Workers’ compensation insurance – commonly referred to as workers’ compensation or workers’ comp – is a type of insurance program designed to provide compensatory benefits to workers who get injured or become ill due to a workplace accident or due to the nature of their work. It also provides death benefits to the family members of workers killed in workplace accidents or as a direct result of their job.
Workers’ Compensation is a No-Fault System
Workers’ compensation is a no-fault system, which means you can get the benefits you need in the event of a work-related injury or illness, regardless of how it was caused and who was at fault. You are not required to prove your employer’s fault (or anyone else’s fault, for that matter) to receive workers’ comp benefits. Similarly, if the accident was caused directly due to your negligence, oversight, or lack of preparedness, you can still receive the benefits to which you are entitled.
Advantages of Workers’ Compensation Insurance
Workers’ compensation is a system that immensely benefits employers and workers.
How it Benefits Workers
- The financial stress caused by an untimely injury can be too much to bear for the average worker. Data shows that people who suffer a severe injury are more likely to file for bankruptcy – mainly due to medical debt. Workers’ compensation eliminates this problem by paying for workers’ treatment and compensating them for lost earnings. As a result, workers do not have to worry about the financial cost of their injuries and focus on their recovery.
- Workers’ compensation also provides a sense of security to workers, as they know they can get the financial assistance they need in the event of an injury or illness. Their family will be compensated in the event of their death.
- Workers’ compensation ensures injured workers get the necessary medical and rehabilitative care. As a result, they are less likely to self-medicate and become dependent on highly addictive pain medications like opioids.
- Having a workers’ compensation program incentivizes employers to maintain a safe work environment, which reduces the risk of workplace accidents greatly.
How it Benefits Employers
- Workers’ compensation insurance protects employers – particularly small businesses – by helping them avoid expensive lawsuits from injured workers. Without a workers’ compensation program, employers might have to pay hundreds of thousands or even millions of dollars to workers who are seriously injured or killed in workplace accidents.
- Under a workers’ compensation system, injured workers can get the medical treatment and care they need immediately, allowing them to recover faster and return to work. It also mitigated the financial impact of absenteeism and lost productivity caused by workplace injuries, which benefits employers in the long term.
Is Workers’ Compensation Mandatory for All Employers in Michigan?
Michigan’s Workers’ Disability Compensation Act (WDCA) applies to almost all employers, including:
- All public employers
- Private employers regularly employ one or more employees for at least 35 hours a week.
- Private employers employ three or more employees on a part-time or full-time basis.
- Agricultural employers regularly employ three or more employees for at least 35 hours a week.
- Householders who employ maids and other third parties for household services regularly for at least 35 hours a week.
The detailed list of workers’ compensation requirements for Michigan employers can be found here.
Types of Accidents That Can Result in Workplace Injuries and Deaths
- Slips, trips, and falls
- Falling from height
- Accidents involving power tools
- Accidents involving heavy machinery
- Getting struck by falling or moving objects
- Crashes involving forklifts and other heavy equipment used at workplaces
- Exposure to dangerous chemicals
- Repetitive motion stress
- Overexertion caused by lifting and moving around heavy items
- Accidents caused by defective or dangerous conditions at work
Injuries Covered Under Workers’ Compensation Insurance in Michigan
Under Michigan law, any injury that you sustain in the course of your employment is covered under workers’ comp insurance. Similarly, suppose you develop or contract any disease that can be attributed to the nature of your work or the specific conditions under which you work. In that case, you can be compensated for it as well.
Injuries Not Covered Under Michigan Workers’ Compensation Law
The following injuries are usually not covered under workers’ compensation insurance.
- Any injury you sustain while you are on the way to or from work.
- Any injury you sustain while taking part in social or recreational activities.
- Any injury you sustain while you are intoxicated.
- Any injury you sustain as a result of fighting with another employee.
- Any injury you sustain as a result of willful misconduct.
- Any injury you sustain as a result of intentional actions.
It is important to note that if your job requires you to travel, and if you sustain an injury while you are away from work, you can still receive workers’ compensation benefits – as long as you do not deviate from your work-related responsibilities. Your purpose for traveling must be business related.
Can I Receive Workers’ Comp Benefits in Michigan If an Existing Injury is Aggravated in a Work-Related Accident?
