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Form WC-739 Carrier's Explanation of Benefits - Michigan
What Is Form WC-739?
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-739?
A: Form WC-739 is Carrier's Explanation of Benefits.
Q: What does Form WC-739 contain?
A: Form WC-739 contains the explanation of benefits for workers' compensation claims in Michigan.
Q: Who fills out Form WC-739?
A: The workers' compensation carrier fills out Form WC-739.
Q: What information is included in Form WC-739?
A: Form WC-739 includes details about the medical treatment provided, any expenses covered, and the payment made for the workers' compensation claim.
Q: Is Form WC-739 specific to Michigan?
A: Yes, Form WC-739 is specific to Michigan workers' compensation claims.
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 printable version of Form WC-739 by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.
