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This version of the form is not currently in use and is provided for reference only. Download this version of
Form WC-100
for the current year.
Form WC-100 Employer's Basic Report of Injury - Michigan
What Is Form WC-100?
This is a legal form that was released by the Michigan Department of Licensing and Regulatory Affairs - 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-100?
A: Form WC-100 is the Employer's Basic Report of Injury in Michigan.
Q: Who should fill out Form WC-100?
A: Employers in Michigan should fill out Form WC-100 when an employee is injured on the job.
Q: What information is required on Form WC-100?
A: Form WC-100 requires information about the employee, the injury, and the employer.
Q: Is Form WC-100 mandatory?
A: Yes, employers in Michigan are required to fill out Form WC-100 when an employee is injured on the job.
Q: When should Form WC-100 be submitted?
A: Form WC-100 should be submitted to the employer's insurance carrier within 48 hours of the injury.
Q: What happens after Form WC-100 is submitted?
A: After Form WC-100 is submitted, the employer's insurance carrier will review the report and make a determination on the claim.
Form Details:
- Released on February 1, 2013;
- The latest edition provided by the Michigan Department of Licensing and Regulatory Affairs;
- 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-100 by clicking the link below or browse more documents and templates provided by the Michigan Department of Licensing and Regulatory Affairs.
