The Social Security Administration’s impairment listing manual (called the blue book) lists a number of impairments, both physical and mental, that will automatically qualify an individual for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI), provided the individual’s condition meets the specified criteria for a listing.

Below is a partial list:

· Musculoskeletal problems, such as back injuries

· Cardiovascular conditions, such as heart failure or coronary artery disease

· Sensory and speech issues, such as vision and hearing loss

· Respiratory illnesses, such as COPD or asthma

· Neurological disorders, such as multiple sclerosis, cerebral palsy, Parkinson’s disease, and epilepsy

· Mental disorders, such as depression, anxiety, schizophrenia, autism, or retardation

· Immune system disorders, such as HIV/AIDS, lupus, and rheumatoid arthritis

· Various syndromes, such as Sjogren’s Syndrome and Marfan Syndrome

· Skin disorders, such as dermatitis

· Digestive tract problems, such as liver disease or IBD

· Kidney disease and genitourinary problems

· Cancer

· Hematological disorders, such as hemolytic anemias and disorders of bone marrow failure

Social Security has a list of impairments that can officially qualify you for disability benefits. Any physical or mental health condition severe enough to prevent you from working can qualify for benefits.

This includes all these common conditions:

• Autism

• Cancer

• Carpal tunnel syndrome

• Chronic fatigue syndrome

• Congestive heart failure

• Coronary artery disease

• Crohns Disease

• Cystic fibrosis

• Diabetes

• Headaches

• Hepatitis C & liver disease

• HIV/AIDS

• Interstitial cystitis

• Ischemic heart disease

• Lung impairments

• Lupus & fibromyalgia

• Mental illness

• Muscular dystrophy

• Musculoskeletal diseases

• Obesity

• Osteoarthritis

• Personality disorder

• Rheumatoid arthritis

• Seizures

• Strokes

Many times people wait to apply for disability benefits, wondering if their health condition is bad enough, or whether they may ultimately return to work.

But if you wait too long, you could miss out on benefits you should receive.

Let me help you determine if you have a disability case or not.

You can always return to work later. But it can take a long time to get your benefits approved, so the sooner you start, the better.

I don’t charge any attorney fee unless you win.

To qualify for Social Security disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four credits per year. The amount of earnings required for a credit increases each year as general wage levels rise. Family members who qualify for benefits on your work record do not need work credits.

The number of work credits you need for disability benefits depends on your age when you became disabled. Generally you need 20 credits earned in the last 10 years ending with the year you became disabled. However, younger workers may qualify with fewer credits.

SSDI Qualification Requirements:

1. Are you working and making more than the limit? If you are making more than a certain amount each month you are not disabled.

2. Do you have medical evidence that qualifies you for a disability? Your medical condition must significantly limit your ability to do basic work activities (walking, sitting, concentrating) for at least one year. If your medical condition is not severe enough, you are not disabled.

3. Is your medical condition on the Social Security List of Impairments? The List of Impairments describes medical conditions that are so severe they are automatically disabling as defined by law. If your medical condition is not on the list, it is reviewed to determine if it is as severe as a condition that is on the list. Feel free to contact our office to discuss your particular case.

4. Can you do the work you did before? Your medical condition must prevent you from being able to do the work you did before. If not, you are not disabled.

5. Can you do any other type of work? Your medical condition must prevent you from doing other work so as to make a living.

Your medical condition, age, education, past work experience and skills are evaluated. If you can do other work, you are not disabled.

If you cannot do other work, you could file disability.

As a Michigan disability attorney who has handled over a thousand Social Security disability claims in the last twelve years, Mr. Andrus has learned that his most important job is providing personal attention to each of his clients.

Mr. Andrus’s experience in Social Security disability law will help you get the best results possible. He has represented claimants with a wide variety of impairments, and has a large number of satisfied Michigan Social Security disability clients.

We accept Michigan Social Security claimants at all stages and help Greater Tri-Cities and Flint disability claimants who have:

· Not yet applied for Social Security disability benefits

· Received a denial of their initial applications

· Had their Requests for Reconsideration denied

· A disability hearing coming up soon

· Appealed to the Appeals Council

· Appealed to the U.S. District Court

We understand that the Social Security disability process can be frustrating, and we work hard to insulate our clients from its challenges. We pride ourselves on delivering compassionate, knowledgeable, and effective service.

