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Useful Information


Workers’ Disability Compensation Procedure

  1. Administration.

    • The Michigan workers' compensation system is administered by the Workers Compensation Agency, a state agency. The Agency is part of the Department of Labor & Economic Growth. The Agency maintains offices in most of Michigan's major cities. The Grand Rapids office is located at 2942 Fuller Avenue, NE, Grand Rapids, Michigan 49505.

    • The relief available through the workers' compensation law is the exclusive remedy for on-the-job injuries. Consequently, all disputes regarding compensation rights are to be submitted to the Agency and not to courts of general jurisdiction. The Agency has its own judges called workers' compensation magistrates, who preside over the workers' compensation courts and render decisions on disputed matters. The courts of general jurisdiction become involved in workers' compensation cases only to enforce Agency orders and as part of the appellate process to be discussed below.

  2. Notice and claim.
    • Before an employee can successfully assert a workers' compensation claim, the employee must prove that the employee has satisfied the "notice and claim" requirements of the Act. "Notice" refers to providing notification to the employer of the occurrence of an injury. The notice itself need not be formal or written, although it will obviously be much easier to prove that notice was given if there is a corroborating writing. There is also no requirement regarding to whom the notice is to be tendered and it is generally accepted that notice, even oral notice, to a foreman or supervisor is sufficient.
    • The law requires that notice be given within 90 days after the happening of the injury, or within 90 days after the employee knew, or should have known, of the injury. Moreover, the statute further provides that the failure to give notice within the 90 day period shall be excused unless the employer can prove that it was prejudiced by the failure to provide such notice. Since it is usually difficult for an employer to make such a showing, notice is often undisputed or minimally disputed even in litigated cases.
    • At the same time, however, the reporting of a work injury may have a significant bearing on whether the employer or the magistrate accepts the claim that the injury did in fact occur at work. All other things being equal, it is a good idea for employees to report all injuries, even though they may seem to be relatively minor at the time of their occurrence. If an employee sustains an injury on a Friday afternoon but does not report it until the following Monday because the employee wanted to see whether the condition would improve over the weekend, the employer will certainly be highly skeptical that the injury actually occurred at work on Friday and may deny a request for benefits on that basis.
    • An employer is supposed to give written notice to the Agency on the so-called "Form 100" (Agency form 1-100) for any injury that results in death, specific loss, or a disability of seven or more days. A copy is supposed to be provided to the employee. However, it has been suggested that in many instances the Form 100 is not filed with the Agency so as not to alert the employee of the employee's potential rights under the compensation law.
    • An employee must make a "claim" for workers' compensation benefits no later than two years from the later of the date of injury, the date disability manifests itself, or the last day of employment with the employer against whom the claim is being made. The time period for filing the claim may be extended if an employee receives benefits, such as sickness and accident benefits, that effectively substitute for workers' compensation benefits.
    • The claim requirement does not mean that an employee must file a formal application for benefits within the two-year claim period. What it does mean is that an employee must notify the employer within the claim period that the employee believes that the employee is entitled to workers' compensation benefits as the result of a work-related injury or exposure.
    • Thus, an employee injured many years prior to the filing of a formal application for benefits would still be entitled to recover benefits if proper notice was given and a timely claim was made. However, the period of recovery of past-due benefits is limited to a maximum of two years back from the date the application for benefits is filed with the Workers Compensation Agency. In some cases the period of past-due recovery can be as little as one year.
  3. The litigation process.

    4. The compensation system is designed to function on its own as much as possible and without the involvement of the Agency itself. For example, an employer or insurance carrier does not need prior approval from the Agency in order to terminate the payment of benefits that it voluntarily initiated.

