Form WC-117 Employee's Report of Claim - Michigan

Form WC-117 Employee's Report of Claim - Michigan

What Is Form WC-117?

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 WC-117?A: Form WC-117 is the Employee's Report of Claim in Michigan.

Q: Who needs to fill out Form WC-117?A: Employees who want to file a workers' compensation claim in Michigan need to fill out Form WC-117.

Q: What information is required on Form WC-117?A: Form WC-117 requires information such as the employee's personal details, employer's information, description of the injury, and details of medical treatment.

Q: When should Form WC-117 be submitted?A: Form WC-117 should be submitted as soon as possible after the work-related injury or illness occurs.

Q: Is there a deadline for submitting Form WC-117?A: There is no specific deadline mentioned for submitting Form WC-117, but it is recommended to submit it promptly.

Q: Can I submit Form WC-117 electronically?A: Yes, you can submit Form WC-117 electronically if your employer offers that option.

Q: What should I do if I need help filling out Form WC-117?A: If you need help filling out Form WC-117, you can contact your employer's human resources department or seek assistance from a workers' compensation attorney.

Q: What happens after Form WC-117 is submitted?A: After Form WC-117 is submitted, the employer's workers' compensation insurance carrier will review the claim and determine its validity.

Q: Can I appeal if my claim is denied?A: Yes, if your workers' compensation claim is denied, you have the right to appeal the decision.

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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;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form WC-117 by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.

Download Form WC-117 Employee's Report of Claim - Michigan

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  • Form WC-117 Employees Report of Claim - Michigan, Page 1
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