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Worker's compensation insurance is mandatory in the state of Michigan, if a company has more than three employees and they work more than 35 hours a week. It is permissible for a company to "self-insure," however. In cases where an employer doesn't carry workers' comp insurance, the state has established an Uninsured Employers Security Fund to provide some degree of coverage in such cases. Employers have the option of joining a worker's comp insurance pool with other companies or self-insuring, with a state board helping to regulate the carriers and guide employers shopping for worker's comp insurance plans. Early withdrawal from a plan can result in a penalty for the employer. Having a fully-realized safety program in place (complete with safety officer) can result in incentives for the employer in the form of reduced premiums. A comprehensive worker safety program should include orientation and training for new employees, periodic inspections, an accident investigation plan, first-aid plans and a well-planned, effective return-to-work program. The federal Occupational Safety and Health Administration can be helpful in setting up company safety programs.
In Michigan, employers are not exposed to civil liability in most worker's comp cases. The employer does have to pay, however, even if an injury was blatantly the fault of the employee himself. The exceptions to this would be in cases where retaliation, discrimination or willful endangerment are involved (which puts them more into the realm of civil rights law). Worker's compensation cases can end up in court when there's a third party involved, i.e. an employee falling off a poorly-designed scaffolding or stock picker. These cases tend to be costly and time-consuming, and are only pursued when the plaintiff is clearly injured and the third party is clearly, provably at fault.
Ann Arbor COVERAGE IN WORKERS' COMPENSATION CASES
An employee who's injured on the job in Michigan (regardless of fault) is entitled to full medical care and wage replacement, as long as it's a result of the work-related injury or disease. A weekly stipend may be paid out as long as the disability and loss of earning power continues. Covered areas would include:
- Doctor bills
- Nursing
- Hospitalization
- Surgery
- Physical therapy and rehab
- Dental care
- Appliances such as limbs, crutches, teeth, glasses, hearing aids, etc
In the event that an employee is too disabled to return to his old job, worker's compensation will take up the expense for vocational rehabilitation such as counseling, guidance, retraining or specialized job placement.
In the event of an on-the-job injury, the employer is required to make a written statement and report it to the proper Worker's Compensation authorities. The employer has first choice of physician, with the employee being able to opt out and pick his own doctor past a certain period of time.
In cases where the employee is out of action for an extended period, his weekly stipend is calculated from his highest average wage in the previous 52 weeks. The employee is then paid 80% of that amount every week, although that may be subject to adjustment in relation to other worker's comp benefits. Total disability payments or partial disability payments may be adjusted downward to offset income from Social Security, pensions, self-insurance plans, profit sharing or unemployment insurance.
If an employer refuses to accomodate an employee after he returns to work, the employee can take it up with the state's Worker's Compensation board and can also consult with an attorney. If the cmployer offers a "light-duty" job after the employee comes back to work, the employee is obligated to take it. Worker's comp may still pay benefits in such cases, though, if the wage at the new job is lower than the employee previously earned. Death benefits are paid out to an employee's surviving family, based on a percentage of the employee's earning power (a minimum amount is also in place in such cases). Death benefits also include a burial allowance. Unlike many states, Michigan has no specific guidelines in place for disfigurement benefits and payouts (although an attorney may take up such issues). There is an allowance, however, for a certain number of weeks' benefits to be paid for specific injuries; those weeks may continue to be paid even if an employee goes back to work early.
A worker's compensation attorney can negotiate a lump-sum settlement of what the employee is due, according to certain guidelines. A magistrate needs to approve any such settlement before it becomes final, and the employee is under no obligation to accept it. In such cases, attorney's fees for the claimants are capped at 30% of the settlement amount. If the case is closed out by way of a redemption settlement, the attorney's fees are capped at 15% for the first $25,000 and 10% past that amount.
