Frequently Asked Questions About
Workers’ Compensation
How long do I have to file a workers’ compensation claim?
Normally, you have one (1) year to file a claim for an on-the-job injury.
2) Will the Employer File a Claim On My Behalf?
The employer is legally obligated file a report, but that report DOES NOT initiate the claim. It is the injured workers’ responsibility to file his or her own claim to ensure proper notification.
3) What if I am here in the United States illegally, can I still file a claim and receive benefits?
Yes, as long as you were injured while doing your job, as an employee of the employer/company, you are entitled to receive workers’ compensation benefits. CALL US TODAY – (602) 527-5808.
4) What Type of Injuries and Expenses are Covered Under Arizona’s Workers’ Compensation Laws?
For any work-related injury or illness, all medical costs are covered and compensation is paid for lost wages. Most injuries are temporary, but permanent compensation and vocational rehabilitation may be available, if warranted.
5) Is Negligence Required?
No, negligence on the part of the employer is not required, in order to file and receive workers’ compensation benefits, here in Arizona. Additionally, negligence on the part of the injured employee does not preclude coverage. However, there are circumstances where an employee’s actions could be so far removed from being work-related as to render benefits unpayable; for example, the commission of a crime.
However, if your injury/accident was the result of a third-party, you could also be entitled to pursue an independent action for damages, including pain and suffering, against the negligent third-party (but NOT your employer).
6) What happens, if my employer didn’t have workers’ compensation insurance?
If your employer does not have workers’ compensation insurance on the date of your injury/accident, you are still entitled to benefits. However, you will receive benefits through the Industrial Commission of Arizona’s Special Fund/No Insurance Section. CALL US TODAY – (602) 527-5808.
7) Can I Get Paid My Lost Wages, and If So How Much?
Yes, with a valid claim, you will be compensated for lost wages. The Industrial Commission of Arizona establishes the payment based upon the average monthly wage (AMW) of the injured employee at the time of the injury, which is capped at a specific dollar amount each year.
8) If your claim has been accepted, are you being paid correctly and timely?
In Arizona, you are entitled to receive temporary disability benefits if you have lost wages, due to your industrial injury. These benefits are based upon your average monthly wage at the time of the injury. There are several ways to calculate your average monthly wage, and the insurance company usually picks the method most advantageous to them. Therefore, you may want to have an attorney look at your check stubs, for you, and advise you regarding this VERY IMPORTANT issue. Once the Average Monthly Wage (AMW) becomes final, if your wage was set incorrectly, you may not receive all the benefits you should have. CALL US TODAY – (602) 527-5808.
9) Can I Choose My Own Doctor?
Yes, in most cases. However, if the employer is self-insured, the employee does not have this option.
10) What if I have already injured the same body part previously, can I still file a claim?
Yes, you may still have a compensable claim, even if you have injured the same area previously, or have a pre-existing condition. However, you will most likely need the help of an attorney, and require expert medical testimony, in order to meet your burden of proof. CALL US TODAY – (602) 527-5808.
11) What if my employer wants me to sign a document?
You should never sign anything without having an attorney review the document(s) first. Your attorney will be able to determine whether the document being presented to you would have an adverse effect on your workers’ compensation claim/benefits.
12) What if my claim is denied?
If your claim is denied, you have a limited amount time (90-days), in which to protest the Notice of Claim Status. In this case, it is very important that you seek legal advice as soon as possible; and we offer free consultations in order to determine whether we can help you. CALL US TODAY – (602) 527-5808.
13) What if my claim has been closed?
If your claim is closed, you have only a limited amount of time (90-days), in which to protest the closure of your claim; along with any additional language or items that maybe have been included on the closing notice. Therefore, it is very important that you seek legal advice as soon as possible; and we offer free consultations in order to determine whether we can help you. CALL US TODAY – (602) 527-5808.
14) Do I need a lawyer?
You can either hire a lawyer or represent yourself; however, if you represent yourself, you will be expected to know the laws and rules that apply to your case. Only a lawyer licensed in Arizona can give legal advice. Please understand that workers’ Compensation issues are COMPLEX & UNIQUE; but a workers’ compensation lawyer will be familiar with the laws, rules, and procedures, and can give you legal advice about how to present your case, what evidence you will need, what witnesses to call, and whether it is in your best interest to settle the case. Therefore, we advise you to hire an attorney to make sure your rights are protected. Hire your own advocate today, by calling (602) 527-5808. We also provide free consultations, in order to determine whether we can help you. CALL US TODAY – (602) 527-5808.
The Defendants (the employer and insurance company) will have a lawyer, and so should you.
The State of Arizona does not appoint lawyers to represent injured workers. You cannot be represented by a document preparer, paralegal, spouse, family member, or friend.
15) How much does an attorney cost?
It is usually a fee contingent upon you receiving benefits; and so, if we can’t help you get & receive benefits, we don’t receive a fee. CALL US TODAY – (602) 527-5808.
16) Does the insurance company pay my attorneys’ fees, if I win?
No, your attorneys’ fees are your responsibility. It is your choice and privilege to have an attorney, but remember that hiring an attorney means you have someone constantly looking out for you and your interests. But more importantly, having a lawyer may result in benefits that you would not otherwise receive or that you did not know you were entitled to. CALL US TODAY – (602) 527-5808.
17) Do I get paid for pain and suffering?
