Episode 13 – Michigan No Fault Catastrophic Claims

 

Catastrophic Claims Under Michigan No-Fault Law

Michigan No-Fault law has a section called catastrophic claims. These are for claims of people that are seriously injured in an automobile accident and their expenses are over half a million dollars.

What Happens With Catastrophic Claims In Michigan?

In cases like this, each case is assigned a new insurance company through what is called the catastrophic claims, and they pay for medical expenses for the rest of that person’s life for any injury related to the automobile accident.

How Are Catastrophic Claims Funded In The State Of Michigan?

This is funded by each of us through the cars we owe. If you have no fault insurance on a motor vehicle, currently, you’re paying roughly two hundred dollars a year extra and that money funds the catastrophic claims. it’s an excellent program that helps the seriously injured.

It Is Important To Keep Catastrophic Claims As Law In Michigan!

Sometimes there’s a challenge to this program due to its cost, however, and there’s been the discussion of trying to change the law in Michigan. So if it ever comes up, you’ll know what it means when they talk about catastrophic claims – it covers the very seriously injured. It’s extremely important to have and Michigan should keep it. There’s arguments that it could be managed better, but it’s a good program and should be kept in place. I encourage you to contact your state representatives and senators to support the program if there’s another challenge to it.

Contact Me If You Have Any Questions Or If You’ve Been In An Automobile Accident

I’ve been representing people injured in auto accidents here in Shiawassee County for over 30 years. Please call me at (989) 725-8118 for a free consultation.

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Episode 12 – Worker Comp Pre-exiting Condition Law In Michigan

Workers Comp Pre-existing Conditions Law in Michigan

A Pre-Existing Condition Can Still Be Covered Under Michigan Workers’ Compensation Law

If you’re injured on the job and have a preexisting condition, the question always comes up. If it’s work-related, a pre-existing condition can still be covered under Michigan Worker’s Compensation Law. So if you have a bad back, and you hurt it again at work, you may still have coverage.

There have been changes in Michigan Law on Pre-existing Conditions

However, there’s been lots of changes in this area. It used to be under the old rules, If you just had a flare up of your symptoms on a pre-existing condition and that prevented you from working, that was enough to have coverage under worker’s comp. But now you have to show that the work injury itself aggravated or changed the underlying pathology in order for it to be covered. This is a significant difference: Symptoms versus underlying pathology.

How to Show Changes in Underlying Pathology

The doctor’s opinions on this is critical in these cases. The best way to show that your work injury changed your pre-existing condition is usually by a diagnostic test, showing a change in the x-ray or a change in an MRI. But it can also be shown clinically.

It’s critical to let the doctor know your history. So even if you did have a bad knee going into the job, if you hurt that knee again, make sure the doctor knows that. But also make sure the doctor knows how significant that work injury was and how much more symptomatic (if it is) that injury is now.  History is the most important thing medically to show in order to get coverage.

 Don’t Believe Insurance Companies That Tell You Pre-existing Conditions Are Not Covered!

insurance companies will tell you if you have a preexisting condition, you do not have worker’s compensation coverage. This is not true. Do not accept that. If you have any questions on that, always talk to worker’s compensation lawyer. You can call me at (989) 725-8118 if you have any questions.

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Podcast Episode 11 – Auto Owner Liability In Michigan

Automobile Insurance And Owner Liability in Michigan

If you own a motor vehicle, you’re responsible for anybody that that vehicle hurts, which means essentially, if you loan the car to somebody and they get in an accident, you’re responsible as the owner of that vehicle, hence owner liability. It’s not important so much as to whether you’re driving or someone else is driving. Whether the car is involved is yours is the issue.

Do Not Register A Vehicle In More Than One Name In Michigan

A lot of people who are married have more than one vehicle. Many people have a vehicle and both their names. I do not recommend that!  You should never have a vehicle and both the husband and wife’s name or spouse and spouse.  Only register a car in one name. You put the insurance in both names, but not the vehicle. The reason is this: Someone gets in an accident in that car that’s in both your names. That means both of you could be sued for that accident. If they get a judgment against you, they can then go after property that’s in both your names, such as your house. If only one name is on that vehicle and the house is in both your names, you have some protections. Don’t give up those protections by putting the car in both your names. One name, one vehicle.

