In Arizona, state law requires that all public and private employers must provide workers’ compensation coverage for employees if they employ one or more individuals full or part time.

Excluded from this are:

  • independent contractors
  • casual employees who are not in the usual business of the employer
  • domestic workers
  • sole proprietors (but they have the option of obtaining coverage for themselves)
  • workers who voluntarily in writing reject coverage

The ICA’s Special Fund Division provides workers’ comp benefits to employees who are injured while working for an employer without insurance.

Workers’ Rights Under Tucson, AZ Workers’ Comp Laws

Workers are entitled to obtain medical care and compensation if they are injured at work, regardless of fault (unless the injury was self-inflicted).

Injured employees may file two types of workers’ comp claims:

  1. Medical only, also known as no time lost. For this claim, only the employee’s medical expenses related to the employee’s injury are paid. This type of claim is filed for injuries that do not result in a loss of earning capacity that extends beyond seven consecutive calendar days; therefore no temporary compensation is paid. Examples of medical expenses for medical-only claims include emergency room charges, doctors’ visits and prescriptions.
  2. Time lost. For this claim, the employee’s medical expenses and temporary compensation benefits for lost wages are paid. For example, if a doctor deems an injured employee is unable to work or can perform only light duty for more than seven consecutive calendar days, the employee is entitled to temporary compensation for the lost wages due to the injury.

Permanent workers’ comp benefits are paid monthly. An injured employee is paid 66 and 2/3% of their average monthly wage. The wage is established as of the date the employee is injured. Arizona law also allows a permanently injured employee to enter into a settlement agreement with their employer’s insurer to receive one lump sum payment, subject to the ICA’s approval.

Arizona workers’ comp law provides a schedule of awards paid for permanent injuries to various body parts, including the hand, arm, foot, leg or eye. Scheduled awards are paid monthly for a set period of time by the insurer.

Compensation for scheduled injuries is calculated according to:

  • Partial loss of use. An employee suffering a partial loss will be paid 50% of their average monthly wage.
  • Total loss of use. An employee suffering a total loss, such as an amputation, will be paid 55% of their average monthly wage.
  • Prevention from return to essential duties. If a doctor determines the permanently injured employee is unable to return to the essential duties of their regular job, the employee will be paid 75% of their average monthly wage.

A permanent injury that is not in the list of scheduled injuries is known as an unscheduled general disability. Examples include occupational diseases and hip and back injuries. The ICA determines how much compensation, if any, the employee with an unscheduled general disability will receive.

An employer has the right to direct an injured worker to a doctor the employer selects for one visit only. After that, the injured employee has the right to select the doctor of their choice.

However, if the employer is self-insured and directs care, that means they have contracted medical care that is registered with the ICA and the injured employee is generally required to see their employer’s doctor.

Filing Process for Workers’ Compensation in Tucson, AZ

It’s up to the employee to understand all notices and documents issued regarding their claim. The employee must report the injury to the employer as soon as it occurs or as soon as the worker is aware of the condition. A claim must be filed within one year of that date.

Here is an outline of the workers’ compensation filing process in Arizona:

  • An employee who is injured on the job should report the injury to their supervisor or employer as soon as the incident occurs or as soon as the employee becomes aware of the injury. Prompt reporting will help avoid unnecessary delays or the possible denial of benefits.
  • The injured employee must fill out a Worker’s and Physician’s Report of Injury, also known as the 102 or Pink Form, which may be provided and completed at the doctor’s office or emergency room. The doctor’s office or hospital will send the Worker’s and Physician’s Report of Injury to the ICA and give copies of the report to the employer and its workers’ comp insurance carrier.
  • Alternatively, the injured employee may complete a Workers’ Report of Injury (0407) form, available on the ICA website.
  • Signing and submitting the forms to the ICA starts your workers’ comp claim. A workers’ comp claim must be filed within one year from (1) the date of injury or (2) when the injured worker became aware of the condition being related to employment.
  • Upon receiving the claim, the ICA will notify the insurance carrier and send a letter to the injured worker identifying the insurance carrier.
  • The insurance carrier will then accept or deny the claim for benefits within 21 days.
  • If the workers’ compensation claim is denied, the employee will receive a Notice of Claim Status from the insurance carrier and will have 90 days to request a hearing to protest the denial by filing a Request for Hearing form on ICA’s website.

Workers’ Recovery for Workplace Injuries Beyond Workers’ Comp in Tucson, AZ

Certain large employers in the state are self-insured. The ICA grants approximately 90 large employers the authority to act as their own insurers for workers’ compensation purposes. Self-insured employers may have the right to direct injured employees’ medical care related to the injury.

For injured employees of employers without workers’ comp insurance, the ICA’s Special Fund Division processes their workers’ comp claims and pays benefits if the claim is found to be compensable. The ICA then pursues the uninsured employer for reimbursement of all benefits paid and penalties assessed for violating Arizona law.

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workers compensation,

Last Update: June 28, 2024