State legislation provides that most people who work for Michigan-based businesses are eligible to collect workers' compensation benefits after suffering an injury or illness due to their jobs. All employers with three or more employees on their payroll must maintain insurance coverage to compensate employees in the event of workplace accidents. Both private and public organizations must carry the insurance with a few exceptions on the employees who must be covered under the policy, such as farm workers or domestic servants who work a limited number of hours per week. While you may be eligible to receive workers’ compensation benefits through your employer’s insurance policy, avoiding common mistakes is vital to avoid delays or receiving a denial of benefits. Learning about the process, requirements, and mistakes to avoid can help you collect the compensation state regulations entitle you to receive. Speak to a seasoned Michigan lawyer at Bruce L. Weider, PC, by calling (734) 485-0535 for more information about workers' compensation mistakes and to request assistance with your claim.
Michigan Workers’ Compensation Benefits
Michigan 418 § 301 specifies the requirement for workers’ compensation coverage for employees who suffer an injury or illness as a result and in the course of carrying out their job duties as employers require. When tasks contribute to or aggravate health conditions, the exacerbated conditions may also be eligible for compensation, but employees must be evidence of the connection between their work and the injury worsening.
The available workers' compensation benefits include:
- Medical benefits that start the day of the accident and receiving medical care
- Payments for wage replacement begin on the 8th day of missed work, as there is a seven-day wait period
- Vocational rehabilitation, such as training for a new role if they cannot return to the original position because of injuries or illness
- Wage replacement benefits for accidents causing disabilities
- Death benefits for surviving family members
Injured employees have options for which benefits they request, and medical-only claims are the most straightforward and quick to process. The two essential factors used to calculate the compensation they are eligible to collect are the employee's average salary and where it falls on the agency's standard benefits rate table.
Challenges in Navigating Workers’ Compensation Claims
While workers’ compensation legislation offers relief through compensation to injured employees, there may be hurdles employees need to overcome in order to receive benefits. Many find it challenging to navigate the complex workers’ compensation insurance system in order to receive benefits. Lack of clear communication from workers’ compensation insurance providers regarding the documentation requirements that pertain to employees can also be a problem, making distrust and complaints routine among injured workers seeking compensation. A few common mistakes made by employees in pursuing their workers’ compensation benefits claims can make getting approval more challenging.
Failing To Report the Workplace Injury or Seek Medical Care
Not reporting workplace accidents or injuries is a typical error and can mean losing eligibility for coverage. According to the instructions of the Michigan Civil Service Commission, employees must notify their manager or person appointed to handle the claims immediately. When the damage happens over time rather than a single incident, such as repetitive motion or stress injuries, the employee must give notice within 90 days of discovering the issue. After they provide notification, their employer will provide guidance, including seeking treatment from an Occupational Health Care Clinic and which paperwork they must complete.
Failing To Seek Medical Care
After a workplace accident, seeing a doctor for treatment must be a priority. When they continue handling job duties instead of seeking medical care immediately, the injuries may get worse. In addition, the insurance carrier or employer could also argue that since the employee was not concerned enough to seek treatment, there must be no serious health concern, and may issue a denial of benefits on these grounds. Injured workers should pursue treatment promptly, follow the healthcare provider’s advice, take medication as prescribed, and attend all follow-up appointments.
Delaying Treatment
Like declining to seek care, delaying the treatment can lead to more health problems and a benefits denial. Insurance providers could assert that the injuries are not severe enough to qualify, or that the injury or illness occurred as the result of the employee’s activities elsewhere. Prompt treatment from a healthcare professional may increase the chance of full recovery and help to establish the need for coverage.
Going to Unauthorized Doctors
When a workplace accident causes life-threatening injuries or illness, employees may need to seek care from an emergency room or urgent care facility. For non-emergency injuries or illnesses that are not life-threatening, however, they should go instead to an Occupational Health Care Clinic. The Michigan Workers' Disability Compensation Act allows a third-party administrator to select which medical care providers provide treatment for the first 28 days. After this period passes, workers have the right to seek care from the medical services provider of their choice. They must notify the insurance administrator of their intent to seek alternate care and provide them with their chosen healthcare professional’s information.
Missing Essential Deadlines or Providing Insufficient Treatment Records
Filing paperwork late, missing deadlines or making clerical errors are common mistakes employees make in pursuing their workers’ compensation claims. Filers must report an accident to their employer within 90 days if they cannot alert them immediately, and file for the benefits within two years of the incident. In cases of fatal workplace accidents, surviving family members also have two years to contact the insurance administrator directly. In general, however, in most cases it is a good idea to initiate contact at the earliest time possible.
Insufficient healthcare and treatment records to support the claim for benefits constitute another primary cause of receiving denials. Keeping and organizing bills and any other treatment records is essential, as the insurance provider or the Workers’ Disability Compensation Agency may request documentation at any time to support the need for payments or as part of the appeals and settlement processes. An attorney from Bruce L. Weider, PC, may be able to help you navigate the procedure and avoid making time-consuming workers' compensation mistakes.
Accepting the Initial Settlement Offer
Michigan workers may settle their claims with a lump sum payment rather than ongoing weekly checks six months after the workplace accident. While there are advantages to taking the offer and closing the case, it is crucial for workers who suffer sickness or injury as a result of their job duties to wait until they have a clear idea of the extent of the injuries or disabilities and the cost of medical care they will need to recover. Often, the best way to ensure the settlement offer is adequate may be by waiting for the treating physician to issue a maximum medical improvement, or MMI, declaration to advise them that the injury or illness is stabilized and that it is unlikely treatment will lead to further improvement.
Schedule a Consultation Today With an Experienced Workers’ Compensation Attorney
A workplace accident leading to injury or illness can lead to a stressful and potentially overwhelming time. Fortunately, most employees are eligible for workers’ compensation protections and may be able to collect benefits to cover the costs of medical care and missed work. To secure the best possible outcome, it is essential to avoid making mistakes in filing, leaving out crucial information to document a medical condition, overlooking deadlines, neglecting to comply with the third party administrator’s authorized provider specifications, and accepting unduly low settlement offers early in the process. Meet with an experienced Michigan workers’ compensation lawyer at Bruce L. Weider, PC, by calling (734) 485-0535 and scheduling a consultation to seek legal guidance and get help avoiding workers' compensation mistakes.
