Form C (WC-104C) Application for Mediation or Hearing - Michigan

Form C (WC-104C) Application for Mediation or Hearing - Michigan

What Is Form C (WC-104C)?

This is a legal form that was released by the Michigan Department of Labor and Economic Opportunity - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form C (WC-104C)?A: Form C (WC-104C) is an Application for Mediation or Hearing in the state of Michigan.

Q: What is the purpose of Form C (WC-104C)?A: The purpose of Form C (WC-104C) is to apply for mediation or a hearing in a workers' compensation case in Michigan.

Q: What information is required on Form C (WC-104C)?A: Form C (WC-104C) requires information about the injured worker, the employer, the insurance carrier, and the specific issues in the case.

Q: What happens after submitting Form C (WC-104C)?A: After submitting Form C (WC-104C), the Michigan Workers' Compensation Agency will review the application and schedule either a mediation or a hearing.

Q: Is there a deadline for submitting Form C (WC-104C)?A: Yes, there is a deadline for submitting Form C (WC-104C). The deadline may vary depending on the specific circumstances of the case, so it is important to check with the Michigan Workers' Compensation Agency for the applicable deadline.

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Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Michigan Department of Labor and Economic Opportunity;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form C (WC-104C) by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.

Download Form C (WC-104C) Application for Mediation or Hearing - Michigan

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