Special Funds Workers Supplemental Claim Form 413
… The injured worker and treating physician will be instructed to complete this form while the injured worker is …
ADOSH Advisory Committee
… The Arizona Division of Occupational Safety and Health (ADOSH) Advisory Committee was established in 1972 to provide …
Claims Request for Hearing Form
… This form may be used to request a hearing. It must be completed in its entirety including the reason …
ALJ Interested Party Workers’ Compensation Document Submission
… of service is via the webform/document upload feature in the new ICA Community. However, in the event an interested …
Claims - Filing a Sole Proprietor/Independent Contractor Statement
… AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Labor - Youth Exemptions
… AZ 85007 - Phone: (602) 542-4515 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Claims - Drug and Alcohol Testing Certification
… Claims Division Drug and Alcohol Testing Is Repealed Ruby Tate, Claims Manager Email: … AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Process For Streamlining The Authorization Process For Treatment That Is Within The Evidence-Based Treatment Guidelines Public Comments 2017
… 542-6731 FAX: (602) 542-4797 Process For Streamlining The Authorization Process For … The Evidence-Based Treatment Guidelines Public Comments (2017) PUBLIC HEARING Transcript For …
Special Fund Apportionments
… there are specific instances where permanent compensation benefits may be apportioned or … that the Special Fund will share in any loss of earning capacity award involving the following …
Accounting Initial Application for Authority to Self-Insure Instructions
… apply for authorization to self-insure workers’ compensation liability pursuant to A.R.S. § … (A) include: Annual payroll in Arizona of at least $2,000,000, and Total assets of at least …