Social Security Disability
Americans with Disabilities Act (ADA)
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You need to contact a workers' compensation lawyer immediately after your workplace accident so you are aware of your rights and obligations. Your employers insurance company may make it difficult for you to get workers' compensation benefits. We only represent employees, so unlike the insurance companies, we have your best interests in mind.
We will fight to get you wage loss benefits and get your medical bills paid. Our workers' compensation attorneys have the experience needed to get you the compensation you need to get back on your feet and return to work. And if you are unable to return to work, Ryan, Podein, Postema & Westgate P.C. will help you get vocational rehabilitation and retraining, or a fair settlement to take care of you and your family.
All of our workers' compensation cases proceed on a contingency fee arrangement meaning you do not pay attorneys fees unless we recover compensation for your injury.
Meeting important time limitations are essential for a successful workers' compensation claims. Contact us to schedule a free consultation with a workers' compensation attorney. We will evaluate your workers' comp claim. For your convenience, night and weekend office hours may be arranged by appointment.
STEPS OF A WORKERS' COMPENSATION CASE
The first step in a case is to discuss your rights under workers' comp and also what obligations you may have to the employer. If we determine that they are failing to pay certain benefits we believe you are entitled to, we have a number of options available to us. Sometimes we can just write to the employer and/or insurance carrier in hopes that they will voluntarily pay without a suit being filed. Workers' compensation also has a small claims division where certain small claims can be handled, without a lawyer, that are typically small medical bills or small periods of workers' compensation wages that might be owed. Generally speaking, in any significant dispute, the attorney will file what is called a Petition for Hearing.
The workers' compensation attorney will decide whether or not he wants to request Mediation or a Pre-trial. Mediation is where there is an informal meeting between the injured worker, the attorney and the attorney for the employer and/or the insurance adjuster. On smaller cases, mediation is a good tool for getting the case resolved early. It sometimes also helps the client understand the insurance company and/or employer's reason for the dispute. It sometimes takes a number of Mediations before the parties can settle a case, or it becomes clear that this case has to move on to the trial docket.
If the mediator is unsuccessful in resolving the dispute, he will assign it to trial before one of our Judge's. If Mediation was not chosen on the Petition, the case will then be set for a Pre-trial. The client does not have to appear at a Pre-trial. I will be there to exchange information with the other attorney, typically medical records, employment records, etc. The two attorneys and the Judge will pick a mutually convenient Trial date. The Trial date is anywhere from two to four months or so after the Pre-trial.
There is a special case called the 60 day case. That is where a person was receiving workers' compensation benefits and were cut off by the insurance company and the injured worker files their Petition within 60 days of the cut-off date. This allows them a fast track trial date, although does not guarantee a trial on the first time up.
WORKERS' COMPENSATION SETTLEMENT VS. TRIAL
Our clients frequently ask whether or not their case will be settled or if they will have to go to trial. I tell my clients that typically 90% or more of our cases actually result in a settlement before trial. The 10% or less of our cases that actually go to trial, typically go to trial because the parties are unable to agree to a settlement figure or there is some other reason why the case may need to be tried. The Judge will make the decision based on the evidence presented to him, such as depositions of doctors and the statements of witnesses. The Judge does not award a lump sum of money, as a jury might in an auto accident case, but rather he will make a determination as to whether or not the insurance company/employer should have paid certain benefits in the past and whether or not the person is currently entitled to receive compensation benefits.
Even if you win your case at trial, the insurance company/employer frequently file appeals of those decisions. What that typically means is that you will start receiving 70% of your weekly compensation benefits while it is on appeal. Any past due monies that were awarded for weekly wages or past due medical is held and not paid until after the appeal is over.
It is important that you continue to treat with your physicians. The Judges frequently think that when you stop treating with doctors, that indicates an improvement in your condition. Sometimes the lack of medical treatment is due to a lack of finances or refusal of the doctor to treat someone without insurance, however continuing treatment is important to your case.
PRIVATE INVESTIGATORS AND/OR INSURANCE INVESTIGATORS
The insurance company and/or employer will sometimes hire a private investigator to go out and check up on you. What they are looking for is to see whether you are working and not disclosing that and whether or not you are performing activities that are inconsistent with your claim of disability. Our Judges do not require you to be bed-ridden in order to win a workers' compensation case, however they will look closely at any evidence that suggests your disability is not as bad as you claim. For that reason, do not attempt to manipulate the doctors, or others, regarding your disability status.
INDEPENDENT MEDICAL EXAMINATIONS
The insurance company will frequently send you to doctors in preparation for the defense of your case. Frequently the doctors have a number of "faking" tests. They also have a number of other tricks to see whether or not a person is honestly conveying their symptoms. The quickest way for you to lose your case is to give the Judge reasons to suspect whether or not you are being truthful or honest in your presentation. For that reason, report exactly what is going on with no embellishment or exaggeration.
