Injured at work? Tips for Workers' Compensation Cases
What is workers' compensation?
Workers’ Compensation is a system that provides wage replacement, payment of medical expenses, and rehabilitation benefits to workers who are injured on the job.
It is essentially a no-fault system that requires an employer to compensate a worker for any injuries suffered in the course of the workers’ employment, regardless of who was at fault.
What to do if you're injured on the job:
A worker should notify their employer of a work related injury or illness as soon as he/she is aware of the injury or illness.
Once you make a report of injury the employer should file an “Employer’s Basic Report of Injury” with the Michigan Workers’ Compensation Agency for all wage loss cases. They should also notify there insurer in medical-only cases.
The employer may direct the injured worker to a treating physician or medical facility of the employer’s choice for the first 28 days of care following the injury or illness. Following the first 28 days of medical care, injured workers may choose their own treating physician, but they must notify the employer of the name of the chosen health care provider.
It is important that when an employee receives his first medical treatment for an injury/illness that he/she gives an accurate history of how and when the injury occurred.
If the employer will not report the injury to the Workers’ Compensation Agency, or its insurer the injured worker should contact the agency for instructions on how they may report their own claims. Injured workers may call 1-888-396-5041 for information.
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How are workers' compensation benefits paid?
Generally, wage loss payments are made directly to the injured. Payments for medical treatment are ordinarily paid directly by the employer or its insurance company to the medical service provider.
There is a 7 day waiting period for benefit payments. You will not receive a workers’ compensation check for disability lasting less than 7 days. However, medical benefits should be provided from the date of the injury.
If your wage loss lasts longer than 7 consecutive days, you are entitled to benefits as of the 8th day. If you wage loss continues for 14 days or longer you are entitled to receive payment for the first week of disability.
Your first check for wage loss benefits are payable on the 14th day of disability. However, a benefit check is not considered late until 30 days after the due date. Generally, benefits are paid on a weekly basis and continue as long as you are disabled in suffering a wage loss.
How much is paid in workers' compensation?
Generally, workers receive 80% of the after tax value of their wage loss. A determination is made about the worker’s “average weekly wage” before the injury. The worker should then be entitled to 80% of the after tax value of that average weekly wage. The average weekly wage is based on the highest 39 weeks of the wages during the 52 weeks immediately prior to the injury. Under certain circumstances, the value of fringe benefits may be included in determining the average weekly wage.
If you are unable to perform the work that you have done previously, you are entitled to vocational rehabilitation. Typically the goal is to return you to work with your employer. However, if you cannot do this or require assistance in finding a new job, vocational rehabilitation services may help.
Your employer or it’s insurer have the right to send you for a medical exam at any point during your claim. Failure to attend could result in a termination of benefits.
The purpose of these exams is to advise the insurer of the extent of your disability and/or whether or not your injury is work related.
Many times the reports from these exams can be used as the basis to terminate benefits.
What to do in case of a dispute:
If there is a dispute regarding benefits you will receive a “Notice of Dispute” from your employer or its insurer.
If you disagree with their determination you have the right to request a hearing by filing an application with Worker Compensation Agency.
It is important as soon as you are aware of any dispute to seek legal advice to discuss your rights.