Arizona Workers’ Compensation Claims – Laws for Work-Related Injuries

Workers’ compensation in Arizona helps employees suffering from job-related injuries or illnesses by paying out benefits or lump-sum settlements. If you were hurt and wish to seek aid from your employer, you may file a workers’ compensation claim.

Workers’ comp works under a no-fault system, meaning that an employee receives benefits regardless of who caused the accident. However, signing up for workers’ compensation bars you from suing your employer for your work injuries.

If you’re confused about where to start your workers’ compensation claim, you don’t need to settle your claim by yourself. You can find expert guidance through a workers’ compensation attorney, who can represent you throughout the claims process.

Here’s a general guide to start your Arizona workers’ compensation claim, from applying to hiring an attorney.

How Does Workers’ Compensation Work in Arizona?

Workers’ compensation is a “no fault” system where injured workers receive damages caused by job-related injuries – regardless of cause.

Medical bills and lost wages are generally covered under workers’ compensation, but continued benefits are available to those suffering intense, long-lasting injury.

This system of repayment is not free money, and there are multiple hurdles an applicant must pass to reach approval.

One major concept to prove in your claim is that your injury happened under the course and scope of employment. You can only receive approval if your injury was work-related.

IMPORTANT: Keep in mind that you’re generally unable to sue your employer for work-related injuries and that workers’ compensation is the only form of repayment for such losses.

Workers’ compensation is governed by the laws found in Article 18, Section 8 of the Arizona State Constitution, Chapter 6 of Title 23 of the Arizona Revised Statutes and Workers’ Compensation Practice and Procedure rules contained in the Arizona Administrative Code.

IMPORTANT: Your employer can direct you to a physician of the employer’s choice for a one-time evaluation. Following that visit, you may return to that physician or pursue treatment with a physician of your choice.

In Arizona, workers’ compensation is regulated by The Industrial Commission of Arizona (ICA). For specific advice related to your claim, consult with your workers’ compensation attorney to have them represent you.

Who Qualifies for Workers’ Compensation Benefits in Arizona?

Arizona law requires that all public and private employers provide workers’ compensation coverage if they employ one or more persons.

In addition, employees of all state agencies, boards and commissions including the three Arizona state universities, are covered. Some volunteers specifically described in A.R.S. Section 23-901 as well as employees of Superior Courts of all Arizona counties except Maricopa are covered.

Who Can Be Excluded From Workers’ Compensation in Arizona?

Workers’ compensation insurance is not required for:

• Independent contractors
• Workers whose employment is both casual and not in the usual business of the employer
• A domestic helper who works in someone’s home

A sole proprietor with no employees is not required to maintain workers’ compensation insurance.

Arizona law also allows for an employee to reject workers’ compensation coverage prior to an illness or injury by providing the employer notice in writing that is signed and dated.

How to Respond to an Injury at Work

Seeking medical attention is your first priority after a work-related injury. Then, when you first receive medical treatment, tell the doctor’s office or emergency room that this was an on-the-job injury.

The reason to notify your doctor is that medical facilities are unable to charge you for work injuries directly. Your immediate medical expenses are covered by your employer under Arizona workers’ compensation law.

Next, notify your supervisor as soon as possible about what happened after you’ve been injured at work. Your supervisor must complete the appropriate forms necessary to start your workers’ compensation claim.

Following these steps is important, and ignoring them may be a mistake you can fall into during a workers’ comp claim.

The paperwork may be confusing to track, especially while recovering from a serious injury. That’s when you should hire a workers’ compensation attorney to negotiate with insurance companies so get the damages you deserve.

How to File for Workers’ Compensation in Arizona

It’s your responsibility to report your injury to your employer as soon as an injury occurs. The deadline to start your claim extends to when you’re aware of your injury if your symptoms were hidden.

Immediately reporting your accident to the supervisor/employer will accelerate the processing of your workers’ compensation claim. This also gives time for your employer to complete their Form 104 to start your claim.

If the form wasn’t completed at the doctor’s office or emergency room, you may complete a Workers’ Report of Injury (407) form. By signing these forms and submitting to ICA, you are legally applying for workers’ compensation benefits.

Sometimes your insurer may require further evidence to know the extent of your injury. Your doctor may order function capacity evaluations (FCE) to verify how much your injury affects your future work capacity.

