If you need an accommodation to view any of our forms, contact Carrie Ross at [email protected] to request assistance.

Apr 26, 2023 · A person receiving benefits under the State of Michigan Disability Benefit Program must reimburse the State any benefits paid under the Program for which the recipient is …

In order for the OCR function to work properly, a submitted form must be identical to the WC-100 provided on the Workers’ Disability Compensation Agency website, including but not limited to …

The Michigan Workers’ Disability Compensation Agency now uses FTS to accept claim forms, insurance forms, applications for mediation or hearing via upload through File Transfer Service …

Once the DMO has received your Workers' Compensation claim, they will file a claim with Sedgwick, our third-party administrator. Sedgwick will send paperwork to your home. You …

The form must be signed by at least the injured worker (or personal representative) or the attorney, preferably both. Unsigned forms will not be considered complete.

In order for the OCR function to work properly, a submitted form must be identical to the WC-107 provided on the Workers’ Disability Compensation Agency website, including but not limited to …

The copy of the WC-701 that is sent to the injured worker may be printed as a double-sided form and must be accompanied by a copy of WC-701 Filing Codes that lists the codes used on the …

This form is used to exclude certain individuals from insurance coverage as permitted by statute and is not available online. To find out whether you qualify for this exclusion and obtain a copy …

If your employer will not file a claim for you, you may file form WC-117 with the Agency. If your claim is disputed by the insurance company or self-insured employer, you may need to file a …