Yes, you can. If an existing injury, disease, or medical condition is aggravated or made worse due to a work-related accident or the nature of your work, and if it leads to a medically distinguishable condition, you can be compensated for it.
Unfortunately, workers’ comp claims stemming from the worsening of a pre-existing injury or condition are often denied in Michigan. Your employer might claim that the workplace accident or the work environment did not contribute significantly to your condition and that it is not medically distinguishable from what it was before.
One of the many reasons you should hire an experienced workers’ comp lawyer in Michigan before filing a claim. Your lawyer can gather all the facts related to your injury, prove that your condition was aggravated due to the workplace accident or work environment, and make sure you receive all the benefits you are entitled to under the law.
How to Report a Work-Related Injury or Illness in Michigan?
Under Michigan workers’ compensation law, you are required to report any work-related injury to your employer (or any person designated by your employer for reporting work-related injuries) within a span of 90 days – starting from the date on which you got injured or from the date on which you should have reasonably known about it.
You should know two key things about reporting a work-related injury or illness in Michigan.
Report Your Injury as Soon as You Can!
Even though you have 90 days to report your injury, it is always advisable to report it as soon as possible. Any delay in reporting the injury can cause your employer and the insurance company to question the severity of your injury. In some cases, they might even ask about your claim that you got injured at work.
Let us assume that you get injured in a workplace accident on Friday. You presume that it is nothing serious and can wait until Monday. When you report it on Monday, your employer might question your claim that you suffered a work-related injury and argue that you might have gotten injured during the weekend while doing something completely unrelated to your work.
In the scenario above, unless you have eyewitnesses and other evidence that can back up your claim, it might be hard for you to promptly get the benefits you need. Similarly, if your employer has reporting requirements unique to your workplace, ensure you follow them. Any violation of the recommended procedure can lead to unnecessary delays in getting the benefits you need.
Report Your Injury Even if it Seems Minor
Not reporting your injury because it seems minor or because there is no pain or discomfort is one of the biggest mistakes you can make as an employee. Adrenaline can be very effective in masking pain, which is why you might not feel any pain immediately after an accident. Moreover, with specific injuries, the symptoms might show up several days or even weeks later. It’s why you should always report your injuries, regardless of how minor they might seem.
Make Sure You File a Written Report
Michigan workers’ compensation law allows you to report your injury orally, which means you can tell your employer about your injury. It’s, however, not recommended. You should fill out a workplace accident report (if your employer has one). Otherwise, you can make a report yourself.
Filing a Workers’ Compensation Claim in Michigan
Michigan law requires you to file a workers’ comp claim within two years – starting from the date you were injured, came to know about your injury, or came to know about your illness or medical condition.
It is in your best interest to file the claim as soon as you can after an accident. You can send an email to your employer and request medical benefits and wage loss benefits. If your employer has their own system of filing a claim, it is advisable to follow it.
Once your employer is informed of your injury, they are required to take the following steps.
- File an Employer’s Basic Report of Injury with the Michigan Workers’ Compensation Agency
- Notify the workers’ compensation insurance company about your injury
- Provide the name and address of the insurance company to the physician who is treating you so that they can send their medical bills to the company
If your employer fails to accept your claim, you can file a claim directly with Michigan’s Workers’ Disability Compensation Agency by filling out and submitting this form.
Getting Medical Treatment for Your Work-Related Injury or Illness
Following your workplace injury, you should seek medical care only from the physician chosen by your employer. This rule is to be followed only for a period of 28 days. After 28 days, you can choose to get treated by your primary care physician or any other doctor of your choice.
Make sure you tell the physician everything about your injury or medical condition. Do not leave out any detail – no matter how inconsequential it might seem to you. Make sure you follow all the instructions provided by the physician carefully.
Dealing with a Notice of Dispute
If there is any dispute regarding your claim, your employer must send you a notice of dispute. Upon receiving the notice, you must file an application for mediation or a hearing with the workers’ compensation bureau. You and your employer can try to resolve the dispute with the help of a mediator. If you cannot do so, your case will go to trial, where a workers’ compensation magistrate will make the final decision.
What Kind of Benefits Am I Entitled to under Michigan Workers’ Compensation Law?
Apart from medical benefits, which will be paid directly to the physician who treats you, you can receive the following benefits – depending on the nature and severity of your injury.
