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Workers Comp Statute of Limitations? Michigan

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  • Workers Comp Statute of Limitations? Michigan

    I received a call from an employee who worked for our company for two months in 2006. He sustained a toe injury during work, went to the hospital for treatment, came back to work and stopped showing up after a few days. He is now saying that we need to pay a hospital bill that remains unpaid, and that he left work because of his injury. I have no records or no previous manager to talk to about this (ouch, I know). Is there anything in the law about the timing of filing a claim?

  • #2
    Do you have any documentation that the injury happened at work? An accident report? Anything?

    If you do then I would submit anything you have to your work comp carrier and they will deal with the claim from that point on.

    Comment


    • #3
      Pg 29/30 here http://www.michigan.gov/documents/wc...4_135317_7.pdf provides for a 2 year SOL for filing a claim.
      The first report of injury however must be made to the ER with 90 days of knowledge of a work related occurrance/injury.
      He is now saying that we need to pay a hospital bill that remains unpaid, and that he left work because of his injury.
      Either the EE, or the provider should have presented the bill to the ER/IC. To wait nearly 3 years is questionable at best.

      That the EE/IW left/abandon the job 'due to the injury', would have to be a medical decision to be compensable. Or through a comp court order...

      Was there a IC providing benefits on this claim...? If so, hand this over the them...That's what premiums are paid for.
      If on the other hand, your ER is legally self insured... you should have complete records of the injury/claim. (somewhere...?)

      What happens in the ordinary case? Answer...http://www.michigan.gov/wca/0,1607,7...867--F,00.html

      What other time limitations apply?

      Answer:
      Circumstances can arise under which a worker has given the proper notice and made a proper claim but for various reasons benefits were not paid. Sometimes many years go by before a worker files an application for hearing. Section 381(2) provides that in those cases the worker cannot receive past due benefits for more than two years back from the date he or she filed an application for hearing.

      Section 833(l) deals with the situation in which a worker receives benefits which are then stopped and the worker later files an application for hearing to have benefits started again. Ordinarily a worker would do this shortly after benefits were stopped. Sometimes, however, this is delayed for a long period of time. Section 833(l) provides that under these circumstances the employer cannot be ordered to pay benefits for more than one year back from the date the application is filed with the bureau.

      Sometimes, for various reasons, an employer pays a worker more benefits then he or she is entitled to. Under those circumstances the employer has a right to recover that overpayment from the worker. Usually this is done by reducing future benefits by a specified amount until the overpayment is recovered.

      Section 833 provides that the employer cannot recover for an overpayment which was made more than one year prior to the date it takes action to recover that overpayment.
      What reports is an employer required to file concerning workers' compensation?

      Answer:
      Benefits are ordinarily paid by the employer or its insurance carrier to the worker. Unless there is a dispute, the Workers' Compensation Agency does not get involved. Sections 801, 805, and Rules 1 and 2, however, require that certain events be reported to the agency.

      If an injury results in death, a specific loss, or a disability of seven days or more, the employer is required to report that injury to the agency on a Form WC-100. (Injuries that require medical treatment but do not result in a disability of seven days do not need to be reported.) In the case of death, a Form WC-106 must also be filed.

      When an employer begins paying benefits or the benefit amount is changed, or if benefits stop, this is reported to the agency on a Form WC-701.

      Comment


      • #4
        Thank you, both. I will forward to the provider and let them sort it out. I am also looking for ways/facts to diffuse this person, perhaps tell him it is up to the provider, since this ex-employee went to the workplace and started yelling at the ladies at the front desk.

        Comment


        • #5
          I am also looking for ways/facts to diffuse this person, perhaps tell him it is up to the provider, since this ex-employee went to the workplace and started yelling at the ladies at the front desk.
          It would be a determination to be made by the IC... they are the party providing the benefits to cover your industrial injuries. Once an ER files the claim for benefits under their plan...the IC becomes the 'ER' for all intent for the duration of the claim.

          If the misconduct continues, you'll have to notify the policy of the disruption of business...that is never called for, current or ex employee.

          Comment

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