How Do I Appeal if Don’t Like My Work Comp Decision?
Arizona’s workers’ compensation program is supposed to be an efficient way for workers who get hurt in Phoenix or other parts of the state to get the professional care they need to recover from their work-related injuries or illnesses.
Workers’ compensation also provides ongoing payments to workers who, because of their injuries, are sidelined from the workforce.
However, when dealing with self-insured employers or an Arizona employer’s insurance carrier, there will sometimes be friction.
For example, an employer or an insurance company may deny the worker’s claim outright. In other cases, they may not agree to pay the amount to which the worker is entitled.
A worker does not have to accept the decision of the insurance company
A worker does not have to accept an unfavorable decision from the insurance company, or a self-insured employer for that matter, at face value. In fact, the worker may not be able to afford the financial fallout of an unfavorable decision.
Under Arizona law, a worker can request a hearing on an unfavorable before an Arizona Administrative Law Judge who works for the Arizona Industrial Commission, that is, the agency which regulates Arizona’s workers’ compensation program.
The worker must file a Request for Hearing within 90 days after having a claim denied.
There are also many other rules and procedures about which a worker, or her attorney, will need to be aware. Not following these rules carefully could cost a worker the right to appeal her claim.
Generally speaking, hearings before an Administrative Law Judge will proceed a lot like a trial where the judge will consider medical evidence and other testimony before deciding whether to uphold an unfavorable decision or change it. In this respect, it is important that a worker put forth his best case possible.