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For an injured worker to be able to recover worker’s compensation benefits in Michigan, (1) the employer must be covered by the Michigan Worker’s Disability Compensation Act of 1969, and (2) the injured worker must be an “employee” of the employer the benefits are sought from.
If an injured worker may be able to recover worker’s compensation benefits from their employer, then the injured worker may recover the benefits if (3) the injury “arose out of and in the course of” the worker’s employment and (4) if the worker is “disabled” as a result of the injury.
Worker’s compensation benefits for a workplace injury include wage loss, medical benefits, and vocational rehabilitation.
(1) Coverage For Employer’s Under The Michigan Worker’s Disability Compensation Act
Whether an employer is covered by The Michigan Worker’s Disability Compensation Act is determined by the number of its employees. If a private employer typically employs three or more employees at a time, or employed one worker for 35 or more hours per week for 13 or more of the preceding 52 weeks, it is subject to the Act. If the employer never had more than two employees simultaneously and had no employees for 40 of the 52 weeks preceding the injury, it is not subject to the Michigan Worker’s Disability Act.
Notably, an employer who is not subject to the Michigan Worker’s Disability Act may still obtain worker’s compensation coverage by purchasing an insurance policy. Moreover, if the Act does not apply, the injured worker may be able to file a typical personal injury lawsuit against the employer that includes damages not compensable under the Act, including pain and suffering damages.
(2) Whether The Claimant Is An Employee
An injured worker claiming worker’s compensation benefits must be an “employee” of the employer to receive worker’s compensation benefits from that employer. The Michigan Supreme Court has held that determining whether an injured worker is an employee involves five specific questions: (I) Whether there is a contract; (II) Whether there is a contract “of hire” for the injured worker (the “of hire” requirement is satisfied where the injured worker’s compensation is “payment intended as wages”); (III) Whether the injured worker maintains a separate business;” (IV) Whether the injured worker holds himself or herself out to provide services to the public, and (V) Whether the injured worker is an employer subject to the Act. If the injured worker is found not to be an employee of the employer, the injured worker may be able to file a typical Michigan injury lawsuit against the employer that includes damages not compensable under the Act, including pain and suffering damages.
(3) Injuries “Arising Out Of” And “In The Course Of Employment
Whether a work injury arose out of and in the course of an injured worker’s employment is often a hotly contested aspect of worker’s compensation disability claims because the law in this area is not clear, and there is not definitive list of factors that allow for a clear determination. There are certain factors that tend to bring an injury under worker’s compensation insurance coverage.
For example, if the work injury occurred while the worker was performing an activity that benefits the employer, the work injury will often be covered under the Worker’s Compensation Act. Or, if the worker’s injury occurs on the employer’s premises, it will often be covered under the Act. However, work injuries suffered by workers while they are not benefitting the employer and while they are not on the employer’s premises might be compensable, as numerous factors beyond the scope of this brief overview are considered. One example might be work injuries that occur during employment-related long-distance trips or traveling.
4) Whether The Worker Is Disabled
An injured worker is disabled if the injured worker is unable to perform and obtain a job suitable to his or her qualifications and training that pays maximum wages. A job provided only because the employer is seeking to avoid liability for worker’s compensation benefits does not necessarily prevent a finding of disability.
After filing a worker’s compensation benefits claim, the first step in the process of determining whether the injured worker is disabled is completing a full disclosure of the injured worker’s qualifications. The second step requires the injured worker to establish the universe of jobs that the injured worker was qualified for at the time of the work injury that pay maximum wages (the universe of jobs includes any potential job that is suitable to the worker’s qualifications and training). The third step is establishing that the injured worker’s injury prevents the injured worker from being able to perform some or all of the jobs within the universe of jobs. If some jobs within the universe of jobs are deemed by the magistrate to be within the injured worker’s capabilities, the injured worker may still obtain worker’s compensation benefits if the injured worker can prove that there is not a “substantial job market” for those jobs, thereby showing that the injured worker cannot obtain the work that is within their capabilities despite their work injury.
