Michigan lawyer explains how to file a workers’ comp claim and what benefits are available.
We get many telephone calls and emails from people hurt on the job who are wondering about their legal rights. It can be overwhelming when paychecks stop, and medical bills start piling up. This situation gets even worse when an employer refuses to submit a request. Here are some issues that pop up after a workplace accident and how to file a workers’ comp claim in Michigan.
How to file a workers’ comp claim in Michigan
In Michigan, to file a workers’ comp claim you must: give notice of your injury to the employer within 90 days and file a request for lost wages and/or medical care within 2 years of the accident. Notice can be oral (telling a manager) though it is recommended to fill out an accident report so there is written proof.
Making a request for medical and/or lost wages benefits can also be accomplished by telling your employer that benefits are needed. When making a request for lost wages and/or medical treatment it is a good idea to send this request in writing.
The employer is supposed to report any workplace injury to its insurance carrier. In situations where disability extends beyond 7 consecutive days, the employer/insurance carrier must also report the injury to the Workers’ Disability Compensation Agency (WDCA).
Here is a more complete breakdown:
- Report the injury immediatetly
- Seek medidal treatment
- File the Michigan workers’ comp claim
- Case review
- Recieving benefits
Report the injury immediately
- Notify your supervisor or employer right away (within 90 days) if you suffer a work-related injury or illness.
- Make sure to note the exact date and time of the incident, what you were doing at the time, and how the injury happened.
Seek medical attention
- Seek care at an approved occupational health clinic
- Under Michigan law, your employer—or their work injury insurance—has the right to select your medical provider for the first 28 days of treatment. If you don’t go to the authorized provider during this time, your medical expenses may not be covered.
- After the initial 28-day period, you have the right to choose your own treating physician, as long as you notify the insurance company in writing.
File the Michigan workers’ comp claim
- Download and complete Michigan’s Workers’ Compensation Claim Form (Form WC-117).
- Submit the form by fax or mail.
- The form requires details about the injured employee and the incident, including the date and time of the injury, the activity being performed, and a brief explanation of how the injury occurred.
Case review
- The WDCA will process your Form WC-117 upon receipt. If you’re employed by a company that uses Sedgwick as their third-party administrator for filing Michigan workers’ comp claims, Sedgwick will receive your case information from the WDCA.
- Sedgwick will then send you additional paperwork to your home address. This paperwork is necessary for Sedgwick to investigate your case and determine if it qualifies for work injury benefits under Michigan law.
- You must carefully complete and return all the required paperwork to Sedgwick. This is a crucial step in the case evaluation, as it allows Sedgwick to properly investigate your case and make a determination.
Recieving benefits
- After your injury is confirmed to be work-related, your eligibility for compensation will be evaluated.
- Compensation may cover medical treatment, wage replacement, and additional benefits as allowed under Michigan law.
Who is eligible to file a workers’ comp claim in Michigan?
In Michigan, most employees are eligible to file a workers’ comp claim if they suffer a work-related injury or illness. You must be classified as an employee—not an independent contractor—and your employer must be required to carry work injury insurance, which generally applies to businesses with at least three employees or one full-time employee working 35+ hours a week for 13 consecutive weeks.
To qualify, the injury or illness must arise out of and in the course of your employment, and it must cause a disability that affects your ability to earn wages. You may also need to show a related wage loss to receive certain benefits. However, benefits may be denied if the injury was caused by gross misconduct or a willful violation of safety rules. If you’re unsure about your eligibility, it’s best to speak with an experienced attorney.
What types of injuries are covered?
Work injury insurance covers a wide range of injuries and illnesses that occur in the course of employment. This includes sudden injuries like slips and falls, broken bones, burns, and concussions, as well as repetitive stress injuries such as carpal tunnel syndrome or tendonitis. Occupational illnesses caused by workplace exposure—like respiratory issues, skin conditions, or hearing loss—are also covered.
If a pre-existing condition is aggravated by your job, it may still qualify for benefits. In some cases, mental health conditions like PTSD or anxiety may be compensable if they’re directly linked to a traumatic work-related event.
However, injuries that happen during your commute, at recreational work events, or due to intoxication or misconduct generally are not covered. Work injury benefits in Michigan may include medical care, lost wages, vocational rehabilitation, disability payments, and even death benefits for surviving family members.
When should I file a workers’ comp claim in Michigan?
In Michigan, if you’ve been injured on the job, it’s important to file your workers’ comp claim quickly. You should report your injury to your employer as soon as possible—ideally right after it happens. Legally, you must give notice within 90 days, but the sooner you report it, the stronger your case will be.
