The Arizona Worker's Report of Injury is a document used by employers and employees in the state of Arizona to report any workplace injury or illness. It is also referred to as a First Report of Injury (FROM). This report must be completed and submitted to the Industrial Commission of Arizona within 10 days of the incident. The report includes information such as the date of the injury, the name and address of the injured worker and the name of the employer. It also includes the type of injury and the location of the incident. There are three types of Arizona Worker's Report of Injury: FROI-1 for occupational diseases, FROI-1A for injuries resulting from a single incident, and FROI-14 for cumulative trauma. All three must be completed and submitted to the Industrial Commission of Arizona in order for the employer and employee to be eligible for workers' compensation benefits.
Arizona Worker's Report of Injury
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All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.
Form 102 is required by the Industrial Commission of Arizona for a Physician's Initial Report of Injury. The report must be made using or by attaching a report to the form.
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.
Claims - Filing a Claim It is the injured worker's responsibility to file a claim within one year of the date of injury. The injured worker should also notify the employer as soon as possible that a work-related injury has occurred.
Arizona's workers' compensation statute of limitations requires an injured worker to report his or her work-related injury within 1 year from the date of injury. If the worker doesn't file a claim before the 1 year deadline, he or she may forfeit their right to receive compensation.
Immediately following the accident, you should notify your employer and seek medical attention. Your employer is then required to provide you certain information such as the name and address of their workers' compensation insurance carrier, the policy number, and the date of expiration of coverage.
In Arizona, injured workers generally have one year from the date of the workplace injury or its discovery to file a workers' compensation claim with the Industrial Commission of Arizona (ICA). This doesn't mean that the case must be resolved within that period.