Worker’s Compensation

For people who were injured on the job...

The “nurse / manager” has no right to attend your doctor appointment with you, unless you allow it.

This might surprise you, but the workers compensation nurse manager has absolutely no right to sit in on your doctor visit. The workers compensation act gives you the absolute right (after a certain number of days) to select your own doctor and to meet with that physician, in private. Sometimes though, because they control the doctor’s payment, a workers’ compensation insurance company can be pretty heavy-handed and insist their representative has a right to sit in on your examination by your doctor. They do not have this right at all. Nevertheless, you do need to know that they may hard time payment for your doctor if you don’t allow their nurse to sit in at your doctor visit. You need to carefully consider whether you should let that nurse in the room. You have the absolute right to see your doctor in private in any workers compensation matter. Whether you allow the nurse in should be your choice. The workers’ compensation nurse can get a copy of the doctor’s records or other file information, so don’t buy into some story that the nurse “needs to go to your appointment with you.” So many times I have heard that the nurse intrudes and controls the appointment, and actually talks to the doctor more than you! This just is not right and you do not have to put up with it. That being said, please know that the minute you start to exercise your rights, the workers’ compensation insurance company is probably going to push back at you-- hard. They are pretty used to getting their way on these kind of things and do not seem to like when people know and exercise their options. So, before you simply tell the nurse she is an invited in, you might want to consider what the workers compensation insurance company may do in response. In any event, it is still helpful to know your rights…

There is one “sure way” to screw up any workers compensation case.

If you are hurt at work, you must report the injury. If someone tells you not to report the injury, or to take FMLA, or to go on short-term disability, or any other reason, ignore it. If you want to have a viable, workable, workers’ compensation claim then you need to report the injury.

Michigan compiled law 418.318 indicates that “… The employee shall provide a notice of injury to the employer within 90 days after the happening of the injury, or within 90 days after the employee knew, or should have known, of the injury.…” If you are hurt in a workers’ compensation “at work” accident, report it immediately. If you do not give that notice, that is the # 1 way to “tank” your workers compensation case. Believe me, this is a “critical” thing. If you don’t report the injury promptly, that failure will be used against you by the workers’ compensation insurance company, or their attorney, if you end up in a litigation situation. Remember… Report it! Report it! Report it!

This is how you file and start a contested workers compensation case…

So let’s say that your workers’ compensation insurance company has refused to pay workers’ compensation wage loss benefits, or terminated your workers’ compensation wage loss benefits after a medical examination, or reduced your workers’ compensation wage loss benefits after a “vocational evaluation.” Generally, everyone in the state of Michigan will file the same document to get a disputed case started; that would be the document titled form WC 104 (A). You can review that form at Michigan.gov/lara. Be sure to open the workers’ compensation agency page and go to the “litigation” forms.

This form has to be filled out carefully. Be very careful about how you describe your injury. Be very careful about the date you claim you were injured. I highly recommend you get professional help but that will, ultimately, be up to you.