Arizona Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
Workers' Comp Exemptions in Arizona. Sole-Proprietors and Partners who include themselves on workers' compensation coverage must use a minimum payroll amount of $31,200 for rating their overall workers' compensation cost.
Arizona law prohibits employers from firing an injured employee strictly because they filed a workers' compensation claim, and your employer cannot prevent you from filing a claim by firing you. However, injured status doesn't protect your job, even if your employer is at fault for your injury.
Compensation is calculated in three different ways for scheduled injuries: (1) For partial loss, you will receive 50% of the average monthly wage, (2) for a loss that is the result of an amputation or a total loss of use, you will receive 55% of the average monthly wage, and (3) if the doctor indicates that the ...
Compensation is payable every 14 to 30 days, depending on the type of disability. No wage loss benefit is payable for the first 7 consecutive calendar days, if total time lost is less than 13 consecutive calendar days. This waiting period occurs only once during a claim.
§ 23-908(A) within eight days after first providing treatment to an injured worker. The physician shall report the injury: 1. Using Commission form 102 (worker's and physician's report of injury), or 2. Attaching to form 102 a medical report that contains the information required in form 102.
In Arizona, workers' comp covers all medical expenses to heal the work-related injury or illness. It can also provide some of the missed wages when injured workers need time off to recover. Coverage requirements in Arizona say you must provide workers' comp for full-time and part-time workers.
To do this, you'll need to fill out one of the following two forms: Worker's and Physician's Report of Injury. You can get this form from your doctor's office. ... Worker's Report of Injury. This form requires that you answer questions about your injury, including the date of the injury and your body part that was injured.
In cases in which the worker doesn't immediately discover their work-related injury or illness, the 1 year statute of limitations begins at the point at which the worker becomes aware of the injury. If you are an injured worker, you should inform your employer immediately.
