Michigan workers’ comp lawyer explains the workers’ comp appeals process when the employer or insurance company file a Notice of Dispute.
Workers’ comp benefits are disputed for a variety of reasons. It can be based upon late employee notice, failure to make a timely claim, or employee misconduct. Some disabled employees have their workers’ comp benefits disputed based upon the independent medical examination (IME).
It does not matter why the insurance company stops paying workers’ comp benefits. The result is no lost wages and/or medical care. Unfair decisions should be challenged with a hearing. Here is what injured workers need to know about their workers’ comp appeal rights.
What is a workers’ comp dispute letter?
In Michigan, insurance companies are required to file a workers’ comp dispute letter known as a Notice of Dispute (Form WC-107) if workers’ comp benefits are not going to be paid. This form indicates to the State of Michigan that a dispute exists regarding a claim.
It lists six broad categories that can be selected as the reason for a dispute. Watch out for generic excuses like “pending investigation” or “medical records under review.”
What is a workers’ comp appeal form?
Injured workers who wish to file a appeal can fill out the Application for Mediation or Hearing (Form WC-104A). This workers’ comp form is used by the injured worker to start a case. Depending upon the circumstances, the case will be set for either telephone mediation or pre-trial. Details about the work injury and other personal information will be required.
Do not start a workers’ comp case without consulting an experienced lawyer. Do not expect a magistrate to award benefits using common sense. Rules of evidence and specific procedures must be followed. Medical, vocational, and witness testimony will also be needed.
How long do workers’ comp appeals take?
It can take months or years to resolve a workers’ comp appeal. A magistrate might issue an award but that does not mean litigation will end. Insurance companies can file additional appeals all the way to the Michigan Supreme Court. An experienced attorney can help speed up the process and obtain a settlement.
What are the chances of winning a workers’ comp appeal?
In Michigan, the magistrates decide the facts and law of each disputed workers’ comp case and the chances of winning an appeal are greater with an experienced workers comp lawyer, though either side can win or lose at trial. This is a powerful incentive for both sides to attempt a workers’ comp settlement.
The burden of proof is always on the injured worker and it can be difficult to win. This is especially true for individuals with preexisting conditions. Medical evidence showing a change of pathology will be required. Insurance companies can also use “phantom wages” to reduce the weekly benefit amount. It is not enough to show disability from your job.
How many times can you appeal a workers’ comp case?
Injured workers who lose at trial can file their own appeal. The review standard gives deference to the original magistrate and a legal error must be shown to flip the decision of the case. It is unlikely that an injured worker is going to win if the magistrate did not believe his or her story. Sometimes it is possible to file a new Application for Mediation or Hearing based upon a change of condition. Speak with an experienced workers’ comp lawyer to find out the best way to protect legal rights.
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) 316-8033 for a free consultation today.
Related information:Workers’ Disability Compensation Appeals Commission