Comprehensive Risk Services, Inc. is the workers’ compensation claims administrator for McLaren Health Care Corporation.
We have recently been notified that you have made a claim for benefits due to a work-related injury and this letter should help you understand how the claims process works.
You are entitled to reasonable and necessary medical care to cure or relieve the effects of your work related injury. This includes medical, surgical, nursing and hospital services; and under certain conditions dental care and prosthetic devices.
McLaren Health Care Corporation is required to provide these services through the
If Comprehensive Risk Services believes that the physician you have chosen is inappropriate and can show why, a magistrate at the Bureau of Workers’ Compensation may order you to discontinue treatment with that physician or order you to personally pay for any treatment subsequent to the date of the Order.
During the course of your recuperation, you should submit your mileage associated with your medical care including physician, physical therapy and rehabilitation appointments for reimbursement.
PAYMENT OF BENEFITS
Workers’ Compensation is paid in accordance with the Workers’ Disability Compensation Act. Your compensation rate is determined by taking your highest 39 weeks gross wages of the last 52 weeks worked. A copy of Form 701 showing our computations will be forwarded separately.
You maximum allowable compensation rate based on your earnings and filing status will be $(unknown).
If medical disability does not extend beyond 7 days, you will not receive lost wage work comp benefits. If disability extends beyond 7 consecutive days, but does not exceed 13 days from your last day worked, workers’ compensation is paid from day 8 on a day-to-day basis, through day 13.
If disability reaches the 14th day after your last day worked, compensation payments will go back to your 1st day of work lost and will pick up from day 1 through day 7 and continue for the duration of your disability.
If during this initial period and after you have reached the 14th day of disability, you have used time from your PTO bank; it will be necessary for you to reimburse your PTO bank through a payroll deduction. Enclosed are forms which you must sign and return to Comprehensive Risk Services, Inc.
MORE THAN ONE EMPLOYER
If you work for more than one employer, you will receive credit for all wages earned and reported to the Internal Revenue Service as well as employment covered by the Workers’ Compensation Disability Act.
If it is medically determined that you are unable to perform work you were hired to do, you are entitled to vocational rehabilitation including specialized job placement or short term retraining. Vocational rehabilitation consideration is made only after all treating or evaluating physicians conclude that you will be unable to return to your previous occupation.
While the above explains your basic rights under the Workers’ Compensation Act, you also have certain responsibilities.
THE TRANSITIONAL WORK PROGRAM
Employees with temporary work related disabilities who would otherwise be on a leave of absence will be brought back to work into a temporary position having requirements matched to their level of ability as determined by physical examination. Participation will be required.
All employees with a work related illness or injury which results in the restriction of regular work duties or causes the loss of one or more days of scheduled work will be evaluated in the
All temporarily disabled employees who cannot perform their regular jobs without restrictions but are capable of tolerating restricted work will be required to participate in the Transitional Work Program. Employees refusing to be placed in transitional work assignments may be subject to termination of their workers’ compensation wage benefits. Every effort will be made to arrange transitional work placements within the employee’s assigned work location and shift.
You are entitled to weekly compensation benefits as long as your disability, supported by medical documentation continues. Documentation by a physician must be provided on the first day of disability to establish coverage. “Back-dated” disability notices are not acceptable. In the event you return to work at a job which pays you less than you were earning at the time of the injury, and the reason is you are physically unable to work at your previous job, you are entitled to “partial” compensation benefits.
During the time you are unable to work or are active in the Transitional Work Program, you must:
If you disagree with any decision made by the McLaren Health Care Corporation or Comprehensive Risk Services you may file an Application for Mediation Hearing with the Bureau of Workers’ Compensation.
This will entitle you to a hearing before a mediator if you request such a hearing in writing.
It is necessary that you complete the attached employee questionnaire, treating physicians, dependents information statement as well as sign the medical authorization and return them to me as soon as possible.
At the bottom of this letter you will find the claim number we have assigned to your file.
I look forward to the opportunity of assisting you during your period of recuperation.
File #: XXXXXX
MMCM NURSE WORKERS’ COMPENSATION RESOURCE/CONTACT LIST
MMCM Workers’ Compensation (Human Resources)
Corporate Workers’ Compensation Representative
PHONE 248 737-1888
FAX 248 737-4619
Page Last Updated: Jun 13, 2014 (09:45:21)