At the Matt Fendon Law Group, our highly skilled and compassionate Phoenix workers’ compensation lawyers are ready to help you with all aspects of your workers’ compensation claim, from dealing with your employer, working with the insurance carrier, and confidently representing you in court. If you need a workers’ compensation lawyer in Phoenix, contact our team at (800) 229-3880 to schedule a free consultation.
Have You Experienced a Workplace-Related Injury, Illness, or Medical Condition in Phoenix?
Workers’ compensation laws in Arizona are about a century old, dating back to the creation of the Industrial Commission of Arizona (ICA) in 1925. The reason why we still have workers compensation lawyers and cases today in Phoenix, Maricopa County, and statewide is because despite improvements in workplace safety over the past hundred years you can still be injured in a job-related accident or suffer a work-related illness.
Injuries are not the only ways you can be harmed at the workplace. Sometimes your work environment can contribute to you becoming ill. Or, your job tasks can over time cause you to experience medical conditions like repetitive stress injury or carpal tunnel syndrome.
Any of these injuries, illnesses, or medical conditions can qualify you to receive workers compensation benefits, a process best aided by a qualified workers compensation lawyer. For simplicity, below we include all three of these causes in the general term, “injury”.
What is Arizona Workers’ Compensation?
The Arizona workers compensation system is a form of insurance for employers. It provides employees who are injured on the job with compensation relief through workers compensation benefits. It also protects employers from employee lawsuits arising from work-related injuries.
With offices in Phoenix and Tucson, the ICA is the Arizona agency responsible for considering workers compensation claims. It has two divisions: the Claims Division and the Administrative Law Judge (ALJ) Division.
The Claims Division is responsible for overseeing worker’s compensation insurers in Arizona and for making sure workers receive proper benefits under Arizona Workers’ Compensation Law. Claims Division personnel can provide you with general assistance and answer questions about filing a claim, but they cannot give you legal advice.
Once the Claims Division receives your request for a hearing, it will transfer your request to the ALJ Division. This is where any disagreements between you, your employer, and the insurance carrier are resolved.
The Arizona Workers’ Compensation Claim Process
Arizona workers compensation claims require you to take some steps to file your claim. We look at each of them below.
Notify Your Employer of Your Injury
You must provide your employer with notice of your injury. You must do this within one year from the date your injury happened, or – in cases like work-related illnesses or conditions that do not manifest themselves right away or only gradually – when you first discover the injury. This is the statute of limitations period for workers compensation claims.
Making a written report to your employer is a basic claim requirement, without which you cannot make a workers compensation claim. You can make this report in one of two ways:
- Complete a Worker’s and Physician’s Report of Injury form. Your doctor’s office should have these forms available. You complete the first part of the form, and your doctor completes the second part. Your doctor must file this form with the ICA within eight days of your initial medical exam.
- Download a Worker’s Report of Injury form from the ICA website, complete it, and then file it with the ICA.
Notifying your employer has an additional benefit, because once your employer receives your notice it must give you important information about its workers compensation insurance carrier.
Your notice to your employer must include the following information:
- The location, date, and time of your accident.
- The cause of your injury.
- The symptoms of your accident and the severity of your injury.
See a Doctor
You should consult with an appropriate medical professional as soon as possible after you become aware of a work-related injury. This is more than just a good idea health-wise. Consulting with medical experts also supports your workers compensation claim in several ways:
- It preserves your ability to make a claim. If you do not see a doctor or other medical professional about your injury, this could lead to doubts about the seriousness or even the validity of your workers compensation claim.
- Medical records help prove your claim. The medical records of your injury, beginning with your initial doctor’s visit and with all subsequent treatment, can be strong supporting evidence for your claim and its severity.
- Medical records help to support a claim denial appeal. Not all workers compensation claims are accepted right away. Sometimes, you might need to provide additional supporting evidence. As with establishing an initial workers compensation claim, your medical treatment records and doctor’s notes that are connected with your workplace injury are an important source of proof.
Your Employer’s Right to Examine You
Your employer’s insurance company has a one-time-only right to have a doctor of its choosing perform a medical examination of you, before you see another physician for treatment of the work-related injury.
If you make a return visit to that doctor, then that person becomes your “attending physician.”
This attending physician relationship does not lock you into relying on your employer’s chosen doctor. It does, however, limit how you can choose a new attending physician: your current attending physician can refer you to a new doctor, or the workers compensation insurer can approve a change of doctors, or you can make an application in writing, and the Industrial Commission of Arizona approves it.
Insurance Carrier Independent Medical Examinations
Your employer’s workers compensation insurance carrier has the right to have you periodically examined by a doctor of its choice. The carrier is required to pay travel expenses (mileage and living expenses) for these types of appointments.
The carrier can use this doctor’s opinion to change the status of your claim.
If you believe you are being unfairly requested to attend an independent medical examination, we can help you file a Motion for Protective Order with the ICA. This will require an administrative law judge to decide if you must attend the exam.
