Search | Industrial Commission of Arizona

Agency Small Business Bill of Rights-202006

… of Rights Upon an inspection by the Industrial Commission of Arizona, small businesses are … to all of the rights established in A.R.S. § 41-1001.01 and A.R.S. § 41-1009 (A)(1)-(7). …

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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 …

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Special Funds Carrier's Notification of Scheduled Injury Time Loss

… administrators and self-insured employers must complete this injured worker profile form when a scheduled injury results in the …

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Claims Request to Change Doctors Form

… authorized representative may petition the Commission for a change of doctors by filing this form. …

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Quorum Notice for January 15, 2020

… QUORUM NOTICE THE INDUSTRIAL COMMISSION OF ARIZONA Notice is hereby given to … Club 2901 North 7th Street Phoenix, Arizona 85014 The Quorum Notice is posted in the first floor …

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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 …

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The Claims Division has developed a procedure for Change of Physician Requests under A.R.S. § 23-1062.02

… … The Claims Division has developed a procedure for Change of Physician Requests under A.R.S. § …

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Request for Hearing Form

Instructions

This form may be used to request a hearing. It must be completed in its entirety including the reason for the request. The request for a hearing should indicate which notice, award, or order is being protested and the grounds on which the hearing is requested. Failure to state the reason for the request may cause a delay in processing.

This form is not used as a Request for Investigation pursuant to A.R.S. § 23-1061(J). For a Request for Investigation, this form must be used: - Request For Investigation Form -

Information about the Industrial Commission of Arizona’s claims and hearing process including applicable laws and rules are available at the Industrial Commission offices and the ICA website: www.azica.gov.