PDF
Word
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.
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.
