Motion to Appoint Guardian Ad Litem for a Minor (1982)
… Use this motion form if a claimant or a beneficiary is a minor. Pursuant to law, a Guardian Ad Litem (GAL) must be …
Legal Petition for Attorney’s Fees
… Arizona law permits workers’ compensation claimants and their attorneys to file a petition, prior to a final …
MRO Request for Administrative Peer Review Form
… This form is to be used by Medical Providers, Injured … contact information provided on the MRO website). For more information, contact (602) …
Special Fund Supportive Medical Care
… Fund Division Supportive Medical Care Pursuant to A.R.S. § 23-1065 (prior to August 8, 1973), … and processed in accordance with workers’ compensation guidelines. … Special Fund …
2015 FS Summary of Commission Action
… & Pharmaceutical Fee Schedule 2015 Summary of Commission Action On April 30, 2015, the … A summary of Commission action taken subsequent to the public hearing, including action taken to …
Claims - Employer's Report of Injury
… Do not use the above email address to send emails (or attachments to emails) … numbers) to the ICA because neither the website nor email is secure. Instead, FAX such …
Claims Employee Rejection of Terms Form
… law presumes that all employees have elected to be subject to the provisions of Arizona’s workers’ compensation laws. However, an employee is …
English - Our Official Language
… Industrial Commission of Arizona PHOENIX: 800 W WASHINGTON ST, PHOENIX AZ 85007 PHONE: (602) 542-4411 …
Official Disability Guidelines
… Guidelines) About the ODG: The Industrial Commission of Arizona (Commission) has adopted … decisions for injured workers. Please refer to: Article 13, Treatment Guideline Rules …
Main Page for Brochures, Forms, and Posters
… Forms, and Posters Phoenix: 800 W Washington St, Phoenix AZ 85007 - Phone: (602) 542-4661 Tucson: 2675 East Broadway, Tucson AZ 85716 - Phone: …