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Special Fund Apportionment Settlement Letter

… a claim with approved apportionment should complete the attached form and submit for consideration. The claimant …

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Quorum Notice for 3/29/2018

… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … Dimas, Commission Secretary … Quorum Notice for 3/29/2018 …

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Quorum Notice for September 12, 2019

… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … Dimas, Commission Secretary … Quorum Notice for September 12, 2019 …

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Petition for Attorney’s Fees

Instructions

Arizona law permits workers’ compensation claimants and their attorneys to file a petition, prior to a final disposition of the case, requesting that the Commission set reasonable attorney’s fees related to a workers’ compensation claim. See A.R.S. § 23-1069. Claimants or their attorneys may use this form to request that the Commission set fees. Please provide the information requested and attach any supporting documents. Failure to provide all requested information may delay processing.

Please submit a Petition for Attorney’s Fees Pursuant to A.R.S. § 23-1069 via the online form link below.:

E-sign Electronic Submission Form

Petition for Attorney’s Fees Form

Commission Sets Maximum Average Monthly Wage for Calendar Year 2019

… … … … Commission Sets Maximum Average Monthly Wage for Calendar Year 2019 …

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Motion to Appoint Guardian Ad Litem for an Incapacitated Adult

Instructions

Use this motion form if a claimant or a beneficiary is an incapacitated adult. Pursuant to law, a Guardian Ad Litem (GAL) must be appointed for such persons. Additionally, the law requires that the GAL must be an attorney licensed in the State of Arizona. You will need to provide the attorney’s bar license number in the motion form. If you do not have an attorney to request for appointment as GAL, an Administrative Law Judge will appoint one at no cost to the parties.

E-sign Electronic Submission Form

Motion for Guardian Ad Litem

Printable Form

GAL-Printable-FINAL-Incapacity_2026_02_10.pdf

Quorum Notice for 10/31/2017

… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … Dimas, Commission Secretary … Quorum Notice for 10/31/2017 …

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