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Workers' Compensation Fund Blue Arrows

Fund Board of Trustees Election - Polling is Open
Click Here to Vote by Online Ballot

Claims Reporting Information & Forms

***  After-hours emergency number:  248-358-1100 ext. 6116 ***

Staff Contacts

Points to Remember

Reporting Procedures

Online Employer's Report of Injury Form (short) - use for:

  • On-the-job injury whether medical treatment is required or not, and

  • Employee’s time away from work does not exceed seven (7) days, and

  • Circumstances of incident/injury are not questionable.

Order for Medical Treatment - Fillable Form

Order for Medical Treatment - Print Blank


If you have trouble emailing or submitting these forms online,
please fax them to 616-649-1796 or mail them to: 

MML WC Claims
3196 Kraft Avenue, S.E., Suite 206
Grand Rapids, MI  49512-2065

 

 

 

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