    • The filing of a Notice of Dispute (Agency form 1-107) is usually the employee's first formal notice that the employee's claim will not be paid or that voluntarily paid benefits have been terminated. A dispute about compensation rights may give rise to formal litigation through the Agency. The filing of a Notice of Dispute insulates the employer and insurance carrier from any liability or penalty for non-payment of benefits.
    • The litigation process is initiated with the filing of an Application For Mediation or Hearing on the part of the employee. The application form requires the employee to provide a wide variety of information about the employee's case to apprise the Agency and the employer of the nature of the dispute. Under more limited circumstances, the employer and/or insurance carrier may initiate litigation by filing a Petition For Determination of Rights or, in cases where the payment of benefits has been ordered by a magistrate, a Petition to Stop.
    • The litigation process may include one or more of the following steps:
      •  Mediation is an informal procedure designed to provide an opportunity to resolve disputed claims without having those claims assigned to the docket of a workers' compensation magistrate for hearing. The mediation process is compulsory for certain types of claims but participation is voluntary where the employee is asserting the right to weekly disability benefits. Sometimes multiple mediation hearings are scheduled in an attempt to give the parties an opportunity to reach a compromise without further litigation.
      • Hearings. If a case is not resolved by mediation or if it involves issues that the parties are not obligated to mediate, the case may be assigned to a workers' compensation magistrate for a hearing. The magistrates are the workers' compensation "judges". It is their responsibility to maintain dockets, manage the litigation, and hear and decide cases that cannot be resolved by the parties themselves. A workers' compensation hearing is a trial before the magistrate to whom the case is assigned. There is no jury in a workers' compensation case and the magistrate is the sole fact-finder and decider of all legal and factual issues. The parties are free to introduce testimony from witnesses as well as documentary evidence and exhibits. Although medical testimony is a virtual necessity, the testimony is usually taken by deposition at the physician's office or some other location. A transcript of the deposition is prepared and submitted to the magistrate at the time of the hearing together with the other evidence. After the proofs have been submitted and the record closed, the magistrate is required by law to produce a written opinion explaining the magistrate's findings and conclusions and the basis for them.
  4. Appeals
    • Appeal to the Workers' Compensation Appellate Commission (WCAC). A party who is dissatisfied with the written decision of the magistrate has a period of 30 days from the mailing date of the magistrate's decision to file a Claim for Appeal with the Workers' Compensation Appellate Commission (WCAC). The commission consists of seven members, appointed by the governor, whose task it is to review decisions of the magistrates. However, unlike the old Workers' Compensation Appeal Board, review by the WCAC is limited. The WCAC is supposed to confine itself to determining whether the decision of the magistrate is legally correct and whether it is supported by "competent, material, and substantial evidence on the whole record." Thus, the WCAC is supposed to affirm the decision of the magistrate if the decision is legally correct and properly supported, even if the reviewing commissioners themselves would have reached different conclusions. It is very difficult to get a reversal from the WCAC absent clear legal error.
    • Appeal to the courts. The party who is dissatisfied with the decision of the Workers' Compensation Appellate Commission has the right to file an Application For Leave to Appeal in the Michigan Court of Appeals. An Application For Leave to Appeal is a request that the Court of Appeals accept the case for review. The Court of Appeals is not obligated to do so and, in fact, accepts relatively few workers' compensation cases for review. If the Court of Appeals refuses to grant leave to appeal, or if the court accepts and decides the case, a party has the right to file an Application For Leave to Appeal in the Michigan Supreme Court. The chances of getting the Supreme Court to accept a case for review are also quite small. The appellate courts are supposed to confine their review to questions of law and to determining whether the decision below was supported by the evidence. The appellate courts do not review the record from scratch and render their own decision on the merits of the case.
  5. Redemption (settlement).
    • Most disputed workers' compensation cases are eventually settled. A redemption is a compromise settlement that exchanges the payment of a lump sum for the employee's full, final, and complete waiver of any further entitlement to workers' compensation benefits in any form, past, present, and future.
    • The magistrate does not determine the amount of the settlement. Instead, the parties negotiate between themselves and present the settlement to the magistrate for approval. Procuring that approval entails a short hearing known as a "redemption hearing" in which the injured employee, in response to questions, makes clear the employee's understanding that the redemption involves a full waiver of rights in exchange for the settlement being paid. At the conclusion of the settlement hearing, the magistrate approves or disapproves of the settlement in writing and serves a copy of the Redemption Order personally if all parties are present. As a practical matter, the magistrates approve almost all the settlements presented to them.
    • The settlement is not final at the time of the magistrate's approval. Rather, the compensation statute provides that the settlement becomes final only after 15 days elapse from the settlement date. During that period of time, either party has the right to request a Review Hearing. The Review Hearing gives the party requesting the hearing an opportunity to explain why that party would like to have the settlement set aside. It is extremely difficult to have a redemption overturned through this process. For the employee, a change in medical condition during the 15 day waiting period is probably the best basis for requesting that a settlement be set aside. After the 15-day period runs, the settlement becomes final and no party can challenge it, irrespective of what the party may have subsequently learned.
    • No date of injury can be settled until six months have passed. Thus, it is impossible to settle a case completely until the employee has been off work from that employer for six months, since employers and insurance carriers settle every date of employment as part of the redemption.
    • Although plaintiffs' attorneys are frequently asked about how much to settle a case for by people whom they do not represent, the only fair answer is "all you can get". There are simply too many variables, including the type of injury, age of the employee, nature of the employment, entitlement to other benefits, etc. to set forth meaningful rules of general application.