Michigan Workers Comp Claims: Eligibility, Filing and Appeals
Understand the process of workers' compensation in the state of Michigan.
Workers' compensation in Michigan is administered by the Michigan Workers' Compensation Agency, a sub-agency of the Michigan Department of Energy, Labor, and Economic Growth. The workers' comp system provides many benefits to workers injured in Michigan, including wage replacement, medical benefits, and vocational rehabilitation (job retraining).
Under Michigan law, it doesn't matter whether or not your employer was at fault in causing your work-related injury or occupational disease (an illness caused by York). Either way, you are eligible for workers' compensation benefits.
Covered Injuries and Diseases
If your injury or disease arose in the course of your employment, and you are a covered employee, you likely have a valid workers' compensation claim. To get workers' comp benefits, your injury must have required medical treatment beyond simple first aid.
Injuries or diseases that arose outside of employment, such as during your commute to ot from work or a work social function, likely do not amount to a workers' compensation claim.
Michigan law requires the vast majority of employers to purchase workers' compensation insurance through a commercial insurance carrier, or become approved as a self-insured employer. A self-insured employer pays its own workers' compensation claims from a separate fund it maintains itself.
If you are a federal employee, such as a railroad worker or a postal worker, your workers' compensation benefits are administered by a separate federal system.
Independent contractors and volunteers are not employees, so they are not covered by workers' compensation for injuries sustained on the job. If your employer or its insurance company says you are not a covered employee, talk to a workers' compensation attorney in your area.
Filing a Claim
As soon as possible, you should notify your employer that you were injured on the job or that you became ill or injured as a result of conditions in your workplace. Your employer should give you the forms required to file a workers' compensation claim with the state. After you notify your employer, your employer is responsible for notifying its workers' compensation insurance company of your claim (unless your employer is if self-insured).
If your employer refuses to acknowledge your claim and report your injury to the Workers' Compensation Agency, you may call 888-396-5041 to report the claim.
Workers' Compensation Benefits
Michigan worker's comp pays the following benefits:
- Reimbursement for medical treatment
- Payment for time off work or decreased pay
- Vocational rehabilitation, and
- Permanent disability payments, if you are left with a long-term impairment.
Let's look at each benefit in more detail.
You are entitled to reasonable and necessary medical treatment for your work-related injury or occupational disease. This may include doctor visits, surgery, dental care, artificial appliances such as hearing aids or prosthetic limbs, and other treatment. However, your employer is not responsible for all of your medical treatment for all conditions while you have an open workers' compensation claim; the treatment the workers' comp insurance company will pay for must be related to your industrial injury or occupational disease.
In Michigan, your employer may require you see a particular physician for the first ten days of your treatment. Following these ten days, you may choose your own physician, but you must inform your employer of your intended physician.
Lost Wages and Decreased Wages
If you are unable to work due to your injury or disease, you are entitled to benefits to compensate for your lost wages. This is a weekly monetary payment of approximately 80% of your post-tax average weekly wage. However, the weekly benefit cannot exceed a maximum set by law each year, which is $870 for 2017.
If you do return to work after your injury, but you earn less than you did at the time of your injury, you will receive partial benefits to account for your loss of earning power. These benefits are 80% of the difference in your wages, subject to the same maximum mentioned above.
Your lost-wage benefits, by law, must start no later than fourteen days after your employer has notice of your disability.
If, once you have recovered to the full extent possible from your injury, you are unable to return to your previous employment, you are eligible for vocational rehabilitation services. A vocational counselor will work with you to create a plan for job retraining so that you can return to your previous employer in another position, or have the skills necessary to look for work elsewhere.
Permanent Disability Payments
If you are permanently disabled, either partially or totally, as a result of your workplace injury or occupational disease, you are entitled to additional disability benefits. These are lump sum monetary payments to compensate you for your permanent disability. You are eligible for permanent disability benefits only after you have reached maximum medical improvement, meaning there are no further curative treatment options for your condition(s).
Appeals of Denied Workers Compensation Claims
It is not uncommon for a legitimate workers compensation claim to be denied. If this happens, you have the option to appeal your claim through a number of stages. Read more about the Michigan appeals process.
When to Talk to an Attorney
If your injuries are severe, if your employer is challenging any aspect of your claim, or if you have other extenuating factors, such as receipt of other benefits like Social Security, you should strongly consider retaining an attorney. An attorney can be a strong advocate on your behalf throughout the administration of your workers' compensation claim. See this article to learn more.