Arizona Claims Kit Download Page
Workers Compensation Claim Reporting Documents
Employer’s Report of Industrial Injury. As soon as you have been notified of a work-related injury, complete this form and submit it to your carrier. This form must be completed within 10 days from notice of an accident. Fatalities must be reported within 24 hours.
Report of Significant Work Exposure to Bodily Fluids. This form is completed by you and must be signed by the employee. You should keep the original and provide a copy to your carrier.
Workers Compensation Posting Notices
Please print and post the following notices in a conspicuous location frequented by employees, such as the breakroom. If you have multiple business locations, be sure to post the notices at each location.
Notice to Employees (Workers' Compensation) Poster (Bilingual). Arizona law requires that this notice be posted in both English and Spanish.
Employers must post the following two forms immediately next to the Notice to Employees: