Workers' Compensation in Arizona
Free Legal Evaluations for Worker's Compensation
If you have been injured at work and are interested in filing a claim for workers' compensation in Arizona, please complete Les's free evaluation form.
What is Worker' Compensation?
Workers' Compensation is a “no-fault” system in which the injured worker receives medical and compensation benefits no matter who caused the job-related accident. Lawsuits against the employer, except under very limited circumstances, are not permitted.
If the injury or illness is job related, the injured worker receives medical benefits and, if eligible, temporary compensation. In some cases, the injured worker may also receive permanent compensation and “job retraining.”
The Industrial Commission of Arizona and the insurance carrier are not identical. The Industrial Commission is a state agency that is responsible for deciding disputes and monitoring the activities of the SCF Arizona, private carriers and self-insured employers, referred to as insurance carriers.
You cannot sue your employer, but if anyone other than your employer and/or co-worker is partly or wholly at fault for your injury you may have a 3rd party claim against that person or company.
How do I File for Workers' Compensation in Arizona?
When you were treated for your injury at either your doctor's office or an emergency room and you told them you were injured on the job, you should have been given a form* to complete and sign. The form is a combination form entitled Worker’s and Physician’s Report of Injury. By signing that form, you were applying for Workers' Compensation benefits.
The hospital or doctor sends the original form to the Industrial Commission (ICA), a copy to your employer and a copy to the insurance company that wrote the policy for your employer. If you did not complete this form at the doctor's office or at the hospital, another form, entitled Worker’s Report of Injury, can be completed and filed with the Industrial commission.
*This form can be obtained through the Industrial Commission at their local office in Tucson or Phoenix by calling them directly and requesting the form be mailed to you. You may also visit their web site to down load and print the form.
Notifying Employer and Filing
An injury is covered under Workers’ Compensation if it is job related. It is the injured worker’s responsibility to make sure the injury is reported to the supervisor/employer as soon as possible. If the injury comes on gradually, it is important to report it as soon as you suspect that it may be work related.
Your claim is officially filed when a proper form is received by the Industrial Commission. If you are not notified of the receipt of your claim within a reasonable time, which is usually about two weeks, please contact the Industrial Commission of Arizona.
All claims must be filed within one year of the date of the injury.
Important Time Limits
You need to notify your supervisor/employer of any work injury as soon as possible. If the injury came on gradually you must tell your supervisor/employer as soon as you suspect that it is work related. It is best to report to your supervisor/employer any problems or pains that seem to get worse as you work.
You must file your claim within one year from the date of the injury.
In addition to the above, there are many other time limits. You need to carefully read all documents you receive since many of them will tell you that if you do not agree with it’s contents, then you must protest within a certain period of time.
The best way to handle time limits is to call a lawyer immediately when anything happens that you do not completely understand.
Benefits if Not Working
If you are taken off work by your doctor, your first 7 days off work are not paid for unless you are off for at least 14 consecutive days per your doctor. If you are only off 13, you are to be paid for the 8th day through the 13th day.
Temporary compensation is paid at 66 2/3% of your average monthly gross wages at the time of your injury. This is referred to as Average Monthly Wage. There is a maximum allowed for an Average Monthly Wage:
Average Monthly Wage maximums:
As of 01/01/ 2011 max = $3,920.75
As of 01/01/2009 - 12/31/2009 max = $3,600.00
As of 01/01/2008 - 12/31/2008 max = $3,000.00
As of 08/06/1999 - 12/31/2007 max = $2,400.00
(This is not a complete past history of the maximum Average Monthly Wages)
Each year the commission shall, not later than August 1 of each calendar year, beginning August 1, 2009, adopt an amount that adjusts the amount from the prior year to reflect the annual percentage increase in the Arizona mean wage published by the department of economic security using the bureau of labor statistics occupational employment statistics data coded for all occupations for the prior calendar year. The amount adopted by the commission shall be effective for the following calendar year and shall apply to all injuries occurring during that calendar year. In adopting the amount under this subsection, the commission shall ot decrease the amount from the prior year or increase the amount more than five per cent from the prior year.
If you are released to light duty and no work is available through your employer, the insurance carrier is to continue to pay you 66 2/3% of your Average Monthly Wage every 30 days. If your employer offers you a position whether at the same wage or different, the insurance carrier will take the position you are able to earn that amount. It is strongly suggested that you take the position. If it is at a lesser wage, you are to report your gross wages every 30 days to the insurance carrier. The insurance carrier is to pay you 66 2/3% of the difference between the earned wages and your Average Monthly Wage.
Types of Benefits
Benefits under workers’ compensation include medical benefits and loss of wages. The medical benefits are paid even if you do not lose any time from work. For more information on compensation benefits see sections on Benefits if Not Working, Scheduled and Unscheduled Injuries and Permanent Benefits.
