Loopholes that need to be fixed in Michigan workers compensation law and games insurance companies play.
Michigan’s workers compensation law was enacted in 1912 and designed as a grand bargain between labor and business. It provides employees with limited benefits in exchange for giving up the right to file a civil action. If an employee gets hurt, he or she receives medical treatment and lost wages only. The employer is shielded from paying additional damages such as pain and suffering.
Many changes to workers compensation have occurred throughout the years. Reform efforts pushed by special interest groups have eroded the safety net. This has resulted in several loopholes that allow insurance companies to avoid paying required benefits.
A loophole is defined by the Merriam-Webster dictionary as “an error in the way a law, rule, or contract is written that makes it possible for some people to legally avoid obeying it.” Here are three loopholes that must be corrected immediately.
1. Spouse not considered a dependent
Michigan law originally provided that a wife was a conclusive dependent entitled to receive survivors benefits if her husband died in the course of his employment. This was found to be unconstitutional gender bias and neither a wife or husband are now a conclusively presumed dependent. A spouse must prove factual dependency to receive survivors benefits and will be disqualified if less than ½ of his or her support came from the decedent. Most families need two incomes to survive and a working spouse might not get any benefits if their husband or wife dies in a workplace accident. The only payment being be a $6,000 burial expense. Talk about a windfall for the insurance company!
2. Seasonal employee losing job and benefits
Michigan courts have found that a seasonal employee is not entitled to any wage loss benefits during a period of time when he or she would not otherwise be working. This applies to teachers, professional athletes, and general laborers. Other Michigan courts have ruled that wage loss benefits continue if a seasonal employee still has a “wage loss” during the off-season. This confusion has led to uncertainty and resulted in many people losing their benefits. Just because a person is not working for a period of time does not mean their disability has ended.
3. Preexisting condition defense
Insurance companies regularly deny claims when a person has some preexisting condition. We see this with people who have degenerative arthritis in their joints or spine. If a person was able to work and now has a problem this indicates something happened. Michigan law requires showing a pathological change and this is a very difficult burden. Many people find themselves without remedy because they can’t actually prove they were hurt.
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 (855) 221-2667 for a free consultation today.
Photo courtesy of Creative Commons, by Mike Dot Mike.