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Industrial Commission of Arizona

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Industrial Commission of Arizona
Protection of life, health, safety, and welfare of Arizona's workforce

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  • Home
  • Agency Information
    • About Us
    • Commissioners
    • Director's Office
    • Legislation
      • Arizona Statutes
      • Arizona Rules
    • Meetings
      • All Public Meetings
      • Commission Meeting Agendas
      • Meeting Minutes
  • Divisions
    • Administration
      • Accounting
      • Human Resources, Special Services and MIS
      • Self-Insurance and Tax Office
    • Administrative Law Judge (ALJ) Division
    • ADOSH
      • Boiler Section
      • Elevator Section
      • Occupational Safety and Health (OSHA / ADOSH)
      • Research & Statistics (BLS)
    • Claims Division
    • Labor Department
    • Legal Division
    • Medical Resource Office (MRO)
    • Special Fund Division
  • News and Events
    • Public Notices
    • News and Events
  • Resources For
    • Resources for Employees
    • Resources for Employers
    • Resources for Insurers
    • Resources for Medical Providers
    • Resources for ICA Community
  • How Do I
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    • Forms
    • Self Service Center
    • ICA Community
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  • Claims - Employer's Report of Injury

Claims - Employer's Report of Injury

Claims Division
Employer's Report of Injury

Ruby Tate, Claims Manager
Email: [email protected]

 Do not use the above email address to send emails (or attachments to emails)  containing sensitive or personal information (such as social security numbers) to the  ICA because neither the website nor email is secure. Instead, FAX such materials to  the FAX number below or mail paper copies to a mailing address below.

Phoenix: 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4661
Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: (520) 628-5181
FAX (use for either office): (602) 542-3373

Click for Phone List of ICA Divisions

 


Employer's Report of Injury


Click here to download form :     Employer Report of Injury Form

The employer must notify his insurance carrier of every known injury or disease suffered by an employee, fatal or otherwise, arising out of or in course of employment.

 

ICA Community is NOW LIVE

Join the ICA Community Now!

Resources for the ICA Community

Wage Information

  • 2023 AMW Statutory Max - $5,393.37 
  • 2023 Minimum Wage - $13.85 per hour
  • 2022 AMW Statutory Max - $5,161.12 
  • 2022 Minimum Wage - $12.80 per hour 

Job Opportunities at the ICA

Job Opportunities at the ICA

Public Notices

  • 12/20/22 ICA Announces Restructured Ombudsman Team
  • 11/16/22 Notice of Public Hearing – Self Insured Premium Rates – December 15, 2022
Public Notice Archive

Recent News & Events

  • 02/01/23 New Medical Resource Office Trainings Available
  • 12/06/22 Rule 20-5-1534 Self-Insurance Q&A
  • 09/15/22 2023 Minimum Wage Increase
  • 06/09/22 Cancer Claim Reporting and MFCR Training
  • 06/01/22 ICA Community Update - Upload Confirmation Email
Recent News Archive

Official Website of the State of Arizona

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Contact Us:

Phoenix Office
800 W. Washington Street
Phoenix AZ 85007
602-542-4661

 

tucson map

Contact Us:

Tucson Office
2675 E. Broadway Blvd
Tucson AZ 85716
520-628-5188

 

 

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