By Donna Motley, Vice President of Claims
Do you believe in angels, ghosts or aliens from outer space? If not, is it because you have never seen one? Well, the average person cannot see the little bug causing havoc with the “world”, but we have “proof” it was here, is here and continues to be here! Something we cannot see is changing the way we live and go about our daily activities. Fall weather has arrived and we are fast approaching winter. And we are still under the watchful eye of COVID-19. Some restrictions have been partially lifted but we are a long way from “life as we knew it” prior to March 2020.
The Workers’ Compensation arena has been affected as well. As you may recall, doctor’s offices were closed for a short period, then only saw patients via telemedicine. While telemedicine was instrumental in a patient being able to be evaluated, the visits technically do not qualify as a form of treatment. Without an actual physical examination, doctors appeared to be somewhat reluctant to do more than prescribe the injured worker to “stay the course”. Of all the cases we handled during that time, not one patient was discharged from care via telemedicine. Typically, a medical professional would want a physical exam of the patient before declaring a full recovery and recommending a return to all normal activities. This results in continued lost wages if the injured worker had previously been diagnosed as disabled from working, and the added fee for a return visit.
The State of Michigan Workers’ Compensation Claims Adjudication Agencies, for all practical purposes, are still closed – unable to abide by CDC guidelines at this time. Our department has participated in Zoom Court hearings and Facilitations. We have been able to settle some cases by way of Redemptions – but nothing has been done in person. For the most part, cases are simply being put over one, two or even three months to another hearing date, with nothing further being accomplished on the case. Our experience has been that most plaintiff attorneys are doing NOTHING! Which I don’t understand, because plaintiff attorneys are paid only once a case settles (they get a percent of the settlement). Defense attorneys, those representing MTMIC and our insureds, are paid an hourly rate. So, are we pushing to settle cases? Absolutely!
Has the delay in settlement had an impact on the settlement figures? Absolutely! Some plaintiff attorneys are of the opinion that as long as the injured worker remains without settlement, disability continues and wage loss continues to accumulate – even though they are not earnestly working toward reaching a settlement. Plaintiffs are of the opinion that looking for work in a COVID environment further jeopardizes their health, thereby keeping them disabled.
On the flip side, we push for settlement knowing the injured worker may be without any income. We push that there are an abundance of jobs available for immediate employment. The delay in settlement also provides us with an added opportunity for surveillance to aid our defense. Either approach can result in additional monies being spent on the case.
Now, with the recent Supreme Court ruling against Michigan’s Governor Whitmer, thereby rendering various previous Orders invalid, some obviously impacting Workers’ Compensation, we wait to see what happens next. Our department has been in the office every day since the onset, and will continue to be here working with your best interest at the foreground!
