Labor and Economic Opportunity
The revised form WC-701 is now available on our website and is a fill-in pdf form. It is to be put into immediate use. The form will provide the information necessary to enable the Agency to comply with its legislative reporting requirements as specified in MCL 418.801(7).
The form revisions facilitate the calculation and reporting of weekly wage loss benefits taking into account the changes to the Workers' Disability Compensation Act in the amendments enacted in December 2011, PA 2011, Act 266; and April 2012, PA 2012, Act 83.
The form revisions separate the WC-701 Filing Codes into a one-page document which is not part of the form 701 pdf. Do not file a copy of the codes page when filing the 701.
The service company information in blocks 19 and 20 should only be provided in the case of the employer being an Agency approved self-insurer.
The form WC-701 instruction guide has been updated to reflect the changes.