When you come to the Andrus Law Firm, PLC for your first appointment, we will take plenty of time to discuss your case with you and answer all of your questions. Before you leave, we will give you written materials explaining the Social Security disability process.

We will analyze what you must prove to win disability benefits. Then we will gather the evidence needed to present the strongest possible case, including the necessary medical data and opinions for your case. We will keep you informed as your case progresses.

Before your Social Security disability hearing, we will get together to review our planned presentation of your case. At that meeting, we will discuss with you your testimony and the questions we plan to ask you. We also will explain in detail what you can expect at the hearing, including what questions the Social Security administrative law judge is likely to ask you, so you will feel fully prepared.

We will be at your side at the hearing and through each step of this often complicated and lengthy process. Our most important job is providing personal attention to each of our clients.

The Disability Process is Long and Confusing. Darrin Andrus Can Help.

Put An Expert On Your Side

· According to the Social Security Administration, it is extremely difficult to obtain social security disability benefits without an attorney.

· A social security disability lawyer can help you complete the forms the Social Security Administration sends you.

· Your disability lawyer can also work with your doctors to get the reports needed to establish your entitlement to social security disability benefits and work with vocational experts to provide documentation and/or testimony regarding the feasibility of your ability to return to work.

· If you need to go to a hearing in Michigan, your social security attorney will prepare you and be with you at the hearing to help you testify.

· Been denied? A social security disability lawyer can help.

By law, there is no fee unless you are awarded benefits. The legal fee is taken out of back payments and can be no more than 25% of your back pay, up to a maximum of $6,000 (subject to possible future changes by Congress).

· No fee unless we win your case

· All appointments are FREE

· $1,000,000s recovered in benefits

· Social Security Disability is our focus

· Over 20 years experience

· Personal attention – you won’t get shuffled around a big office

Bigger isn’t always better. The appeal and prestige of a regional or national firm can be enticing, but at the end of the day, your case is going to be heard in a local Michigan hearing office. Mr. Andrus represents clients every day in local Michigan hearing offices. He has the passion and experience needed to prepare and successfully present your case.

An application can now be completed online at www.ssa.gov.

Or you can apply at any Social Security office as soon as you become disabled. You may file by phone, mail or by visiting the nearest office. Note that, while you may receive back benefits from the date you became disabled, they are limited to one year before the date you filed for benefits.

I can also do your application for you for FREE at my office by appointment.

After helping you complete your application, the Social Security office will review it to see if you meet the basic requirements for disability benefits. They will look at whether you have worked long enough and recently enough, your age and, if you are applying for benefits as a family member, and your relationship to the worker.

The office then will send your application to the Disability Determination Services (DDS) office in your state. The DDS will decide whether you are disabled under the Social Security law.

The rules for determining disability are different from the disability rules in other government and private programs.

Social Security will automatically enroll you in Medicare after you get disability benefits for two years.

Medicare has two parts: hospital insurance and medical insurance. Hospital insurance helps you pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it’s free.

The other part of Medicare, medical insurance, helps pay doctors’ bills and other services. You will pay a monthly premium for this coverage if you want it. Most people have both parts of Medicare.

In general, your benefits will continue as long as you are disabled.

However, we will review your case periodically to see if you are still disabled. The frequency of the reviews depends on the expectation of recovery.

If medical improvement is “expected,” your case normally will be reviewed within six to 18 months.

If medical improvement is “possible,” your case normally will be reviewed no sooner than three years.

If medical improvement is “not expected,” your case normally will be reviewed no sooner than seven years.

There are two things that can cause Social Security to decide that you are no longer disabled and to stop your benefits.

1. Your benefits will stop if you work at a level considered to be “substantial.” Usually, average earnings of $800 or more a month are considered substantial.

2. Your disability benefits also will stop if it is determined that your medical condition has improved to the point that you are no longer disabled.

You must promptly report any improvement in your condition, your return to work and certain other events as long as you are receiving benefits.

