Steps For Filing a Workers’ Compensation Claim In Michigan
Legally Reviewed and Edited by: Terry Cochran
Workers’ compensation insurance covers businesses and employers if one of their employees is injured or becomes ill due to conditions at work. Workers’ comp protects both the employee and the employer, providing financial support for medical bills, lost wages, and funeral costs. Follow these steps to file a claim and start receiving your benefits.
Who is Eligible For Workers’ Compensation?
Your Michigan employer must hold workers’ compensation insurance if they employ more than three employees or employ one or more employees for over 35 hours per week.
An employee, a designation that doesn’t include independent contractors or volunteers, can claim workers’ comp if they have sustained an injury or become ill because of the working environment or an incident at work. This includes both one-off accidents, such as trips and falls, and issues that occur over a longer period, such as repetitive strains.
Initial Steps for Filing a Workers’ Compensation Claim
If you have become ill or been injured on the job as a result of the conditions of your workplace, notify your employer as soon as possible. While you have 90 days to let them know, the sooner you do, the better. Your employer could use a delay in notification as a reason to deny your claim.
Your employer then provides you with the necessary forms to file a workers’ compensation claim with the state. Apart from these forms, you don’t need to submit any written records; however, you may want to keep your own records, including copies of any documents you fill out.
Once your employer has been notified of your injury or illness, they are responsible for informing their workers’ compensation insurance company of your claim. For injuries that are predicted to last more than seven days, the employer should file an Employer’s Basic Report of Injury with the Michigan Workers’ Compensation Agency.
Sometimes, the employer may refuse to acknowledge the injury or file the claim on your behalf. If this is your situation, you can file the WC-117 form with the Workers’ Compensation Agency yourself or consult an experienced workers’ comp attorney at our law office for advice.
Appealing a Denied Claim
If you believe you are eligible for workers’ compensation benefits, but your claim is denied, you may appeal the decision. The first thing you must do to appeal is file an application (Form WC-104A) for a mediation or hearing with the Michigan Workers’ Compensation Agency.
It’s often preferable to settle claim disputes through mediation rather than going to a hearing. This involves a third party being assigned to your case to mediate between you and your employer or their insurance company to help you settle your claim.
The workers’ compensation agency may assign a mediator in less complicated cases, such as those that are only claiming for medical treatment and those who have returned to work and are only claiming a set period, rather than for an ongoing illness or injury.
If they cannot settle your case through mediation, there will be a workers’ compensation hearing. The hearing is similar to a trial but is held before a magistrate rather than a judge and jury. During the hearing, you or your lawyer can present evidence that backs up your claim, including medical records and witness testimonials. The magistrate informs you of their decision by mail shortly after the hearing.
Hiring a Workers’ Comp Attorney
Workers’ comp claims are designed so that the employer can navigate the process without a lawyer’s help. However, sometimes certain circumstances complicate the process and make hiring a workers’ comp attorney the smartest decision. These situations include:
- Denial of claim: If your case goes to mediation or hearing, you need a professional’s support. A hearing is particularly complicated, as it involves submitting evidence, presenting witnesses, and making legal arguments.
- Social Security Disability Insurance Benefits (SSDI): As long as you are eligible, you are legally allowed to receive both SSDI and workers’ comp, though the former may be reduced because these benefits must not exceed 80% of your previous income. A lawyer can ensure you receive the maximum amount of benefits possible.
- Poor settlement offers: Insurance companies want to reduce the amount they have to payout, so they usually make very low initial settlement offers. Your lawyer knows when to push for more and can advise you when to accept an offer.
- Pre-existing conditions: If you have a pre-existing condition, the insurance company may try to blame your injuries or illness on that instead of your working conditions. Not only can an attorney help avoid this, but they can also give you a better chance of gaining compensation for conditions that your work has made worse.
- Disability rating: If your work-related injury or illness is permanent, you may be able to receive permanent compensation. The rate you receive is determined by your disability rating assigned by a doctor. Insurance companies can dispute this rating and require you to see their doctors, who tend to give you a lower rating. Your lawyer can ensure you maintain the higher rating.
Get The Benefits You Deserve
If you’ve sustained injuries or become ill at work, you may be eligible for workers’ comp. While filing your claim can be relatively straightforward, working with an experienced law firm that understands the ins and outs of workers’ compensation like Cochran, Kroll & Associates, P.C., makes the process much less stressful and helps you get the compensation you truly deserve.
Call 866-MICH-LAW today for more information and to book your free initial consultation.
Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.