News and Insights
No-Fault Auto Insurance
& Workers Compensation
What happens when an employee is injured on the job while operating a motor vehicle? This situation merges two areas of law: (1) Michigan Workers Compensation, and (2) Michigan No-Fault Automobile Insurance.
Under workers compensation, injured employees are entitled to “80 % of after-tax average weekly wages” (aprox 66% of the gross wages) at the time of the injury.
Under No-Fault, the injured motorist is entitled to 85% of the income lost during the first three years of disability. Thus, a difference in disability wage loss benefits, with No-Fault paying a higher benefit. Workers compensation is primary and No-Fault Automobile Insurance usually obligated to pay the difference.
Often the injured worker does not know that No-Fault Automobile Insurance is payable in addition to Workers Compensation or that the claim must be filed within
one year of the accident.
Awareness of the interplay of the two areas of law, Workers Compensation and No-Fault Automobile Insurance, is crucial.
If you know of anyone injured in a motor vehicle accident and receiving workers compensation, tell him or her of the added benefits available.
The Case of the Honest Intoxicated Defendant
Many tragic automobile crashes are caused by a driver’s excessive alcohol consumption. That is a well-known fact and there are criminal statutes that punish the driver who operated a vehicle “under the influence”
When alcohol-induced crashes result in personal injury there are, in many cases, civil lawsuits seeking damages for the injured victim from the intoxicated driver of the vehicle and its owner. Automobile insurance indemnifies the at-fault driver and pays the damages. The insurance company hires attorneys to defend the driver/owner and prepares the driver for testimony during pre-trial depositions and at trial. In many cases, the driver will testify that he or she had “a couple of beers” and was not impaired when the accident occurred.
Many years ago, Ryan & Ryan represented a passenger who was injured when a mini-van left the roadway and crashed into a tree. The passenger and driver had just left a tavern in a small town when the crash occurred. During the pre-trial deposition of the driver, Bill Ryan asked “how many drinks did you have at the tavern?” Ryan expected the driver to admit to “a couple of beers.” However, in remarkably honest testimony the driver paused, considered the question, and responded, “I think I had fifteen Captain Morgan’s and Coke.”
Needless to say, the insurers for both the driver and the tavern agreed to settle the case shortly after that testimony!
The Case of the
$340,000 Ice Cube
In a fairly recent Kalamazoo County Circuit Court case Ryan & Ryan fought one of the nation’s largest retailers after the client slipped and fell near the cashier station at the front of the store and sustained a knee injury.
The store denied that the floor was dangerously slippery and refused to compensate the woman for her pain and physical impairments. In fact, the manager of the store testified that the floor was dry in the area of the fall.
However, in surveillance video obtained from the store a man was seen in the same area carrying a bag of ice from a nearby ice freezer minutes before the fall. The cashier testified at deposition that he had observed an ice cube melting on the floor near his work station. Yet, the store still insisted that the floor was safe and that it owed no duty to clean up or mop the area near the cashier and ice freezer.
One week before a jury trial was scheduled the parties reached a settlement of $340,000. At the time of the mediation, months before the trial, the store had offered only $15,000...before it wisely changed its evaluation.
Trends in Social Security Disability
The Social Security Disability Insurance (SSDI) program, an integral part of Social Security, provides vital benefits to workers who can no longer support themselves due to a serious and long-lasting medical impairment. The Social Security Administration (SSA) administers SSDI. Some 8.2 million people receive disabled-worker benefits from Social Security. Payments also go to some of their family members: 104,000 spouses and 1.4 million children. In addition to monthly payments the SSDI program provides Medicare coverage to the disabled.
Full SSDI is available to those persons who have paid into the system Social Security taxes for a significant length of time through payroll deductions. Satisfying the disability criteria and eligibility criteria is not easy, however. According to the Center on Budget and Policy Priorities (CBBP) the rate of successful applications for SSDI varies depending on the age of the applicant, but the overall rate of all ages is less than 40%.
It is important to provide thorough and supportive medical evidence of disabling conditions. Supportive doctors and therapists are crucial to a successful SSDI application. Appealing a denial of SSDI usually involves an administrative law judge (ALJ) hearing.
