Claims - Request for Hearing
Claims Division
Request for a Hearing
Ruby Tate, Claims Manager
Email: [email protected]
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
Request for a Hearing
Click here to download form : Request for Hearing Form
When you formally disagree with a document that contains a protest period, you may request a Hearing.
IMPORTANT: This completed form must be filed at an Industrial Commission of Arizona (ICA) office.