reglab/statecodes huggingface dataset:
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.42 - Application for specific risk insurance policy to cover specified construction site

Current through Vol. 24-12, July 15, 2024
Rule 12. An applicant may make written application to the
					 agency for permission to obtain a specific risk insurance policy to cover all
					 employers on a specified construction site where the cost of construction will
					 be more than $65,000,000.00 and the contemplated completion period will be 5
					 years or less. The application must give sufficient detail to specify the
					 location of the proposed construction site, a breakdown of the total cost, and
					 the contemplated completion period for the construction. After considering the
					 application and all supportive data, the agency shall either grant approval or
					 advise the owner of the requirements to be met before approval is granted. The
					 applicant shall be given 30 days from the receipt of the agency's notice in
					 which to comply with the requirements of the agency. The approval for a
					 specific risk policy is not effective until the agency has received proof that
					 all requirements of the agency for issuance of a specific risk policy to cover
					 a specified construction site have been met. The applicant, at the discretion
					 of the director, may be granted additional time to meet the requirements for
					 approval of a specific risk policy. A request for an extension of time must be
					 made in writing within the 30-day compliance period. If the agency does not
					 receive proof that all requirements for the approval of a specific risk policy
					 for a specified construction site have been met within the time prescribed,
					 then the application is considered withdrawn.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.42a - Notice of insurance; specified construction site insurance policy

Current through Vol. 24-12, July 15, 2024
Rule 12a. If an insurance policy is issued to cover a
					 specified construction site where the cost of the construction will be more
					 than $65,000,000.00 and the contemplated completion period will be 5 years or
					 less, then the insurers shall notify the agency on a form WC
-
400A,
					 insurer's notice of issuance of specific risk policy, of the date upon which
					 the employer became subject to the specific insurance policy. If the employer
					 is a partnership, then the notice must state the names and addresses of all the
					 partners. If the employer is doing business under an assumed name, then the
					 notice must state the assumed name and the names of the parties doing business
					 under the assumed name. If the employer is a corporation doing business through
					 a number of divisions, then the notice must state the name of the employer and
					 the divisions that are covered under the specific risk policy. The specific
					 risk carrier shall notify the agency when the specific risk carrier receives a
					 change of address for the employer.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.42b - Termination of insurance; specified construction site insurance policy

Current through Vol. 24-12, July 15, 2024
Rule 12b.
(1) A
				  notice of termination for coverage of an employer under an insurance policy
				  covering the specified construction where the cost of construction will be more
				  than $65,000,000.00 and the contemplated completion period will be 5 years or
				  less, must be reported to the agency on form WC
-
401A, notice of
				  termination of liability for employer under specific risk policy.
(2) The insurer shall mail a copy of the
				  notice to the employer. If the employer is a partnership, then the notice must
				  state the names and addresses of all the partners. If the employer is doing
				  business under an assumed name, then the notice must state the assumed name and
				  the names of all parties doing business under the assumed name. If the employer
				  is a corporation doing business under a number of divisions, then the notice
				  must state the name of the employer and the divisions of the corporation
				  covered by the termination. If the business changes names, then notice must be
				  given stating both the new and former names. Notice of termination of a policy
				  that has expired may not be reported when the specific risk carrier has
				  accepted responsibility under a further or renewal policy, except for an
				  assured's name change. The termination notice must be filed with the agency at
				  Lansing, Michigan, not less than 20 days before the effective date of any
				  termination or cancellation of the policy with respect to the employer. The
				  notice must give the date of termination or cancellation of the contract or
				  policy with respect to the employer. Termination or cancellation of the
				  specific risk policy takes effect, with respect to the employees of the insured
				  employer, 20 days after notice of a proposed termination or cancellation is
				  received by the agency.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43 - Employer self-insured application; combinable entities