Types of Arizona Workers’ Comp Benefits You May Qualify For

There are the types of workers’ compensation claims you can submit in Arizona:

Compensation for medical fees: If you were to suffer a work-related injury and file a claim, your medical costs are covered by your employer. Medical costs like physical therapy, ongoing care, and transportation fees may be applied to your case.

Lost wages: These benefits are paid at 66 and 2/3% of your established average monthly wage if a doctor/medical provider deems you’re unable to work or only perform light duty because of your injury. For this to kick in, you have to experience a loss of earnings for more than seven calendar days.

Disability benefits: If your injury prevents you from participating in the workforce, you may be entitled to numerous forms of disability benefits. You can also apply for temporary disability benefits if your injury disabled you for a limited period of time.

Deadlines for Reporting an Arizona Workers’ Comp Claim

The legal deadline to file an Arizona workers’ comp claim must be within one year from the date of injury or when you became aware of your condition. Injured workers are responsible for making sure that the claim is filed.

Contact ICA to determine the status of your claim if you have not received a letter from ICA within 14 days.

Once your claim was notified, your employer’s insurance must accept or deny the claim for benefits within 21 days from the date of notification. Failure to do so may result in your case getting barred.

What if Your Arizona Workers’ Comp Claim was Denied?

If your Arizona workers’ comp claim was denied, you’ll receive a Notice of Claim Status (form 104) from your employer and have 90 days to protest the notice.

To proceed with your appeal, contact the Ombudsman’s Office at the Industrial Commission of Arizona (602-542-4350).

If you’re still unsuccessful in resolving the dispute, you may request a hearing before a judge to the Industrial Commission.

You may request a hearing by sending a letter or filing a Request for Hearing form on ICA’s website.

Arizona Employee Rights While on Workers’ Compensation

Keep in mind these rights as an Arizona employee while pursuing a workers’ compensation claim. If you have questions about how long your claim may take, always consult an attorney for direct legal assistance.

1. Can You Quit Your Job While on Workers’ Comp in Arizona?

Yes, you can quit your job while receiving medical benefits to pay for ongoing treatment. Wage loss benefits will stop, however. Before quitting, you may want to speak to a lawyer to be sure you understand all of your options.

2. Can You Be Fired While on Workers’ Comp in Arizona

Technically, you cannot be fired solely due to receiving workers’ comp, but you can still be fired for separate reasons. Facing adverse actions from situations like layoffs and company restructuring is legal.

Because Arizona is an at-will employment state, your employer reserves the right to fire you for any legal reason not rooted on discrimination. However, employers may try to justify firing you, when in reality they want to avoid paying expensive workers’ comp fees.

If you’re fired while on worker’s comp, talk with an attorney to investigate your case directly.

3. Can You Sue Your Employer While on Workers’ Compensation?

In general, you cannot sue your employer for damages while receiving workers’ comp, but different state laws may apply.

However, if you rejected workers’ compensation coverage prior to your injury, or if your employer fails to post the notice advising you of your rights, then you retain the right to sue.

Also, if you’re injured but your employer doesn’t carry workers’ compensation insurance, you can choose to file a civil suit against your employer or file a workers’ compensation claim with the ICA.

How Arizona Responds to Workers’ Compensation Fraud

Claim fraud occurs when an employee tells their employer’s insurance company that they suffered an injury when no injury occurred. Inflating the severity of your injury to seek underserved damages may also constitute workers’ compensation fraud.

Claims that are false, incomplete, or misleading are prohibited under federal laws as well (18 U.S. Code § 1920). Committing workers’ compensation fraud is against the law, and leads to serious consequences such as fines and prison time.

These include forfeiture of future benefits and conviction of a class 6 felony.  A felony conviction can lead to up to one and a half years in prison and a $50,000 fine.

Find an Arizona Workers’ Compensation Attorney with LegalASAP

If you need a workers’ compensation attorney to represent you, don’t hesitate to tap into our attorney network through LegalASAP.

LegalASAP partners with 500+ law firms with thousands of attorneys across the United States. We can help you find a local workers’ comp attorney in Arizona who will help you file your claim, and help you prepare for the consultation.

Attorneys representing injured workers are generally paid on a contingency basis and are experts in workers’ compensation requirements.

Fill out this short evaluation form to start your workers’ comp journey with a legal specialist. Your Arizona benefits are worth fighting for, so don’t let them go by the wayside.