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Arkansas Workers' Compensation Commission

Special Funds DivisionAWCC

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Arkansas.gov
SUPPORTING DOCUMENTS

Below are standard lists of documents that will be needed to support your FIRST notice filing of Form AR-D. Since each claim is unique, the lists are meant to be general. Additional documentation may be required by Special Funds Division.

Permanent Total Disability:

  • wage statement (if required)
  • medical reports to support the date claimant’s healing period ended
  • vocational rehabilitation reports.

Death Claims:

  • marriage license
  • birth certificates of children
  • wage statement
  • certificate of death
  • social security numbers for dependents
  • child support decrees for step-children; child support decree for natural children living apart from deceased
  • school records for any dependent student over the age of 18.

AWCC

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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