ADOSH Compliance Assistance Instructions
… An employer may request a free compliance assistance activity or visit for a … information, contact ADOSH toll free at (855) 268-5251 or (602) 542-5795 (Phoenix) or (520) …
Claims Record Request Form
… can access claim documents through the ICA Community ( https://azica.my.site.com/claims/s/ … compensation claim records will only be released to an interested party to a workers’ …
Claims Request to Leave State Form
… An injured worker may not leave the state for a period exceeding two weeks, … continues, without the written approval of the Commission. This form may be used to request …
Motion to Appoint Guardian Ad Litem for an Incapacitated Adult (1982)
… Use this motion form if a claimant or a beneficiary is an incapacitated adult. Pursuant to law, a …
Frequently Asked Questions
… AZ 85007 - Phone: (602) 542-4411 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Procurement - Requests for Proposal
… Click here It is the responsibility of each respondent to examine the entire … Process. If an RFP/RFQ/RFI/IFB requires any "common documents," these can be downloaded …
Claims Professional Employer Agreement Form
… A Professional Employer Organization (PEO) is required to file this Notice with the PEO's Workers' Compensation Insurance Carrier and the …
GAO State of Arizona Substitute W-9 & Vendor Authorization Form
… This form is required in order to establish or … receives payment from the State of Arizona must complete this form. Once completed, mail the …
Special Fund Uninsured Claimants
… Special Fund Division Uninsured Claimants Pursuant to A.R.S. § … Section of the Special Fund processes workers’ compensation claims filed by employees of …