Most work-related injuries are minor and require minimal or no treatment. However, you can sustain severe work injuries requiring costly and extensive medical care. You may even need some time away from work as you recover. Arizona law requires employers to have worker’s compensation insurance coverage for their employees.
So, if you have recently been injured on the job, Arizona law entitles you to workers’ compensation benefits to help pay for your medical expenses and lost wages. However, workers’ compensation benefit is a ‘no fault’ program meaning you cannot sue your employer in a personal injury lawsuit for the same injuries.
In most work-related injury cases, the workers’ compensation benefit program may be the only viable way of getting compensation. But, there are many cases of insurers denying workers’ compensation claims. Accordingly, you should understand the claim process, your rights and obligations, and your options.
In this article, we will explore the claim process, how to file a compensation claim, and what you can expect as a claimant.
Who is Eligible for Workers’ Compensation in Arizona?
The Arizona law requires all employers with one or more employees or workers to carry worker’s compensation. All full-time and part-time workers are eligible for workers’ compensation for work-related injuries or illnesses. However, certain employees are ineligible for workers’ compensation, including:
- Independent contractors
- Casual or temporary employees whose work is not part of the normal operation of a business
- Domestic employees working in a private home
What Does a Workers’ Compensation Cover?
In Arizona, you can make a workers’ compensation claim for;
- Injuries sustained on the job. For instance, you can seek medical benefits after spraining your ankle in a slip-and-fall accident at work.
- Lost wages. You can claim compensation for lost wages if you need time off to recover after work-related injuries.
- Ongoing care. If you sustain severe injuries, you may need extensive medical treatment, including surgeries and rehabilitative therapy. You can seek compensation to cover the cost of ongoing care.
- Work-related illnesses. You can seek compensation for illnesses due to exposure to hazardous working conditions or toxic substances.
- Disability benefits. You can seek compensation if a work-related injury leaves you disabled and unable to work again or return to work right away.
- Funeral costs and death benefits. You can seek compensation if a family member dies in a work-related accident.
What to Do After a Workplace Injury
- Seek immediate medical attention. Your safety should be your priority.
- Report the details of your injury to your supervisor. The report should be in writing as it is part of the claim process.
- Write down the details of the accident or injury as soon as possible. Your record should include the exact date and time of the injury, the exact location, all injured body parts, and how the accident or injury happened.
These actions after a work-related injury are critical as they act as evidence when making a compensation claim, especially in an appeal hearing.
Arizona Workers’ Compensation Claim Process
You are responsible for filing a workers’ compensation claim as the injured party. You need to file the claim within one year from the date of your injuries. But, you need to notify your employer as soon as you can. Immediate reporting helps speed up the claim process.
The workers’ compensation claim process only begins when you report the details of your accident or injuries to your supervisor. You also need to request a claim form from the supervisor, which Arizona law requires the employer to provide.
You then request your employer to refer you to an approved medical care provider. Arizona laws allow employers to choose a doctor for your first medical treatment. But, you get to choose your doctor for later treatments. Yet, in case of serious injuries, you can seek emergency treatment services and thereafter notify your employer as soon as possible. The notice should be in writing.
After you have notified your employer about your accident or injuries, the law requires them to file an Employer Report of Injury with the Industrial Commission of Arizona (ICA). The ICA will notify your employer’s workers’ compensation insurance carrier of your claim. The insurer has 21 days to accept or deny compensation.
If the insurance carrier accepts your claim, they will compensate you for medical expenses under Arizona laws. However, there are two types of workers’ compensation claims, including medical only or no time lost claim which covers only medical expenses. The second type is the time lost claim which covers both medical expenses and compensation benefits for lost wages.
If the insurance carrier denies your workers’ compensation claim, you have 90 days to file an appeal with the ICA. After filing the appeal in writing, you will receive a notice indicating the details of your appeal hearing, including place, date, and time. Typically, the hearing is set within three months of the appeal filing.
How Can A Lawyer Help?
The entire workers’ compensation claim process involves many documents and notices. And it is your responsibility to understand them. It is advisable to seek the help of a skilled and experienced work injury attorney. The lawyer will guide you through the legal complexities of the claim process and help you get a successful outcome.
The complexity of the claim process can make employers and insurers wrongfully deny your compensation claims. For instance, your employer might claim that your injuries are due to disregarding reasonable working rules and regulations. That can be a reason for the insurer to deny your claim. You need a legal representative to help protect your rights while helping you understand and fulfill your obligations.
Contact a Phoenix Workers’ Compensation Attorney
Filing compensation claims for some work-related injuries and receiving benefits is not easy, especially for injuries that lead to disability. Your employer’s insurance carrier is also likely to deny your compensation claims if your injury has a mental health component or if they suspect a miscalculation of your average monthly wage. Many denials are excuses not to pay. If you are in Phoenix, AZ, contact our well-qualified and skilled workers’ compensation attorney at the Karina Ordonez Law Office. We will help you get the compensation you need and deserve. Contact us today to schedule a consultation and learn more about our services.
