Arkansas Workers' Compensation Commission

Special Funds DivisionAWCC

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[Form AR-D] should be filed with the Special Funds Division for a Death claim or Permanent Total Disability claim. The Special Funds Division is located at:

Special Funds Division
324 South Spring Street
P.O. Box 950
Little Rock, AR 72203-0950

[Rule 099.28] specifies the notice requirement. Please refer to this Rule for proper and timely notice. The form AR-D also requires subsequent filings to be made by January 31st in each year unless a Certificate of Acceptance is issued by the Trust Fund.

PERMANENT TOTAL DISABILITY: Form AR-D should be filed on permanent total disability claims by January 31st following the acceptance or award of permanent total disability, but in no case later than the requirements set out in [Rule 099.28].

DEATH CLAIMS: Form AR-D should be filed on Death claims at the time of filing [Form AR-2] with the Arkansas Workers’ Compensation Commission.

If you fail to provide notice at least 90 days prior to the completion of your liability, your firm will be responsible for continuing benefits for 90 days after the Special Funds Division has received your AR-D filing notice.


State of Arkansas
Workers' Compensation Commission
324 South Spring Street
P.O. Box 950
Little Rock, Arkansas 72203-0950
Telephone 1-501-682-3930 / 1-800-622-4472
Legal Advisor Direct 1-800-250-2511
Arkansas Relay System TDD 1-800-285-1131

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