Current through Vol. 24-12, July 15, 2024
Rule 13.
(1) An
				  employer who applies for the authority to become an individual self-insurer
				  shall apply to the agency on form WC
-
402, or its electronic
				  equivalent.
(2) The initial and
				  annual renewal application must contain answers to all questions, shall include
				  all requested supporting information, as directed, and be sworn to by an
				  authorized representative of the employer whose signature is
				  notarized.
(3) Separate legal
				  entities may be self-insured under a single authority if they are
				  majority-owned by the self-insured entity submitting the application or if the
				  same person or group of persons owns a majority interest in each entity on a
				  single application. "Majority interest" of a corporation means ownership of a
				  majority of the voting stock or authority to appoint a majority of directors,
				  if there is no voting stock. "Majority interest" of a partnership means
				  majority partnership interest by the same person or group of persons. "Majority
				  interest" in a limited liability company means majority member ownership by the
				  same person or group of persons.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43a - Employer individual self-insurer; surety bond or letter of credit; consideration of employer in business less than 5 years; excess liability insurance; required guaranties; claims service companies; self-administered claims

Current through Vol. 24-12, July 15, 2024
Rule 13a.
(1) A
				  nonpublic self-insurer may be required to furnish a surety bond or letter of
				  credit. The agency will establish the amount of security at the time of initial
				  application. The agency shall review the adequacy of security periodically. The
				  agency shall prescribe the format and language of the bond or letter of credit.
				  The agency shall accept surety bonds only from a surety writer authorized to
				  transact security bond business in Michigan. A surety bond must provide for 60
				  days' notice of cancellation to the agency. Letters of credit are administered
				  under
				  R 408.43q.
(2) An employer that is in business less than
				  5 years may not be considered for selfinsured authority unless its worker's
				  disability compensation liability will be guaranteed by a parent corporation or
				  combinable affiliated entity that has been in business not less than 5 years
				  and that would qualify for self-insured authority in Michigan.
(3) The agency shall require specific excess
				  liability insurance, with policy limit and retention acceptable to the agency,
				  for every self-insured employer, unless the agency, at its discretion, waives
				  the requirement. The agency may require aggregate excess liability insurance as
				  a condition of approval for a self-insured employer. Specific and aggregate
				  excess liability insurance policies are accepted under
				  R 408.43k.
(4) Parent corporations shall guaranty all
				  liability incurred by their self- insured subsidiaries under the act, unless
				  the agency, at its discretion, waives the requirement. The agency shall
				  prescribe the form and substance of the guaranties. The agency may require
				  employers, combinable under a single self-insured authority, to execute
				  workers' disability compensation payment guaranties as a condition for approval
				  of the selfinsured authority. The agency shall prescribe the form and substance
				  of the guaranties.
(5) A
				  self-insurer approved under section 418.611(1)(a) of the act, MCL 418.611,
				  shall contract with a claims service company approved by the agency under
				  R 408.43m. The agency may approve a
				  self-insurer to self-administer claims if the employer has all necessary
				  systems, processes, and reporting capabilities and can demonstrate it has
				  employed competent claims personnel with Michigan workers' compensation
				  adjusting experience.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43b - Employer individual self-insurer; compliance with agency requirements; notice; additional time; certification; renewal application

Current through Vol. 24-12, July 15, 2024
Rule 13b.
(1) If
				  the agency approves an initial application of an employer to be an individual
				  self-insurer, then the approval must be in writing. The approval letter must
				  contain the excess liability insurance terms, bond, letter of credit, and
				  guaranties required by the agency as a condition of the self-insured authority.
				  The employer has 30 days from the receipt of the agency's notice in which to
				  comply with the requirements of the agency. The self-insured authority may not
				  become effective until the agency has received proof that all requirements of
				  the agency for self- insured authority have been met.
(2) The employer may, at the discretion of
				  the agency, be granted additional time to meet the requirements for the
				  self-insured authority. An employer shall make a request for an extension of
				  time in writing within the 30-day compliance period. If the agency does not
				  receive proof that all requirements for the self-insured authority have been
				  met within the time prescribed, then the application is considered
				  withdrawn.
(3) The agency will
				  issue a letter certifying self-insured authority to the employer when the
				  employer meets the requirements of the agency. The self-insured authority for
				  all approved employers expires on the designated renewal date, which may not be
				  more than 12 months from the effective date of the authority. A self-insured
				  employer shall submit a renewal application (form WC
-
402R), or its
				  electronic equivalent, and requested documents, including a current financial
				  statement and loss information, to the agency 30 days before the expiration of
				  the self-insured authority. Upon receipt of a renewal application, the
				  authority is extended until denied or approved for an additional 12
				  months.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43c - Financial, loss experience and liability exposure analysis; notice of denial or termination

