By Donna Motley
Vice President of Claims

A little bit of a refresher course

How do we determine an injured employee’s Workers’ Compensation weekly benefit amount? To calculate an average weekly wage, we need 52 weeks of gross wages dating back from the date of injury. This includes overtime and bonuses. Of those 52 weeks, we pick out the highest 39 weeks. This gives the injured worker the highest possible average weekly wage. If an employee has only worked 20 weeks prior to the date of injury, the average weekly wage would be based upon 20 weeks of gross weekly wages divided by 20. If an employee is injured their first week of work (and yes, this does occur), the employee’s hourly rate is multiplied by 40 if the employee was hired to work 40 hours per week, to establish the average weekly wage. Based on the employee’s average weekly wage, tax filing status and number of claimed dependents allowed by Workers’ Compensation criteria, the State of Michigan provides the weekly benefit rate.

Workers’ Compensation wage loss benefits commence after the injured worker has been taken off work (disabled) more than 7 consecutive days. If the employee can return to work within the first 7 days, no wage loss benefits are payable. If the employee returns to work after 7 days but before 14 days, wage loss benefits are paid for the days missed between 7 and 14. If an employee is disabled by the treating physician for more than 14 consecutive days, wage loss benefits commence the day “after” the injury and continue until released to return to work, the first payment covering the first 14 days. Benefits are paid weekly after the first 14-day period.

Wage loss benefits are “non-taxable” income. Taxes are not deducted, and the money is not claimed at the end of the year. If an employee is collecting Workers’ Compensation wage loss benefits and is released to return to work, MTMIC files a State form and sends a copy to the employer and employee indicating the total amount of benefits paid and the dates of disability.

Our Department is seeing more claims of injured workers over the age of 65 – the historical age of retirement. The average weekly wage and weekly compensation benefit rate are determined in the same manner as outlined above. However, there is a difference – that being at age 65 the weekly compensation rate is reduced 5% per year until the weekly benefit rate is reduced by 50%. If the injured worker, 65 or older, has started collecting (old age) social security benefits we can coordinate with said benefits instead of the 5% per year reduction. We are allowed a one-time change regarding the method in which we reduce benefits based on age. We can reduce by the method that provides the largest reduction.”

Now for “WHAT’S NEW”

Within the next few months MTMIC is rolling out a NURSE TRIAGE PROGRAM. This will entail a 24 hour hot-line that injured workers, with employer authorization, can call and receive, basically, telemedicine. A qualified medical professional (i.e., Nurse) will speak with the injured worker and make a medical determination as to necessary form of treatment. MTMIC, as your Workers’ Compensation carrier will receive a report of the call and medical recommendation(s). This will provide instant reporting, immediate medical attention, reduction in lost production because of the injury and a reduction reflected on your Loss History – all impact the employer’s bottom line. Sounds like a WIN all around! Look for more details coming soon!!!!”