Matt C. Fendon 2013-02-01 02:49:33
Arizona Workers’ Compensation Q & A with Matt Fendon A brief overview of the Arizona Workers’ Compensation System I recently had an article published in “Que” magazine which is a Spanish magazine in Phoenix. I thought it would be a good idea to republish it in English with additional information for my colleagues in the Phoenix legal community. The information below is not as detailed as a treatise or a practice manual, but it gives fellow lawyers a good idea in relation to how workers’ compensation operates. Feel free to make copies of the article and distribute it to your clients. I believe it is valuable information, especially for personal injury attorneys whose clients also have workers’ compensation claims. 1. What should I do if I am injured on the job? The first thing you should do is report the injury in writing to your employer and keep a copy for your records. The next thing you should do is go to a doctor. You can go to the company doctor or a doctor of your own if your employer will not send you (please keep in mind that if you employer is self-insured for workers’ compensation that they may be able to control which doctors you see, see number four below). It is important that you seek medical attention right after your injury even if it means going to the emergency room. In addition, you should contact the Industrial Commission of Arizona at 602-542-4661 and make sure a workers’ compensation claim is filed with them. 2. Am I eligible for workers’ compensation benefits if I am undocumented? Yes, undocumented immigrants are eligible for workers’ compensation benefits in the state of Arizona. There is no reduction of benefits for not being a legal resident. Undocumented immigrants should follow the steps above in answer number one if they are injured on the job. 3. How do I prove I am an employee if I am paid in cash? Just because you are paid in cash does not mean you will not be able to prove that you are an employee. The best ways in workers’ compensation cases to prove an employment relationship when the injured worker is paid by cash is to bring forth coworkers as witnesses. Another good way to prove it is by uniforms distributed to you by the employer. 4. Can I see the doctor of my choice? Your employer is entitled to send you to the doctor of their choice for an initial examination. However, as long as your employer is not a self-insured employer that directs medical care, you can go to the doctor of your choice for your medical care after the first office visit. 5. What happens if my employer is uninsured? If your employer is uninsured, then you can actually sue the employer in tort if you can prove negligence. In the alternative, you can file a workers’ compensation claim via the Special Fund Division of the Industrial Commission of Arizona. If accepted by the special fund, the claim will be paid out by that entity, and they will seek full reimbursement from the employer, plus penalties and interest. 6. What types of benefits are available in the Arizona workers’ compensation system? It’s a three-prong system. An injured worker is entitled to medical benefits reasonably related to the industrial injury, temporary compensation during temporary disability (e.g., no work per doctor’s orders or light duty), and permanent disability benefits if applicable. Permanent disability benefits may be owed when an injured worker incurs an impairment typically rated by a physician utilitizing the American Medical Association (AMA) guidelines. Vocational rehabilitation is not mandatory in Arizona. 7.What are the different forms of medical benefits available? Typically, there are two different forms of medical care in a workers’ compensation case: active care, and supportive care. Active care is designed to improve a condition, and supportive care is to maintain an injured worker’s condition. Active care is usually in place from the date of injury until the injured worker is deemed medically stable by a physician. In workers’ compensation, “medically stable” is defined as reaching a point where there will be no further improvement in the patient’s condition. Active care typically includes forms of treatment such as surgery, injections, and diagnostic studies. Supportive care, if recommend, usually begins once an injured worker is found medically stable. Supportive care is much more limited and typically includes a cap on office visits, physical therapy, and medications. 8. If my case is closed, can it ever be reopened? It can if a physician finds and documents a “new, additional, or previously undiscovered condition” since the closure of the case. A petition to reopen must be filed at the Industrial Commission prior to a surgery, etc., for it to be covered. Furthermore, the petition must have a medical report substantiating the reopening attached to it when filed. Many claimants make the mistake of undergoing surgery prior to filing a petition to reopen, and end up without industrial coverage for the surgical procedure. Matt Fendon is a shareholder with Fendon Law Firm, P.C. The firm handles workers’ compensation, social security disability, employment, and landlord/tenant cases with offices in Phoenix, Prescott, and Flagstaff. Mr. Fendon has worked in the workers’ compensation industry since 2001. He started as a certified paralegal and graduated from law school in 2008. He was licensed to practice in AZ the same year. He has a 10.0 (“Superb”) rating with Avvo.com. He is a member of the Arizona Trial Lawyers Association, the Worker’s Injury and Law Advocacy Group (WILG), the workers’ compensation section of the state bar, and he is board member with the Young Lawyer Division of the MCBA.
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