Current through Vol. 24-12, July 15, 2024
Rule 13c.
(1) The
				  agency may decline to approve an application for, or may terminate the
				  self-insured authority, if an employer is unable to demonstrate a position of
				  reasonable solvency and the ability to pay benefits as prescribed in the act.
				  The agency analysis of each nonpublic employer application shall include a
				  review of the employer's financial position and operating results. Standard
				  financial ratio analysis and comparison to similar industry statistical data
				  will be considered in the financial position analysis. Other information
				  relevant to the applicant's financial ability, including, but not limited to,
				  the following, will be considered:
(a) The
				  historical operating results.
(b)
				  Evaluation of financial trends.
(c)
				  Banking relations.
(d) Contingent
				  liabilities.
(e) Pending
				  litigation.
(f) Corporate
				  guaranties.
(g) Management team
				  continuity and experience.
(h)
				  General and specific industry economic conditions.
(i) Legal structure.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43d - Group self-insurers; application

Current through Vol. 24-12, July 15, 2024
Rule 13d. Application for group coverage, as contemplated
					 in section 611 of the act, MCL 418.611, for the express purpose of establishing
					 a group self-insurers' fund, to be administered under the direction of an
					 elected board of trustees and to provide workers' compensation coverage for a
					 group of private employers in the same industry or for public employers of the
					 same type of unit, must be made to the agency. The application must be made on
					 a form prescribed by the agency and shall contain answers to all questions.
					 Answers must be given under oath.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43f - Group self-insurance; same industry requirement; approval; review; certificate

Current through Vol. 24-12, July 15, 2024
Rule 13f.
(1)
				  After considering an application for group self-insurance and all supportive
				  data, the agency shall either grant approval or advise the trustees of the
				  selfinsurers' group of the requirements to be met before approval is granted.
				  In determining whether private employers are in the same industry, the agency
				  may use the standard industrial classification codes assigned to each employer
				  applying for membership in the group. The agency shall also consider all
				  information available on the nature of the business of each private employer
				  and may require the group fund to present additional evidence, either oral or
				  written, to verify that all employers applying for membership in the group fund
				  meet the statutory requirement of being in the same industry. The group has 30
				  days from the receipt of the agency's notice to comply with the requirements of
				  the agency. The self-insured authority may not become effective until the
				  agency has received proof that all requirements of the agency for selfinsured
				  approval have been met.
(2) The
				  group may, at the discretion of the director, be granted additional time to
				  meet the requirements for the self-insured program. A request for an extension
				  of time must be made in writing by the group within the 30-day compliance
				  period. If the agency does not receive proof that all requirements for the
				  self-insured program have been met within the time prescribed, the application
				  is considered withdrawn.
(3) On new
				  and renewal applications, the agency may require evidence that the proposed
				  rate for each payroll classification is adequate to cover expected losses for
				  that payroll classification and evidence that the experience rating formula
				  will be actuarially sound. The agency shall take all of the following factors
				  into account before granting approval for a group self-insurance program:
(a) Past and anticipated losses.
(b) Proper reserves for reported and
				  unreported losses.
(c) Past surplus
				  and expected increase in benefit levels.
(d) Administrative costs.
The agency may contract with a consulting actuary, at the
					 expense of the group fund, to determine if the proposed group self-insurance
					 program will be actuarially sound.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43h - Group self-insurance; reports and filings

Current through Vol. 24-12, July 15, 2024
Rule 13h.
(1) The
				  group shall make all reports and filings required of carriers by the act. In
				  addition, the group fund shall comply with all of the following provisions:
(a) The financial position of the group fund
				  shall be reported, by the trustees or their designated representative, on a
				  quarterly basis for each open fund year. The report is due within 30 days after
				  the quarter ends.
The format for the report may be prescribed by the agency.
					 A fund year is considered open as long as there are unsettled claims. The
					 annual financial statements must be audited by a certified public accountant
					 and filed with the agency within 180 days after the fund year ends.
If a fund ceases to provide coverage on an ongoing basis,
					 annual audited financial statements must be provided to the agency within 180
					 days of the end of the fund's fiscal year.
(b) The fund shall file summary loss data, in
				  a manner prescribed by the agency, on each fund year within 30 days after the
				  evaluation date. Losses must be evaluated on a monthly basis or as required by
				  the agency.
(c) The fund shall file
				  a copy of the minutes of all trustee meetings with the agency within 30 days
				  after the meeting.
(d) The fund
				  shall provide reports or filings on payroll audits, investments, experience
				  rating, or any other information concerning the group fund upon specific
				  request of the agency.
(e) An
				  authorized representative of the fund shall sign all financial reports and
				  minutes submitted.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43i - Group self-insurer's fund; board of trustees' power and duties; investment restrictions