Under Arizona law, there is no compensation for pain and suffering in workers’ compensation. However, there are other benefits, and we can help you determine whether you are receiving all the benefits available to you under the law.
18) Do I have to attend an independent medical examination (IME)?
An IME is an examination with a doctor picked by the defendants. If you receive a Notice of IME, you must attend unless you are excused. You may file a motion for protective order, with a copy sent to the defendants’ lawyer, stating your reason for wanting to be excused. You will not be excused because you do not like the doctor chosen by the defendants or because you believe your doctor has provided enough information to prove your claim. Per A.R.S. § 23-1026; R20-5-114, failure to attend an IME can result in a request for hearing being dismissed and/or suspension of benefits. CALL US TODAY – (602) 527-5808.
19) What happens when a request for hearing is filed?
When a request for hearing is filed on your claim, the Claims Division forwards your file to the Administrative Law Judge Division (ALJD), also known as the Hearing Division. The file is then referred to an administrative law judge (ALJ). The ALJ will send you a Notice of Hearing with the date, time, and location of the hearing. CALL US TODAY – (602) 527-5808.
20) What is an ALJ?
ALJ stands for Administrative Law Judge, and S/He is the judge who will decide your case. They will schedule the hearings, rule on motions, listen to the testimony presented, by you and other witnesses (i.e. doctors and/or labor market consultants), review evidence (i.e. medical reports), apply the law to the facts and evidence of your case, and issue a written decision.
21) How soon will my hearing be scheduled?
The initial hearing is usually scheduled about 90 days after the Hearing Division receives the file. This gives both sides time to prepare their case. CALL US TODAY – (602) 527-5808.
22) How long will my hearing take?
Every case is different; but most cases require more than one hearing to complete. Usually, at the initial hearing, the ALJ will hear testimony from you and any non-expert witnesses. It may last as little as 30 minutes or it could take several hours. Further hearings are held to take testimony from medical experts and/or labor market consultants. Scheduling further hearings depends on the availability of the experts, and it can take weeks or even several months to get everyone scheduled. CALL US TODAY – (602) 527-5808.
23) What is discovery?
Discovery is the process for exchanging information before the hearing. Discovery includes signing medical releases, attending depositions, and answering interrogatories. You are required to cooperate in the discovery process. CALL US TODAY – (602) 527-5808.
a. Medical Release: You are required to sign medical releases to allow the defendants to obtain medical records, tests, or other information from any doctor or health care provider who has seen or treated you in connection with your industrial injury. A.R.S. § 23-908(C); R20-5-131(G).
b. Deposition: is an oral question-and- answer session, and you must participate. It is usually conducted at the lawyer’s office or by telephone. You can ask the defendants’ lawyer to change the date or time, but the defendants’ lawyer is not required to do so. Your answers will be under oath and recorded by a court reporter. The ALJ is not present during the deposition. R20-5-142 and R20-5-143.
c. Interrogatories: are written questions that you must answer in writing and under oath within ten days after you receive them. The answers should be returned to the person who sent them, usually your own lawyer, if represented or the defendants’ lawyer, but not the Commission or the ALJ. R 20-5-144.
24) What will the hearing be like?
Most hearings are held in hearing rooms at the commission in Phoenix or Tucson. Outside of Phoenix and Tucson, hearings are held in hotels, government offices, or other facilities that have meeting rooms. The location of the hearing will be on the Notice of Hearing. You, the defendants’ lawyer, a court reporter, and the ALJ will be present at the hearing. There may also be a representative of the employer or the insurance carrier who is allowed to sit in at all hearings. Witnesses are usually asked to wait outside the hearing room until they are called to testify.
The ALJ will start the initial hearing by introducing the case and identifying the issue(s). Since injured workers usually have the burden of proof, you will be asked to present your side first at the hearing. The ALJ may ask you some preliminary questions. The defendants’ lawyer can cross-examine you and your witnesses. You will also have the opportunity to cross-examine any and all defense witnesses, if you so choose.
Medical witnesses often testify by telephone at further hearings. The parties usually appear in person, but may be permitted to participate by telephone. You should check with the ALJ’s office, if you are not sure whether you need to attend the hearing in person.
The hearing is your only opportunity to present evidence and prove your case. Bring any notes or papers you think you might need. You should think about what questions you want to ask and write them down before the hearing. Usually, after the last hearing, you will not be allowed to call additional witnesses or submit any additional documents or evidence into the
record. CALL US TODAY – (602) 527-5808.
25) What if I do not understand English?
We have individuals that speak Spanish. And in the case of a hearing, we would notify the Administrative Law Judge (ALJ) of the language issue, and an interpreter will be provided for you at the hearings, at no charge to you. However, all written correspondence from the ALJ and the Commission will be in English. CALL US TODAY – (602) 527-5808.
26) How long after the last hearing will the ALJ decide my case?
The ALJ will issue a written decision (Decision Upon Hearing) usually within 30-60 days after the last transcript is filed and any post-hearing memoranda are submitted. A copy of the decision will be mailed to your last known address of record. A.R.S. § 23-942.
27) What if I do not agree with the ALJ’s Decision Upon Hearing?
There is a paragraph at the end of the decision that sets forth your rights. You have 30 days after the date the decision is mailed to you to file a Request for Review. The ALJ will consider your request and the defendants’ response, and then issue a written Decision Upon Review. If you do not file a timely Request for Review, the Decision Upon Hearing will become final. A.R.S. § 23-942(D).