Yes, you can refer friends or family members to our office. Many of our clients come to us through referrals from past clients, long-term disability insurers, unions, medical professionals, social workers, other attorneys, and family members.

Yes, we offer free case consultations with no charge or obligation. Consultations can be held in our office, by phone, or via email—whichever is most convenient for you. We can meet at our office in Grand Blanc, Michigan, or by appointment at the Flint Office of Disability Adjudication and Review. If you decide to retain us, you will not be charged an attorney’s fee unless you are awarded disability benefits. If you think we can help with your Social Security disability claim, please complete the FREE Case Review form below or contact our office directly.

To be eligible for Social Security Disability Insurance (SSDI) benefits, you must have worked and paid Social Security taxes. If you have stopped working, you are typically eligible for up to five years after you stop working. It's crucial to apply as soon as possible after you stop working to ensure you can prove your disability before your insured status lapses.

Social Security has a list of impairments that can officially qualify you for disability benefits. Any physical or mental health condition severe enough to prevent you from working can qualify for benefits.

This includes all these common conditions:

• Autism

• Cancer

• Carpal tunnel syndrome

• Chronic fatigue syndrome

• Congestive heart failure

• Coronary artery disease

• Crohns Disease

• Cystic fibrosis

• Diabetes

• Headaches

• Hepatitis C & liver disease

• HIV/AIDS

• Interstitial cystitis

• Ischemic heart disease

• Lung impairments

• Lupus & fibromyalgia

• Mental illness

• Muscular dystrophy

• Musculoskeletal diseases

• Obesity

• Osteoarthritis

• Personality disorder

• Rheumatoid arthritis

• Seizures

• Strokes

Many times people wait to apply for disability benefits, wondering if their health condition is bad enough, or whether they may ultimately return to work.

But if you wait too long, you could miss out on benefits you should receive.

Let me help you determine if you have a disability case or not.

You can always return to work later. But it can take a long time to get your benefits approved, so the sooner you start, the better.

I don’t charge any attorney fee unless you win.

Yes, getting professional help can significantly increase your chances of winning your case. We can help you gather evidence, complete forms, work with disability adjudicators, and walk you through the entire process – even if you haven’t been denied.

Gather the names of your conditions, doctors, tests, medications, and work history before logging into the Social Security website at www.ssa.gov. Gather job related information for 15 years prior to when you became disabled. Make sure to write down your re-entry number or have them email it to you in case you have problems during the application process.

If you are no longer able to work because of a severe impairment or combination of impairments that is expect to last for at least 12 months or end in death, you should file a claim for disability benefits. We can help you determine the best time to file and help you understand the process.

There is a two year waiting period for Medicare benefits. Medicare benefits will normally begin within 24-months of your onset date.

Yes, there is a five-month waiting period for SSDI benefits. The waiting period will affect when you will be entitled to your first SSDI benefit check if you are found disabled.

If you have worked and paid social security taxes into the system, your children may qualify for benefits on your record. Typically, your children would be eligible for 1/2 of your PIA or personal insured amount.

In certain circumstances your claim for benefits can be expedited. One reason may be if you have a terminal illness. If you have a terminal illness, notify our office immediately and we will help you get the documentation necessary to turn in to SSA.

Another circumstance that may speed up your case is if you are in a dire need situation. Some examples of a dire need situation would be home foreclosure, bankruptcy, etc.

Social Security also has a class of conditions called “Compassionate Allowances” the list of qualifying conditions can be found at

https://www.ssa.gov/compassionateallowances/conditions.htm

There are many variables that can factor into determining the proper “onset” date in a disability case. If you’ve worked five out of the last ten years, we can meet with you and help you determine the most advantageous date to maximize your past-due benefits and document any issues necessary to support the date we choose. This is important because SSA can potentially pay you up to 12 months of benefits prior to your application date. That’s why we suggest consulting us before filing your claim and let us determine the best “onset” date for you and not leaving it up to SSA to “pick a date” for you.

Though not required, a supportive medical opinion from your doctor can sometimes help your case. The ALJ will determine how much weight to give that opinion based on a number of factors such as: the specialty of the doctor, the length of the treating relationship, how consistent the opinion is with other evidence in your file, and other factors. At Southeastern Disability, we have a library of specialized forms that you can take to your doctor to get completed.

