A workplace injury or illness in Arizona should not be a burden on the average employee as most employers are required by Arizona state law to carry workers’ compensation insurance with a commercial carrier. A successful claim made to the insurer can help pay medical costs and a portion of any time lost from work due to the injury. Not all workers’ comp. claims are honored. Your employer’s insurer may deny the claim for some reason. You can still make an appeal with the state’s Industrial Commission, but it helps to have the expertise of a workers’ comp. attorney to guide you through the process. Workers' Compensation Law in Arizona The state body that deals with all workers’ compensation claims in Arizona is the Industrial Commission of Arizona (ICA). Few employers in Arizona are not required to provide workers’ compensation insurance cover for their employees in the event that they are injured or become sick while at work. In the first instance, if you have been injured or suffered an illness while at work, you should let your employer know the details. Your employer will be expected to let their own insurer know as well as the Industrial Commission of Arizona. You must submit a “Worker’s Report of Injury” to the ICA. Your doctor can do this when you go for your first visit. In any event, the ICA must be informed within one year of the incident. The ICA should confirm that they have received your claim within two weeks of receiving it. Your Arizona employer’s insurance company will make a decision whether to honor the claim or deny it. A successful claim means that all your medical costs should be paid as long as they are directly related to your workplace injury or illness. Any time lost because of your injuries or illness should also be compensated, although not the full amount. The insurer should pay two thirds of the average wage you may have earned based on your last month’s earnings. Why Your Claim Could be Denied A common reason for a denial of a workers’ comp. claim is that the claim was not submitted on time or the employer was not notified on time. There are strict deadlines for claims to be submitted which must be adhered to unless there are good reasons why this might be impossible (for example, you were in a coma after the injury and could not inform your employer within the specified time limit). Another simpler reason is that the date of your accident or illness has not been documented accurately, leading to a discrepancy between the actual date that you were injured and the date that the employer has notified its own insurer. These administrative errors can usually be rectified by checking with your employer if you get a denial letter. A workers’ compensation claim in Arizona can be denied for other reasons. The insurer may claim that your injury or illness did not happen at work or was pre-existing. They may say that you were intoxicated or affected by drugs when the incident happened. The Arizona Workers' Compensation Appeals Process You have 90 days to file a request for a hearing if your workers’ comp. claim is denied or you are dissatisfied with the amount that has been awarded. The hearing is held by the ICA’s workers’ comp. judge, usually within three months of the request. There may be a pre-hearing or a further hearing after the main one. The judge at the hearing will hear evidence from your employer, the employer’s insurer as well as from you regarding your reasons for contesting the decision about your claim. If the decision is not in your favor, you may be able to make a further appeal as long as this is done within a one month period after the initial hearing. Why a Workers' Compensation Attorney May be of Help If you do decide to request a hearing because of a claim denial, you may find that an attorney will handle the hearing more effectively than trying to represent yourself alone. Remember that your employer and possibly the insurer will have their own attorneys present at the hearing and may use language that is difficult to follow without the help and guidance from an attorney of your own,
