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Form WC-750 Provider's Request for Reconsideration - Michigan
What Is Form WC-750?
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-750?
A: Form WC-750 is the Provider's Request for Reconsideration in Michigan workers' compensation cases.
Q: Who can use Form WC-750?
A: This form can be used by medical providers who are seeking reconsideration of a denied or disputed claim in a workers' compensation case in Michigan.
Q: What is the purpose of Form WC-750?
A: The purpose of Form WC-750 is to request a reconsideration of a denied or disputed claim in a workers' compensation case in Michigan.
Q: What information is required on Form WC-750?
A: Form WC-750 requires the provider to provide information about the patient, the treatment provided, and the reasons for requesting reconsideration.
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 WC-750 by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.