Current through Vol. 24-12, July 15, 2024
Rule 13i. To ensure the financial stability of each group
					 self-insurers' fund, a board of trustees of each fund is responsible for all
					 operations of the fund. A board of trustees is a group of members elected by
					 the membership of the fund for stated terms of office. The majority of the
					 trustees must be owners or employees of members of the self-insurers' fund, but
					 a trustee may not be an owner, officer, or employee of a service company. The
					 board of trustees of each fund shall take all necessary precautions to
					 safeguard the assets of the fund, including all of the following:
(a) Designate a trustee as administrator or,
				  in the alternative, hire an employee or designate an individual to act as the
				  group fund administrator. The trustees may delegate to the administrator the
				  duties they determine proper. The duties may include, but are not limited to,
				  advising the board with regard to any of the following:
(i) Contracting with a service
				  company.
(ii) Determining the
				  premium charged.
(iii) Investing
				  surplus money, subject to the restrictions set forth in this rule.
(iv) Accepting applications for membership.
				  However, the board of trustees remains the responsible party for the operation
				  of the fund. The duties delegated to the administrator and all compensation to
				  be paid to the administrator must be reduced to writing, and a copy provided to
				  the agency with each annual group renewal application. The group fund
				  administrator may not be an owner, officer, or employee of a service company.
				  The trustees shall purchase a fidelity policy covering the fund trustees,
				  administrator, employees of the fund, and the service company in an amount
				  sufficient to protect the assets of the fund. A copy of the fidelity policy
				  will be provided to the agency with each annual renewal.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43j - Group self-insurers' funds; advance premium discounts; surplus money; surplus investment income and premiums; unfunded claims

Current through Vol. 24-12, July 15, 2024
Rule 13j.
(1) The
				  trustees of any group self-insurers' fund shall not authorize advance premium
				  discounts to any member in excess of those authorized by the excess insurance
				  underwriter and approved by the agency. If discounts are approved by the excess
				  carrier and the agency, the excess carrier shall agree to base the loss fund on
				  the premium collected after discount.
(2) Any surplus money for a fund year in
				  excess of the amount necessary to fulfill all obligations under the act for
				  that fund year, including a provision for claims incurred but not reported, may
				  be declared to be refundable by the trustees at any time, and the amount of the
				  declaration is a fixed liability of the fund at the time of the declaration.
				  The date of payment is as agreed to by the trustees and the agency, except that
				  money not needed to satisfy the loss fund requirements, as established by the
				  aggregate excess contract, may be refunded immediately after the end of the
				  fund year with the approval of the agency. The intent of this rule is to ensure
				  that sufficient money is retained so that total assets are greater than total
				  liabilities for each fund year.
(3)
				  If premiums collected and earned investment income associated with any fund
				  year are insufficient to completely fund all reported claims and expenses for
				  that year, unfunded amounts, by fund year, must be reported immediately to the
				  agency with the proposed plan to achieve 100% funding. The plan to achieve 100%
				  funding for all claims is subject to agency approval. A plan may include, but
				  is not limited to, all of the following:
(a)
				  Use of premiums collected in other fund years, but not necessary for payment of
				  claims or expenses in the year collected.
(b) Use of investment earnings associated
				  with other fund years, but not necessary for payment of claims or expenses in
				  the year in which associated.
(c)
				  Assessment of members by order of the agency.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43n - Hearing before director; self-insured status, individual and group fund; group fund rates, membership applications, security requirements, and surplus refunds

