Skip to main content
Search

2015 FS Summary of Commission Action

… & Pharmaceutical Fee Schedule 2015 Summary of Commission Action On April 30, 2015, the … and Pharmaceutical Fee Schedule to the 2014 & 2015 editions of the CPT-4 and to update …
Know more
Commissioner Orion Godfrey blk and white
Member
… Corps, where he rose to the rank of sergeant before being honorably discharged.  Since joining … responsibilities of educating and advocating for firefighters with cancer throughout the …
Know more

Notice of Public Hearing Regarding Setting Self-Insurer Premium Calculation Rates and Schedule of Deviation Rates Pursuant to A.A.C. Rules 20-5-1534 and 20-5-1535 for December 19, 2024

… Rates Pursuant to A.A.C. Rules 20-5-1534 and 20-5-1535 for December 19, 2024 …
Know more

Navajo 10

… No overdue inspections were found for this report request. … Navajo 10 …
Know more

Workers Supplemental Claim For Compensation

Workers Supplemental Claim For Compensation

Instructions

The injured worker and treating physician will be instructed to complete this form while the injured worker is on a no work status. It must be completed in its entirety. 

IMPORTANT:  Any person who knowingly makes a false statement or representation to obtain any compensation, benefit or payment is guilty of a class 6 felony and is subject to up to one and one-half years in prison, a fifty thousand dollar fine and forfeiture of benefits.

Printable Form

claims-seminar-material

… Seminar Manual Download Handout 1 - Is It Compensable Download Handout 2 - France V ICA … Handout 3 - France Discussion Download Handout 4 - SB 1451 Download … claims-seminar-material …
Know more

ADOSH Advisory Committee June 1, 2022

… NOTICE OF MEETING OF THE ADOSH ADVISORY COMMITTEE MEETING Pursuant to A.R.S. §38-431.02, notice is hereby given to the members of …
Know more

Notice of Public Hearing Regarding One-Half Percent Assessment Under A.R.S. § 23-1065(F) on June 26, 2025

… Assessment Under A.R.S. § 23-1065(F) on June 26, 2025 …
Know more
news-default.jpeg

Quorum Notice for 10/31/2017

… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … 23636 North 7th Street Phoenix, Arizona 85024 Including a tour of the Waddell Pumping Plant …
Know more

Ombudsman

… W Washington St, Phoenix AZ 85007 Phone: (602) 542-4538 Under Arizona law, the Ombudsman Office at the Industrial Commission of Arizona is established to provide …
Know more