Vocational Rehabilitation Benefits
If you cannot do the same kind of work that you used to do before your injury, you might need vocational rehabilitation to return to the workforce. Vocational rehabilitation services typically include counseling, vocational assessment, on-the-job training, retraining, and placement assistance. Vocational rehabilitation benefits are meant to cover the cost of these services.
Wage Loss Benefits
Under Michigan law, you can be compensated for lost wages if your injury or medical condition results in 7 days of disability. You can start receiving the benefits from the eighth day – assuming no dispute regarding your claim.
If your injury or medical condition results in 14 days of disability, you will be compensated for the wages lost during the first seven days of disability as well.
You are entitled to receive 80% of your after-tax pre-injury weekly wages. These are calculated based on the gross wages you were paid (including overtime pay) during the 39 highest-paid weeks – of the 52 weeks immediately before your injury or medical condition.
If you can work in a limited capacity, you will be paid the difference between 80% of your after-tax pre-injury weekly wages and your current weekly wages.
Total and Permanent Disability Benefits
If your work-related injury or medical condition leaves you totally and permanently disabled, you can receive total and permanent disability benefits. The minimum payment you can receive is 25% of the state average weekly wage, and the maximum amount you can receive is 90% of the state average weekly wage.
Why Legal Representation Matters in a Michigan Workers’ Compensation Claim
You need to hire an experienced Michigan workers’ compensation attorney to handle your claim for several reasons. These include:
Determining Your Eligibility
Following a workplace accident, you might not know whether your injury is covered under your employer’s workers’ comp coverage, and if so, what kind of benefits you might be entitled to. A capable Michigan workers’ compensation lawyer can determine your eligibility to file a claim and tell you what kind of benefits you are eligible to receive.
Collecting the Required Evidence
Lack of sufficient medical evidence is one of the most common reasons why many workers’ comp claims in Michigan are denied. Your workers’ comp lawyer can avoid this problem by collecting all the evidence needed to support your claim, including your medical records, reports from physicians who treated you, reports from medical experts, reports from vocational experts, statements from your family members and friends regarding your condition and its impact on your daily life, and more.
Maximizing Your Benefits
If you lose the practical use of a major body part or if you are permanently disabled as a result of your injury, you might be entitled to receive a substantial amount of benefits for an extended period. Your workers’ compensation attorney can ensure that you are paid the maximum compensation you are entitled to under the law.
Negotiating with the Insurance Company
An experienced lawyer can negotiate with your employer’s workers’ compensation insurance company to get you the settlement you deserve. If a negotiated settlement is impossible, your lawyer can represent you at your workers’ compensation hearing and the trial and make a compelling case for granting the benefits you seek.
Advising You about the Possibility of Third-Party Claims
Suppose a third party’s negligence played a role in the workplace accident in which you are injured. In that case, your lawyer could help you file a tort claim against them and recover compensatory benefits.
Under Michigan’s workers’ compensation law, you are prohibited from suing your employer. Your right to file a tort claim against third parties is not restricted. By filing a tort claim, you can receive non-economic damages like pain and suffering, mental anguish, disfigurement, diminished quality of life, and loss of consortium, which are not covered under Michigan workers’ comp insurance.
Get Effective Legal Representation From Our Award-Winning Michigan Workers’ Compensation Attorneys
When you are injured and unable to work and provide for your family, the last thing you want to do is to deal with the insurance company to get the benefits you need. At The Lobb Law Firm, we have been fighting for the rights of injured workers in Michigan for over 50 years. We can represent you, protect your workers’ rights, and ensure you are paid every dollar of benefits you are entitled to.
Our Michigan workers’ compensation lawyers have decades of experience in handling different types of disability as well as death claims. We have extensive knowledge of Michigan’s workers’ compensation laws and how the workers’ compensation system works in Michigan. We are well aware of the common tactics employers and insurance companies use to delay and deny claims unfairly.
We can help you file a claim or appeal a denied claim and take all possible steps to recover the benefits you are entitled to through negotiation or litigation if necessary.
Our legal team is led by Joseph R. Lobb – one of Michigan’s most accomplished and highest-rated civil litigators. We bring over 40 years of legal experience to the table. We will not rest until we recover every single dollar you are owed.