Current through Vol. 24-12, July 15, 2024
Rule 13n.
(1) Upon
				  receiving a notice of intent to deny or terminate self- insured status under
				  section 611 of the act, MCL 418.611, a party may request a hearing before the
				  director within 15 days of the mailing of the notice by the agency.
Upon receiving a notice denying a request by a group fund
					 for deviation from manual rates, denial of an individual membership application
					 or security requirement, or a denial of a request for a refund of surplus, the
					 group fund may request a hearing before the director within 15 days of the
					 mailing of the notice by the agency.
(2) The director shall, by certified or
				  registered mail, notify the appealing party of the date, time, place, and
				  reasons for holding the hearing. The director shall mail the notice not less
				  than 15 days before the hearing. If the intent to terminate self-insured status
				  is based on the self-insurer's failure to maintain existing security
				  requirements, then the notice must advise the self-insurer that proof of
				  reinstatement of the security must accompany the request for hearing or the
				  director may make a final decision on the termination without further
				  hearing.
(3) If an appearance is
				  made at a hearing, then it must be made in person by a duly authorized
				  representative or by counsel.
(4) A
				  person who has been served with a notice of hearing may, at his or her option,
				  file a written statement before the date set for hearing or may appear at the
				  hearing and present an oral statement and other evidence on the issues
				  contained in the notice of hearing. When written briefs or arguments are
				  presented, a copy must be served upon the director and other interested parties
				  not less than 5 days before the date set for the hearing.
(5) If the person or persons who have
				  requested a hearing fail to appear at a noticed hearing, the director may
				  consider the request for a hearing as having been abandoned or, in his or her
				  discretion, may proceed with a hearing of the case and may, on the evidence
				  presented, make a decision.
(6) A
				  hearing may not be adjourned or continued, except upon an order of the
				  director.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43p - Enforcement by director of order of denial or termination of self-insured status; circuit court relief

Current through Vol. 24-12, July 15, 2024
Rule 13p. If the director has probable cause to believe
					 that an order denying or terminating self-insured status is being violated, or
					 that an employer who is approved or has been previously approved as a
					 self-insured is liquidating or may be about to liquidate and distribute its
					 assets to its stockholders or to its members without providing for its
					 obligation as a self-insured employer to pay or arrange for the payment of
					 compensation and benefits as directed by chapter 6 of the act, the director
					 may, through the attorney general of the state, cause a petition to be filed in
					 the circuit court of Ingham County or the county in which such person does
					 business to enjoin and restrain such person from engaging in such method, act,
					 or practice.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43r - Public employer group funds; waiver of requirement for excess insurance

Current through Vol. 24-12, July 15, 2024
Rule 13r. A public employer group fund may request a waiver
					 of the requirement for excess insurance. The director may waive the requirement
					 for excess insurance for a public employer group fund if the fund demonstrates
					 that it has sufficient financial strength and liquidity to ensure that all
					 obligations under the act shall be promptly met without the protection of an
					 excess insurance policy.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43s - Group funds; insufficient funding; creation of trust; appointment of trustees

Current through Vol. 24-12, July 15, 2024
Rule 13s.
(1) If
				  the plan to achieve full funding for payment of all claims and expenses of the
				  self-insurers group pursuant to
				  R 408.43j is not approved by the
				  agency, then the agency may order the board of trustees of the self-insurers
				  group to immediately assess the employer members of the group for the full
				  amount of the deficiency or order that any surplus funds distributed to group
				  members during the previous 12 calendar months from the date of discovery of
				  the funding deficiency by the group fund be immediately returned, or
				  both.
(2) If the agency determines
				  that the self-insurers group ceases to provide ongoing and active coverage to
				  its members or the requirements of this rule are not sufficient to secure all
				  future liability established by the act, or both, then the agency may require
				  additional assessment of the employer members of the group and request the
				  director to create and establish the terms of a trust, at the expense of the
				  selfinsurers group, for the deposit and administration of any assessment
				  received or all assets of the self-insurers group, or both. The trustees of the
				  funds appointed under section 511 of the act, MCL 418.511, must be appointed
				  trustees of the self-insurers group trust fund established under this
				  rule.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 3 - HEARINGS › Section R. 408.43t - Group self-insurance; employee leasing

