The Michigan Employee's Report of Claim (fill-in form) is a document provided by the State of Michigan to be used by employees to report claims for compensation resulting from job-related injuries or illnesses. The form is used to report the details of the injury or illness, including the date and time it occurred, the description of the injury or illness, the body part affected, the type of injury or illness, the job duties that caused the injury or illness, and any medical costs associated with the injury or illness. The form is also used to provide contact information for the claimant and the employer, as well as to document the employee's right to file a workers' compensation claim. There are two types of Michigan Employee's Report of Claim (fill-in form): one for the employee and one for the employer. The employee's version includes sections for the employee to provide information about the injury or illness, the employee's contact information, and the employer's contact information. The employer's version of the form includes sections for the employer to provide information about the injury or illness, the employee's contact information, and the claim's status.