How to File a Workers’ Compensation Claim in Arizona

Law Offices of Robert E. Wisniewski

Hurt on the job? Call Bob.

Serving Phoenix and Arizona

(602) 234-3700 Free consult

Specialty: Workers' compensation

To get workers' compensation benefits, you need to follow Arizona's laws for reporting the injury and filing a claim

If you suffer a work-related injury in Arizona, you might be entitled to workers’ compensation benefits. In order to obtain these benefits, you’ll need to follow certain procedures. Failing to do so may delay your claim or—even worse—prevent you from collecting any benefits at all. 

1. Notify your employer

The first thing you’ll need to do if you suffer a work-related injury is inform your employer. Once notified, your employer is required to provide you with certain information about their workers’ compensation insurance carrier. This information includes:

• The name and address of the insurance carrier
• The policy number
• The date of expiration of coverage

Keep this information somewhere safe. It will be useful down the road.

Once your employer learns of your injury, they’re also required to notify their workers’ compensation insurance carrier and the Industrial Commission of Arizona (ICA) by filing an Employer’s Report of Industrial Injury. This must be done within 10 days of learning of the injury. 

2. See a doctor

Seeing a doctor as soon as possible after your injury is extremely important for two reasons. First, even though you may be worried about recovering workers’ compensation benefits, your health should be your number 1 priority.

Second, failing to see a doctor will raise doubts about the legitimacy of your claim. Visiting a doctor soon after your injury helps establish that your injury and claim are legitimate. If your claim is denied or your employer contests your claim, you’ll want to be able to provide solid medical evidence of your injury.

To this end, be sure to tell your doctor that your injury was work-related. That way, your doctor will include this information in your medical records.

3. Fill out the proper form

It’s your responsibility to file a workers’ compensation claim within 1 year of the date of your work-related injury. In order to do this, you need to complete 1 of the following 2 forms:

Worker’s and Physician’s Report of Injury

The Worker’s and Physician’s Report of Injury can be obtained from your doctor’s office. You can also download the form here and take it with you to the doctor’s office.

You must complete the first section of the form entitled “Worker’s Report.” Your health provider must complete the second section of the form entitled “Physician’s Initial Report.”

Worker’s Report of Injury

You can download the Worker’s Report of Injury form here. The form requires you to answer basic questions about your injury, including the date of the injury and the body part that was injured. You must fill out all sections of the form. Don’t forget to sign and date at the bottom.

4. File the form

Once you complete the form, it must be filed with ICA. The steps for filing each form differ slightly depending on which form you complete:

Worker’s and Physician’s Report of Injury form

The medical provider completing this form must file it with the ICA within 8 days of rendering treatment. This is accomplished by mailing the original form to ICA at:

P.0. Box 19070, Phoenix, AZ 85005

One copy must also be sent to your employer and your employer’s workers’ compensation insurance carrier.

Worker’s Report of Injury form

The Worker’s Report of Injury form must be filed within 1 year after the injury occurs. Once the form is completed, you need to mail the form to one of the addresses listed below:

Phoenix: 800 W. Washington St., Phoenix AZ 85007

Tucson: 2675 E. Broadway Blvd., Tucson AZ 85716

You can also fax the form to the number below:

FAX (use for either office): (602) 542-3373

Once your claim is filed, your employer’s workers’ compensation insurance carrier will be notified of the claim. The insurance carrier has 21 days to accept or deny the claim. If the insurance carrier denies the claim, you’ll need to file a Request for Hearing within 90 days from the date you receive the denial notice.

Consult with an attorney

An attorney can help ensure that you don’t miss any important procedural steps and can further ensure that you receive all the benefits to which you’re entitled. The earlier in this process you consult with a workers’ compensation attorney, the more likely your claim will be accepted.

Visit our free online directory of personal injury and workers’ compensation attorneys to find a lawyer in Arizona.