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Submit First Report of Injury
Date of Injury (MM/DD/YYYY)
Job Class
Where Did Injury Occur?
Injury State
MI
Is this claim a report only without treatment?
No
Yes
Location
( MIWC-31446-1) A-Ray-A, LLC Admin Building
( MIWC-31415-1) A.D. Food Service, Inc. Admin Building
( MIWC-31402-1) BVK2, Inc. Admin Building
( MIWC-06513-1) Datta Corporation Admin Building
( MIWC-28995-1) Draves Family Restaurants, LLC Admin Building
( MIWC-31439-1) GMDS, Inc Admin Building
( MIWC-13316-2) J.A.C.S. Enterprises, Inc. Admin Building
( MIWC-13602-1) Jenell Corporation Admin Building
( MIWC-04001-1) JMC #1, Inc. Admin Building
( MIWC-31404-1) JTLJ, LLC - Admin Building
( MIWC-22555-1) Lakeshore Staffing Admin Building
( MIWC-04315-1) LLS, Inc Admin Building
( MIWC-31267-1) MAS, Inc Admin Building
( MIWC-31427-1) MLW Management Inc Admin Building
( MIWC-23475-1) People Promises, LLC
( MIWC-21277-1) Percent, Inc. Admin Building
( MIWC-22700-1) Quarter Pak, Inc. Admin Building
( MIWC-31440-1) SM Saputo, LLC Admin Building
( MIWC-24736-1) STC, Inc. Admin Building
( MIWC-22555-10055) Store Number - 10055
( MIWC-31406-10056) Store Number - 10056
( MIWC-17541-10331) Store Number - 10331
( MIWC-27313-10332) Store Number - 10332
( MIWC-31437-1043) Store Number - 1043
( MIWC-27313-10433) Store Number - 10433
( MIWC-31415-10435) Store Number - 10435
( MIWC-27313-10436) Store Number - 10436
( MIWC-31427-10557) Store Number - 10557
( MIWC-27313-10683) Store Number - 10683
( MIWC-06513-10697) Store Number - 10697
( MIWC-31440-10729) Store Number - 10729
( MIWC-22555-10886) Store Number - 10886
( MIWC-06513-10950) Store Number - 10950
( MIWC-24736-10987) Store Number - 10987
( MIWC-31439-11015) Store Number - 11015
( MIWC-07780-11037) Store Number - 11037
( MIWC-31415-11067) Store Number - 11067
( MIWC-31404-11182) Store Number - 11182
( MIWC-24736-11183) Store Number - 11183
( MIWC-31445-11263) Store Number - 11263
( MIWC-17912-11317) Store Number - 11317
( MIWC-31267-11348) Store Number - 11348
( MIWC-31403-11369) Store Number - 11369
( MIWC-23475-11440) Store Number - 11440
( MIWC-31417-11453) Store Number - 11453
( MIWC-31450-11481) Store Number - 11481
( MIWC-31406-11498) Store Number - 11498
( MIWC-31275-11505) Store Number - 11505
( MIWC-06513-11520) Store Number - 11520
( MIWC-31440-11554) Store Number - 11554
( MIWC-31267-11633) Store Number - 11633
( MIWC-31417-11788) Store Number - 11788
( MIWC-04001-11852) Store Number - 11852
( MIWC-31230-11871) Store Number - 11871
( MIWC-31403-11921) Store Number - 11921
( MIWC-28200-11935) Store Number - 11935
( MIWC-22555-11962) Store Number - 11962
( MIWC-04001-11994) Store Number - 11994
( MIWC-10166-12012) Store Number - 12012
( MIWC-31403-12047) Store Number - 12047
( MIWC-21771-12094) Store Number - 12094
( MIWC-04001-12123) Store Number - 12123
( MIWC-31415-12131) Store Number - 12131
( MIWC-31404-12142) Store Number - 12142
( MIWC-31409-12189) Store Number - 12189
( MIWC-13316-12245) Store Number - 12245
( MIWC-17541-12265) Store Number - 12265
( MIWC-24736-12308) Store Number - 12308
( MIWC-31435-12321) Store Number - 12321
( MIWC-31428-12373) Store Number - 12373
( MIWC-31452-12466) Store Number - 12466
( MIWC-04001-1252) Store Number - 1252
( MIWC-04315-12563) Store Number - 12563
( MIWC-04001-1270) Store Number - 1270
( MIWC-17541-12715) Store Number - 12715
( MIWC-22555-12774) Store Number - 12774