What If Someone Takes My Car Without My Permission?

Someone’s driving your vehicle without your permission. Then you’re not responsible at all. So if you ever have any questions, give me a call (989) 725-8118.

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Episode 10 – Medicare and Medicaid

 

There are two types of government benefits for health insurance: Medicare and Medicaid. Medicare is for the elderly and the disabled. Medicaid generally is for the poor.

What Is Medicare?

You’re entitled to Medicare if you’re over sixty-five or if you are disabled and drawing Social Security disability benefits. Medicare begins two years after you start receiving Social Security disability benefits why they have a two-year wait for the Medicare. I cannot tell you why, but if you become disabled today, you will not get Medicare until two years after your benefits start.

What Is Medicaid?

Medicaid, as most people are familiar with, are benefits of health insurance, either through the state or federal programs if you meet certain poverty levels or income levels. That’s changed a lot over the years, especially with the Affordable Care Act (ACA) and other changes under Michigan law.

A few years ago, not many people at all received Medicaid, then they changed the rules under the ACA and many people qualified for it. (Thank goodness, because most of my clients were without insurance until then). Now, however, they’ve changed the rules again, and they’ve implemented a rule that if you have no dependent children, even if you qualify for Medicaid income-wise, you have to either work twenty hours a week, do volunteer work, or be in school in order to continue your Medicaid coverage.

This is going to jeopardize a lot of benefits for people, especially people that can’t commit to twenty hours a week. If you have concerns about this, I strongly recommend you contact your congressman about it.

The Difference Between Medicare and Medicaid

Medicaid coverage actually is generally better than Medicare. Medicare is an eighty-twenty plan. Medicaid covers most any and all treatment. With few exceptions. The problem is sometimes is finding a doctor that’s willing to take on another Medicaid or Medicare patient.

You May Be Able To Qualify For Both Medicare And Medicaid

Some people qualify for both benefits, both Medicaid and Medicare. If you qualify for both, you pretty much have one hundred percent coverage.

Exceptions to Medicare Rules

There’s a couple of exceptions. In Medicare, for example, one is dialysis. If you have kidney failure and you’re on dialysis. You get Medicare automatically, even if you’re working. There’s no two-year wait. There’s, no need to show disability and there’s no need to analyze income.

See An Attorney If You Think You Qualify For Medicare Or Medicaid

There are different rules for both federal and state programs. It’s very tricky. If you think you may qualify, you can always check with DHS for any Medicaid benefits, but if you have questions on it, always talk to an attorney that’s familiar with the health insurance laws. Have any questions? Call me at (989) 725-8118.

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Episode 9 – Workers’ Comp Wage Calculations In Michigan

 

How are workers compensation wages determined? If you’re injured on the job and off work you’re entitled to wages but it isn’t full pay. Most people tell me is that as far as they’re concerned, their understanding is they get 80% of their pay. 

How Workman’s Comp Wages Are Calculated In Michigan

How it really works is this: They go by a formula – if you work someplace for over a year. You take the highest 39 weeks of the last 52 weeks you worked and average it out. We then plug that into a formula based on whether or not you’re married or single, or have dependent children. That is what we call your average weekly wage and your benefits are based on that.

The Maximum Worker’s Comp Benefit In Michigan Is $900

Currently, in Michigan, the highest you can be paid in workers compensation benefits is $900 a week. Every year they change the average weekly wage and increase typically the rate. How it works out for most people is generally 80% – but its 80% of your take-home pay – or 60% of your gross. This is not a rule. This is just a guideline. The formula determines how much you’re entitled to. 

How Much Am I Entitled To If I Worked Less Than A Year?  

If you worked in a place that you’re injured at for less than a year, they just add up the number of weeks you worked and divide that out by how much you made in those weeks. So if you were 10 weeks made $2,000 your average pay is $200.

Exceptions To The Michigan Workers’ Comp Rule

There are always exceptions to that. For example, if you get hurt the first week at work and or even the first day you worked, in those cases, it depends what you were hired for. Even in those cases, the average pay generally comes out to 60% of your gross. There are other factors as well – whether or not you’re entitled to fringe benefits such as health insurance, sick pay, disability pay things of this nature, that may or may not change your rate. As it currently stands though, no matter how much you made the most you can get from workers compensation is $900.

