Form Claims ICA0124 Report of Significant Work Exposure to Bodily Fluids or Other Infectious Material - Arizona

What Is Form Claims ICA0124?

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 ICA0124 report?
A: The ICA0124 report is a form used in Arizona to report significant work exposure to bodily fluids or other infectious material.

Q: Who needs to complete the ICA0124 report?
A: Employees who have experienced significant work exposure to bodily fluids or other infectious material in Arizona need to complete the ICA0124 report.

Q: What information is required in the ICA0124 report?
A: The ICA0124 report requires information such as the employee's personal details, the nature of the exposure, the source of the exposure, and any medical treatment received.

Q: Is the ICA0124 report confidential?
A: Yes, the information provided in the ICA0124 report is confidential and protected under Arizona law.

Q: What should I do if I have experienced significant work exposure to bodily fluids or other infectious material?
A: If you have experienced significant work exposure to bodily fluids or other infectious material, you should report it to your employer and complete the ICA0124 report as soon as possible.

Q: Are there any time limits for submitting the ICA0124 report?
A: Yes, the ICA0124 report should be submitted within 4 working days of the exposure or as otherwise specified by your employer.

Q: What happens after I submit the ICA0124 report?
A: After you submit the ICA0124 report, your employer and the Industrial Commission of Arizona will review the information provided and take appropriate action.

Q: Can I claim workers' compensation for work exposure to bodily fluids or other infectious material?
A: Yes, if you have experienced significant work exposure to bodily fluids or other infectious material, you may be eligible to claim workers' compensation benefits.