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Form Claims ICA0124 Report of Significant Work Exposure to Bodily Fluids or Other Infectious Material - Arizona
What Is Form Claims ICA0124?
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 ICA0124 report?A: The ICA0124 report is a form used in Arizona to report significant work exposure to bodily fluids or other infectious material.
Q: Who needs to complete the ICA0124 report?A: Employees who have experienced significant work exposure to bodily fluids or other infectious material in Arizona need to complete the ICA0124 report.
Q: What information is required in the ICA0124 report?A: The ICA0124 report requires information such as the employee's personal details, the nature of the exposure, the source of the exposure, and any medical treatment received.
Q: Is the ICA0124 report confidential?A: Yes, the information provided in the ICA0124 report is confidential and protected under Arizona law.
Q: What should I do if I have experienced significant work exposure to bodily fluids or other infectious material?A: If you have experienced significant work exposure to bodily fluids or other infectious material, you should report it to your employer and complete the ICA0124 report as soon as possible.
Q: Are there any time limits for submitting the ICA0124 report?A: Yes, the ICA0124 report should be submitted within 4 working days of the exposure or as otherwise specified by your employer.
Q: What happens after I submit the ICA0124 report?A: After you submit the ICA0124 report, your employer and the Industrial Commission of Arizona will review the information provided and take appropriate action.
Q: Can I claim workers' compensation for work exposure to bodily fluids or other infectious material?A: Yes, if you have experienced significant work exposure to bodily fluids or other infectious material, you may be eligible to claim workers' compensation benefits.
Form Details:
- Released on July 1, 2011;
- 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 ICA0124 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Industrial Commission of Arizona.