( MIWC-31267-12780) Store Number - 12780
( MIWC-31415-12818) Store Number - 12818
( MIWC-31447-12819) Store Number - 12819
( MIWC-31418-12839) Store Number - 12839
( MIWC-31451-12925) Store Number - 12925
( MIWC-07780-1309) Store Number - 1309
( MIWC-22555-13118) Store Number - 13118
( MIWC-31275-1312) Store Number - 1312
( MIWC-31433-1318) Store Number - 1318
( MIWC-31439-1329) Store Number - 1329
( MIWC-17541-1339) Store Number - 1339
( MIWC-31267-13563) Store Number - 13563
( MIWC-07780-13606) Store Number - 13606
( MIWC-13866-13640) Store Number - 13640
( MIWC-21771-13686) Store Number - 13686
( MIWC-04315-13710) Store Number - 13710
( MIWC-27313-13736) Store Number - 13736
( MIWC-31409-13821) Store Number - 13821
( MIWC-31412-13841) Store Number - 13841
( MIWC-10166-13842) Store Number - 13842
( MIWC-31440-139) Store Number - 139
( MIWC-04315-13977) Store Number - 13977
( MIWC-23475-14045) Store Number - 14045
( MIWC-31427-14148) Store Number - 14148
( MIWC-31414-14154) Store Number - 14154
( MIWC-31433-14166) Store Number - 14166
( MIWC-28995-14210) Store Number - 14210
( MIWC-31440-14292) Store Number - 14292
( MIWC-31230-14320) Store Number - 14320
( MIWC-28450-14363) Store Number - 14363
( MIWC-31403-14664) Store Number - 14664
( MIWC-27313-15244) Store Number - 15244
( MIWC-31417-15267) Store Number - 15267
( MIWC-31434-15295) Store Number - 15295
( MIWC-22555-15297) Store Number - 15297
( MIWC-07780-15467) Store Number - 15467
( MIWC-13316-15600) Store Number - 15600
( MIWC-17887-15714) Store Number - 15714
( MIWC-04315-158) Store Number - 158
( MIWC-04001-15872) Store Number - 15872
( MIWC-31427-16071) Store Number - 16071
( MIWC-31451-16072) Store Number - 16072
( MIWC-04315-16073) Store Number - 16073
( MIWC-31434-16074) Store Number - 16074
( MIWC-04315-1611) Store Number - 1611
( MIWC-04001-16112) Store Number - 16112
( MIWC-13602-16134) Store Number - 16134
( MIWC-06513-1633) Store Number - 1633
( MIWC-22555-16674) Store Number - 16674
( MIWC-22555-16729) Store Number - 16729
( MIWC-21771-16733) Store Number - 16733
( MIWC-17541-16905) Store Number - 16905
( MIWC-31267-16997) Store Number - 16997
( MIWC-07780-1702) Store Number - 1702
( MIWC-31427-17103) Store Number - 17103
( MIWC-31427-17104) Store Number - 17104
( MIWC-31402-17125) Store Number - 17125
( MIWC-28450-17236) Store Number - 17236
( MIWC-31446-17266) Store Number - 17266
( MIWC-21771-17295) Store Number - 17295
( MIWC-04315-17430) Store Number - 17430
( MIWC-31267-17469) Store Number - 17469
( MIWC-21875-17550) Store Number - 17550
( MIWC-31435-17565) Store Number - 17565
( MIWC-21771-17601) Store Number - 17601
( MIWC-31450-1766) Store Number - 1766
( MIWC-31404-17704) Store Number - 17704
( MIWC-21771-17705) Store Number - 17705
( MIWC-22555-17741) Store Number - 17741
( MIWC-31409-17778) Store Number - 17778
( MIWC-13316-17896) Store Number - 17896
( MIWC-21771-179) Store Number - 179
( MIWC-22555-18004) Store Number - 18004
( MIWC-31415-18160) Store Number - 18160
( MIWC-08180-18175) Store Number - 18175
( MIWC-21875-18269) Store Number - 18269
( MIWC-04001-18273) Store Number - 18273
( MIWC-31440-18314) Store Number - 18314
( MIWC-24733-1838) Store Number - 1838
( MIWC-21875-18603) Store Number - 18603
( MIWC-21875-1882) Store Number - 1882
( MIWC-23475-18846) Store Number - 18846
( MIWC-31406-18919) Store Number - 18919
( MIWC-22555-19024) Store Number - 19024
( MIWC-22700-19044) Store Number - 19044
