Workers Comp in Lansing

The industries located in and around Lansing offer a real workout to just about every area of workers compensation law, just about every day.

The automobile industry and plants that provide it parts, produce a steady stream of work-related orthopedic injuries; state government workers lead Michigan in the number of emotional disability cases; and corrections officers at nearby G. Robert Cotton prison facility face post-traumatic stress disorder problems that often require treatment based on workers compensation laws.

And most of them receive benefits allowed under Michigan’s sometimes baffling workers compensation system.

“I’d say 90% of the cases we have, get worked out without ever going to trial,” said Steven Pollok, who has been practicing workers comp law in the state capital for more than 40 years.

Pollok says he has to issue a warning note to all his clients that workers compensation is not a “one-and-done” system. If an injured employee is treated, returns to work and reinjures the same body part a month, two months or even years later, they’re still covered.

“The workers think ‘Oh, I already had this problem resolved, they’re not going to let me file a claim again,'” Pollok said. “That’s not the case.

“Workers compensation is like a long-term disability policy you keep in your back pocket. You may never use it again, but if you get hurt again, it’s always available. That’s a state law and employees ought to make their employers comply with that.”

» More about: Workers Comp Benefits in Michigan

Reasons to Hire a Lansing Workers Comp Attorney

It’s common — and even a good sign — for an injured worker to question whether he/she needs an attorney to resolve claims.

Pollok has been answering that question for 44 years while practicing workers compensation cases in Lansing. He said there a lot of signs that you need help from an attorney and they aren’t hard to spot:

• You’ve been out of work two or three weeks after reporting the injury and you haven’t heard a word from your employer.
• Your employer or his insurance carrier says the injury didn’t happen at work.
• Your employer tells you to use your own health insurance to pay medical claims.
• Your employer says to send all medical bills to him and he’ll pay them himself
• Your employer threatens to fire you if you report the injury.
• The insurance carrier denies medical treatment ordered by your doctor.
• You receive written notice from the carrier that they are disputing the claim.
• You haven’t received any wage benefits.

“The state of Michigan does a poor job of communicating to workers what their rights are,” Pollok said. “If an employee is going to be off work for any length of time, they should at least confer with an attorney.

“The only real way for an injured worker to know if he’s getting all the benefits due to him is to talk to an attorney.”

What Does a Workers Comp Lawyer in Lansing Do?

In recent years, judges and legislators have combined to make Michigan’s already convoluted workers compensation laws even more difficult to understand for anyone without a legal degree.

That’s only half the problem for someone weighing the choice of hiring or not hiring an attorney to plead his/her case.

“Disputed workers compensation cases are about medical, medical, medical,” Pollok said. “There is a specific form, a specific method for getting medical evidence into a case and if you don’t it right, it’s not going to be admitted and you’re going to lose.”

Knowing the right forms and procedures is just the tip of what an attorney does. Here’s a short list of things Pollok says must be done to achieve a positive outcome:

• Be able to identify and argue the statutes that apply to a dispute
• Know the rules of evidence and how your case must be presented
• Identify medical experts to testify for the injured worker
• Present worker’s detailed medical history to magistrate
• Help worker calculate average weekly wage and corresponding workers compensation rate
• Obtain claims records via subpoena
• Prove how pre-existing conditions were aggravated by the latest injury.
• Use experience with doctors, insurance companies and opposition lawyers to reach a fair outcome for the injured worker.
• Remind worker that he must look for work while seeking wage benefits
• Fulfill requirement for vocational testimony.

“Maybe back in the 1970s when I first started doing this, maybe you could represent yourself and win a case, but not now,” Pollok said. “There have been so many changes i the law with specific provision and specific ways to introduce evidence that the only way to succeed is to hire not just an attorney, but workers compensation attorney.”

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

The excuse: “I can’t afford a lawyer,” doesn’t fit in Michigan because it’s a “contingency fee” state, meaning the attorney only gets paid if he/she wins the case. So, in essence, it costs nothing to hire a workers comp lawyer.

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 or settles 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.

An attorney’s compensation is governed by state law in Michigan. Pollok said the outcomes for workers comp cases in Michigan fall into three categories:

• Redemption while benefits are being voluntarily paid: This is where the case is settled while insurance carrier is voluntarily paying for medical treatment and lost wages. The attorney receives only 10% of the settlement award.
• Redemption before trial: Most workers comp cases end in a settlement, meaning there is an agreement on the amount the carrier will pay. In a settlement, the attorney receives 15% of the first $25,000 awarded and 10% of any money over that.
• Trial: If no medical and/or wage benefits have been paid and the attorney wins the case at trial, he/she is reimbursed for expenses and receives up to 30% of the award. Not of the whole reward, just the accrued compensation benefits ordered by the magistrate.

“I’m very blunt about attorney fees with all my clients,” Pollok said. “I tell them up front that 25% of my cases, I’m going to lose money; 50% I’ll break even and the other 25% pay for everything else. I generally know which category they’ll fall in after the first visit and I’ll tell them.”

Handling a Workers Comp Case on Your Own in Lansing, 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 Lansing

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.

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 Lansing

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.