Here are some issues to watch out for when a third-party administrator gets involved in your Michigan workers’ comp claim.
A third-party administrator (TPA) is a separate entity that manages workers’ comp claims for the responsible employer or insurance carrier. Hiring a TPA is like outsourcing administration of the claim. Decisions about paying medical and wage loss will be made by this entity so don’t count on your boss just doing the “right thing.”
The TPA is hired because it has specific knowledge about managing workers’ comp claims in Michigan. This includes obtaining favorable medical examinations and hiring defense attorneys. Controlling costs and minimizing what needs to be paid are typical goals.
Some of the companies who act as a TPA in Michigan include CMI, Comprehensive Risk Services, Inc., Mackinaw Administrators, LLC, Maxcis, Inc., Broadspire Services, Inc., Meadowbrook Claims Service, CompOne Administrators, Inc., Sedgwick Claims Management, Services, Inc. York Risk Services Group, Inc. Gallagher Bassett Services, Inc.
Issues to watch when your claim is handled by a TPA
It is common for a TPA to schedule an independent medical examination (IME). The same doctors are used over and over again by these companies. Biased medical opinions are then used to stop benefits. A Garden City doctor performed 1258 of these exams in just 1 year.
We have also been involved in claims where a defense attorney has been consulted long before any formal dispute is filed. The TPA is looking for legal issues that can be used against the claimant.
A vocational counselor might be hired to perform a transferable skills analysis and labor market survey. This report will say a person has a “wage earning capacity” even though no job has been offered. Phantom wages will be used to reduce or stop the payment of weekly checks.
We recommend having an attorney on your side from the start to level the playing field. Solving minor issues before they explode into major problems is the best way to protect your workers’ comp benefits.
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 chrismeller.