The Workers’ Compensation System is a no-fault system which is designed to provide limited benefits to injured workers regardless of who is at fault for the accident. Generally in a workers’ compensation case you cannot sue your employer for any negligence which may have caused or contributed to your injury.
how it works
When you get injured, you should immediately report your injury to your employer. Then you should see your doctor. However, if your employer is self-insured they have the right to direct medical care. You are responsible to file your claim, not the employer. You can either file a Worker’s Report of Injury with the Industrial Commission or fill out a Worker’s and Physician’s Initial Report in your doctor’s office.
Once your claim is filed with the Industrial Commission, they will forward it to the insurance carrier for your employer. The insurance carrier has twenty-one days from the date they receive notification from the Industrial Commission to either accept or deny your claim.
what they pay
Workers’ Compensation will pay for the medical bills, prescriptions, and medical equipment that are related to your industrial injury. It will also pay you two thirds of your average monthly wage when a doctor takes you off work for the injury. Please note there is a wage ceiling in Arizona that sets a maximum average monthly wage.
You also have additional entitlements which may include permanent disability benefits and reopening your claim once it is closed. If you are reopening an industrial claim, you need to prove that you have new, additional or previously undiscovered conditions.
how the claim is processed
When an insurance carrier changes the status of your claim, it will issue a Notice of Claim Status. The insurance carrier will have a medical opinion that supports the notice. On the notice is a paragraph that states you have ninety days to file a request for hearing if you disagree with the notice. If you do not file the request for hearing within the ninety days, the notice will become final. You should put the name, address and telephone number of your doctor on the request for hearing. Please note you are responsible to file the request for hearing with the Industrial Commission, not the insurance carrier.
The Industrial Commission will then set a hearing which will be about three months after you file the request for hearing. The insurance carrier is required to hire an attorney. We recommend you also have an attorney. If you choose to represent yourself you will be required to know the rules, statutes and case law that apply to your claim. Therefore, we urge you to speak with an attorney as soon as you receive a Notice of Claim Status.
The way injured worker attorneys are compensated, is usually based off a percentage of the disability benefits they are able to obtain for you. Usually our fees are 25% of whatever money compensation you would be entitled to. All of the medical bills are paid directly from the insurance carrier to the provider unless the claim is settled out-of-court.
In an industrial claim, you generally have a choice whether you want to go to court to get your medical care and disability benefits or settle the claim for a sum of money. Every claim is different. You do not have to go to court if you settle your claim. Please talk to us and we can advise you of your options.
talk to us
If you decide you need an attorney, we offer free consultations about your case. Please fill out our Free Consultation Form and we will contact you to speak with you further. You are also welcome to call our office at (520)881-8300 and set up a free consultation either over the phone or in person. Our address is 2573 North 1st Avenue in Tucson and 1001 North Central Avenue, Suite 701 in Phoenix. Please feel free to give us a call and we will be happy to discuss your case.