The important thing to remember in all of this is, as an injured employee you have the right to choose your doctor. You are not required to use the physician your employer engages to examine you as your attending physician.
What Kinds of Workplace Claims Does Workers’ Compensation Cover?
Arizona’s workers compensation policies help cover the following kinds of injuries and their related treatment costs:
- Medical expenses for accidents or injuries that happen to you on the job.
- Lost wages if you need time off to recover. Payments depend on your average monthly wage before your claim.
- Ongoing care costs for more severe injuries.
- Illnesses from exposure to unhealthy working conditions or substances.
- Repetitive injuries, like carpal tunnel syndrome from repeated strain during the work day.
- Funeral costs and death benefits if you die from a work-related injury or illness.
- Disability benefits if a work-related injury or illness delays your return to work.
Benefits Available Under Arizona Workers’ Compensation
Depending on the nature of your injury, Arizona’s workers compensation law can provide you with medical benefits, wage loss and disability benefits, and death and dependent benefits. A workers compensation lawyer can help you understand which of these you may be eligible for given your particular circumstances.
Medical Benefits
Workers’ compensation benefits cover all reasonable and necessary medical costs associated with your injury. Those expenses include hospital visits, prescription drugs, vocational rehabilitation, and physical therapy. You can also be reimbursed for your travel expenses to doctors’ offices in or outside of the Phoenix area, or for therapy appointments.
Wage Loss and Disability Benefits
In some circumstances, you may be entitled to lost income benefits when you miss work because of your injury. How much workers compensation provides in wage loss and disability benefits depends on the effects your injury has on your ability to work. Below are the kinds of wage loss and disability benefits available.
Permanent Impairment Benefits
A permanent impairment is one that results in your loss of a body part, or its becoming disabled in a way that it will never heal and cannot be repaired.
Two kinds of permanent impairments exist for monthly workers compensation benefits: “scheduled” and “unscheduled.” Also, unscheduled permanent impairments can be total, or partial.
Scheduled Permanent Impairment Benefits
For some permanent injuries, Arizona workers compensation law establishes how much your monthly payment benefit can be. These kinds of payments are known as “scheduled” benefits. Payments are based on a percentage of your average monthly wage before your injury.
How much you can receive in scheduled disability benefits depends on the severity of the permanent impairment:
- Partial Loss: 50% of your average monthly wage.
- Amputation: 55% of your average monthly wage.
- Total Loss: 75% of your average monthly wage.
Unscheduled Permanent Impairment Benefits
Under workers compensation, certain impairments are considered permanent, total disabilities. Those impairments include:
- Loss of sight in both eyes.
- Amputations of feet or hands.
- A spinal injury that has caused paralysis.
- Serious mental impairments due to traumatic brain injuries.
An unscheduled injury is the result of a general impairment, or multiple impairments to different body parts arising from the same cause, or a history of other permanent impairments.
The ICA decides how much unscheduled permanent impairment compensation you are entitled to, mainly based on your loss of earning capacity. Additional factors the ICA considers are your age, education, and work experience. The amount of income you will be able to earn in the future is also considered.
Permanent unscheduled total disabilities can qualify you to receive workers compensation benefits for the rest of your life.
Permanent unscheduled partial disability benefits are different from total disabilities in that they usually involve the trunk of your body (for example, your head, back, shoulders, and hips). This kind of permanent partial disability can also result from having multiple scheduled impairments, and from mental health conditions.
To qualify for permanent unscheduled partial disability benefits, you must show that because of your injury-related work restrictions you earn less income than you made before you were injured. Permanent partial disability benefits are also available if you are unable to return to work or find an appropriate job.
Temporary Impairment Benefits
Temporary Total Disability Benefits
You can receive temporary total disability (TTD) benefits if you cannot work during your injury recovery period. TTD benefits are equal to two-thirds of your average monthly wage before you were injured. TTD benefits are also capped at a maximum amount, which changes every year.
Temporary Partial Disability Benefits
If you have a work-related injury but can return to work to do some of your job duties, then temporary partial disability benefits might apply to you. A doctor must specify what restrictions prevent you from doing all of the work tasks you did before the injury.
Temporary partial benefits are two-thirds of the difference between your pre-injury monthly wages and the earnings you are earning during your recovery.
Death and Dependents’ Benefits
If workplace injuries result in death, the surviving spouse or surviving dependents of the deceased worker can file a claim with the ICA to receive workers compensation benefits and burial expenses. Death benefits are usually limited to spouses, children and other family members who relied financially on the deceased worker.
Death and dependent’s benefits can include:
- Compensation for medical bills relating to the final injury.
- A burial allowance.
- Wage replacement benefits.
Frequently Asked Questions About Workers’ Compensation in Phoenix
Here are some questions we are often asked about workers compensation:
Can I sue my employer for a work-related injury, illness, or medical condition?
Generally, workers compensation insurance represents a compromise between you and your employer. The benefit you receive is that workers compensation is “no fault” insurance. What this means is that if you qualify to receive medical benefits under a claim regardless of the circumstances of the accident.