( MIWC-13866-1908) Store Number - 1908
( MIWC-04315-19088) Store Number - 19088
( MIWC-21875-19098) Store Number - 19098
( MIWC-23475-191) Store Number - 191
( MIWC-23475-19180) Store Number - 19180
( MIWC-27313-19188) Store Number - 19188
( MIWC-31267-1936) Store Number - 1936
( MIWC-31435-19386) Store Number - 19386
( MIWC-31435-19405) Store Number - 19405
( MIWC-31406-19614) Store Number - 19614
( MIWC-31402-19866) Store Number - 19866
( MIWC-31403-19871) Store Number - 19871
( MIWC-31412-1992) Store Number - 1992
( MIWC-13316-20444) Store Number - 20444
( MIWC-06513-20448) Store Number - 20448
( MIWC-07780-2071) Store Number - 2071
( MIWC-31450-2072) Store Number - 2072
( MIWC-31440-20756) Store Number - 20756
( MIWC-31405-20827) Store Number - 20827
( MIWC-31230-2083) Store Number - 2083
( MIWC-27313-210) Store Number - 210
( MIWC-13866-21049) Store Number - 21049
( MIWC-31435-21221) Store Number - 21221
( MIWC-31405-21244) Store Number - 21244
( MIWC-23475-21245) Store Number - 21245
( MIWC-31409-2154) Store Number - 2154
( MIWC-21875-2162) Store Number - 2162
( MIWC-21277-21836) Store Number - 21836
( MIWC-31437-21837) Store Number - 21837
( MIWC-13316-21854) Store Number - 21854
( MIWC-13488-22006) Store Number - 22006
( MIWC-23475-2201) Store Number - 2201
( MIWC-21875-22032) Store Number - 22032
( MIWC-31427-22035) Store Number - 22035
( MIWC-31418-22143) Store Number - 22143
( MIWC-31427-22180) Store Number - 22180
( MIWC-27313-222) Store Number - 222
( MIWC-23475-2228) Store Number - 2228
( MIWC-22555-22609) Store Number - 22609
( MIWC-13316-22634) Store Number - 22634
( MIWC-31275-22695) Store Number - 22695
( MIWC-31447-22702) Store Number - 22702
( MIWC-31415-22869) Store Number - 22869
( MIWC-22700-2291) Store Number - 2291
( MIWC-13866-22939) Store Number - 22939
( MIWC-07780-22984) Store Number - 22984
( MIWC-17541-2305) Store Number - 2305
( MIWC-31403-2306) Store Number - 2306
( MIWC-22555-2308) Store Number - 2308
( MIWC-31411-2311) Store Number - 2311
( MIWC-31437-23213) Store Number - 23213
( MIWC-31404-23265) Store Number - 23265
( MIWC-31414-23342) Store Number - 23342
( MIWC-31409-23358) Store Number - 23358
( MIWC-31439-23429) Store Number - 23429
( MIWC-04315-23668) Store Number - 23668
( MIWC-28450-2387) Store Number - 2387
( MIWC-31415-23878) Store Number - 23878
( MIWC-22555-24068) Store Number - 24068
( MIWC-04001-24103) Store Number - 24103
( MIWC-21875-24327) Store Number - 24327
( MIWC-21771-24404) Store Number - 24404
( MIWC-08180-2469) Store Number - 2469
( MIWC-07780-24733) Store Number - 24733
( MIWC-31406-24809) Store Number - 24809
( MIWC-27313-2482) Store Number - 2482
( MIWC-31405-24999) Store Number - 24999
( MIWC-07780-25025) Store Number - 25025
( MIWC-27313-25050) Store Number - 25050
( MIWC-31409-25053) Store Number - 25053
( MIWC-23475-2525) Store Number - 2525
( MIWC-31437-25320) Store Number - 25320
( MIWC-04001-25356) Store Number - 25356
( MIWC-27313-2553) Store Number - 2553
( MIWC-22555-25545) Store Number - 25545
( MIWC-31439-25550) Store Number - 25550
( MIWC-31404-256) Store Number - 256
( MIWC-24736-25691) Store Number - 25691
( MIWC-13316-25700) Store Number - 25700
( MIWC-28200-25702) Store Number - 25702
( MIWC-27313-25762) Store Number - 25762
( MIWC-31267-25781) Store Number - 25781
( MIWC-17541-2581) Store Number - 2581
( MIWC-23475-25831) Store Number - 25831
( MIWC-31411-26114) Store Number - 26114
( MIWC-31267-26174) Store Number - 26174