Your benefits begin as of the date you are injured. They continue until you are stationary or cured. Even after your case is closed, you may be able to reopen your case for additional benefits, which may include further medical treatment and further compensation.
Scheduled and Unscheduled Injuries
There are two types of permanent injuries: Scheduled and Unscheduled. There is also death, which is a separate category.
Scheduled injuries are permanent injuries to a certain part of the body, such as an eye, a hand, an arm, etc. Compensation for Scheduled injuries depends on a formula which is spelled out in the workers’ compensation law. The benefits are a fixed amount of money for a fixed period of time.
Unscheduled injuries are injuries that are not Scheduled. For example, backs, necks, shoulders, etc. Unscheduled injuries may also be based on other considerations such as previous injuries and disabilities. A lawyer is recommended to sort these considerations out. Compensation for an Unscheduled injury is based on the effect the injury has on your ability to return to work and the wages you are able to earn compared to your average monthly wage.
Permanent benefits depend upon whether the injury is scheduled or unscheduled. If scheduled, the benefits are spelled out in the Statue on workers' compensation.
If the injury is unscheduled, the benefits depend on the effect, if any, the injury has on your earning capacity. Proof of your earning capacity, if you have not returned to your regular job and/or are not making as much money as you did before the injury, usually requires experts in both the medical field and the labor market field.
The determination takes many factors into consideration, such as age, education, previous occupations, physical limitations, and wages after the injury.
The calculation of benefits if you have an unscheduled injury, is 55% of the difference between your average monthly wage and the amount of money you should be able to earn with your injury on the open and competative labor market. It also considers your labor market, which is where you live, and the area surrounding where you lived or worked at the time of injury.
If your employer had no workers’ compensation insurance on the date of your injury, you may either file a civil action (lawsuit) against your employer in Superior Court, or file a claim for workers’ compensation benefits with the Industrial Commission.
The Industrial Commission has a trust fund called the Special Fund, which was set up to pay the medical and/or compensation benefits to workers injured during the course of their employment with uninsured employers. The Industrial Commission's Special Fund Division will process your claim and conduct an investigation to determine if you were an employee or an independent contractor and, whether the injury arose during the course and scope of your employment.
The decision whether to file a civil action or proceed with the Special Fund can be a very complicated issue. It is recommended that you contact both a personal injury lawyer and a worker’ compensation lawyer, or a lawyer who specializes in both before making this decision.
Issues Surrounding Doctors
Do I have the right to select my own doctor?
You have the right to select the doctor of your choice unless your employer is self-insured.
What happens if my employer (not self-insured) wants me to see it’s doctor?
It is okay to see your employer’s doctor. In fact, it is mandatory under certain circumstances. Keep in mind,however,that if you voluntarily visit a doctor more than once, it is interpreted that you have officially chosen that doctor to be your doctor.
Leaving The State
Are there restrictions to leaving Arizona while under the workers' compensation system?
Yes there are restrictions. You may not leave the State for more than two (2) weeks while under active medical treatment without prior approval. If you are planning to be outside the State for more than two weeks, you must have written approval from the Industrial Commission before you leave the State. Requests to leave the State must be sent to the Claims Division of the Industrial Commission of Arizona. The request should include the reasons that you need to or want to leave the State, the date you plan on leaving and the date of return. Obviously, moving out of State creates problems which need to be considered.
What problems can I expect if I leave Arizona for more than 2 weeks without prior approval?
If you fail to get approval, prior to leaving the State, the insurance company may suspend your benefits.
Do I need a Lawyer?
Do I have to have an attorney, or can I represent myself?
You can represent yourself. Keep in mind however, that the Workers’ Compensation Law is very complex and the insurance company or self-insured employer will be represented by attorneys who specialize in Workers’ Compensation Law at the hearing. If you choose to represent yourself, you will have to follow the Rules of Procedure for hearings before the Industrial Commission of Arizona. A copy of the rules can be obtained from the Industrial Commission of Arizona’s Administrative Law Judge Division.
How can I afford an attorney?
Attorneys representing injured workers are paid on a percentage basis. This means that they will receive an agreed upon percentage, usually 25% of your compensation benefits, if any. If they are not successful in obtaining any compensation benefits, whether short term (temporary) or long term (permanent) there is usually no fee. You need to talk over the fees and costs with your attorney in detail so you understand. The fee agreement should be in writing.
Is there a certain type of attorney that I should hire?
Yes, it is recommended that you consult with an attorney who is a specialist in Workers’ Compensation. You can also contact the Arizona State Bar Association for a list of qualified attorneys.