The benefit your employer receives is that as long as it carries a policy of workers compensation insurance, then except under limited situations you cannot sue the employer for work-related harm. Instead of insurance benefits, you would be suing for personal injury damages.
The times when you can sue your employer are if the injury was caused by your employer’s intentional conduct or if it does not carry workers compensation insurance.
Does workers compensation allow me to keep my job while I am away from work?
Arizona workers compensation law does not protect your right to employment. If you believe that your employer has retaliated against you because you have filed a workers compensation insurance claim, then you can choose state and federal remedy options to seek redress:
- Under the Arizona Employment Protection Act you can file a civil lawsuit against the employer for retaliatory termination.
- The Equal Employment Opportunity Commission and the Office of Americans with Disabilities are federal organizations you can also turn to for help with a retaliatory firing from your job.
What happens if my employer does not have a policy of workers compensation insurance?
If your employer has no workers compensation insurance, then you have the right to file a civil action against the employer in your county’s superior court, or to file a claim for workers compensation benefits with the ICA, which maintains a Special Fund that can pay benefits like those paid by workers compensation insurance carriers.
An employer that does not maintain a policy of workers compensation insurance might also be subject to penalties imposed by the ICA.
What do I need to do to preserve my workers compensation benefits?
If your workers compensation benefits claim is approved, then the state of Arizona will expect you to follow some terms to remain eligible. Here are some ways to make sure your benefits do not get suspended by your employer’s workers compensation insurance carrier:
- Check with the ICA before you leave the state of Arizona. If you leave the state without filing for and receiving written approval to do so by the ICA, this could lead to a benefits suspension.
- Report your income annually. This is important if you are receiving benefits for monthly loss of earning capacity. Not filing an annual income report can lead to suspension of benefits until you do so.
- Comply with independent medical examination requests. If your employer’s insurance carrier requests an independent medical examination, your cooperation with such a request is required to preserve your benefits claim. If you refuse such a request or obstruct it, this can be grounds for termination of benefits.
- Stay out of jail or prison. If you are incarcerated in Phoenix or elsewhere in Arizona while receiving workers compensation benefits, this could cause your compensation benefits to be suspended during that time (any medical benefits you receive through workers compensation would still continue).
Do I need an attorney to file a workers’ comp claim in Phoenix?
Arizona law does not require you to have an attorney to make a claim for workers compensation benefits. You can make a claim on your own. Note, though, that the workers compensation claim process can be unforgiving of mistakes. You must make sure to keep track of all the deadlines, information requests and meetings connected with your claim. If you miss a deadline, fail to respond to an information request, or skip a meeting, this can delay or defeat your claim. This is another reason why hiring an experienced Arizona workers compensation attorney is well worth the investment.
What happens if my workers’ compensation claim is denied?
If your workers comp claim is denied, then you have 90 days to file a request for a hearing by completing and submitting a hearing request form to the ICA.
You can also write a letter to the ICA requesting a denied claim hearing, after which the ICA will set the date and time for your hearing.
If your workers comp claim has been denied, contact Matt Fendon Law Group immediately to discuss your legal rights. Our Phoenix workers compensation attorneys can help you navigate the complicated appeals process in time so you do not lose your rights.
Talk to a Phoenix Workers’ Compensation Lawyer Today
At the Matt Fendon Law Group, our highly skilled and compassionate workers’ comp lawyers are ready to help you with all aspects of your workers’ compensation claim.
We can help you:
- Understand what is happening. The process of obtaining workers’ compensation benefits can be stressful and complicated. It’s critical that you have an experienced Arizona workers comp lawyer on your side.
- Deal with your employer. Employers often try to intimidate or take advantage of injured workers. The attorneys at Matt Fendon Law Group will stand up for your rights.
- Negotiate with the insurance carrier. Insurance carriers are less likely to give you the run-around when you have a skilled and aggressive attorney in your corner.
- Receive the compensation you deserve. While you recover from your work injury, workers’ compensation benefits pay a portion of your lost wages, as well as your medical bills. Our attorneys will fight to get you the benefits you need and deserve.
- Represent you at the hearing. A hearing before an administrative law judge could be required. When that is the case, our attorneys will represent you and argue on your behalf.
- Handle your appeal. If your workers’ compensation claim is denied, our experienced workers’ compensation lawyers can help you put together the strongest argument on your behalf within the tight 90-day appeal deadline.
- File a civil lawsuit. If your employer fails to maintain workers’ compensation, litigation may be necessary. We can file a lawsuit to seek compensation on your behalf.
Call us today at (800) 229-3880 to schedule a confidential, free consultation with an experienced Phoenix workers’ compensation lawyer. Or, if you prefer, you can contact us online to ask a question or to schedule a free initial consultation.
Our law firm has offices in Phoenix, Prescott, Flagstaff, Scottsdale, and Tucson. Let us show you how we can help you with your Arizona workers’ comp case. We will provide straightforward advice and help you understand your legal options.