( MIWC-31452-26259) Store Number - 26259
( MIWC-28450-26347) Store Number - 26347
( MIWC-31447-26495) Store Number - 26495
( MIWC-13316-26496) Store Number - 26496
( MIWC-31427-2699) Store Number - 2699
( MIWC-31440-2722) Store Number - 2722
( MIWC-22555-2737) Store Number - 2737
( MIWC-31409-27385) Store Number - 27385
( MIWC-31403-2749) Store Number - 2749
( MIWC-15337-2778) Store Number - 2778
( MIWC-08180-27820) Store Number - 27820
( MIWC-17541-28045) Store Number - 28045
( MIWC-31433-28332) Store Number - 28332
( MIWC-21875-2852) Store Number - 2852
( MIWC-31440-2853) Store Number - 2853
( MIWC-31267-2877) Store Number - 2877
( MIWC-31418-28938) Store Number - 28938
( MIWC-31428-2896) Store Number - 2896
( MIWC-31433-2901) Store Number - 2901
( MIWC-21277-29225) Store Number - 29225
( MIWC-31405-2936) Store Number - 2936
( MIWC-31412-2999) Store Number - 2999
( MIWC-31275-3003) Store Number - 3003
( MIWC-24736-30337) Store Number - 30337
( MIWC-21875-30586) Store Number - 30586
( MIWC-17541-306) Store Number - 306
( MIWC-31267-30617) Store Number - 30617
( MIWC-31452-30673) Store Number - 30673
( MIWC-13316-30801) Store Number - 30801
( MIWC-21277-3085) Store Number - 3085
( MIWC-06513-3086) Store Number - 3086
( MIWC-21277-3087) Store Number - 3087
( MIWC-04315-309) Store Number - 309
( MIWC-04001-31406) Store Number - 31406
( MIWC-31439-3155) Store Number - 3155
( MIWC-31439-319) Store Number - 319
( MIWC-28995-3192) Store Number - 3192
( MIWC-31402-3196) Store Number - 3196
( MIWC-31440-3198) Store Number - 3198
( MIWC-31230-32123) Store Number - 32123
( MIWC-21771-32510) Store Number - 32510
( MIWC-13602-32729) Store Number - 32729
( MIWC-27313-33146) Store Number - 33146
( MIWC-31412-33298) Store Number - 33298
( MIWC-31275-33312) Store Number - 33312
( MIWC-07780-33522) Store Number - 33522
( MIWC-31406-3354) Store Number - 3354
( MIWC-21771-3356) Store Number - 3356
( MIWC-21277-33596) Store Number - 33596
( MIWC-17541-3387) Store Number - 3387
( MIWC-13602-3396) Store Number - 3396
( MIWC-31450-34061) Store Number - 34061
( MIWC-31449-3414) Store Number - 3414
( MIWC-31450-346) Store Number - 346
( MIWC-17541-3493) Store Number - 3493
( MIWC-04315-3494) Store Number - 3494
( MIWC-21277-35179) Store Number - 35179
( MIWC-23475-3519) Store Number - 3519
( MIWC-04315-35513) Store Number - 35513
( MIWC-27313-357) Store Number - 357
( MIWC-28995-35810) Store Number - 35810
( MIWC-10166-35855) Store Number - 35855
( MIWC-13316-35919) Store Number - 35919
( MIWC-13866-36102) Store Number - 36102
( MIWC-04315-36277) Store Number - 36277
( MIWC-31275-36302) Store Number - 36302
( MIWC-31267-36331) Store Number - 36331
( MIWC-13488-36392) Store Number - 36392
( MIWC-21771-36549) Store Number - 36549
( MIWC-04315-3711) Store Number - 3711
( MIWC-06513-37212) Store Number - 37212
( MIWC-31404-3768) Store Number - 3768
( MIWC-21875-3827) Store Number - 3827
( MIWC-21875-3829) Store Number - 3829
( MIWC-31417-38335) Store Number - 38335
( MIWC-13316-3845) Store Number - 3845
( MIWC-31404-3854) Store Number - 3854
( MIWC-31439-38765) Store Number - 38765
( MIWC-13316-3892) Store Number - 3892
( MIWC-24736-391) Store Number - 391
( MIWC-21277-39144) Store Number - 39144
( MIWC-13488-39235) Store Number - 39235
( MIWC-31411-39477) Store Number - 39477
( MIWC-17541-3949) Store Number - 3949
( MIWC-22700-3976) Store Number - 3976
( MIWC-31435-3988) Store Number - 3988
( MIWC-31412-3990) Store Number - 3990