The insurance company and/or employer can have you examined by a number of people in defending your workers' compensation case. They are required to pay you mileage to and from the health care provider that they are seeing. You must attend any medical exam that is set up. If you fail to attend, the Judge can suspend or dismiss your workers' compensation Petition. He may also require you to reimburse the insurance company for the cost of these medical exams, which can be upwards of $1,000.00. We may also have you examined by a doctor of our own choice and it is mandatory that you appear for such exam. We may also have you examined by a doctor of our own choice and it is mandatory that you appear for such exam.
HOW MUCH IS MY CASE WORTH?
We are frequently asked by clients how much their case is worth. Many factors go into how an attorney values a workers' compensation case. Please be assured that we will never settle your workers' compensation case without your permission. Generally speaking, there are a large number of issues that are factored into determining what an appropriate workers' compensation settlement would be. The two most important factors are the workers' compensation rate and disablement.
The workers' compensation rate that you may be entitled to is based on 80% of your after tax income. They determine your average weekly wage by going back one year from your date of injury, taking the highest 39 weeks of income and dividing by that number to come up with an average weekly wage. Depending on how high your comp rate is, the cash value of any discontinued fringe benefits may be added to the gross wage, and your work comp rate is established using both figures. The rate is then determined by using a rate table based on the number of dependents and your tax filing status.
There are other factors that affect a settlement. Your willingness to return to light duty work, your education, other job skills you might have, residual work ability that you have, etc. Every effort is made to maximize the recovery for clients.
WAGE REPLACEMENT/MEDICAL BILLS/REHABILITATION-RETRAINING/MILEAGE
Workers' compensation pays four basic benefits: (1) They pay disability benefits during the period of time you are unable to work because of a work-related injury. That is premised on 80% of your after tax income. (2) They also pay 100% of all medical bills under Michigan Cost-Containment (that means the State of Michigan tells the doctor how much the procedure should be, regardless of what he charge), all prescriptions, braces and other appliances as needed. (3) It also pays for rehabilitation and retraining in certain circumstances. Workers' comp may pay for home modification if you are paralyzed. (4) They pay for all of the mileage to and from your health care providers. It is important that you keep a master list of all the unpaid medical bills you have and provide them to us prior to trial.
LIGHT DUTY WORK
The quickest way to lose a case in workers' comp is for an injured worker to refuse to do light duty work that the Judge ultimately believes you could have done. Never reject light duty work without discussing it with me first.
Before starting any other job, please consult with us regarding the affect any subsequent employment will have on your workers' disability compensation claim. Generally speaking, the insurance company/employer is allowed credit for the wages you earn during the same period you are claiming workers' compensation benefits. If you do start a job, keep all of the paycheck stubs so we know how much money you have earned and can calculate the amount of partial compensation, if any, that might be owed to you.
Workers' comp has several time limitations that apply. If workers' comp has already been paid, then an employee is limited to going back one year from the filing of a Petition for Hearing in order to recover unpaid benefits. If no workers' compensation benefits have been paid, then there is a two year back rule, meaning you must make claim within two years of the date of injury, last day worked or onset of disability. We tell all of our clients that they should consult with their attorney any time the insurance company is refusing to pay benefits you believe you are entitled to receive.
UNEMPLOYMENT CREDIT WEEKS
The Michigan Employment Security Commission allows for a preservation of unemployment credit weeks. This needs to be done within 90 days of going off of work. You need to go to your local unemployment office and request a preservation of unemployment credit weeks form which needs to be completed by your doctor. Unemployment will then allow you to save the unemployment credit you currently have built up into the system for possible future use. The reason the preservation becomes important is if you end up being disabled for an extended period of time, unemployment requires you to have worked so many weeks out of the last 52, and if you have not preserved the unemployment credit weeks you will fail to qualify for unemployment in the future.
Some people that have a relatively modest impairment, that is one that prevents them from working at their regular job but does not prevent them from other types of employment, will sometimes choose to draw unemployment benefits while they pursue their workers' compensation claim. It is important that you not make an inconsistent claim, and for that reason, when you fill out your application for unemployment benefits, you must state what your restrictions are or what limitations you have on your employment activities. If you tell unemployment that there are no physical impairments whatsoever, you may be barred from making an inconsistent claim in workers' compensation court. Any unemployment benefits that you draw are taxable and they are also deducted, dollar for dollar, off any workers' compensation benefits that may be owed to you. Please refer to the MARVIN unemployment page at www.michigan.gov/uia for more information.
We instruct our clients that under no circumstances should you quit your employment without discussing it with us first. Generally speaking, it can have serious adverse consequences on a workers' compensation claim should you voluntarily resign your employment. The reason for that is you prevent the employer from providing you light duty or favored work which might reduce or eliminate the workers' compensation benefits they might have to pay to you.
