Transcription of Employer's Basic Report of Injury - Michigan
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Employer's Basic Report of Injury - Michigan
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You must complete all questions on this form if the injury or disease results in any of the following: (a) Disability extending beyond seven (7) consecutive days, not including the date of injury; (b) Death; (c) Specific loss. The original form must be mailed to the Workers’ Disability Compensation Agency, P.O. Box 30016, Lansing, MI 48909.
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