This form must be submitted by the 5th Business Day from the cleared date of the ACH Payment. Once completed, email the form to the GAO AFIS Operations Group at: [email protected].

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.: