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

What Is Form A (WC-104A)?

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 A (WC-104A)?
A: Form A (WC-104A) is an application for mediation or hearing in Michigan for workers' compensation cases.

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

Q: Who can use Form A (WC-104A)?
A: Form A (WC-104A) can be used by employees, employers, or their representatives who are involved in a workers' compensation case in Michigan.

Q: What is mediation?
A: Mediation is a process where a neutral third party helps facilitate a resolution between the parties involved in a dispute.

Q: What is a hearing?
A: A hearing is a formal legal proceeding where the parties present their arguments and evidence to an administrative law judge who will make a decision on the case.

Q: How do I fill out Form A (WC-104A)?
A: You need to provide your personal information, the details of your workers' compensation case, and indicate whether you are requesting mediation or a hearing.

Q: Is there a fee to file Form A (WC-104A)?
A: There is no fee to file Form A (WC-104A) in Michigan.

Q: What happens after I submit Form A (WC-104A)?
A: After you submit Form A (WC-104A), the Michigan Workers' Compensation Agency will review your request and schedule either a mediation or a hearing.