Workers' compensation is designed to cover the costs of medical care, rehabilitation, and wage replacement for employees who are injured on the job. Worker’s compensation insurance plans also typically protect employers from lawsuits and liability after employees are hurt at work. Most residents in Michigan have the right to file for workers' compensation benefits if they suffer injuries in the course of completing their duties on the job. Unfortunately, these simple criteria for eligibility do not necessarily translate into an equal simple process for applying. Many employees receive denials because of errors and face a stressful, protracted process to collect the compensation to which they are entitled under state law. To avoid delays and receive the maximum allowable benefits, workers need to follow Michigan’s often complex workers' compensation filing guidelines to the letter. If you have questions about how to file a workman’s comp claim, contact an experienced attorney at Bruce L. Weider, PC, at (734) 485-0535.
Does My Employer Have To Carry Workers’ Compensation?
State laws require every company with employees meeting the Workers' Compensation Act criteria to provide employees with monetary assistance after an accident at work. Every employer in the state that meets the requirements under the Act must provide wage replacement, in addition to covering 100 percent of medical and rehabilitation care related to the accident.
Under the guidance of the Michigan Workers' Disability Compensation Act of 1969, employers meeting the following standards must carry workers' comp insurance:
- Public employers
- Private employers with over one employee working a minimum of 35 hours per week for 13 weeks consecutively
- Private employers with over three employees, including part-time workers
- Farmers and other agricultural employers with over three employees working 35 hours a week or more for 13 weeks consecutively
- Domestic servant employers with over one employee working 35 hours a week or more for 13 weeks consecutively
If an employer fails to adhere to the rules of the Act, the agency may petition the court to request they prohibit the business from hiring workers until they comply. Employers could also face fines of up to $1,000 and 30 days in jail for each offense.
After an accident at work, the injured individual must show that the injuries caused a disability and inability to handle job duties and earn a wage. The benefits provider will calculate the wage loss benefits based on the estimated wages they lost due to the injury. The calculation is called wage earning capacity, and the benefits provider will compare the person's pre-accident earning capacity to the salary they can earn with the disability.
Workers should alert their employer about the injury immediately, but the statute requires they provide the notification within 90 days. Failing to give the notice within the law's requirements could result in losing eligibility. The individual must file for worker's compensation benefits within two years of the date they suffered injuries.
The first and most crucial step to receiving benefits is reporting the injury to the employer immediately. The medical care coverage under the Act will start the day of the injury. The employer has the legal right to choose the healthcare provider for the first 28 days of treatment. If the employee requires medical care after those 28 days have passed, the worker has the legal right to notify their employer and insurance provider that they wish to see a doctor of their choice. Upon receiving authorization, they have the right to seek reasonable and necessary medical treatment from a healthcare professional they choose themselves.
After seeking medical treatment, the employee must file a claim with the Michigan Workers’ Compensation Agency. They can file the claim on the agency's website using a WC-117H form. After benefits begin, it is vital to follow the doctor’s care plan or risk losing coverage. A lawyer at Bruce L. Weider, PC, can answer a variety of questions about workers’ compensation requirements, including how to file a workman’s comp claim.
Denial of benefits is an all-too-common experience after filing for workers' comp. Employees should remember that a denial does not mean they do not qualify. If an individual receives a denial and believes they should be eligible, they have the legal right to file an appeal. The Workers' Compensation Agency asks that everyone attempt to settle disputes with their employers and the insurer first. However, injured employees may contact the agency to begin the appeals process if they cannot resolve the disagreement. The steps to appeal a denial include the following:
After filing the appeal with the agency, the worker may receive a notice they are scheduled for a mediation. People have the right to mediation for issues including medical care reimbursement and discussion of a lump sum settlement. The agency may also schedule a mediation if they believe it will help settle the dispute. During the meeting, a mediator will help the employee and their employer or the employer’s insurance agency reach an agreement and settlement amount.
The agency will schedule a hearing if all parties cannot resolve the dispute through mediation. The workers’ compensation judge, also called the magistrate, will review the case during the hearing and schedule a trial. During the trial, the employee, employer, and insurer will present evidence. After hearing all sides and reviewing the evidence, the judge will issue a decision, and the worker will receive a copy of the letter by United States mail.
If the person disagrees with the decision, they have the right to proceed to the next step and file an appeal with the Michigan Compensation Appellate Commission.
While most employees working in Michigan are eligible to collect workers’ compensation benefits after an injury, the process of applying for these benefits can be complex and often stressful. Therefore, many reach out for help to ensure they follow the correct steps and successfully collect the benefits to which the law entitles them. A compassionate and experienced lawyer at Bruce L. Weider, PC, can answer your questions on how to file a workman’s comp claim and help you through the process. Call our office today at (734) 485-0535 to schedule a consultation.