Michigan Workers Disability Compensation Act

Act 317 of 1969

The ACT was created to revise and consolidate the laws relating to worker’s disability compensation; to increase the administrative efficiency of the adjudicative processes; to improve the qualifications of the persons having adjudicative functions within the worker’s compensation system; to prescribe certain powers and duties; to create the board of worker’s compensation magistrates and the worker’s compensation appellate commission; to create certain other boards; to provide certain procedures for the resolution of claims, including mediation and arbitration; to prescribe certain benefits for persons suffering a personal injury under the act; to prescribe certain limitations on obtaining benefits under the act; to create, and provide for the transfer of, certain funds; to prescribe certain fees; to prescribe certain remedies and penalties; to repeal certain parts of this act on specific dates; and to repeal certain acts and parts of acts.

View the Workers Disability Compensation Act of 1969 on Michigan Legislative Website

Your Rights Under the Act

Medical Care

You are entitled to reasonable and necessary medical care for work related injuries or diseases. This includes medical, surgical, nursing and hospital services, and, under certain conditions, dental care, crutches, and such artificial appliances as limbs, eyes, teeth, eyeglasses and hearing aids.

Employers or their insurance carriers are required by law to provide these services. During the first 28 days of treatment your employer has the right to choose the physician. After 28 days you are free to change physicians, but you must notify your employer of the change.

Compensation for Wage Loss

You are entitled to weekly compensation benefits, which may be claimed as long as a disability and wage loss continue.

Prompt Payment

Prompt payment of benefits is required by law. The first payment is due on the 14th day after your employer has notice or knowledge of a disability or death, and all compensation accrued should be paid weekly.

Coordination of Benefits

If you are eligible for or are receiving old-age social security benefits, pension or retirement benefits, or benefits under a wage continuation plan, self-insurance plan or disability insurance policy paid for by your employer, there will be an offset or coordination of benefits. This does not apply to specific losses such as fingers, eyes, arms, and legs, nor does it apply to social security disability insurance benefits.

Vocational Rehabilitation

If you are unable to perform the work that you have done previously, you are entitled to vocation rehabilitation with the number one goal being a return to your previous employer. If you cannot do this or require assistance in finding a new job, vocation rehabilitation services are available.

Hearing/Mediation

If you disagree with any decision of your employer or their insurance carrier, you may file an application for hearing, which we can help you with.

CIVIL LAWSUITS

Can a worker sue for damages other than workers’ compensation?

An individual injured at work can only receive workers’ compensation benefits and cannot sue for other damages. This is provided for in Section 131 of the Act. There are a few exceptions to this rule.

When can a worker sue his or her own employer?

Intentional torts

Section 131(1) provides that an “intentional tort” is an exception. This means that if an employer deliberately takes an action that is specifically intended to injure a worker, the worker can sue the employer.

Suits based on contract or other statutes

There are other laws that give workers a right to sue their employers. These include Civil Rights statutes, labor laws, and other similar Acts. The workers’ compensation law does not deprive a worker of the right to sue under those circumstances. Workers may also have a right to sue their employer if there was a contract between them, which the employer breached.

Generally under these circumstances the worker is not suing as a result of a “personal injury or occupational disease.” It is lawsuits based on an injury or a disease that the Workers’ Disability Compensation Act prohibits.

Uninsured employers

Section 641(2) of the Act provides that if an employer is covered by the Act but fails to provide security for workers’ compensation, a worker who is injured on the job may sue that employer for civil damages.

Retaliation

Section 301(11) of the Workers’ Disability Compensation Act provides that an employer cannot discriminate against an employee because the employee exercised his or her rights under the Workers’ Disability Compensation Act.

Think you need a lawyer? Do you have any questions?

You may be entitled to receive workers’ compensation if you are suffering from any of the following injuries:

Slip and fall injuries

Back and spinal cord injuries

Facial injuries

Traumatic brain injuries

Crush injuries

Burns

Loss of vision

Overuse injuries

Chronic pain

Hearing injuries

Injuries caused during transportation while on-the-clock

Injuries caused by large machinery

Chemical or toxin exposure

Soft-tissue injuries

Cuts, lacerations, or sprains

Broken bones and fractures

So what qualifies as a work related injury? Almost any injury that was sustained while the employee was on the job or participating in a job-related activity could entitle them to receive workers’ compensation.

