All Michigan Workers Compensation forms

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Discovery

• Requests for Production of Documents to Carrier US-01367
• Claimant's First Set of Requests for Production US-01366
• Claimant's First Set of Interrogatories to Employer and Carrier US-01365

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Official - Addresses

• Notice of Name or Address Change for Workers' Compensation MI-BWC403-WC

Workers Compensation - Official - Certifications

• Application for Certification for Workers' Compensation MI-BWC590-WC

Workers Compensation - Official - Charts

• Amputation Chart for Workers' Compensation MI-BWC728-WC

Workers Compensation - Official - Claims

• Employees Report of Claim for Workers' Compensation MI-BWC117-WC

Workers Compensation - Official - Disability

• Service Company Application for Workers' Compensation MI-BWC404-WC

Workers Compensation - Official - Disputes

• Notice of Dispute for Workers' Compensation MI-BWC107-WC

Workers Compensation - Official - Injury

• Employers Basic Report of Injury for Workers' Compensation MI-BWC100-WC

Workers Compensation - Official - Insurers

• Group Self Insurer notice of Acceptance for Workers' Compensation MI-BWC650-WC
• Group Self Insurer Notice of Termination for Workers' Compensation MI-BWC651-WC
• Insurer Notice of Policy for Workers' Compensation MI-BWC400-WC
• Carriers Response for Workers' Compensation MI-BWC251-WC

Workers Compensation - Official - Liability

• Agreement to Redeem Liability for Workers' Compensation MI-BWC556-WC
• Notice of Termination of Liability for Workers' Compensation MI-BWC401-WC

Workers Compensation - Official - Payments

• Voluntary Payment for Workers' Compensation MI-BWC115-WC
• Application for Advance Payment for Workers' Compensation MI-BWC108-WC

Workers Compensation - Official - Redemption

• Redemption Order for Workers' Compensation MI-BWC113-WC

Workers Compensation - Official - Reimbursements

• Application for Reimbursement for Workers' Compensation MI-BWC271-WC
• Application for Reimbursement for Workers' Compensation MI-BWC112-WC

Workers Compensation - Official - Reports

• Supplemental Report of Fatal Injury for Workers' Compensation MI-BWC106-WC

Workers Compensation - Official - Settlements

• Worker Settlement Statement for Workers' Compensation MI-BWC544-WC

Workers Compensation - Official - Subpoenas

• Subpoena for Workers' Compensation MI-BWC508-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038