Workers’ compensation (workers’ comp) helps people who get hurt or sick from the work they do. Wage loss benefits are a type of workers’ comp benefits. For general information about workers’ comp, read An Overview of Workers’ Compensation Benefits.
The Michigan Workers' Disability Compensation Act (Act) established protections for workers who get sick or injured from the work they do. It makes benefits available to most workers no matter who is at fault for the injury or illness.
The Michigan Department of Labor and Economic Opportunity, Workers' Disability Compensation Agency (Agency) is in charge of administering those claims.
You could get wage loss benefits if your injury or sickness results in a disability. A worker has a disability if the injury or illness limits their ability to earn wages. You need to share information about your qualifications at the time you get injured or sick. This can include education, training, work experience, and other skills. These things don’t necessarily have to be related to the work you were doing at the time you got sick or injured.
If you file a claim for wage loss benefits, the Agency will look at what jobs you can do now that you are injured or sick that will earn similar wages to the amount you earned before. To get benefits, you must show that you can’t earn what you did before because of the injury or illness. The Agency will look at your qualifications and training when deciding if your ability to earn wages is limited. You must show there are no jobs you can do now based on your qualifications that would earn as much. If there are jobs that you are qualified for that would earn as much, you need to make a good-faith effort to get those jobs.
If you start working at a job that pays less, you could get partial wage loss benefits to cover the loss of income. If you get a job that pays the same or more than your job where you were injured or developed an illness, you will not get wage loss benefits.
If your employer, their insurance company, or the Agency believes that you can do some type of work to earn money, they will expect you to. If you don’t agree with that decision, read the section “Disputed Claims” below.
If your injury is related to a loss of a body part, such as an eye or a hand, this is known as a “specific loss.” There are benefits for each specific loss. Section 2 of MCL 418.361 lists the different benefits for specific loss. This is known as the “schedule of disabilities.”
Getting Your Benefits
After you report your injury, there is a seven-day waiting period before you can get wage-loss benefits. The seven days include weekends and holidays. You are eligible for benefits on the eighth day. This means if your injury does not last that long, you will not get wage loss benefits. If you stay out of work for at least 14 days, you can get benefits for the first seven days you were out of work.
Weekly benefits are about 80% of your wages after taxes. Your first payment is due 14 days after the onset of your disability. However, your first payment isn’t considered late until 30 days after the due date of your benefits.
The Amount of Benefits You Will Get
The Agency uses your average weekly wage (AWW) and the state average weekly wage (SAWW) to decide your benefit amount. To get your AWW, the Agency looks at your highest 39 weeks of gross wages of the last 52 weeks, leading up to the date of injury/illness. They calculate the average of these 39 weeks to get your AWW. This means the amount of time you’ve been with an employer could affect the AWW. Sometimes the value of fringe benefits you’re no longer getting because of your injury or illness are calculated into the AWW. Examples of these benefits are the cost of health insurance, employer contributions to retirement plans, and paid time off.
To get the SAWW, the Agency does the same calculation but uses the average wages on a state level. The Agency provides a chart of the SAWW for every year.
The Agency has a different way of deciding the benefit amount if you worked less than 39 weeks in the year leading up to your injury or illness. To learn more, contact the Agency or a lawyer for help. Use the Guide to Legal Help to find lawyers in your area.
You can use the Benefit Calculator on the Agency’s website to get an estimate of your weekly wage loss benefits.
The Maximum Amount of Wage Loss Benefits
There is a cap to the benefits you can receive. The Act says that the most you can get is 90% of the SAWW. No one can get more than that amount, no matter how much the worker’s actual salary is or was.
Generally, there is no minimum amount of benefits. For specific loss injuries, there is a minimum amount you are guaranteed to get. That amount is 25% of the SAWW. Workers who are totally and permanently disabled will also get at least 25% of the SAWW.
Getting other benefits could affect your wage loss benefit amount. To learn more about this, contact the Agency, or use the Guide to Legal Help to find lawyers in your area who could help you.
A worker’s benefit amount could change based on the number of dependents they have. A dependent of a worker is someone who is related to the worker, and who receives at least half of their financial support from the worker. A child of a worker who is younger than 16 is presumed to be a dependent of that worker. However, spouses, parents, and siblings can also be considered dependents. It may be harder to show someone is a dependent if a person is not a child under 16. People who have those relationships may want to speak with a lawyer for help. Use the Guide to Legal Help to find lawyers in your area who could help.
If a worker dies from their injury or illness, their dependents are entitled to at least 50% of the SAWW. A dependent must show that the work performed by their family member was the “proximate cause” of the death. The Michigan Supreme Court has said the proximate cause is “the one most immediate, efficient, and direct cause” of death.
Your responsibilities for getting workers’ comp begin by promptly reporting your injury or illness to your employer. Once you are getting benefits, you must let your employer or their insurance company know if you are getting income from work. You cannot get workers’ comp if you are working and earning the same amount or more than you did before you were injured. The two exceptions to this are if your disability is total and permanent or if you lost a body part as a result of the injury (specific loss).
To continue getting your benefits, you must do all of these:
- Look for jobs that you are able to do with your injury or disability
- Agree to reasonable medical exams if your employer or their insurance company requires them
- Continue rehab that will help you return to work
- Accept employment offers if you are physically able to do the work
Many benefit claims are undisputed. However, when there is a dispute, the Workers’ Compensation Board of Magistrates hears them. In most cases, neither the worker nor employer can take a workers' comp issue directly to court.
If your claim is disputed by your employer or their insurance company, you will need to file form WC-104A, Application for Mediation or Hearing with the Agency. Depending on the facts of your case, the Agency will schedule your case for a mediation or a magistrate hearing.
The Agency will schedule your case for mediation if any of these are true:
- Your employer does not have workers’ comp insurance;
- Your claim is only for vocational rehabilitation services or only for medical benefits;
- You do not have a lawyer;
- The Agency believes the dispute could be resolved by mediation.
If none of those situations apply to your case, the Agency will schedule your claim for a hearing in front of a magistrate. If your case starts with mediation but is not resolved, the Agency will schedule it for a hearing in front of a magistrate.