Fraud Complaint Form

Instructions

Instructions

Pursuant to A.R.S. § 23-934 the Commission established a Workers’ Compensation Fraud Unit for the purpose of investigating fraud in connection with workers' compensation claims. A person alleging fraudulent activities, statements, or representations made in connection with Arizona workers' compensation claims may file a written complaint with the Fraud Unit using the form below. Please provide the information requested and attach any supporting documents. Failure to provide all requested information may delay processing.

The Commission only has jurisdiction to investigate complaints as they relate to allegations of:

1.     Claimant fraud related to workers’ compensation claims receiving indemnity or medical benefits.
2.     Employer or Carrier fraud related to workers’ compensation insurance coverage, payment of premiums, or payment of workers’ compensation benefits.
3.     Medical Provider fraud related to workers’ compensation claims.

You may submit a Workers’ Compensation Fraud Complaint in the following way:

Complaints must be filed via email with the form provided below and sent to [email protected]. If you have any questions, please call 602-542-5667 or email [email protected]

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