My office may be able to provide you with representation if you have been a victim of any of the following accidents:

Slip and fall accident

Auto vehicle accidents

Machinery accident

Workplace violence or assault

Climbing accidents including falling from a ladder or scaffolding

Overexertion or overuse of a particular body part

Crush injuries

Others

Michigan law requires that you file a workers’ compensation claim within 60 days of the initial injury. Failure to do so could result in a rejection of the claim.

If you were injured as a result of a workplace negligence, lack of training, lack of safety equipment or signage, or if you suspect that your employer created a careless or illegal environment and you were injured as a result, you may be entitled to receive compensation.

Put A Work Injury Expert On Your Side

There’s so much to think about when you’ve been hurt on the job. Who will cover your medical care? How will you pay the bills? How is your employer required to help? Are you getting the proper medical care?

Your company is going to do what’s best for the company, which isn’t always what’s best for you. You need an advocate – someone on your side, who has experience, knows the system and can work hard for you to get the benefits you deserve.

Hiring a workers’ comp attorney costs you nothing up front (how we get paid), and it gives you the best chance to receive a fair settlement for your injuries. Your employer’s settlement offer may not cover all your lost wages or medical bills, and a work injury lawyer will work to recover those costs.

What We Do For You

A workers comp lawyer will explain how the system works, how it can help you after an at-work injury, how the law applies to you, who is considered disabled and injuries that usually are not covered. We can help you understand whether you qualify and what benefits you might be entitled to.

So, if your injuries are clearly work-related, require extensive medical treatment, involve long periods of time off work, or result in permanent disability, call us directly or request a FREE CASE review online.

Workers’ compensation benefits are ordinarily paid on a weekly basis. There are a number of circumstances, however, under which workers can receive a payment of benefits in a single lump sum.

When an employer has denied benefits and a case is eventually decided in favor of the worker, the worker is usually entitled to receive a large payment for past due benefits. Under these circumstances the worker receives a large lump sum payment but it is not in any way a “settlement” of the case.

Under the circumstances described above, the worker keeps his or her right to file a new claim if he or she has additional trouble in the future. In other words, if the worker has more medical bills or another period of disability involving that same injury, the claim can be reopened.

Sometimes cases are settled by a redemption. If a case is redeemed, the worker receives a single, lump sum payment from the employer and in return gives up all of his or her future rights to workers’ compensation benefits. Redemptions are valid only if they are approved by a magistrate after a formal hearing. At such a hearing papers are prepared that show exactly how much the settlement will be, where the monies will go and how much the worker will receive. The case and reasons for the settlement are then explained to the magistrate by the parties. The magistrate makes certain that the worker understands his or her rights. Only then will a magistrate approve such a redemption settlement.

If an employer is represented by an insurance company, it must be notified of any proposed redemption at least ten days before the hearing. It has a right to come to the hearing and object to the settlement.

Think you need a lawyer? Do you have any questions?

The timeline for Workers' Comp settlements varies based on several factors. If you are currently receiving workers' compensation benefits and the insurance company or employer is looking to settle, an agreement can sometimes be reached within a week or a month. However, additional issues such as Medicaid, Medicare, and Friend of the Court (FOC) liens need to be resolved before the case can be settled in front of a workers' compensation judge (magistrate). If your case involves litigation, it can take up to two years to resolve, though many cases are settled sooner if all parties agree on the conditions. Having a skilled attorney specializing in Workers' Compensation in Michigan is crucial for navigating these complexities.

Nearly all employers in Michigan are covered by workers’ compensation. This includes both public and private employers. In fact, when talking about workers’ compensation, it is easier to discuss the exceptions.

