18 79 WCC Form AR-M: Monthly Report on Medical-Only Injury Data [This form is completed by Respondents]

JurisdictionArkansas
LibraryArkansas Form Book - Complete (2024 Supplement)

18-79 WCC Form AR-M: Monthly Report on Medical-Only Injury Data [This form is completed by Respondents]

This form is completed and submitted to the Arkansas Workers' Compensation Commission by an Insurance Carrier or Self-Insured to report summary information on medical-only claims for which a Form I-A1 or Form C have not been filed with the Commission.

https://www.labor.arkansas.gov/wp-content/uploads/formm.pdf

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