Current through Vol. 24-12, July 15, 2024
Rule 43t. On or after the effective date of this rule, an
					 employee leasing company approved for membership in a group self-insurance fund
					 pursuant to MCL 418.611(2) of the workers' compensation act shall qualify as
					 being in the same industry of the group fund if the employee leasing company
					 meets all of the following conditions:
(a) The individual or individuals or entity
				  or entities owning the entity or entities where the employees are or will be
				  placed shall have a combined majority ownership interest of at least 51% in the
				  prospective member leasing company.
(b) The leasing company shall only lease
				  employees to entities that qualify for and participate in the group to which
				  the leasing company seeks admission.
(c) The application submitted for membership
				  by the employee leasing company shall clearly state on the first page of the
				  application that the entity is an employee leasing company and shall name all
				  the owners of the leasing company and the percentage of ownership of each
				  owner. Any change in the percentage of ownership shall be reported to the group
				  fund and the agency within 10 days of the ownership change. If the leasing
				  company no longer meets the requirements of subdivision (a) or (b) of this rule
				  after the change in ownership, then the leasing company shall be subject to
				  termination pursuant to
				  R
				  408.43g(4).
(d) The application shall identify and name
				  the entity or entities with which employees are placed or to be placed, the
				  name of each individual or entity that owns the entity with which employees are
				  or will be placed, and the percentage or ownership interest for each.
(e) If the leasing company leases employees
				  to any entity which is not a member of the group fund of which the leasing
				  company is a member, or the leasing company fails to report any changes in
				  ownership to the group fund and the agency within 10 days of the change in
				  ownership, then the leasing company shall be terminated from participation in
				  the group fund, pursuant to
				  R
				  408.43g(4).
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 4 - MISCELLANEOUS › Section R. 408.44 - Attorney fees

Current through Vol. 24-12, July 15, 2024
Rule 14.
(1) The
				  limitation in this rule as to fees applies to plaintiff's attorneys, including
				  combined charges of attorneys who combine their efforts toward the enforcement
				  or collection of any compensation claim.
(2) Reasonable expenses, as used in this
				  rule, include all of the following:
(a) Fees
				  for reports and depositions of doctors, vocational experts, and other experts
				  incurred in the prosecution of the claim.
(b) Medical examination fees and witness
				  fees.
(c) Any other medical witness
				  fee, including the cost of a subpoena.
(d) Costs of subpoenas, and costs to obtain
				  and copy medical and other records.
(e) The costs of court reporter services,
				  transcripts, subpoena enforcement fees, and certified copies.
(f) Costs of travel to depose medical and
				  vocational witnesses.
(g) Appeal
				  costs.
(h) Other costs or expenses,
				  or both, determined by a magistrate to be reasonable for the prosecution of the
				  claim.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 4 - MISCELLANEOUS › Section R. 408.45 - Medical examination rehabilitation, and forensic vocational evaluation

Current through Vol. 24-12, July 15, 2024
Rule 15.
(1) Under
				  circumstances prescribed by the director, a carrier, PEGSISF, first responder
				  presumed coverage fund, or self-insurers' security fund shall report to the
				  agency what provision has been made for rehabilitation on all cases for which a
				  final WC
-
701, notice of compensation payments, has not been
				  filed.
(2) When an employee
				  consents to a request by the carrier, first responder presumed coverage fund,
				  or a fund created in section 501 of the act, MCL 418.501; or is ordered by the
				  agency to submit to a medical examination, forensic vocational evaluation, or
				  rehabilitation; or undergoes any medical treatment related to the disability,
				  the carrier, first responder presumed coverage fund, or a fund created in
				  section 501 of the act shall pay the traveling expenses incidental to such
				  examination, medical treatment, evaluation, or rehabilitation. The employee
				  shall notify the carrier, first responder presumed coverage fund, or a fund
				  created in section 501, in writing, of the mileage involved and other expenses.
				  When an employee is examined at the request of the carrier, first responder
				  presumed coverage fund, or a fund created in section 501 under the provisions
				  of section 385 of the act, MCL 418.385, the expenses incidental to such
				  examination or evaluation shall be paid in advance. The traveling expenses are
				  those authorized in the state standardized travel regulations, except that when
				  special transportation is medically required, payments must be made at actual
				  cost. Reasonable transportation services may include those provided by an
				  entity licensed under the limousine, taxicab, and transportation network
				  company act, 2016 PA 345, MCL 257.2101 to 257.2153. The allowance for other
				  expenses, if any, are those allowed by this state. The provisions of this rule
				  do not apply to the first examination requested by the employer or insurer if
				  all of the following conditions exist:
(a) An
				  application for hearing is filed upon which no payment of compensation or
				  medical expense has been made for 1 year before the date of filing.
(b) The employee's home at the time of filing
				  the application for hearing is outside of this state.
(c) The citation to appear for examination is
				  at a time reasonably close to the date of hearing so as to obviate the
				  necessity of an additional trip on the part of the employee to attend the
				  hearing.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 4 - MISCELLANEOUS › Section R. 408.45b - Vocational rehabilitation rules disputes