How Can I Figure What My Workers’ Comp Benefits Are?

The best way to determine this is to have it reviewed by someone that knows how to calculate this mathematically.  I can guarantee you any workers compensation attorney knows how to do that. If you ever have any questions on your rate whether or not you’re being paid correctly. Give me a call. 989-725-8118

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Episode 8 – Rules on Shop Doctors (“Shop Docs”) in Michigan

Shop Docs Law In Michigan

What is a “shop doc”?

I would like to talk about work injuries and in particular doctors who are referred to you by your employer after an injury on the job. Many of us are familiar with the term “shop docs” or shop doctors. That’s the doctor a lot of companies will send you to if you get hurt on the job factories, in particular, have a doctor that they always send somebody to.

Michigan Law: Have to see the Shop Doc for the Frist 28 Days

Now as you can imagine these facilities are paid by the employer and they’re looking out for the employer’s interest so they don’t always look out for the workers’ interest.  Unfortunately, under Michigan worker’s compensation law, you must treat with the employer’s doctor the shop doctor for the first twenty-eight days after you are hurt.

You Can Treat With Your Own Doctor, But Your Employer Doesn’t Have to Pay For It.

You can treat with your own doctor if you want. Unfortunately, your employer or their insurance does not have to pay for it in the first twenty-eight days after the injury. This leaves many people having to see the shop doc for a while.

You Are Entitled to Treat With Your Own Doctor After 28 Days In Michigan

What you need to remember is after twenty-eight days you are entitled to treat with a doctor of your own choice. Many, if not all, worker’s compensation insurance carriers and employers will tell you that’s not true. Don’t believe them!  You have the right to treat with your own doctor after twenty-eight days.

It’s important for this reason: You want to get better. Therefore, you want to treat with a doctor that you trust. The doctor that will look out for your interest not necessarily how to get you back to work.

You want someone who’s placing your interests first and you need to see a doctor that you can follow up with and trust.

Getting Authorization for Your Doctor to Treat After 28 Days

The big issue that usually arises when it comes to treating with your own doctor is getting authorizations. I can pretty much guarantee I can get a bill paid if you see your doctor and your employer refused to pay it after 28 days,  but some doctors will not see you unless you have an authorization from the worker’s compensation carrier to treat.

Many workers compensation carriers will not authorize the treatment to go to your own doctor. They may have to pay the bill but unless there’s a court order there’s nothing that requires them to pre-authorized the treatment.

Contact Me If You Are Having Trouble Seeing Your Doctor After A Work-Related Injury

There are things you can do it to get around this and still get the treatment you need with the doctor you trust so after twenty-eight days get into your own doctor. If you have a problem and getting a bill paid or getting authorization to see the doctor, you need to contact worker’s compensation lawyer immediately even before the twenty eight days if you can’t. So if you have a question about your injury and who can treat you, contact me at (989) 725-8118

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Work Injuries and Back to Work Law In Michigan

Back to Work, Light Duty and Favored Duty Law In Michigan

Today, I’d like to talk about work injuries and going back to work law in Michigan. We’ll talk about going back to work, light duty or what we call favored work in this article. If you’re hurt on the job and your doctor has you on restrictions or light duty, the employer has two choices. Let you stay home and heal or take you back to work and offer you a legitimate job within the doctor’s restrictions and recommendations. 

 

If You’re Off More Than Fourteen Days – You’re Entitled To Lost Wages

Now, if your employer sends you home, you have to be off work for more than seven days in order to be entitled to wage loss. If you are off work for more than fourteen days, they have to pay you back to day one. A lot of employers will try to get you back to work, certainly within the fourteen days, but even within the seven, so they don’t have to pay wage loss. They’ll offer you a job and say it’s within the restrictions, and sometimes it isn’t.

