Five Secrets Workers Comp Doesn’t Want You to Know

Michigan workers comp lawyer lists the top five secrets the insurance company doesn’t want you to know about and how to protect yourself.

1. Your wage loss benefits are frequently paid at the wrong rate.

Most people assume that they are receiving the correct amount of lost wages. The truth is that insurance companies often make mistakes – and those mistakes are never in your favor.

Workers comp is supposed to pay 80% of your after-tax average weekly wage.  Insurance companies often fail to include overtime, premium pay, tips, bonus payments, and the value of fringe benefits in your average weekly wage calculation.

Other errors that insurance companies make are failing to include all of your dependents and using the wrong tax filing status.   You can also get additional workers comp benefits if you were working a second job.

2. Insurance companies push you to see their doctors.

One of the most important benefits under workers comp is access to medical care.  You are entitled to unlimited medical treatment for your work injury. Medical treatment can include surgical and hospital services as well as prescription medications.  You can also get dental care, artificial limbs, eyeglasses, hearing aids, wheelchairs, and other appliances necessary to cure or relieve the effects of your work injury.

You can pick your own doctor after 28 days from the start of medical treatment. Be careful treating with doctors recommended by your employer or the insurance company because of a potential conflict of interest.  Insurance companies use the same doctors over and over again because they know how they view a particular injury.  If your workers comp benefits are ever denied, you need a doctor who will be on your side.

The best way to find a good doctor is by asking your friends and family for a referral.  Notify the insurance company of your selection by providing the name and address of the doctor as well as your intent to treat for your injury.

3. It is standard practice for insurance companies to dispute some work injuries.

Insurance companies deny workers comp benefits for a variety of reasons.  The number one reason is because you have some incidental findings of arthritis.  Almost everyone develops arthritis as they get older and it does not mean that you did not suffer a real injury at work.

Most people with arthritis have some pain but are able to work.  When you have a specific injury, something may have changed.  It is important to explain to your doctor how you hurt yourself at work and any new symptoms.

Insurance companies think of arthritis as a magic bullet that gives them license to stop workers comp benefits. They will ignore the facts surrounding your injury. This is especially true if you have preexisting arthritis in your back or neck.  Conditions like degenerative disc disease or stenosis are often used to deny workers comp benefits.  It is important to understand that these medical conditions can be made worse by a traumatic injury and can be compensable under workers comp law. This also applies to workers comp claims involving your knees, shoulders, and elbows.

4. Insurance companies are watching you.

Insurance companies hire professional investigators to follow and record the activities of most individuals who claim workers comp benefits.  These investigators will scour the Internet and social media websites like Facebook looking for evidence against you.  Some investigators will even talk to your neighbors behind your back.

Insurance companies will tell you that they use investigators to stop fraud and abuse.  Many times they are just looking for a way to deny workers comp benefits.  Insurance companies will attempt to find some proof that your workers comp claim is not legitimate. 

Be cautious of your surroundings and never do anything beyond the medical restrictions given by your doctor.  Investigators will take snippets of video out of context and try to prove in court that your work injury is not real. Just because you took a fifteen minute walk does not mean that you can work on a full time schedule.

5. Insurance companies will not tell you about all available benefits.

Insurance companies want to save money on workers comp claims.  This results in you not being told about all the benefits available under the law.

The insurance company must pay for the cost of attendant care from a nurse or other skilled individual.  This is to help with activities of daily living.  Some examples are assistance with mobility, bathing, using the bathroom, eating, dressing, and taking medications.

Your family members can also receive up to 56 hours per week for providing attendant care. A spouse, brother, sister, child, parent or any combination of these persons can receive payment directly from workers comp. A family member is generally entitled to the same hourly rate as a professional and should be paid accordingly.

To speak with one of our workers comp attorneys, call (855) 221-COMP for a free consultation. There is no fee unless workers comp benefits are recovered for you.

Alex Berman is the founder of the law firm. He’s been representing injured and disabled workers exclusively for more than 35 years.  Alex has helped countless people obtain workers compensation benefits and never charges a fee to review a case.

Related information:

FAQs about workers compensation to help protect you

Have your workers compensation benefits been denied or terminated?

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