined by dividing up total earnings by the number of weeks worked. If a person returns to work at a lower rate of pay, however, the company must pay the wage difference from the higher rate to the current rate.
A knowledgeable workers’ compensation lawyer in Michigan could help a claimant to understand what benefits are available to them, as well as guide them through the process of filing a claim.
State law provides that the maximum rate of wage benefits is 90 percent of the state average weekly wage for the year prior to the injury. Therefore, a worker cannot receive benefits higher than this amount regardless of how high his or her earnings might have been. Furthermore, these benefits are only taxable certain unique circumstances.
There is no requirement to pay compensation for an injury that does not last for at least one week. Beyond one week, the worker is entitled to benefits as of the eighth day after the injury.
For a disability that continues for two weeks or more, the worker is entitled to be paid compensation for the first week of disability.
Wage loss benefits continue as long as the worker is disabled and this can be for a lifetime. The amounts get reduced after the worker’s 65th birthday, and again at age 75.
Despite these requirements, employers and insurance companies often look for reasons to terminate, or cut off, an employee’s wage loss benefits. It can either be just the refusal to pay the benefits or termination of benefits based upon a company doctor or highly paid insurance medical examiner (IME) doctor.
What do I Get Paid if I am Totally Disabled from Working?
Michigan has a specific statute governing the basis for determining if a worker is permanently disabled from work.
Section 361(3) provides that a worker is totally and permanently disabled if he or she has suffered:
- Total and permanent loss of sight of both eyes.
- Loss of both legs or both feet at or above the ankle.
- Loss of both arms or both hands at or above the wrist.
- Loss of any 2 of the members or faculties in subdivisions (a), (b), or (c).
- Permanent and complete paralysis of both legs or both arms or of 1 leg and 1 arm.
- Incurable insanity or imbecility.
- Permanent and total loss of industrial use of both legs or both hands or both arms or 1 leg and 1 arm — for the purpose of this subdivision, such permanency shall be determined not less than 30 days before the expiration of 500 weeks from the date of injury.
Unfortunately, employers, companies, and insurance companies often deny that a worker has a permanent disability. They might also dispute that any total disability was work-related or arose out of the employment. Because of this, retaining a hardworking attorney to argue against these exact issues might be crucial.
When a worker is permanently disabled, the employer must pay the same benefits it would in an ordinary case. However, the worker is allowed to take advantage of changes in the minimum and maximum rates of benefit.
The additional benefits paid to the worker are the responsibility of the Second Injury Fund and are called differential benefits. Additionally, a totally and permanently disabled worker is entitled to the minimum benefit available, which is equal to 25 percent of the state average weekly wage. Finally, a permanently disabled worker is not subject to the coordination of other benefits.
Can I be Fired while on Workers’ Compensation in Michigan?
Under Michigan law, your employer can terminate you while on workers’ compensation leave. There is nothing in the law that protects your employment and prevents you from being fired.
However, your employer cannot fire you because you applied for or are receiving workers compensation benefits. This is considered retaliation is against the law. If that happens, you can pursue money beyond workers compensation benefits. Many employers threaten to terminate a worker if a request for benefits is made. This is also illegal under Michigan law.
What Happens if my Company did not have Insurance?
In Michigan certain employers are required to have workers compensation insurance. The law requires the following to be insured:
a) All private employers regularly employing 1 or more employees 35 hours or more per week for 13 weeks or longer during the preceding 52 weeks.
b) All private employers regularly employing 3 or more employees at one time. (This includes part-time employees).
c) Agricultural employers if they employ 3 or more employees 35 hours or more per week for 13 or more consecutive weeks.
d) Households employing domestic servants if they employ anyone 35 hours or more per week for 13 weeks or longer during the preceding 52 weeks.
e) All public employers
Unfortunately, not all businesses comply with these requirements. Many injured workers are shocked and disappointed to find out that the company did not have a policy in place. When this happens, you are permitted to file a direct lawsuit against the employer. In that case, you may also be able to demand pain and suffering compensation.
Am I Required to Pay Income Tax on my Workers Compensation Benefits?
Workers’ compensation benefits are generally not subject to either state or federal income tax.
If the insurance company pays you interest on past unpaid benefits, the interest payments may be subject to both state and federal income tax.
Can I Get Pain and Suffering Compensation for my Injury?
Under Michigan law, you cannot receive pain and suffering compensation in a worker’s compensation claim.
There may be other circumstances for a work injury that allow this compensation, such as if you were injured due to the negligence of another company or by a worker with a different employer.
Our attorneys will review your case to determine if you can make a claim for a pain and suffering settlement.
What are the Most Common Reasons for Denying Work Comp Claims?
Quite often, an employer or their insurance company will dispute a claim to delay or deny benefits.
The most common reasons for denying workers compensation claims include the argument that the:
- Employee was not acting in the course of employment.
- Injury occurred before or after work hours, or during a lunch break.
- Worker had a pre-existing condition that was not caused by a work injury.
- Injured worker has fully recovered and can return to employment.
- Worker was injured but was not disabled from performing the job duties.
Employees and insurance companies are also notorious for cutting off, or terminating, benefits after an “independent medical examination.”
Of course, everyone knows these are not independent at all and the companies have a stable of high paid doctors who are ready and willing to cut off benefits of disabled workers. You will need a lawyer with experience battling these unscrupulous doctors to win your case and get your benefits paid.
What Happens if my Claim is Denied?
When an employee is facing medical bills and is unable to continue earning pay, denial of workers’ comp benefits may be a frightening possibility. However, a determined Michigan workers’ compensation attorney could help to assess the circumstances of a claim and its denial and work toward filing an appeal.
These appeals are applied for through an application for mediation or a hearing with the Michigan Workers’ Compensation Agency.
If an appeal application is accepted, an injured claimant often must enter a legal dispute over the denial of their benefits. Here, the skill of a legal professional may prove useful.
Call our Michigan Workers’ Compensation Attorneys for Assistance
After sustaining a workplace injury, an employee may worry about their financial security as they recover from a potentially severe injury and miss time at work. However, a claim for workers’ compensation benefits will reduce your financial strain and allow you to focus on your recovery.
If you were injured on the job, call our Michigan workers’ compensation lawyers to discuss how to best proceed with a claim.
Our attorneys will help to guide you through each step to get your benefits paid.
How Much Does it Cost to Hire a Workers’ Compensation Lawyer?
Under state law, the attorney’s fees for representing you in workers’ compensation case are paid from the settlement amount when the case is over.
There is a specific schedule of fees set forth by law and the amount of your fees is calculated by that schedule. Essentially, it is a percentage of the settlement amount that you receive and based upon the amount of your award.
To discuss your workplace injury, call our experienced workers compensation lawyers today.