Form Claims ICA0407 Worker's Report of Injury - Arizona

Form Claims ICA0407 Worker's Report of Injury - Arizona

What Is Form Claims ICA0407?

This is a legal form that was released by the Industrial Commission of Arizona - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the ICA0407 form?A: The ICA0407 form is a Worker's Report of Injury form.

Q: Who needs to fill out the ICA0407 form?A: The form needs to be filled out by a worker who has suffered an injury in Arizona.

Q: What information is required on the ICA0407 form?A: The form requires information such as the worker's personal details, details about the injury, and information about the employer.

Q: When should the ICA0407 form be submitted?A: The form should be submitted as soon as possible after the injury occurs, preferably within 10 days.

Q: What happens after the ICA0407 form is submitted?A: Once the form is submitted, the Arizona Industrial Commission will review the information and may begin processing a workers' compensation claim.

Q: Is it mandatory to fill out the ICA0407 form?A: Yes, it is mandatory for workers in Arizona to fill out the ICA0407 form if they have suffered an injury on the job.

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Form Details:

  • Released on May 15, 2017;
  • The latest edition provided by the Industrial Commission of Arizona;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form Claims ICA0407 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Industrial Commission of Arizona.

Download Form Claims ICA0407 Worker's Report of Injury - Arizona

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