At the ALJ hearing, an attorney experienced in Social Security Disability is vitally important. Ryan & Ryan Law does not accept all cases to represent claimants at the ALJ hearing. However, we are available to review the facts, the medical evidence, and the age of the claimant to determine if we can be successful at the hearing. Attorney fees are only charged upon successful representation and are approved by the Social Security Administration.
Workers Disability Compensation Agency Announces In-Person Hearings
For nearly one and a half years, the Michigan Workers Compensation Agency courtrooms have been closed due to the COVID-19 pandemic. Thousands of injured and disabled workers have suffered delays in scheduling in-person hearings conducted by judges (magistrates) and have suffered financially. During the past 18 months, cases have proceeded with some trials conducted virtually with the worker and his or her attorney in a remote location, the employer and its attorneys in another remote location, and the magistrate at the Agency offices. But, the vast majority of cases were repeatedly delayed.
The Agency announced that July 12, 2021 is the date when magistrates will open their courtrooms for in-person hearings and trials. That is welcome news!
During the pandemic many injured workers have received unemployment benefits (both state and federal monies), which they would not have received under normal circumstances. For those workers, weekly unemployment checks have provided an essential “safety net” during this period of business and industries slow-down. However, the anticipated termination of the pandemic unemployment state and federal payments places renewed importance on workers compensation benefits for those workers and their families who are suffering from disabling work injuries.
Michigan No Fault Automobile Insurance Law Changes
Since the early 1970’s Michigan law required all motorists to maintain No Fault auto insurance which pays certain benefits to injury victims regardless of fault. Benefits included loss of income and all medical costs regardless of the extent or size of the medical bills. However, In May of 2019 the Michigan legislature, bending to the insurance industry’s pressure and influence, enacted changes to the No Fault law which drastically changed requirements for insurance coverage, placed a “cap” on certain benefits, allowed persons to “opt out” of coverage which formerly was required, and limited the amount of certain benefits, such as home attendant care by family members for severely injured persons. Effective July of 2021, family members’ compensation for attendant care is limited to 56 hours per week, even in those cases where 24-hour care per day is required.
One of the most distressing changes in the insurance law is establishing a motorist’s personal responsibility for the medical costs of persons injured in a collision. Under the former law, a motorist causing injuries could be held liable for certain kinds of damages such as pain and suffering, but could not be personally liable for most “economic damages”, including medical expenses.
The “opt out” provisions of the new law, not surprisingly, shift the costs of medical care from the auto insurers to other insurance policies and/or to welfare programs such as Medicaid. Despite many consumer groups and attorneys arguing that these insurance “reforms” would benefit the insurance industry the most, the legislature and the governor surrendered.
Union Membership Dropped in 2020; Percentage of Unionized Workers Rose
According to the U.S. Bureau of Labor Statistics (BLS), 14.3 million (10.8%) of US employees were in unions last year. That’s just over half of the 20.1% in 1983 when there were 17.7 million employed, waged, and salaried workers in unions. The number of union members declined 321,000 between 2019 to 2020; however the percentage of unionized employees increased by half a percentage point. This suggests most pandemic job losses were in non-union jobs. While there are strong indications workers may need union representation in the current work environment, the recent defeat of unionization efforts at Amazon’s warehouse in Alabama in April was discouraging to the advocates of organized labor. Another discouraging statistic in the US BLS was the difference between younger and older workers in union membership. In 2020, 13% of workers 45 to 54 years of age were union members (private and public) compared to 9.8% of workers 25 to 34 years old.
Nationwide, union members accounted for 10.8 percent of employed wage and salary workers in 2020, up 0.5 percentage point from 2019. Since 1989, when comparable state data became available, union membership rates in Michigan have been above the U.S. average. Michigan had 604,000 union members in 2020.
Social Security Disability Applications Have Decreased During the COVID-19 Pandemic
Since the COVID-19 pandemic began, Social Security Disability applications have decreased slightly, reflecting the ongoing trend of declining applications over the last 10 years, according to the Congressional Research Service. For example, applications averaged about 156,700 per month during January-September 2020, compared with nearly 172,200 per month during January-September 2019. The decline in disability applications thus far may be due to the stimulus programs such as unemployment and short-term disability benefits. However, if the economic downturn continues and these temporary supports are stopped, then the Social Security Disability applications among older workers who are not yet at retirement age and who have disabilities may rise in response.