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Restoring
Personal ServiceREDEMPTION ORDER Michigan Department of Labor and Economic Opportunity
Workers Disability Compensation Agency
PO Box 30016, Lansing, MI 48909MailedDay of20Magistrate (please
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01
To fill out form wc-113, follow these steps:
02
Start by entering the date of the form in the designated field.
03
Provide your personal information, including your name, address, and contact details.
04
Indicate your employment status and employer information, if applicable.
05
Specify the details of the injury or illness, including the date, time, and location.
06
Describe the nature of the injury or illness and how it occurred.
07
Provide information about any witnesses to the incident, if applicable.
08
If you received medical treatment, enter details of the healthcare provider, treatment received, and any associated costs.
09
Sign and date the form to certify the accuracy of the provided information.
10
Submit the completed form to the appropriate recipient or authority.
Who needs form wc-113?
01
Form wc-113 is needed by individuals who have suffered a work-related injury or illness and are seeking compensation or benefits from their employer's workers' compensation insurance.
02
Employers may also require their employees to fill out this form as part of the claims process.
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What is form wc-113?
Form WC-113 is a specific form used for reporting workers' compensation claims in certain jurisdictions.
Who is required to file form wc-113?
Employers who have had workers' compensation claims or incidents that require reporting are typically required to file Form WC-113.
How to fill out form wc-113?
To fill out Form WC-113, you should provide the required information about the employee, the incident, and any applicable benefits according to the instructions provided with the form.
What is the purpose of form wc-113?
The purpose of Form WC-113 is to document claims and provide necessary information for the administration of workers' compensation benefits.
What information must be reported on form wc-113?
Form WC-113 typically requires information such as the employee's details, the nature of the injury, the date of the incident, and any medical treatments received.
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