Form Claims ICA0101 Employer's Report of Industrial Injury - Arizona

What Is Form Claims ICA0101?

This is a legal form that was released by the Industrial Commission of Arizona - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of Form Claims ICA0101?
A: Form Claims ICA0101 is used by employers in Arizona to report industrial injuries.

Q: Who is required to fill out Form Claims ICA0101?
A: Employers in Arizona are required to fill out Form Claims ICA0101.

Q: What information is needed to complete Form Claims ICA0101?
A: Form Claims ICA0101 requires information about the injured employee, including their name, address, and Social Security number, as well as details about the injury and the circumstances surrounding it.

Q: When should Form Claims ICA0101 be submitted?
A: Form Claims ICA0101 should be submitted within 10 days of the employer's knowledge of the injury or illness.

Q: What happens after Form Claims ICA0101 is submitted?
A: Once Form Claims ICA0101 is submitted, the Industrial Commission of Arizona will review the report and may contact the employer or injured employee for additional information.