Accounting Insurance Carrier Quarterly Tax Form
… Any Insurance Carrier which paid or is required to pay a tax of two thousand dollars … an Insurance Carrier - Quarterly Tax Form. This completed form must be submitted by the end of …
Out-of-State Adjuster Authorization Program
… carriers that have or are underwriting workers’ compensation policies in Arizona are required to … noted above, any Claims handling professional is welcome to join the training and earn Arizona …
ICA Job Posting: Administrative Assistant 2
… Industrial Commission of Arizona Administrative Assistant 2 …
Legal-BackUpPage
… Legal Division Afshan Peimani, Chief Legal Counsel … Report an employer who does not carry workers’ compensation insurance. Click here The Sole …
ALJ Interested Party Workers’ Compensation Document Submission
… currently in litigation at the ICA’s ALJ Division will be able to serve the ICA using the … webform/document upload feature in the new ICA Community. However, in the event an interested …
MRO Request for Administrative Peer Review Form
… This form is to be used by Medical Providers, … denied the request, or (3) a Payer failed to communicate its decision on a request for …
Accounting Initial Pool Application for Authority to Self-Insure Instructions
… This application to self-insure is for Arizona … to Self-Insure the payment of workers’ compensation as provided by A.R.S. § 23-961.01, …
Special Funds Workers Supplemental Claim For Compensation
… and treating physician will be instructed to complete this form while the injured worker is on a no work …
Claims Request to Change Doctors Form
… authorized representative may petition the Commission for a change of doctors by filing this …
Small Business Bill of Rights
… are entitled to all applicable rights established in A.R.S. § 41-1001.01, A.R.S. § 41-1009, and the Industrial Commission of Arizona statutes and rules. Under …