When an employee is injured on the job, proceed with the following:

  1. Contact a preferred urgent care facility by telephone prior to sending the injured worker.
    • Inform the urgent care you have an injured worker coming and S & C Claims Services is the claims administrator.
  2. If a worker is seriously injured and needs immediate care or is transported by ambulance, the employer should have a co-worker or supervisor accompany the injured worker to assist with any insurance-related information the medical provider may require.
    • If possible, the injured worker must return to your office or job site after seeing the doctor and give you the doctor’s signed return to work slip or disability slip.
  3. If there is a serious injury, notify S & C Claims Services immediately by telephone at 1-800- 289-4502.
  4. It is necessary for the employer fill out the required Form ICA 04-0101 and notify S & C Claims Services immediately. Please forward the return the work/disability slip from the doctor to S & C Claims Services as soon as possible.

Required State Forms

Medical Providers

Concentra Urgent Care
1818 E Sky Harbor Circle
North Building 2, Ste 150
Phoenix, AZ 85034

602-244-9500

MBI Industrial Medicine
West Phoenix Clinic
3501 W Osborn Rd
Phoenix, AZ 85019

602-272-7676

US Healthworks
Southwest Phoenix
2010 N 75th Avenue
Phoenix, AZ 85035

623-245-6695

Please send the Form ICA 04-0101 and the medical slip to:

S&C Claims Services, Inc.
P.O. Box 140577
Boise, ID 83714
Telephone: (208) 848-2020
Toll free (800) 362- 5198
Fax (208) 853-4076