REPORTING A WORKERS’ COMPENSATION CLAIM

Report a workers’ compensation claim IMMEDIATELY. The earlier a claim is reported, the sooner it can be resolved. Do not wait to report a claim!

All workers’ compensation claims need to be reported on the EMPLOYER’S BASIC REPORT OF INJURY form WC-100. This form can be found at the Michigan.gov website or by clicking below:

Click here for printable WC-100 Form

Policy holders are encouraged to report workers’ compensation claims directly to the insurance company through phone call or company websites. This information can be found in your policy or by going directly to the insurance company website. You can also contact us directly at (989) 772-2977. We are open Monday – Friday 8 a.m. – 5 p.m.

IMPORTANT INFORMATION ON SERIOUS INJURIES AND DEATH CLAIMS MIOSHA and OSHA Requirements:

In the event of a DEATH, it is required by law that the employer notify MIOSHA at (800) 858-0397 and OSHA at (800) 321-6742 within 8 Hours. As the employer, you are responsible to report.

OSHA also requires 24-hour notification in the event of the following injuries:

• In-Patient Hospitalization
• Amputation
• Loss of an eye(s)

If you fail to report any of the above to MIOSHA and OSHA, you could face possible fines that are NOT covered by workers’ compensation insurance or any insurance.

Should you have any questions, please contact our office at (989) 772-2977.