Workers Comp in Detroit

Detroit is known as the “Motor City” because the automotive industry was born there and remains the towering giant in the city and region’s economy.

Ford and General Motors employ 372,000 of the area’s 821,000 workers and are responsible for $307 billion of the $443 billion economy In Detroit. In fact, Detroit has 10 businesses in the Fortune 500 and nine of them have some tie to automobile manufacturing.

“Lots of factory workers and lots of workers compensation cases because of injuries to the factory workers,” said Joel Alpert, who has been trying workers compensation cases In Detroit for more than 40 years.

Those cases stalled in 2020 thanks to the coronavirus that dealt a punch-in-the-gut to the U.S. economy and all but sidelined workers compensation cases. COVID-19 precautions closed public facilities in Michigan, including courtrooms. Pre-trial, mediation and settlement hearings took place via Zoom and many were resolved.

However, lawyers involved in trial hearings prefer a courtroom setting to doing the trial via Zoom calls so most were postponed.  Of the 8,455 workers comp cases that haven’t been decided (as of March 2021) in Michigan, 3,395 of them are from the Detroit area.

“We haven’t been able to try a case for over a year now and nobody knows when they’re going to open everything up,” Alpert said.

Jack Nolish, the director of Michigan’s Workers’ Disability Compensation Agency, said the state is working to catch up.

“We’re looking at ways to cycle the 8,500 cases back into what already was a crowded system,” Nolish said. “It’s not like we can flip a switch and open the doors. The medical has to be timely, if people have had ongoing care, they have to update the records, so getting this train moving again is going to be tough. But we’ll get it done. I’m sure we’ll get it done.”

» More about: Workers Comp Benefits in Michigan

Reasons to Hire a Detroit Workers Comp Attorney

When an employee gets injured at work, the first question many ask themselves is: Do I need an attorney to handle this?

Fair enough. Workers know they have rights, but most don’t know how far those rights go and whether the employer or insurance carrier will see to it that all the benefits due are delivered in a fair and timely fashion.

Alpert has a very simple way to determine if you need a lawyer. “If you think you are entitled to a medical treatment or benefits and the insurance carrier says no … you need an attorney,” the long-time Detroit attorney said.

That’s it in a nutshell, though there are many signals that indicate you should at least consult with an attorney. Among the most obvious signs are:

• Your employer or his insurance carrier says the injury didn’t happen at work.
• The insurance carrier denies your claim.
• Your employer threatens to fire you if you report the injury.
• You have been out of work for more than two weeks because of the injury, but have not received any wage compensation.
• The carrier wants to settle the case quickly and you’re not accustomed to settlement negotiations.

That last one is often an overlooked sign, and it can be costly for a client. It takes an experienced negotiator, someone with a thorough understanding of the medical issues involved, to arrive at a fair workers comp settlement, especially one involving a serious injury.

Alpert tells the story of an insurance carrier attorney who after reaching a settlement agreement, asked the injured worker if he thought it was fair. “Fair?” the injured worker responded. “My attorney got me twice what I expected, so yeah, it definitely was fair.”

Adds Alpert: “That’s why you need an attorney!”

What Does a Workers Comp Lawyer in Detroit Do?

Workers compensation laws in Michigan already were difficult to understand, but in recent years, judges and legislators have written or rewritten the rules to the point where everyone involved is often confused, especially the injured worker.

“I don’t think any individual who is not trained as a workers compensation specialist could know how to present their case properly to a magistrate,” Alpert said. “The system is so complex, there are no real fixed rules, a lot of things are done by custom or equity … it’s just a lot less structured than other courts.”

In other words, don’t try this at home!

But If you need more convincing, consider what Alpert and other workers comp attorneys bring to a case that a non-lawyer might struggle with:

• Presenting a detailed medical history of the injured worker to the magistrate.
• Proving how pre-existing conditions were aggravated by the latest injury.
• Obtaining claims records via subpoena.
• Handling all preparations and meet all deadlines if the case goes to a trial.
• Calling witnesses and cross-examining the opposition.
• Obtaining all medical records and providing medical testimony via depositions prior to trial.
• Using experience with doctors, insurance companies and opposition lawyers to reach a fair outcome for the injured worker.
• Using experience with trial judges to know what expert witnesses to call.

“We know all the players in the game,” Alpert said. “We know their tendencies, how they like to do things and what you’re going to be able to accomplish with them.

“We know how to present evidence, questions that should be asked in cross-examination, the medical terminology you need to know to make your case … there is just a lot of things that you learn over time that can really help a client and if you haven’t done it … well, it would be really hard to understand all that goes into it.”

How Much Does It Cost to Hire a Workers Comp Attorney in Detroit?

Michigan is a “contingency fee” state, meaning the attorney only gets paid if he/she wins the case. It does not cost an injured worker anything to hire a lawyer in Michigan so the excuse “I can’t afford a lawyer” doesn’t fit here.

The lawyer must pay all the costs of preparing the case — gathering medical records, doctor’s examinations, testimony from expert witnesses – and those costs get reimbursed, but only if the attorney wins the case. Technically costs are the obligation of the client, but in an unsuccessful case, trying to collect from the client is just not practical or likely even possible.

What that means is an attorney will be very selective about whether to take a case. The attorney must win to get paid and reimbursed for expenses, so he/she has to be fairly certain they are going to win the case.

