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Refresher on Arizona Workers’ Compensation Insurance

At Snow, Carpio & Weekley, PLC, our Arizona workers’ compensation lawyers hear from many members of the public who were injured on the job. They often search online for useful information, only to come away with misinformation or outdated advice. We believe in empowering Arizona workers, and to that end provide some basic information about Arizona workers’ compensation claims you can share with friends and family. Contact us to schedule a consultation to discuss your case, (877) 370-5788.

Every Employer Must Buy Workers’ Compensation Insurance

The law is clear that any business with at least one full- or even part-time employee must purchase workers’ compensation insurance. Although there are some statutory exceptions, they are narrow.

Also, the employer must pay the full cost of insurance. They cannot deduct from a workers’ paycheck to pay any part of the premium.

Your Employer Can Select Your Doctor—But for Only One Visit

Many people are confused about whether they can meet with their own doctor. The answer is “yes.” However, your employer can pick your medical provider for the first visit only. After that, you may choose your own doctor. Things are a little different if your employer self insures, but that’s not the norm.

Once you select a doctor, however, you can’t change to someone else without approval from either your doctor, the insurance carrier, or the Industrial Commission of Arizona (ICA).

Workers’ Compensation Covers Work Related Injuries

Confusion abounds about what is a “work related” injury. Essentially, it is an injury you suffer while working.

Most people are injured at their workplace. They have an office or other place of employment they visit five days a week. They are injured while working their shift. This is a clear example of a work-related injury.

Some workers travel as part of their job. You might also have a work-related injury if you were hurt while working away from the office. For example, delivery drivers are on the road constantly—that’s their job. Another person might attend road shows as part of their employment or visit clients. They can also suffer a work-related injury even if away from the office.

Report Injuries Promptly

You should tell your employer as soon as possible whenever you are hurt in an accident. Try not to delay. Profoundly serious accidents require immediate medical care, of course. You might be unconscious and loaded into the back of an ambulance. Nonetheless, you should report the accident as soon as you can.

You should also tell the doctor or emergency room you were injured on the job. They will provide you with an injury report, also called the Pink Form.

Occupational Illnesses are Also Covered

Not everyone is injured in a dramatic fall or fire. You might slowly get injured doing repetitive work which can lead to carpal tunnel or another soft-tissue injury. Other workers suffer from respiratory illnesses, cancer, or hearing loss.

An occupational illness is covered if you suffered it because of work. For example, you might have been exposed at work to excessive noise, leading to hearing loss. Or you inhale particulate matter on the job, leading to lung cancer or respiratory disease. These disabilities or illnesses are traced back to your work environment.

You Get One Year to File a Claim

You should report the accident or occupational illness as soon as possible. However, you get one year to file a workers’ compensation claim. The clock begins the day you were injured or the day you realize you have a job-related injury.

For example, you might be exposed to toxic chemicals back in 2017. However, it’s not until 2024 that you are diagnosed with cancer, so the clock begins with your diagnosis.

You Have the Right to an Appeal

If you are denied benefits, you should receive a Notice of Claim Status, Form 104 from your employer’s insurance carrier. You will get 90 days to protest.

You can request a hearing by submitting a form to the ICA. You will then receive a notice of hearing, which includes the date and time. An Administrative Law Judge will conduct the hearing and decide whether you qualify for benefits.

The person on the other side isn’t your employer. Instead, it’s their insurance carrier, who is responsible for paying workers’ compensation benefits.

You Should Not Have to Pay Medical Bills

If your claim is approved, then your employer’s insurance carrier should pay for all necessary medical care. If you get a bill at home, you should send it to the insurer for payment.

You Might Not Get Paid for All Missed Days

Many workers need to take time off to recover. That’s understandable. However, Arizona’s workers’ compensation law has a weird rule when it comes to time loss benefits.

Essentially, you are not paid for the first 7 missed days of work unless you end up missing at least 14 days. So if you miss 9 days, you are only paid for the last two days. But if you miss 14, then payment is retroactively applied to the date of the injury, so you are paid for all 14 days.

The good news: medical benefits have no waiting period.

How Time Loss Benefits Are Calculated

Generally, workers only get 2/3 of their average monthly wage. In most cases, your average is what you earned in the 30 days before you were injured. The state also uses a maximum monthly wage.

If a worker’s average monthly wage is $1800, then he would receive $1200 at most in time loss benefits.

You Need Permission to Leave the State

Arizona restricts your ability to leave the state for more than 14 days while you are receiving medical treatment. You’ll need permission from the ICA if you intend to be away longer. Should you leave without approval, the insurance carrier can suspend benefits.

Questions about Workers’ Compensation in Arizona? Call Us!

Snow, Carpio & Weekley, PLC, is happy to discuss your on-the-job injury. Our Arizona workers’ compensation lawyers have helped hundreds of people obtain benefits after a workplace injury or accident. Call to schedule a consultation.


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