There are a few classes of workers who are covered by federal laws and are not covered by the Workers’ Disability Compensation Act of Michigan. Employees of the federal government (such as postal workers, employees at a veterans administration hospital, or members of the armed forces) are covered by federal laws. People who work on interstate railroads are covered by the Federal Employers Liability Act. Seamen on navigable waters are covered by the Merchant Marine Act of 1920, and people loading and unloading vessels are covered by the Longshoremen’s and Harbor Workers’ Compensation Act. Virtually all other workers and employers are subject to Michigan’s Law.

Certain very small employers are exempt. If a private employer has three or more employees at any one time, or employs one or more workers for 35 or more hours per week for 13 or more weeks, the employer is subject to the Workers’ Disability Compensation Act. (Section 115)

Workers' compensation covers injuries that occur at work or arise out of employment. While it's usually clear if an injury happened at work, there are cases where this can be questionable.

Generally speaking, if a worker is injured on the way to or from work, he or she is not covered. If, however, the worker is on the employer’s premises when injured, then he or she is covered.

If a job requires a person to travel, he or she is covered while traveling. However, if the worker “deviates” from the business travel, he or she may not be covered.

The courts have recognized that a certain amount of “horseplay” is to be expected on most jobs and that if a worker is injured as a result of such horseplay, that injury is compensable. The courts have also held, however, that there is a limit to this situation. If the worker is injured as a result of his or her “intentional willful misconduct,” he or she is not entitled to benefits. The courts have held that if an injury results from a violation of a rule, which is clearly announced and regularly enforced by the employer, the worker is not entitled to workers’ compensation benefits.

Sections 301(4) and 401(1) of the Workers’ Disability Compensation Act state:

As used in this chapter, “disability” means a limitation of an employee’s wage earning capacity in work suitable to his or her qualifications and training resulting from a personal injury or work related disease. The establishment of disability does not create a presumption of wage loss.

In order to receive benefits, a worker must be “disabled” as defined above. However, the fact that a worker is disabled is not enough to obtain benefits. In addition to being disabled, the injury or disability must be work-related and there must be a wage loss. Benefits can also be denied if the worker has refused a reasonable offer of employment or has established a wage-earning capacity.

Section 373 of the Act contains a special definition of disability for retirees. It makes it harder for a retiree to obtain benefits. A person is considered a “retiree” if he or she is receiving a pension or retirement benefit (but not a disability pension) that was paid for by the employer. To be disabled, a retiree must prove that he or she is unable “to perform work suitable to the employee’s qualifications, including training or experience.”

Yes, the work must “cause” the disability. If John Doe simply comes down with the flu while on the job, he is probably not entitled to workers’ compensation benefits. The work must somehow be the cause of the disability.

The work does not have to be the only cause. It is enough if the work causes, contributes to, or aggravates a condition which results in disability. Some of us can lift 200 pounds without any difficulty. Some of us, however, would severely hurt our back if we lifted 100 pounds. The law does not make this distinction. If a person does something at work that causes him or her to become disabled, the worker is entitled to benefits. It does not matter if there was some pre-existing weakness or if the worker was born with some condition that made him or her more susceptible to injury. This is an old principle of law that has been applied by the courts to all kinds of damage actions, including workers’ compensation.

There are some special rules for certain conditions. In cases of heart disease, mental disabilities, and conditions of the aging process, the worker must prove that the employment aggravated or accelerated the condition in a significant manner. In cases of mental disability, the condition must be caused by actual events of employment. A worker is not entitled to benefits if he or she simply imagined something at work which caused the disability.

Death claims and disability claims are managed similarly under the Act, with identical coverage rules. However, death claims require a dependent to receive wage loss benefits. If a worker without dependents dies on the job, their estate can receive a burial allowance of up to $6,000.

'Specific loss' benefits are detailed in Section 361 of the Act. For example, if a worker loses a thumb on the job, they are entitled to 65 weeks of compensation, regardless of disability or wage loss. If the worker recovers and returns to work after two weeks, they still receive benefits for the remaining 63 weeks. If complications prevent the worker from returning to work, their situation is evaluated like any other general disability. Benefits are calculated similarly to other injuries, with a minimum rate of 25% of the state average weekly wage for specific losses, ensuring even low-wage workers receive adequate compensation.

The workers’ compensation law provides a strict limit on the benefits that an individual can receive as the result of a job-related injury. A worker can only receive certain specified (1) wage loss benefits, (2) medical benefits, and (3) rehabilitation benefits. Each of those benefits will be discussed in the following sections.

