Updated WC-104C Form

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Workers’ Compensation Agency (WCA) releases updated Application for Mediation or Hearing — Form C.

The WCA has published a new Application for Mediation or Hearing — Form C. It now includes two additional check boxes for “Redemption Only” and “Petition to Determine Medical Treatment.” Changes were made based upon user feedback and to streamline operations/procedures.

Claimants who wish to settle for a lump sum cash payment must request the WCA file be sent from Lansing to the appropriate hearing site. A magistrate will then make a determination about whether the settlement is just and proper. Form WC-104C is used to streamline the file request procedure and the box “Redemption Only” should be checked.

Some claims involve disputes about just medical treatment. These issues can sometimes be resolved through an informal telephone mediation process with WCA staff. Each side will be given the opportunity to discuss relevant issues and come up with a resolution. It is anticipated this will be more frequently used with disputes involving the new opioid treatment rules. The box “Petition to Determine Medical Treatment” should be checked in this situation.

We strongly recommend contacting an experienced workers’ compensation lawyer before taking any action on your own.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (855) 221-2667 for a free consultation today.

Related information:

MEMO: Updated WC-104C, Application for Mediation or Hearing

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Author Bio Jeffrey Kaufman

Author
Jeffrey E. Kaufman
Michigan Workers Comp Attorney

Jeffrey E. Kaufman has extensive experience in workers compensation cases and has recovered millions of dollars in benefits for his clients. He believes all injured workers deserve to be on equal footing with insurance companies and employers, and fights tenaciously so their rights are secured and protected.


“Jeff also helped me with getting my Blue Cross bills paid. I would absolutely recommend him and the whole firm. Jeff and the firm did everything they were supposed to do for me and my case.”
Ricardo Perfetto

Hundreds of 5-Star Reviews

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Get Help From our Michigan Workers’ Comp Lawyers Today

You’re not alone. Our Michigan workers’ comp lawyers have been called the best in the state, and our clients love how they’re treated with care, respect, and responsiveness. We will give you the time you need, we will explain your legal rights, and we will always treat you with respect.

Our workers’ compensation and Social Security disability lawyers always put your needs first. Get to know your legal team.

Our attorneys post regularly about common issues related to workers’ comp, including common injuries, settlement calculations, laws, and more.

Injured? It’s Time to Get Some Answers

Don’t let the insurance adjuster push you around. Request your free consultation today.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Our attorneys post regularly about common issues related to workers’ comp, including common injuries, settlement calculations, laws, and more.

Our workers’ compensation and Social Security disability lawyers always put your needs first. Get to know your legal team.