 

You Should Try Light Work If It’s Offered By Your Employer

If they offer you a legitimate job that is within your doctor’s restrictions, you are required to take the job or at least try it. If the job does turn out to be too painful, what you want to do is go back and report to your doctor and get your restrictions amended, or have the doctor take you off entirely, but at least try the job. Otherwise, if you don’t even try the job, the employer is going to be in a position better than you to argue that you didn’t even try, it was within the doctor’s restrictions, and you don’t get any wage loss. The most important thing to do is clarify the restrictions with your physician – just what they are and are not. 

Consult Your Doctor If Your Employer Asks You To Do Too Much

Obviously, if the employer wants you to lift fifty pounds and your restriction is five, you have the right to refuse that. But if it’s five-point-five pounds, your doctor has you on five-pound restrictions, well, you may want to at least see if you can do it or not – as long as you don’t jeopardize further injury, according to the doctor’s opinions.

So anytime you get hurt, be aware that a lot of employer’s primary goal is to get you back to work – favored work, light duty work – it has many terms. But they’ll do anything they can to avoid having you off more than two weeks, so they don’t have to pay wage loss. 

If you need time off to heal, just have the doctor take you off entirely and that’s the first and best way to protect yourself. If you have any questions on this, call me at (989) 725-8118.

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Episode 6 – Michigan Dog Bite Law Overview

Dog Bites Are Strict Liability Claims in Michigan

There are not many areas in the law that have strict liability, meaning that you have an automatic claim against someone for your injury. Dog bites are one of these areas. If you are bitten by someone else’s dog, you automatically have a case against the owner of that animal.

The Exception to Liability of Dog Owners

There’s only one exception to this that exception is if you provoked the dog or animal. In other words, you get them to bite you by playing aggressively with him, kicking him something along those lines. Otherwise, even if you’re just trying to pet the dog or walk by a dog and you get bit, the owner is responsibleWhat this means is they have to pay for any damages that you incur because of the bite.  This would include medical bills, pain and suffering, wage loss and more.

What You Need to do if You Suffer A Dog Bite in Michigan

The first thing you want to do if you are a bit by an animal is investigate what the animals owner’s insurance covers. That is what it comes down to in most cases, whether or not the owner has the proper insurance. Many dog owners do not. Many dog owners do not have a license for their animal, let alone insurance. There may be other types of insurance you can tap into. For example, if a dog owner is living with someone else who has insurance, it’s possible you may be able to tap into that.

So the key is investigating the claim immediately and getting medical treatment immediately. Then the issue is really just one of damages and how much it would take to make you whole.

If you’re bitten by a dog or really any animal that’s owned by another individual, have it investigated immediately. The owner of that animal has a strict liability against you for the entry, investigate the claim immediately for insurance coverage and damages.

Contact Me if You Have a Dog Bite Injury

I’ve had over 30 years experience in the Owosso and Shiawassee County Michigan area and am here to help! Please call me at (989) 725-8118 for a free consultation.

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Podcast Episode 5 – Michigan Automobile Uninsured and Under-Insured Law

 

Michigan Automobile Drivers May Be Uninsured or Under-Insured!

We all know that if you get hurt by someone else in an automobile accident, you may have a claim for damages for things like pain and suffering. What most people don’t realize is often times there are drivers on the road who either have no insurance or did not have sufficient insurance.

What Michigan Law Requires

Michigan law only requires a person to have $20,000/ $40,000 coverage on a motor vehicle. Most people know this as PLPD. PLPD means that that person can be sued and insurance will only pay up to $20,000 per injury and $40,000 total per accident. So, for example, if 3 people get hurt there’s only $40,000 to be divided up from the insurance company. Now what most people don’t have and should have is both what is called under and uninsured motor vehicle coverage.

Ask Your Insurance Agent For Uninsured Motor Vehicle Coverage

Be aware, this is something that a lot of insurance agents will not bring up. There’s not enough money in it for them to make it worth their while, and it is surprisingly cheap.  Here’s the difference: If you have uninsured motor vehicle coverage and you get hurt by someone else’s negligence in a car accident, your insurance company will pay what their insurance company should have paid, except they didn’t have insurance.

Why You Should Have Automobile Under-Insurance Coverage In Michigan

For example, if you have $100,000 uninsured policy, it turns out the drunk driver had nothing, you can still make a claim for $100,000 with your insurance company for their negligence. The other portion of the policyunder-insured, simply means if they don’t have enough insurance, you could make a claim against your company for over and above what their insurance provided.

