Michigan Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State

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Workers' compensation laws are designed to ensure payment by employers for
some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. Worker's compensation legislation requires the employer to furnish a reasonably safe place to work, suitable equipment, rules and instructions. State workers' compensation statutes vary by state. The Federal Employment Compensation Act covers non-military federal employees or those workers employed in some significant aspect of interstate commerce.


The compensation acts require that notice of the fact of injury be given to the employer, or to the compensation board or commission, or to the insurance carrier, or to all of them. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.

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FAQ

A register of injuries must be kept for workers to record workplace injuries or illnesses. The register of injuries may be kept in writing or be electronic (like on a computer). Having a register that all workers can access will help them raise any safety issues they have.

Available benefits include medical treatment, lost wages, and vocational rehabilitation. Employees can short-circuit this obstruction by filing their own Employee's Report of Claim (Form WC-117) with the Workers' Disability Compensation Agency.

Filing a Claim for Workman's Comp in Michigan You'll have to file a claim for workman's comp in Michigan within two years of your employee's work-related injury or illness. Otherwise, you'll need to file it within two years from the date that an injury or illness shows up.

Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].

When an injury/illness occurs: Immediately notify your supervisor. Seek treatment at an Occupational Health Care Clinic. Submit a Workers' Compensation Claim: Apply Online, or. Print, complete, and fax a State of Michigan Workers' Compensation Claim Form.

Occupational Safety and Health Administration (OSHA) Form 301, ?Injury and Illness Incident Report,? is used by employers to keep a record of a single injury, illness, or death in a workplace. This form is found within OSHA Form 300, which is used to log and classify all such incidents for a workplace.

Instructions: Employees shall use this form to report all work related injuries, illnesses, or ?near miss? events (which could have caused an injury or illness) ? no matter how minor. This helps us to identify and correct hazards before they cause serious injuries.

Dislocations. Electrical injuries. Fractures (broken bones) Sprains and strains.

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Michigan Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State