Michigan workers compensation application form 2025

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In Michigan, to file a workers comp claim you must: 1) Give notice of injury to employer within 90 days of it occurring. 2) Make a claim for lost wages and/or medical treatment within 2 years of the accident. When giving notice of injury it is recommended to fill out an accident report so there is written proof.
0:26 2:00 This will include your higher date. And your job duties. You will also need to provide your wageMoreThis will include your higher date. And your job duties. You will also need to provide your wage information this typically means your hourly rate or salary.
The State of Michigan has the right to choose who will provide your medical treatment for the first 28 days following the initial treatment of the injury or illness. If you are not seen at an Occupational Health Care Clinic, the State is not required to pay for any medical bills from other providers during this time.
WC-337 (12/15) Notice of Exclusion provided by the Michigan Department of Labor Workers Compensation Agency, is used to exclude certain individuals from insurance coverage as permitted by statute. To. find out whether you qualify for this exclusion and obtain a copy of the form, contact the Compliance Employer.
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