Claims Request for Hearing Form
… This form may be used to request a hearing. It must be completed in its entirety including the reason …
Claims - Filing a Sole Proprietor/Independent Contractor Statement
… 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Labor - Youth Exemptions
… 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4515 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Claims Worker’s and Physician’s Report of Injury Form
… An injured worker must file a workers’ compensation claim in writing with the Commission within one year after the injury occurred. The time for …
Process For Streamlining The Authorization Process For Treatment That Is Within The Evidence-Based Treatment Guidelines Public Comments 2017
… 800 W Washington St, Phoenix AZ 85007 Phone: (602) 542-6731 FAX: (602) 542-4797 … The Evidence-Based Treatment Guidelines Public Comments (2017) PUBLIC HEARING Transcript For …
Claims - Drug and Alcohol Testing Certification
… 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Special Fund Apportionments
… there are specific instances where permanent compensation benefits may be apportioned or divided between an insurance carrier and …
Accounting Initial Application for Authority to Self-Insure Instructions
… apply for authorization to self-insure workers’ compensation liability pursuant to A.R.S. § … W Washington St, Room 301, Phoenix AZ 85007 Phone: (602) 542-1839 FAX: (602) 542-3070 … …
Accounting Self-Insured Employer Annual Hospital Report Form
… on or before January 31. The “Hospital Report” is required of self-insurers that operate a … NOTE: AS OF APRIL 1, 2023, THE INDUSTRIAL COMMISSION WILL NO LONGER ACCEPT PAPER FORMS. …
Links to Related Websites
… 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4411 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …