Arizona workers compensation 2026

1. Click ‘Get Form’ to open the Arizona Workers Compensation form in the editor.
2. Begin by filling in the employee's last name, first name, and social security number. Ensure accuracy as this information is crucial for identification.
3. Provide the home address of the employee, including city, state, and zip code. This helps in establishing the employee's residence for any correspondence.
4. Indicate the date of injury or illness and time of event. Be precise with these details as they are vital for processing claims.
5. In the section regarding the nature of business, describe what your company does. This context can assist in understanding the work environment related to the injury.
6. Detail what happened during the incident in question 32. Use specific language to describe how the injury occurred and any objects involved.
7. Complete all wage data sections if work loss is expected to exceed seven calendar days. This includes hours worked per day and gross earnings prior to injury.
8. Review all entries for accuracy before submitting. Once completed, save your document and follow instructions for mailing it to both the Industrial Commission and your insurance carrier.

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