In the ordinary case a worker receives 80 percent of the after-tax value of his or her wage loss. It does not matter whether the worker is “totally” or “partially” disabled. Benefits are based on the wage loss and set at 80 percent of the after-tax value of the loss. (Total and permanent disability is a special category.)

Thus, if Jane Smith is unable to work, a determination would be made of her “average weekly wage” before her injury and she would be paid benefits equal to 80 percent of the after-tax value of that amount. If she returned to work and because of her injury received wages less than her average weekly wage, she would receive benefits equal to 80 percent of the after-tax value of the difference.

Prior to 1982 the basic rate of benefits was two-thirds of the worker’s gross average weekly wages rather than 80 percent of the after-tax value of his or her wages. When this law changed, it was also provided that if the two-thirds formula subject to the 1981 maximum limitation would result in a higher rate, the worker is entitled to receive that rate. The tables published by the bureau for calculating the compensation rate indicate when this situation applies.

Under certain circumstances the value of fringe benefits may be included in determining the average weekly wage. “Fringe benefits” include things such as the cost of health insurance, employer contributions to a pension plan, and vacation and holiday pay. Sometimes when a worker is injured, the company continues to provide fringe benefits. There is nothing in the law that requires the company to do this.

However, if benefits are not continued, the worker has suffered a greater loss of income. The value of fringe benefits that are not continued is added to the value of the cash wages to determine the worker’s average weekly wage. There is a limit, however. Fringe benefits cannot be used to raise the benefit to more than two-thirds of the state average weekly wage.

If a minor is illegally employed and gets injured, they are entitled to double compensation under Section 161(1)(b). This rule does not apply if the minor used fraudulent permits or age certificates to obtain the job.

If a worker is employed by more than one employer at the time of injury, the earnings from both employers are added together to calculate the average weekly wage. The worker’s benefits are based on the total wages from all employments. If the job in which the worker was injured accounts for more than 80 percent of the worker’s wages, that employer is responsible for all the benefits owing. If, however, that employer was responsible for less than 80 percent of the worker’s wages, it pays the entire benefits, but is reimbursed a proportional amount by the Second Injury Fund.

Section 315 of the Workers’ Disability Compensation Act provides that a worker is entitled to all reasonable and necessary medical care. This includes medical, surgical, and hospital services, dental services, crutches, hearing apparatus, chiropractic treatment and nursing care. The responsibility to provide medical care continues indefinitely so long as the need for the care is related to the industrial injury.

During the first twenty-eight (28) days of treatment the employer has the right to choose the doctor. After that the worker is free to change doctors if he or she so desires. The worker, however, must notify the employer of the change.

In practice, many large employers have company doctors. The worker ordinarily seeks treatment from the company doctor first. If the assistance of a specialist is necessary, the company doctor refers the worker to such a specialist. Small employers, on the other hand, often tell their workers that they should go to their family doctor or some other physician in the community.

Section 319 of the Act provides that a worker has a right to vocational rehabilitation benefits. Vocational rehabilitation can include a whole variety of things. It might simply mean that the employer makes some minor change in the worker’s job station so that he or she can return to the work in spite of some continuing problem. It might mean that an outside rehabilitation counselor will work with the employer and the employee to aid in a return to work at the same job or a similar job with the same employer.

It might mean that a vocational rehabilitation agency, either a state agency or private agency, will help the worker find a job with some other employer.

It might involve short-term training to help the worker find a new job or in some unusual circumstances, long-term re-education. In the appropriate circumstance an employer can be required to provide up to two years of vocational rehabilitation services.

Get A Free Case Review

Let’s discuss your disability or workers’ comp claim.

The consultation is 30-60 minutes long and can be conducted in person, via email or over the phone. We’ll discuss your claim, determine if you need representation, go over how our fees are paid (only if we win). If you are appealing an adverse decision, we will be honest regarding your chances of success after reviewing all the facts.

If you’d like us to review your case, please call or complete the form below to schedule it.

Note: We keep your information strictly confidential. Free means free. We don’t get paid until we win.