PENSION OR RETIREMENT BENEFITS
Section 345 of the Workers' Compensation Act allows the employer to deduct a number of benefits from workers' comp. One of those benefits is any company paid retirement benefit, such as a pension, 401K contribution, profit sharing, etc. Do not withdraw any monies from your pension, 401K, etc., without consulting with us first. Such a withdrawal can have a significant impact on your workers' compensation case. There are also tax penalties that apply to these pension monies. If the employer requires you to exit a pension plan, you should then be rolling the money over to an IRA or ROTH IRA account so as not to incur any tax penalties and to prevent a work comp offset.
OLD AGE SOCIAL SECURITY BENEFITS
Do not request old age retirement benefits without consulting with our office first. Part of the Workers' Compensation Statute states that if you voluntarily seek old age retirement benefits from Social Security, you are presumed not to be disabled and it can have serious adverse consequences on any workers' compensation claim. Please consult with us prior to taking any such action.
FRIEND OF THE COURT LIENS
If you are behind on child support, the Friend of the Court may place a lien against your workers' compensation case. Frequently child support is deducted from a person's workers' compensation weekly benefit. If there is past due monies owed, the Friend of the Court may actually attach a lien to the workers' compensation case that will have to be dealt with. The monies will then be deducted from any workers' comp settlement or award. If you have any Friend of the Court arrearages or liens, you should bring that to our immediate attention, both at the time of the interview or shortly thereafter. Sometimes Friend of the Court liens can be negotiated down or they will take a partial payment, depending on the amount of the settlement.
SOCIAL SECURITY DISABILITY BENEFITS
In addition to workers' disability compensation benefits, some workers' will also have a disability that meets the social security disability criteria. Generally speaking, social security requires a higher level of disability than does workers' comp, although there can be some exceptions to that. If you believe you may be entitled to social security disability benefits, please feel free to discuss it with us.
You can apply for social security disability benefits without a lawyer. Generally speaking, the first application is denied by the Social Security Administration, but depending on your age and your disability, you may have a very good chance of winning the case on appeal. If you would like the offices of Ryan, Podein, Postema & Westgate P.C. to represent you on a social security disability claim, we will have to agree, in writing, to do so. If you would like to discuss any aspect of a social security claim, please feel free to contact Kellie Postema, an attorney in our office who practices in that area. These cases are typically taken on a contingency fee basis and there is no attorney fee unless we win the case for you. Please see our Social Security Disability tab for more detailed information. You can also go to the Social Security Administration's website at www.socialsecurity.gov for additional information.
AUTO NO-FAULT CLAIMS
If your workers' compensation injury occurred as a result of the motor vehicle accident or with a motor vehicle involved, you may be entitled to either first party or third party auto benefits. Please see our Auto Accident tab for more detailed information.
THIRD PARTY/PRODUCT LIABILITY/PREMISE LIABILITY, ETC
Depending on how your injury occurred, you may also have other possible causes of action. For example, if your injury occurs as a result of a negligent driver, you may have the right to sue the other driver for damages. If you are working in a factory and another company was negligent and caused the injury to you, you may have the right to sue the other company for damages, although your workers' compensation insurer may be entitled to a reimbursement for monies paid to you. If you believe there is any other claim or cause of action, you should bring it to our attention immediately.
HEALTH CARE LIENS/SHORT TERM DISABILITY LIENS/ LONG TERM
Many of our clients have had their workers' compensation claim rejected by the insurance company and/or the employer and that is why we file a Petition for Hearing on their behalf. Many injured workers' also have group health insurance that is available to them through their employment or through their spouses and we frequently encourage our clients to submit the bills to their health care provider in order to have those bills paid. There is no guarantee that we will necessarily win your workers' compensation case and many health care plans require the bills to be submitted to them usually within one year in order to be paid by them. If the health insurance company believes that this is a workers' compensation case and they should not have to pay, they will frequently pay the bills but place a lien against any workers' compensation claim you might have. We will have to deal with that lien and/or pay them back at the time of the settlement or an award from the Judge.
If your group health insurance is paying your bills, please make sure to bring that to our attention, especially if they have filed a lien or you have signed a Reimbursement Agreement. The same thing is true for short term disability benefits and long term disability benefits. Most disability plans typically state that they do not pay for work-related injuries. However, if your workers' compensation case is disputed, you may start receiving short term disability or long term disability benefits. They may also require a pay back in the event of a settlement or if you are successful at trial on your workers' compensation case. If you are receiving short term disability and/or long term disability benefits, please make sure that we know so we can include those monies in the settlement negotiations or in trial preparations.
GRAND RAPIDS PERSONAL INJURY ATTORNEY
Have you been injured at work? If so, you might be entitled to workers' compensation.
At the law firm of Ryan, Podein, Postema & Westgate P.C., in Grand Rapids, Michigan, we have substantial experience representing clients throughout western Michigan who have suffered workplace injuries, including: