Most workers in Michigan should know if their employer has workers’ compensation cover in case they are injured or become ill at work. Michigan workers’ comp. law states that the majority of employers have to take out workers’ compensation insurance to ensure their workers don’t suffer any financial hardship if they are injured or fall sick while at work. Unfortunately, situations arise when a workers’ compensation claim is denied and it takes a lot of time to work out whether the denial is justified. However, if you persevere and talk to a workers’ comp attorney to discuss your case you may find you can work through the appeal process to get the compensation you deserve. Workers' Compensation Law in Michigan Workers' compensation is in force to provide a regular payment for lost wages, the cost of medical treatment and rehabilitation expenses to employees who have been injured or fallen sick at work. The Workers' Compensation Agency (WCA) is the authority in the State of Michigan responsible for overseeing workers’ comp law. It doesn’t actually pay workers' compensation benefits as most employers in Michigan buy an appropriate insurance policy from a private insurer. As soon as you are injured you are required to tell your employer immediately. From the day you are injured you should receive medical benefits but your employer is permitted to choose your doctor for the 1st 28 days of your treatment. If you are still needing treatment after that time you may select your own but you must send a written notification to both your employer and the insurer. You can’t begin to receive your loss of wages payment until 7 consecutive days have passed. If you can’t return to work after fourteen days you will be entitled to wages compensation for the 1st week. Weekly benefits work out to be 80% of your wages after-tax. Why Your Claim Could be Denied Sometimes, claims are denied for reasons that are easy to dispute. These include your employer stating your injury didn’t take place at work or an error in the paperwork which affected your claim. There are more serious reasons why a claim is denied. These are the sorts of reasons that are more difficult to challenge and may involve an appeal. For example, the insurer may claim that you: did not file a claim in the requisite time; were involved in unnecessarily unruly behavior causing the injury to happen; had an injury which did not take place at work; had an illness which was not due t work conditions; did not follow safety rules or refused to use safety equipment provided for you; were drunk at work or had taken drugs which affected your judgment. The Michigan WC Appeals Process If your claim is disputed or denied by either your employer or insurer you are entitled to file an application to request mediation. This has to take place within 2 years of your injury. If the dispute is not resolved at the mediation, the case is assigned a trial date before a workers' compensation judge. You may represent yourself during this process, but an attorney can be extremely helpful in meeting deadlines, gathering evidence, and representing you against the insurance company's attorneys. The judge will review evidence listen to witnesses, ask questions and finally make a decision about the claim. There are steps beyond the formal hearing which you can take if still dissatisfied with the judge’s ruling. The next step would be the Michigan Compensation Appellate Commission. This doesn’t involve a hearing as such, or a trial, but an analysis of the available evidence and a written decision being made. Further appeals are theoretically possible to the state’s Court of Appeals. Why a WC Attorney May be of Help If your employer’s insurer has failed to agree to your claim, or the amount is far from satisfactory, you will need to appeal this decision. It is advisable to secure a workers’ comp. attorney at this stage. Your attorney will ask for as much evidence that you can find to back up your workers’ comp claim denial. This could include eye witness’s accounts, your physicians report and proof of your wages before you became sick or were injured.
