By Donna Motley, Vice President of Claims

Workers’ Compensation insurance coverage is mandated in the State of Michigan. Even so, Workers’ Compensation is a “benefit” to the employee (and the employer). Employees are “entitled” to medical care and compensation should they have an injury while in the course of employment. But that does not allow the injured worker to have an “entitlement attitude”. Workers’ Compensation is not a “social program”. Benefits are governed by laws that were enacted over 100 years ago. Those laws have been periodically modified to change with the times. When you talk about laws, you are talking about attorneys – hence the modifications! Our success in the Workers’ Compensation courts is strongly influenced by the current political arena in our State at that time.

Employers know the part they play in the process: safety programs, safety training, drug screening, employment physicals, prompt reporting of injuries, accident investigations (and preventions).

The Workers’ Compensation carrier/professionals know the part they play in the process: investigating facts surrounding reported injuries, providing prompt and appropriate medical care, providing wage loss benefits when appropriate – all with a common goal of a successful physical recovery and return to productive employment. Again, what the Workers’ Compensation carrier provides is governed by law.

But what about the injured worker? What is their role in the process? What are their responsibilities? Well, their role certainly is not to play the part of victim! While some injured workers may simply be in the wrong place at the wrong time when an injury occurs, more often than not, the injured worker played a part in their own injury. Were they taking a short cut, not following proper procedures, utilizing proper safety precautions? Did they come to work tired, stressed out, pre-occupied or hung over from the night before?

Once an injury has occurred, did the employee report it promptly and to the appropriate personnel? Once medical treatment was administered, did they follow the doctor’s instructions? Take their medication as prescribed? Or were they seeking medical treatment on their own? Are they attending all of the scheduled medical appointments? Are they giving maximum effort in physical therapy? Doing their home exercises?

It is the injured worker’s responsibility to keep their employer informed of their work status and provide the employer with a disability slip after every doctor visit. If restrictions are imposed, the injured worker should ask the employer if there is work they can do within those restrictions. (Restricted or light duty work does not have to be at the same rate of pay or on the same shift. However, if at a different rate of pay, Workers’ Compensation would have to pay a differential.)

Did the injured worker provide the medical provider with the Workers’ Compensation carrier contact information? Or did they give the provider their Health Insurance information? Is the injured worker receiving medical bills or statements related to the injury? If so, are they bringing them to the employer to turn in to the Workers’ Compensation carrier? Before they go to a “collection agency”!

Just about every injured worker we talk to says they “can’t wait to get back to work”. However, their actions don’t always indicate the same. Do they have a positive attitude or are they focusing on the negative? I’ve had claimants say “Just fix me” or “I’m not 100%” – well, whether you feel medicine is a science, an art form or just plain voodoo – doctors are trying to mend a broken body – not repair a machine. And in this world of entitlement in which we live, there are people who feel they are “owed” something or “entitled” to more because … ? Then we have litigation!