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Workers' Compensation

If you have sustained a work related injury or illness, you must file a report, even if you do not wish to seek medical treatment or will not lose any time from work.

If you expect to be off work for more than seven (7) calendar days, you are required to apply for a leave of absence, and you may be eligible for workers' compensation benefits.

The links below will give you the forms and information you need.


Forms

• Instructions for Reporting a Work Related Injury or Illness DOC icon

• State of Michigan Report of Claim DOC icon

• Approved Medical Providers & Authorization for Treatment DOC icon

• Clinic Listing PDF icon

• Authorization for Treatment PDF icon

• Facts for Employee with Work Related Injuries PDF icon

• Memo - You may receive this at the beginning or your leave. DOC icon

• C53, Application for Leave or Extended Use of Leave Credits PDF icon

• C38, Medical Certification by Physician - Employee DOC icon

• Frequently Asked Questions - Part I DOC icon

• Frequently Asked Questions - Part II DOC icon

• Frequently Asked Questions - Part III DOC icon


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