Employees who are hurt on-the-job face many problems under workers’ comp and possible solutions to bring fairness back to the system.
It is no secret to anyone who reads this blog that we believe workers’ comp has major problems. Legislative reforms have resulted in much lower premiums, but it has come at the expense of disabled employees. Claimants are suffering because they cannot get needed medical treatment or lost wages to support their families. Here are some of the problems that our clients face and possible solutions.
Problem: Insurance companies use biased medical opinions
Michigan law requires a claimant to submit to an independent medical examination (IME) if requested. These doctors are hired by the insurance company and are not “independent.” They perform thousands of IME exams and make careers out of testing against disabled employees. These biased medical opinions are then used to stop payment of benefits. An easy solution to this problem is requiring insurance companies to use doctors who have active practices seeing patients at least 75% of the time.
Problem: Reduction for “phantom wages”
Legislative reforms passed in 2011 allow insurance companies to automatically reduce weekly benefits based upon post-injury wage earning capacity (PIWEC). These “phantom wages” are from jobs the insurance company says a disabled employee can perform. It does not matter whether these jobs are truly available. We had a client see his weekly checks reduced to $19 per week based upon 1 online job listing that he was not even qualified to perform. Other clients have seen their weekly checks reduced to $0. We must return to the days when the insurance company only got a credit for wages that are truly earned.
Problem: Long wait to get benefits reinstated
Many of our clients have not received wage loss benefits for months or even years. These individuals cannot pay bills or put food on the table. Some lose their homes to foreclosure while others end up in bankruptcy. Workers’ comp is supposed to be a safety net for people hurt on-the-job. We believe a temporary reinstatement of benefits pending a formal hearing is a good solution. Claimants who win their cases at trial are entitled to 70% payments while the matter is on appeal. This rule should be expanded to include those claimants who were cut-off within the last 60-days and are waiting for a hearing.
Problem: Late settlement checks
Settlement becomes the only viable option for claimants who are about to lose everything. Checks that are not issued timely are a major concern. The administrative rules allow for waiver of the 15-day appeal period to shorten the process but have no penalty for late checks. We recently had an insurance company take two months to issue a draft. We think magistrates should be empowered to grant penalties when a settlement check is over 30 days late.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.
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