Most workers comp cases are settled, meaning there is an agreement between the insurance carrier and the injured worker on the amount the carrier will pay. If there is a settlement, the attorney receives 15% of the first $25,000 awarded and 10% of any money over that.

So, for example, if the injured worker is awarded $50,000 and the lawyer’s expenses for trying the case are $3,000, then the attorney’s fee is calculated based on $47,000.

If the case goes to trial and no medical and/or wage benefits have been paid and the attorney wins the case, he/she is reimbursed for expenses and receives up to 30% of the award. Not of the whole reward, just the accrued compensation ordered by the magistrate.

If medical and/or wage benefits already are being paid and the case settles, the attorney only gets 10%.

Handling a Workers Comp Case on Your Own in Detroit, MI

Most claims do not require the help of a workers comp attorney. When the system works as intended, you simply have to notify your employer to kickstart the process of filing a workers compensation claim. If things do not work out in your favor, you have the option to appeal a claim denial. This will require the help of a workers comp lawyer, but for reference, the step-by-step guide is detailed below.

How to File a Workers Compensation Claim in Detroit

An employee injured in the workplace should report it to a supervisor immediately, regardless of the severity of the injury, and promptly seek medical assistance. It is in everyone’s best interest to document an injury and have it treated as quickly as possible.

If you report the injury to your employer, it is their responsibility to inform their insurance carrier. If the injury keeps you out of work for more than seven days, the employer must report it to Michigan’s Workers Disability Compensation Agency (WDCA).

Michigan laws say that the injured worker must see and be treated as needed by the employer’s designated physician or medical facility for the first 28 days following an accident. Beyond that, injured employees can choose their own doctor, but only after notifying the employer and insurance carrier.

If possible, the employee should take note of the time, location and cause of the accident, as well as the names of employees who witnessed it. If you have a smartphone available, it is extremely helpful to take pictures that help document the situation.

The more complete your documentation of the incident is, the easier the claims process will be.

Employer’s Responsibility for Filing Claim

It is the employer’s responsibility to notify their insurance carrier when an employee is injured on the job site. If the recovery period for the injury is going to last more than seven days, the employer also must file Form WC-100 with the state’s Workers’ Disability Compensation Agency.

Form WC-100 asks for basic information (employee’s name, address, social security number, etc.) as well as the employer’s general business information. The form asks questions about where and how the accident occurred and descriptions of the injury, so it is best to have conducted at least a cursory investigation of the incident before filling out the form.

If, for any reason, your employer chooses not to file a workers compensation claim form, you may do so yourself. Form WC-117 is available on the state website, along with other forms pertinent to your claim.

Insurance Carrier’s Responsibility for Claims

If an employer is covered by workers compensation insurance, the carrier claims adjusters will take over the investigation. The insurance carrier’s adjuster will determine what benefits the employee qualifies for and notify both the employee and employer.

If the employer is self-insured, the case typically will go through a workers compensation department within the company or be sent to an outside agency that handles workers compensation claims.

What Happens If a Workers Comp Claim Is Disputed?

If an injured worker or the insurance carrier disputes the claim, it goes to the Workers Disability Compensation Agency for resolution.

If the worker does not have a lawyer, there is a facilitation process. The WDCA tries to help the two parties reach a resolution and Nolish says that happens most of the time.

Email: LEO-WDCAC@michigan.gov
Phone: (313) 456-3650
3026 W. Grand Blvd., Suite 3-700

Detroit, MI 48202

However, if the facilitation process does not resolve the matter, or the worker has a lawyer, the case is referred to a magistrate, who serves as the judge. Workers compensation cases in Michigan are bench trials. There is no jury.

Michigan is a wage-loss compensation case state. Not only do you have to prove that the injury arose out of and was in the course of employment, but as a result of that injury, you are losing wages.

The magistrate makes the final decision on the matter. There is no jury in a workers compensation case.

The trial includes documents, witnesses and medical testimony. The magistrate has 42 days to reach a verdict and write a detailed opinion on what they found.

The vast majority of reported work-related injuries are compensated in these cases. However, Alpert says that is not always the case with significant work-related injuries.

“The laws need to be rebalanced to be more equitable to injured workers,” Alpert said. “Workers gave up the right to sue for pain, suffering and employer’s negligence. In return, they are supposed to be guaranteed benefits and it’s supposed to be simple to get them, but there has been a complete reversal of that. It’s not simple anymore.”

How to Appeal a Workers Comp Claim in Detroit

Either party in a workers compensation case can dispute the magistrate’s decision but be prepared for a long process that may take up to a year to reach a final decision.

The first step in the process is to file an administrative appeal with the Workers’ Disability Compensation Appeals Commission. The group is made up of three commissioners appointed by the governor.

The WDCA appeals commission will look at record as a whole to see if the decision was based on competent material and substantial evidence. The appeals commission could affirm the original verdict; it could ask for additional testimony and fact finding or it could reverse it.

If two of the three commissioners agree on an outcome, that is the outcome. The reversal rate is not very high.

If either side wants to appeal beyond that, it must ask the Michigan Court of Appeals to review it. The Court of Appeals can choose to review the case or deny the application. Very few cases get that far. The Court of Appeals addresses errors in law that may have been made by the magistrate or appeals commission.

The last stop in the appeal’s process is at the Michigan Supreme Court, which also is by application for leave to appeal, but it is rare for a case to reach that level.NA.