Request For Hearing {ICA 0446} | Pdf Fpdf Docx | Arizona

 Arizona   Workers Comp 
Request For Hearing {ICA 0446} | Pdf Fpdf Docx | Arizona

Last updated: 11/26/2025

Request For Hearing {ICA 0446}

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Description

ICA 0446 - PETITION TO REOPEN BASED ON NEW, ADDITIONAL OR PREVIOUSLY UNDISCOVERED DISABILITY OR CONDITION. This form is issued by the Industrial Commission of Arizona (ICA) for workers seeking to reopen a closed workers’ compensation claim. This petition must include a current medical report or physician statement supporting the request and describing the new or worsening condition related to the original injury. The form also collects employment and medical history from the past two years. By signing, the petitioner authorizes the ICA and relevant insurers to access medical records for claim review. www.FormsWorkflow.com

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