All Arizona Workers Compensation forms

Workers Compensation - Claims

• Dependent Benefits Claim - Fatality AZ-106-WC
• Checklists - Worker's Compensation Claims US-04076BG
• Petition For Rearrangement Or Readjustment Of Compensation AZ-112-WC
• Petition To Reopen AZ-113-WC

Workers Compensation - Discovery

• Claimant's First Set of Interrogatories to Employer and Carrier US-01365
• Claimant's First Set of Requests for Production US-01366
• Requests for Production of Documents to Carrier US-01367

Workers Compensation - Employers Reports

• Employers Report Of Injury AZ-101-WC

Workers Compensation - Hearings

• Request a Hearing AZ-114-WC

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Initial Pool Application For Authority To Self Insure AZ-103-WC
• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Physicians

• Request to Change Doctors AZ-105-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Reports

• Medical Report for Workers' Compensation AZ-110-WC
• Injury Report for Workers' Compensation AZ-108-WC

Workers Compensation - Requests

• Request to Leave the State AZ-109-WC

Workers Compensation - Taxes

• Annual Taxes for Workers' Compensation AZ-102-WC