State News : Arizona

New Rollout: ICA Introduces Updated Form 101 – Employer’s Report of Accident

The Industrial Commission of Arizona (ICA) has officially launched its newly updated Form 101 – Employer’s Report of Accident as part of a modernization initiative directed by the Governor’s Office. A recent presentation by the ICA introduced the changes and provided important rollout details for employers and stakeholders.

What’s New?

This updated form aims to simplify the reporting process while ensuring critical information is captured:

• Simplified layout and removal of outdated or unnecessary fields.
• New fields added, such as dominant upper extremity, which plays a role in determining permanent disability awards.
• Web-based submission only – The Commission will not accept service via fax or mail.

Compliance Deadline

Per ARS § 23-908(G), employers must report workplace injuries within 10 days.
The new online-only form was released on April 7, 2025, and the ICA is allowing a 90-day transition period.
Effective Monday, July 7, 2025, the ICA will no longer accept faxed or mailed versions of Form 101.

Complete the new form here:
https://www.azica.gov/forms/employers-report-injury-form

Signature Process & Confirmation

After the form is completed:

1. The submitter will receive an email requesting a digital signature.
2. Once signed, a confirmation email will be sent along with the option to download a copy for records.

Access Issues

There was some confusion about the form’s visibility on the ICA Community page:

• It is supposed to appear under “Claims” as the second form at the bottom.
• However, if logged into the ICA account, the form may not appear due to a technical issue. ICA is working to resolve this.
• In the meantime, the direct link above remains functional.

Employer Outreach & TPA Clarification

ICA encourages carriers to notify employers of this change and recommend attending upcoming training sessions. More presentations are scheduled next week, and ICA may add additional sessions based on demand.

At the present time, Third-Party Administrators (TPAs) can submit this form on behalf of employers. The Commission has indicated they will issue separate direction concerning TPA processing of this form. Ritsema will update clients regarding any administrative guidance received from the Commission.

New Rollout: ICA Introduces Updated Form 105 – New Notice of Suspension Informational Meeting

The Industrial Commission of Arizona (ICA) has proposed a new Form 105 – Notice of Suspension, intended for use by carriers or self‑insured employers to formally notify injured workers when their workers’ compensation benefits are suspended (e.g. due to noncompliance or missed medical requirements).

⚠️ The form is not yet effective. To review and provide feedback, the ICA is hosting an informational stakeholder meeting on October 8, 2025.
🔗 Join the stakeholder meeting on 10/08/2025

Why this matters:

• Stakeholders can ask questions, offer commentary, and help shape how Form 105 will be implemented.

• Employers, claims professionals, attorneys, providers, and injured worker advocates should participate to stay ahead of compliance changes.

• After the meeting, ICA will issue a formal announcement of the effective date and procedural guidelines.