Current through Vol. 24-12, July 15, 2024
Rule 15b. Any party may request a vocational rehabilitation
					 hearing before the director or his or her representative, on form WC-104a or
					 form WC-104c, application for mediation or hearing, or an electronic
					 equivalent, and all the following provisions shall apply:
(a) If the director, on his or her own
				  motion, orders a rehabilitation program, then he or she shall notify all
				  parties and, if requested by either party within 15 days, schedule a
				  hearing.
(b) A hearing must be
				  scheduled within a reasonable time, subject to the availability of the director
				  or his or her representative and the parties involved. A request for a hearing
				  must, at a minimum, contain all of the following:
(i) A brief statement of the question
				  concerning rehabilitation.
(ii) If
				  requested by the employer, a citation of the specific instances of the
				  employee's failure to cooperate in the rehabilitation program or other
				  objections related to a proposed or ordered IWRP.
(iii) If requested by the employee, the type
				  of program requested and the reason for it or other objections related to a
				  proposed or ordered IWRP.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 4 - MISCELLANEOUS › Section R. 408.46 - Application for silicosis, dust disease, and logging industry compensation fund and second injury fund benefits

Current through Vol. 24-12, July 15, 2024
Rule 16.
(1) An
				  application for reimbursement of benefits from the silicosis, dust disease and
				  logging industry compensation fund and second injury fund must be made on form
				  WC
-
112, or its electronic equivalent, and sent to the principal
				  office of the funds administrator.
(2) A carrier believing that reimbursement
				  may be due from the second injury fund under section 372 of the act, MCL
				  418.372, shall immediately notify the fund of the potential claim. The fund may
				  then conduct an investigation of the personal injury and must have reasonable
				  time to schedule medical examinations. If an application is filed with the
				  agency, then the carrier shall add the second injury fund and the fund shall
				  have the same rights as any other party defendant. The magistrate shall enter
				  an order determining the liability of the carrier and the fund.
(3) If an employee files an application for a
				  hearing under section 356(1) of the act, MCL 418.356, then the second injury
				  fund is deemed a party in interest and must be named on the application filed
				  by the employee or added by the carrier when it has knowledge that a claim is
				  being filed under section 356(1) of the act, MCL 418.356. The fund shall have
				  the same rights as a carrier in the proceedings.
(4) Reimbursement pursuant to the second
				  injury fund, dual employment provision must be made on a quarterly basis.
				  Reimbursement payments from all other funds must be made periodically every 6
				  months.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 4 - MISCELLANEOUS › Section R. 408.47 - Extensions of time granted by the director

Current through Vol. 24-12, July 15, 2024
Rule 17. The director or his or her authorized
					 representative may grant extensions of time in which to comply with any rule as
					 the director deems reasonable.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Compensation Agency - General Rules › Part 5 - REVIEW AND APPEAL › Section R. 408.49 - Determination of an employee

Current through Vol. 24-12, July 15, 2024
Rule 19. If a business entity requests a determination by
					 the director whether 1 or more individuals performing service for the entity in
					 this state are in covered employment, under section 161(n) of the act, MCL
					 418.161, and Executive Reorganization Order 2019-3(7)(l)(5), MCL 125.1998,
					 unless the issue is already pending before the board of magistrates, the
					 director shall issue a determination of coverage of service performed by those
					 individuals and any other individuals performing similar services under similar
					 circumstances. The request must include the names and addresses of all those
					 known to be impacted by the determination. The agency shall provide written
					 notice to all identified individuals and provide an opportunity to be heard
					 prior to making a determination. The business entity seeking the determination
					 shall notify any carrier that might be impacted, and prominently post, at the
					 business site, notice of any hearing on the request. Any decision rendered
					 pursuant to this rule is not binding on an individual who did not receive
					 notice or was not performing services for the business entity at the time of
					 the closing of proofs.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.61 - Scope

Current through Vol. 24-12, July 15, 2024
Rule 1. These rules apply to practice and procedure before
				  the workers' disability compensation appeals commission, or any successor to
				  that body, in appeals taken under the worker's disability compensation act of
				  1969, 1969 PA 317, MCL 418.101 to 418.941.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.62 - Definitions