( MIWC-31427-4005) Store Number - 4005
( MIWC-24736-4009) Store Number - 4009
( MIWC-17541-4022) Store Number - 4022
( MIWC-27313-4096) Store Number - 4096
( MIWC-08180-41205) Store Number - 41205
( MIWC-21277-4157) Store Number - 4157
( MIWC-31435-4162) Store Number - 4162
( MIWC-31409-4186) Store Number - 4186
( MIWC-17541-4276) Store Number - 4276
( MIWC-27313-432) Store Number - 432
( MIWC-31447-4321) Store Number - 4321
( MIWC-31418-4427) Store Number - 4427
( MIWC-22555-4451) Store Number - 4451
( MIWC-17541-4473) Store Number - 4473
( MIWC-31418-4488) Store Number - 4488
( MIWC-31267-4635) Store Number - 4635
( MIWC-13316-4639) Store Number - 4639
( MIWC-07780-4667) Store Number - 4667
( MIWC-31415-4704) Store Number - 4704
( MIWC-31439-4763) Store Number - 4763
( MIWC-21771-4799) Store Number - 4799
( MIWC-31449-4849) Store Number - 4849
( MIWC-04001-4853) Store Number - 4853
( MIWC-31427-4863) Store Number - 4863
( MIWC-31434-4881) Store Number - 4881
( MIWC-17887-4882) Store Number - 4882
( MIWC-31414-4906) Store Number - 4906
( MIWC-04315-5057) Store Number - 5057
( MIWC-21875-5084) Store Number - 5084
( MIWC-31447-5114) Store Number - 5114
( MIWC-31414-5208) Store Number - 5208
( MIWC-21771-5237) Store Number - 5237
( MIWC-31267-5238) Store Number - 5238
( MIWC-31431-5251) Store Number - 5251
( MIWC-31418-5299) Store Number - 5299
( MIWC-17541-5300) Store Number - 5300
( MIWC-28450-5353) Store Number - 5353
( MIWC-21875-5389) Store Number - 5389
( MIWC-31267-5477) Store Number - 5477
( MIWC-17541-5478) Store Number - 5478
( MIWC-04001-550) Store Number - 550
( MIWC-13316-5504) Store Number - 5504
( MIWC-21277-5506) Store Number - 5506
( MIWC-31415-5568) Store Number - 5568
( MIWC-31435-5569) Store Number - 5569
( MIWC-07780-567) Store Number - 567
( MIWC-31267-5681) Store Number - 5681
( MIWC-31415-5738) Store Number - 5738
( MIWC-04001-5853) Store Number - 5853
( MIWC-28450-5882) Store Number - 5882
( MIWC-28450-5896) Store Number - 5896
( MIWC-21771-6130) Store Number - 6130
( MIWC-17541-6229) Store Number - 6229
( MIWC-04315-6237) Store Number - 6237
( MIWC-17541-6287) Store Number - 6287
( MIWC-22555-6362) Store Number - 6362
( MIWC-31406-6517) Store Number - 6517
( MIWC-21771-6642) Store Number - 6642
( MIWC-31267-6644) Store Number - 6644
( MIWC-07780-6799) Store Number - 6799
( MIWC-31267-7006) Store Number - 7006
( MIWC-31417-7034) Store Number - 7034
( MIWC-22700-7333) Store Number - 7333
( MIWC-31402-74) Store Number - 74
( MIWC-31446-7453) Store Number - 7453
( MIWC-22555-7479) Store Number - 7479
( MIWC-31453-7595) Store Number - 7595
( MIWC-04001-761) Store Number - 761
( MIWC-04315-7650) Store Number - 7650
( MIWC-21277-7659) Store Number - 7659
( MIWC-31417-7700) Store Number - 7700
( MIWC-17912-7946) Store Number - 7946
( MIWC-31435-7955) Store Number - 7955
( MIWC-13488-7976) Store Number - 7976
( MIWC-07780-8003) Store Number - 8003
( MIWC-23475-8097) Store Number - 8097
( MIWC-31418-8145) Store Number - 8145
( MIWC-31267-958) Store Number - 958
( MIWC-31445-979) Store Number - 979
( MIWC-31403-1) TKMAV, Inc. Admin Building
( MIWC-21875-1) ULM Restaurants, Inc. Admin Building
( MIWC-31445-1) Vera Bardha Admin Building
( MIWC-31411-1) VS & F, LLC Admin Building
( MIWC-25980-1) Wilson Management, Inc. - Admin Office
Does incident require additional investigation or will injured employee miss more than 7 days of work?
No
Yes
Proceed with New Claim?