… 11/20/2018 Re: Upcoming Changes in ICA Communication Methods The … Claims System in February 2019. The new Salesforce-based system will feature automated …
Claims - Request for Dependents' Benefits (Fatality)
… Claims Division Request for Dependents' Benefits (Fatality) Ruby Tate, … AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …
Quorum Notice for September 26 and 27, 2018
… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … County Rehabilitation Center 502 W Main St Safford, AZ 85546 4:00 pm – 5:30 pm Quality Inn & …
MRO Request for Administrative Peer Review Form
… This form is to be used by Medical Providers, Injured … denied the request, or (3) a Payer failed to communicate its decision on a request for …
Claims Request to Leave State Form
… An injured worker may not leave the state for a period exceeding two weeks, (15 days or … continues, without the written approval of the Commission. This form may be used to request …
… Industrial Commission of Arizona Annual Workers’ … Compensation Assessment Rates Assessment Rates for Calendar Year 2026 At the Commission's …
Official Disability Guidelines
… Guidelines) About the ODG: The Industrial Commission of Arizona (Commission) has adopted … by MCG Health, as the standard reference for evidence based medicine within the context …
Accounting Initial Pool Application for Authority to Self-Insure Instructions
… This application to self-insure is for Arizona pools that have the ability to apply … to Self-Insure the payment of workers’ compensation as provided by A.R.S. § 23-961.01, …
Claims - Request for Hearing
… Claims Division Request for a Hearing Ruby Tate, Claims Manager Email: … you may request a Hearing. Important: This completed form must be filed at an Industrial …
… Industrial Commission of Arizona Annual Workers’ … Compensation Assessment Rates Assessment Rates for Calendar Year 2022 At the Commission's …