Current through Vol. 24-12, July 15, 2024
Rule 2. As used in these rules:
(a) "Commission" means the workers'
				disability compensation appeals commission or any successor to that
				body.
(b) "Commissioner" means a
				member of the workers' disability compensation appeals commission or any
				successor to that body.
(c)
				"Director" means the director of the workers' disability compensation agency or
				any successor to that body. "Director" includes his or her duly authorized
				representative.
(d) "Electronic
				filing" means the process of submitting a document over the internet to the
				commission, including the State of Michigan File Transfer System (FTS), in
				accordance with the instructions available on the commission's
				website.
(e) "Electronic signature"
				means an electronic sound, symbol, or process, attached to or logically
				associated with a record and executed or adopted by a person with the intent to
				sign the record.
(i) An electronic signature
				may be a graphic representation of the signature.
(ii) The following forms are acceptable: "/s/
				John Smith" or "/s/ John Smith, Attorney."
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.63 - Filings generally

Current through Vol. 24-12, July 15, 2024
Rule 3.
(1) All
				pleadings, transcripts, briefs, and other documents pertaining to an appeal
				must be filed with the commission. Each document must bear both of the
				following:
(a) The Board of Magistrate's case
				number or, if no case number has been assigned, the claimant's social security
				number with the first 5 digits redacted.
(b) The Commission's docket number, if
				assigned when the document is filed.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.64 - Filing of claim for review

Current through Vol. 24-12, July 15, 2024
Rule 4.
(1) An
				appeal to the commission begins when a party files a claim for review. Any
				party filing a claim for review is an appellant. All other parties are
				appellees, but their filings may also make them an appellant, cross appellant,
				or cross appellee. An appellant shall provide copies of the filing to all other
				parties at the time of filing with the commission, and shall certify to the
				commission that the required copies have been provided.
(2) Unless otherwise provided by the
				provisions of the worker's disability compensation act of 1969, 1969 PA 317,
				MCL 418.101 to 418.941, a claim for review is timely if received by the
				commission as follows:
(a) Not later than 30
				days after the mailing date stamped or designated by the workers' disability
				compensation agency on the appealed decision or order, in the case of an appeal
				from the order of a workers' compensation magistrate.
(b) Not later than 15 days from the mailing
				date stamped or designated by the workers' disability compensation agency on
				the appealed decision or order, in the case of an appeal from an order of the
				director.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.65 - Cross appeals

Current through Vol. 24-12, July 15, 2024
Rule 5.
(1) A cross
				appeal must be received by the commission not later than 30 days after the
				cross appellant has first received a copy of an appellant's brief. A party
				filing a cross appeal is a cross appellant and all other parties are cross
				appellees. The cross appellant shall certify the date of first receipt of
				appellant's brief. The failure to so certify creates a rebuttable presumption
				that the cross appellant received the appellant's brief on the date the
				commission received that brief. The cross appellant shall provide all other
				parties with copies of the cross appeal at the time of filing with the
				commission, and shall certify to the commission that this has
				occurred.
(2) A cross appeal may
				not be filed before the cross appellant has received appellant's
				brief.
(3) A delayed cross appeal
				may not be filed. An extension of time to file a reply brief does not extend
				the time to file a cross appeal.
(4) The withdrawal or dismissal of the
				appellant's appeal extinguishes the cross appeal.
(5) A cross appeal must be filed on the claim
				for review form, and state that the cross appellant cross appeals the order
				from which an appellant has filed a claim for review.
(6) A document purporting to be a cross
				appeal that is not filed pursuant to the requirements of this rule is a claim
				for review.
Michigan Administrative Code › Department - Labor and Economic Opportunity › Workers Compensation Agency › Workers' Disability Compensation Appeals Commission › Section R. 418.66 - Briefing deadlines without filing transcript

Current through Vol. 24-12, July 15, 2024
Rule 6.
(1) For
				purposes of briefing deadlines, a transcript is considered to be filed as
				follows:
(a) If a record was not made of the
				hearing, a transcript is considered to have been filed on the same day the
				claim for review is filed.
(b) If
				the commission accepts a stipulation of all parties to proceed without the
				filing of a transcript, a transcript is considered to have been filed on the
				date the commission accepts the stipulation.