In Arizona, the Industrial Commission of Arizona is responsible for administering the state's workers' compensation insurance to injured workers. The workers' compensation system provides injured employees with medical and wage replacement benefits without assessing fault. Employees can receive temporary and permanent wage benefits if they suffer serious injuries and may receive job training.
Arizona Workers' Compensation Claims
Injured employees can file two different types of workers' compensation claims with the Industrial Commission of Arizona. Employees can file "medical expenses only" claims or "time-loss" claims. Time loss claims provide medical benefits and temporary compensation to injured employees. Employees who file time-loss claims can receive benefits after seven days of injury-related absences from work. After 14 days missed, employees can receive back wages for those first seven days, excluding the first day of injury, since Arizona law considers Day One as one day worked. Employees who miss fewer than 14 days will receive wages beginning on the eighth day of their absences.
Medical-Only Claims
Employees file medical-only claims when they miss fewer than seven days of work. Insurance companies pay for all reasonably necessary medical treatment, and employees can receive treatment pending their benefits' determinations from the Industrial Commission. Arizona requires employers to purchase insurance to fund the state's workers' compensation program but allows some large businesses to obtain status as a self-insurer. Employees who work for non-self-insured businesses have right to receive medical treatment from doctors of their own choosing; employees who work for self-insured businesses cannot select their own physicians. Employees may not change physicians without obtaining pre-authorization from the Industrial Commission.
Time Lost Claims
To receive both medical benefits and lost wages, injured employees must obtain a physician's certification that they is unable to work for more than seven days because of their injuries. To qualify for benefits, employees do not have to stay home seven days in a row, and they may aggregate his days off. Time off includes weekends and holidays. Under Arizona law, there is no time limit for how long injured employees can receive temporary compensation wages. Benefit amounts depend on the employee's monthly wages, and average monthly benefits total two-thirds of the employee's monthly salary. To calculate the monthly average, the Industrial Commission reviews the average wages employees earned during the 30 days before suffering injuries.
Permanent Compensation
Employees may qualify for permanent compensation based on the American Medical Association's "Guides to the Evaluation of Permanent Impairment." Injured employees must receive certification from their doctors that their injuries are stationary, meaning there is no realistic chance of improvement, and continuing medical treatments are unlikely to yield positive results. Permanently injured employees can receive up to 75 percent of their monthly wages prior to suffering their injuries as permanent compensation. The Industrial Commission uses a formulaic calculation to determine benefit amounts.
Considerations
Since business laws can frequently change, do not use this information as a substitute for legal advice. Seek advice through an attorney licensed to practice law in your jurisdiction.
