• WC-100 (10/05) - Employer's Basic Report of Injury (fill-in form) 

• WC-106 (7/05) - Supplemental Report of Fatal Injury (fill-in form) 

• WC-107 (11/04) - Notice of Dispute (fill-in form) 

• WC-108 (9/04) - Application for Advance Payment (fill-in form) 

• WC-110 (3/05) - Report on Rehabilitation (fill-in form) 

• WC-114 (8/05) - Application for Reimbursement from the Compensation Supplement Fund (fill-in form) 

• WC-117 (9/05) - Employee's Report of Claim (fill-in form) 

• WC-500 (6/08) VR Provider Professional Disclosure Statement 

• WC-701 (9/05) - Notice of Compensation Payments

• Need to Know How to Complete a Form 701? 

• WC-728 (8/05) - Amputation Chart 

• BWC-112 Application for Reimbursement (from the Funds Administration) (fill-in form) 

• BWC-271 Application for Reimbursement from the Medical Benefit Fund 

• WC-104B (4/06) - Health Care Services Application for Mediation or Hearing (fill-in form)

• WC-117H (1/04) Provider's Report of Claim & Request for Medical Payment 

• WC-406 (4/08) Annual Medical Payment Report 

• WC-590 (1/04) Application for Certification of a Carrier's Professional Health Care Review Program 

• WC-739 (4/07) Carrier's Explanation of Benefits 

• WC-337 (4/04) Notice of Exclusion

• WC-338 (10/05) Notice to Terminate Exclusion

• WC-400 (9/05) - Insurer's Notice of Issuance of Policy (fill-in form) 

• WC-400A (11/05) - Insurer's Notice of Issuance of Specific Risk Policy

• WC-401 (11/05) - Notice of Termination of Liability (fill-in form) 

• WC-401A (11/05) - Notice of Termination of Specific Risk Policy

• WC-403 (11/05) - Insurer's Notice of Name or Address Change (fill-in form) 

• WC-500 (Español)

• BWC-113 (Español) - Demanda de Redención 

• BWC-119 (Español) - Declaracion que Apoya el Acuerdo de Redencion 

• WC-500 (Español) - Proveedor de Rehabilitación Vocacional Declaración de Divulgación Profesional 

• BWC-544 (Español) - Declaración del Acuerdo del Trabajador 

• BWC-556 (Español) - Acuerdo Para Redimir Responsabilidad 

• WC-104A (2/04) - Plaintiff's Application for Mediation or Hearing

• WC-104B (4/06) - Health Care Services Application for Mediation or Hearing (fill-in form)

• WC-104C (4/05) - Defendant's Application for Mediation or Hearing

• WC-105 (8/08) Work History, Work Qualifications & Training Disclosure Questionnaire (fill-in form) 

• WC-113 (1/04) - Redemption Order 

• WC-113 (1/04) - Redemption Order (fill-in form) 

• WC-113A (8/05) - Multiple Carrier Redemption Form (fill-in form) 

• WC-115 (5/05) - Voluntary Payment Form (fill-in form) 

• WC-119 (8/05) - Affidavit in Support of Redemption (settlement) Agreement (fill-in form) 

• WC-251 (8/05) - Carrier's Response (fill-in form) 

• WC-262 (4/05) - Claim/Cross-Claim for Review (fill-in form) 

• WC-508 (2/07) - Subpoena for Production of Records (and/or) Witness Subpoena (fill-in form) 

• WC-544 (7-05) - Worker's Settlement Statement (fill-in form) 

• WC-556 (5/05) - Agreement to Redeem Liability (fill-in form) 

• WC-402 (7/04) Self-Insurer Application Packet 

• WC-402A (2/06) Self-Insurer Request to Add or Delete Subsidiary/Affiliate (fill-in form) 

• WC-402G (8/05) Group Self-Insurer Application Packet 

• WC-402GR (1/04) Group Self-Insurer Application (fill-in form) 

• WC-404 (1/04) Service Company Application (fill-in form) 

• WC-650 (3/05) - Self-Insured Group Notice of Acceptance of Membership (fill-in form) 

• WC-651 (3/05) - Notice of Termination of Membership (fill-in form) 

• Letter of Credit/Memorandum of Understanding (8/08) (fill-in form) 

• Michigan Continuous Surety Bond (12/03) 

• Michigan Certificate of Specific/Aggregate Excess Liability Insurance (1/04) 

• Self-Insurer's Claims Transfer Agreement