s Claims - Worker's Report of Injury
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•  AMW Statutory Max - $4,428.91

•  Arizona Minimum Wage - $8.05
(no change from 2015)

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Claims Division
Worker's Report of Injury

Molly Jones, Claims Manager
Email: Claims@azica.gov

 Do not use the above email address to send emails (or attachments to emails)  containing sensitive or personal information (such as social security numbers) to the  ICA because neither the website nor email is secure. Instead, FAX such materials to  the FAX number below or mail paper copies to a mailing address below.

Phoenix: 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4661
Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: (520) 628-5181
FAX (use for either office): (602) 542-3373

Click for Phone List of ICA Divisions

Worker's Report of Injury

Click here to download form :     Worker's Report of Injury (PDF)

An injured worker must file a claim in writing with the Commission within one year after the injury occurred. The time for filing a compensation claim begins to run when the injury becomes manifest or when the injured worker knows or in the exercise of reasonable diligence should know that he or she has sustained a compensable injury.

For more information on the process of filing a claim, click here.