If your employer or their insurance company denies benefits, you have up to 2 years from the date of injury (or when you became aware of your work-related condition) to file a formal case with the WDCA.
Delaying your request for benefits can result in denied benefits or missed deadlines, so don’t wait to take action.
What happens if I miss the filing deadline?
If you miss the deadlines to submit your case, your request may be denied and you could lose access to important benefits, including:
- Wage loss compensation
- Medical treatment coverage
- Rehabilitation or disability benefits
In some cases, exceptions may apply—such as if your employer was already aware of the injury or gave you incorrect information about your rights.
If you think you’ve missed a deadline, contact one of our experienced attorneys right away to explore your options.
What benefits are available?
After you have filed a workers’ comp claim in Michigan, employees who are disabled from employment are supposed to receive wage loss benefits. The amount paid should equal 80% of your after-tax average weekly wage. A rough estimate would be 60% of gross wages. This is based upon the highest 39 paid weeks out of the last 52. Income received is tax free.
Medical treatment is also covered 100% without any copayments or deductibles. This includes attendant care, doctor visits, durable medical equipment, prescription medications, physical therapy, and surgery. Mileage to and from appointments should also be covered.
What happens after I file a workers’ comp claim in Michigan?
In Michigan, once you file a workers’ comp claim, several steps follow that determine whether you’ll receive benefits:
- Case review by employer/insurer: Your employer and their insurance company will review the details of your injury and may investigate the case.
- Medical treatment: If approved, your employer is responsible for providing medical care related to your injury. You must treat with a doctor chosen by your employer for the first 28 days.
- Wage loss benefits: If you’re unable to work for more than 7 days, you may begin receiving weekly wage loss benefits, usually equal to 80% of your after-tax average weekly wage.
- Possible disputes: If your case is denied or benefits are delayed, you have the right to file an application for mediation or a hearing through the WDCA.
- Ongoing communication: You may need to provide medical updates, attend independent medical exams (IMEs), or participate in vocational rehabilitation, depending on your situation.
Beginning the compensation process is just the first step. Having an experienced attorney can help protect your rights and ensure you receive the full benefits you deserve.
What about when an employer refuses to initiate a case?
Unfortunately, some employers refuse to submit job-related injury requests. They are worried about higher insurance premiums and want to game the system. Some employers have large deductibles and believe they can escape payment by obstructing cases.
Employees can short-circuit this process by filing their own Employee’s Report of Claim (Form WC-117) with the WDCA. Notice will be sent directly to the employer’s insurance carrier who will then investigate the situation.
Watch out for employers who promise to pay money under the table. It rarely lasts and can jeopardize other legal rights. Never lie to a medical provider about how an accident occurred! Employees cannot sign away their legal rights so don’t be deceived.
What about when an insurance company disputes payment of benefits?
To start a workers’ comp claim in Michigan, when the insurance carrier has disputed payment, file an Application for Mediation or Hearing (Form WC-104A). We recommend hiring a lawyer because these cases are difficult. A magistrate will decide if additional benefits must be paid.
Should I get a lawyer to file my workers’ comp claim in Michigan?
While you can file a workers’ comp claim on your own, hiring an experienced lawyer can significantly improve your chances of getting the full benefits you deserve. A lawyer can help by:
- Ensuring all paperwork is completed correctly and filed on time
- Communicating with your employer and their insurance company
- Protecting your rights if your case is denied or disputed
- Helping you navigate complex medical and legal issues
- Maximizing your benefits for medical care, wage loss, and disability
If your injury is serious, or if your case faces delays or denial, consulting an attorney is highly recommended to protect your interests and reduce stress during the process.
Injured on the job in Michigan and need help filing a workers’ comp claim? Call our work injury attorneys now!
If you suffered an injury on the job in Michigan and need help filing your workers’ comp claim, call now to speak with an experienced attorney, call now at (855) 221-2667 or fill out our contact form for a free consultation with an experienced attorney. There is absolutely no cost or obligation. We’re here for you.
For more than 40 years, our lawyers have been helping people like you who have suffered from on-the-job injuries in Michigan. We understand the physical, emotional, and psychological hardships you are experiencing from your accident. We also have the skill, experience, and know-how to protect you and get you the best possible payout amount for your case.
To see what our own clients have to say about the caring, compassion, and communication they received from us, you can read in their own words about their experience here on our testimonials page from clients we have helped.
Remember, every work injury case and settlement is different and must be negotiated on its own merits. Do not accept any payout amount without fully understanding your legal rights.
Michigan Workers’ Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled employees exclusively for more than 40 years. Call (855) 221-2667 for a free consultation today.
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