So I’ll give you another example, let’s say a drunk driver severely injured you and they have PLPD, that is $20,000 in limits, and you have $100,000 injury. Well, if you have $100,000 policy, your insurance will make up the difference between that $20,000 limit and $100,000, Which means they’ll pay 80 plus the 20, for a total of 100. The whole idea is to make you whole. 

A Typical Michigan Underinsured Policy Is Surprisingly Cheap

Now, you have to purchase this policy on your own. You’d be surprised how cheap it is. I currently have $1,000,000 for both under and uninsuredand the last time I looked, it cost me $16 every six months. Some companies don’t even sell this, so you do need to shop around. But it’s, easy to find one that does, and it’s the cheapest part of a policy by far.

So if you ever look into reviewing your auto insurance policy, always ask your agent about, and make sure you include, uninsured and under-insured coverage.

Call Patrick Maruiak If You Have A Question About Michigan Automobile Accident Law

Any questions on this? Contact me at (989) 725-8118. I have 30 years experience representing people in Shiawassee County and surrounding areas who have been harmed in automobile accidents.

 

 

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Podcast Episode 4 – Slip and Fall Injuries in Michigan

Welcome to the Patrick Marutiak Podcast. I’d like to talk to you today about slip and fall cases. It is probably the biggest misconception there is in the law.

What you have to prove to recover damages in a slip and fall case in Michigan

People assume if you get hurt on someone else’s property you can sue them for your injuries. nothing could be further from the truth. In Michigan, in our state, in order to make a claim if you fall on someone else’s property, you have to prove not only was the landowner negligent but there was a latent or hidden defect.

No damages if the defect is open and obvious in Michigan

There are two words to remember concerning slip and falls: open and obvious. The law currently states if there is a defect on property that is open and obvious, even if the landowner was negligent, you cannot make a claim for damages. This can result in very egregious than unfair standards.

I’ll give you an example: There was one case where a blind lady was walking up some stairs and she fell because one of stairs was missing. They were doing construction on the stairs.

The court threw the case out because to a reasonable person, the fact that half the stair was missing should have been open and obvious- It didn’t even matter that she was blind – If a reasonable person could have seen that defect, there’s no case.

The exception to the open and obvious rule in Michigan

There’s one exception to this and that concerns landlords. If for example, you’re living in an apartment complex, you may be able to get around the open and obvious defense, but if you’re hurt on commercial property or someone else’s home, these cases are very difficult to make.

It is important, therefore, to contact a lawyer immediately after you get hurt. An investigation needs to be done right away to determine if there was a hidden or latent defect, and whether or not the open and obvious defense applies.

Contact an attorney immediately after getting hurt on a commercial property

One thing you should always know is, if you get hurt, you may be able to make a claim for medical bills. I would like to talk to you about medical payment coverage if you are hurt and someone else’s property.

Even if you cannot make a claim for damages, that is pain, suffering, wages and the like, you may be able to make a claim for what we call “med pay” or payment of medical bills.

What insurance typically pays for in slip and fall cases in Michigan

If you’re hurt on a commercial property or even someone’s home or private property, most any homeowners insurance or commercial insurance policy contains a “med pay” provision. What this means is they will pay your medical bills, regardless of who’s at fault – your fault, the homeowner’s fault, or nobody’s fault. They’ll still pay the medical bills.

Limits to “med pay” provisions in Michigan

Now the “med pay” has certain limits. Most homeowner policies only have a thousand dollar limit. Many commercial policies have more: some five, some ten. A good one would have twenty-five thousand. What this means is they’ll pay any of your co-pays and out of pocket expenses up to that limit, as long as you make the claim within a year of when you were hurt. Depending on how you were hurt, you may not be able to make a claim for your pain and suffering, but as long as there’s insurance coverage, you can always make a claim for medical bills.

Call me if you’re in the Owosso or Shiawassee County Region!

You want to talk to an attorney immediately. If you’re hurt on someone else’s property, even getting your medical bills could go a long way to help to make you whole. Give any questions on this. Always contact a lawyer. You can contact me at (989) 725-8118.

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