Programs & Services

Workers’ Compensation Fund Claims Reporting Information & Forms

Meadowbrook Claims Service: 800-752-7477

After-hours emergency number:  248-358-1100 ext. 6116

Claims Staff Contacts

Claims Procedures (start here if you’re new to MML claims)

Employer’s Report of Injury Form
Use this form to report all regardless of medical treatment or disability.

Order for Medical Treatment – Fillable Form

Order for Medical Treatment – Print Blank

Claim forms can be submitted directly online or by email, fax, or mail.
Additional documentation may be submitted by email, fax, or mail.

Email:  [email protected]

Fax:  616-649-1796

MML WC Fund Claims
3196 Kraft Avenue, S.E., Suite 206
Grand Rapids, MI  49512-2065

COVID-19 NOTE: The Workers’ Compensation Agency Emergency Rules dated 3/30/20 and 10/16/20, which established and extended coverage for First Responder Employees diagnosed with COVID-19 between 3/30/20 and 3/20/21, have expired without further extension. Therefore, employees with COVID-19 diagnoses dated 3/21/21 or later are not eligible for coverage under presumption of work-related injury.

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