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Worker's Compensation AgencyMichigan.gov: Official Web Site for the State of Michigan
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What's New

• Press Release - New Rule Allows Injured Michigan Workers to be Paid Electronically

• Electronic Payment of Benefits Now Allowed Under Rule 408.48 PDF icon

• Agency Form Formatting for Optical Character Recognition (OCR)

• 2013 Calculation Program Correction

• 2013 Calculation Program Now Available

• Change to Agency Online Fill-In Forms

• 2013 Weekly Benefit Table Now Available

• Agency Communication Regarding Insurers with a Service Company or Third Party as Claims Administrator


Forms & Publications

• WC-100 (2/13) - Employer's Basic Report of Injury (fill-in form) PDF icon

• WC-107 (2/13) - Notice of Dispute (fill-in form) PDF icon

• WC-108 (11/11) - Application for Advance Payment (fill-in form) PDF icon

• WC-114 (11/11) - Application for Reimbursement from the Compensation Supplement Fund (fill-in form) PDF icon

• WC-117 (4/13) - Employee's Report of Claim (fill-in form) PDF icon

• WC-701 (2/13) - Notice of Compensation Payments (fill-in form)

• WC-728 (12/11) - Amputation Chart (fill-in form) PDF icon


Claims Reports

• 2011 Pay Lag Report

• 2011 Notice of Dispute Report

• 2010 Pay Lag Report

• 2010 Notice of Dispute Report

• 2009 Notice of Dispute Report

• 2009 Pay Lag Report

• 2008 Pay Lag Report

• 2008 Notice of Dispute Report

• 2007 Pay Lag Report

• 2007 Notice of Dispute Report


Other Information

• 2013 Weekly Benefit Tables PDF icon

• 2012 Weekly Benefit Tables PDF icon

• 2011 Weekly Benefit Tables PDF icon

• 2010 Weekly Benefit Tables PDF icon

• 2009 Weekly Benefit Tables PDF icon

• 2008 Weekly Benefit Tables PDF icon

• 2007 Weekly Benefit Tables PDF icon

• 2006 Weekly Benefit Tables PDF icon

• 2005 Weekly Benefit Tables PDF icon

• Help with Navigating our Toll Free Phone Number PDF icon

• Need to Know How to Complete a Form 701? PDF icon

• WC Insurance Companies / NAIC Numbers List PDF icon




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