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Common Questions About Workers’ Compensation Benefits.
Contents
These are common questions about workers’ compensation benefits.
Workers' compensation benefits help people who get hurt or sick from the work they do. Sick or injured workers can get medical care, wage loss benefits, and vocational rehabilitation (VR). Most employers pay for workers' compensation insurance or are authorized to be self-insured.
To learn more, read An Overview of Worker’s Compensation Benefits.
The Michigan Department of Labor and Economic Opportunity, Workers' Disability Compensation Agency (Agency) is in charge of administering those claims.
All public (government) employers are subject to the Michigan Workers' Disability Compensation Act (Act). Private (non-government) employers who regularly have three or more workers are also subject to it. If a private employer only has one worker, but that worker worked at least 35 hours a week for 13 of the last 52 weeks, that employer is subject to the Act. There are exceptions for employers who don’t meet this standard but are part of certain industries. Some examples of industries where employers may still be subject to the Act are agriculture, housekeeping, and real estate. Employers not subject to the Act can still get workers’ compensation insurance.
If you have questions about whether your employer must offer benefits, you may want to speak with a lawyer. Use the Guide to Legal Help to find lawyers in your area. You can also contact the Michigan Department of Labor and Economic Opportunity, Workers' Disability Compensation Agency.
If your employer is subject to the Michigan Workers' Disability Compensation Act (Act), then chances are your job is covered. The Act covers all workers regardless of whether they are full-time or part-time. It also covers workers regardless of length of time they have worked for the employer.
However, if you get sick or hurt from the work you do and you are an independent contractor, you will not be able to get workers’ compensation benefits. It is possible that your employer wrongly classified you as an independent contractor. Independent contractor status is not controlled only by what your employer calls you. Many factors are used to decide if you are an independent contractor or an employee. You may want to talk to a lawyer if you feel your worker classification is wrong. You can use the Guide to Legal Help to find lawyers and legal services in your area.
The Michigan Workers' Disability Compensation Act (Act) covers a worker who gets hurt or sick from the work they do. If the work they do causes, contributes, or aggravates the condition, the worker should get workers’ comp. The worker has to prove a connection between their work and their condition. They may need medical evidence that shows the condition is linked to their work. Some conditions may be hard to connect to the work someone does.
To learn more, read An Overview of Workers’ Compensation Benefits.
The Michigan Workers' Disability Compensation Act (Act) applies to work-related injuries or illnesses that occur in Michigan. It doesn’t matter if the employer or worker aren’t residents of Michigan, or the employment contract was signed out of state.
The Act can also apply when the injury or illness occurs outside of Michigan. The Act will apply if the worker is a resident of Michigan at the time of the injury or illness, or the employment contract was made in Michigan.
To learn more, read An Overview of Workers’ Compensation Benefits.
Workers who are hurt because of their “intentional and willful” misconduct cannot get workers' compensation benefits (workers’ comp). Intentional and willful misconduct means an employer regularly enforced a safety rule that a worker ignored and was hurt as a result.
However, judges have recognized that a certain amount of horseplay is expected at most jobs. If horseplay causes an injury or illness, that doesn’t mean a worker can’t get workers' comp.
Medical Benefits
Medical benefits should be made available to you starting the day you get hurt or sick. If you need extended medical care, your employer gets to select the doctor you see for the first 28 days. After that, you can switch doctors if you would like. If you do, let your employer and their insurance company know by writing them a letter or an email. They can dispute who you choose. To learn more about what happens if your employer disputes the doctor you choose, read the section “Disputed Claims” below.
Wage Loss Benefits
After you report your injury, there is a seven-day waiting period before you can get wage loss benefits. The seven days include weekends and holidays. You are eligible for benefits on the eighth day. This means if your injury does not last that long, you will not get wage loss benefits. If you stay out of work for at least 14 days, you can get benefits for the first seven days you were out of work. Weekly benefits are about 80% of your wages after taxes. To learn more about wage loss benefits, read Workers’ Compensation Wage Loss Benefits.
Vocational Rehabilitation (VR)
You have a right to VR if you cannot do the same work you did before your injury or illness. VR can include services to help you return to the workforce. Some examples include new job training and education. To learn more, read this pamphlet about VR from the Michigan Department of Labor and Economic Opportunity, Workers' Disability Compensation Agency (Agency).
If you and your employer cannot agree on a VR program, you have the right to a hearing in front of the Agency. Learn more by reading the section “Disputed Claims” below.
If you get hurt or sick from the work you do, report it right away to your employer. Reporting an injury or illness is different than filing a claim. You need to report getting sick or injured within 90 days of the injury or learning you are sick.
You have two years from the date you are hurt or the date your disability starts to file a claim for medical benefits. You must file a claim for wage loss benefits within one year of the date you get hurt or sick. However, the sooner you report it, the sooner you might get access to benefits.
To learn more, read An Overview of Workers’ Compensation Benefits.
Your responsibilities for getting workers’ compensation benefits (workers’ comp) begin by promptly reporting your injury or sickness to your employer. Once you are getting benefits, you must let your employer or their insurance company know if you are getting income from work. You cannot get workers’ compensation benefits if you are working and earning the same amount or more than you did before you were injured. The two exceptions to this are if your disability is total and permanent, or if you lost a body part as a result of the injury (specific loss). To learn more about specific loss, review the “schedule of disabilities” section of the Michigan Workers' Disability Compensation Act, or talk to a lawyer. Use the Guide to Legal Help to find lawyers in your area.
To learn more, read An Overview of Workers’ Compensation Benefits.
Many benefit claims are undisputed. However, when there is a dispute, the Workers’ Compensation Board of Magistrates hears them. In most cases, neither the worker nor employer can take a workers' compensation (workers’ comp) issue directly to court.
If your claim is disputed by your employer or their insurance company, you will need to file form WC-104A, Application for Mediation or Hearing with the Michigan Department of Labor and Economic Opportunity, Workers' Disability Compensation Agency (Agency). Depending on the facts of your case, the Agency will schedule your case for a mediation or a magistrate hearing.
To learn more, read An Overview of Workers’ Compensation Benefits.