Are you in need of a trusted Arizona worker's compensation lawyer? Thomas C. Wilmer, P.C. has provided skilled legal guidance to those who have suffered injuries in the workplace since 1990. Those living in the Ahwatukee. C handler, Gilbert, Mesa, Peoria, Queen Creek, Sun City and Tempe areas can count on us for strong legal representation. We provide our services to those in the Cave Creek, Flagstaff, Glendale, Payson, Phoenix, Scottsdale and Surprise communities. When you are researching Arizona workman's compensation attorneys in the area, keep in mind that skill, experience and knowledge are key to a successful outcome.
The Arizona Worker's Compensation Act provides that those injured while in the course and scope of their employment shall be provided medical and compensation benefits irrespective of fault. For example, even if your work related injury is due to your own fault, you are nonetheless eligible for worker's compensation benefits. There are a wide variety of occurrences which can support an award for worker's compensation benefits. They include some of the following:
- Acute physical injuries
- Exposure to toxins, pollutants, diseases and irritants
- Injuries gradually developing over time due to cumulative trauma
- Aggravation or exacerbation of pre-existing condition regardless of whether the prior condition is work related or not
- Mental stress injuries resulting from unexpected or unusual stress at work
- Personal injuries caused by others outside of your employment while you are on the j
The answer is a definite yes. Many people have the notion that the worker's compensation system is simple and straightforward and, if you are injured on the job, benefits will flow without any difficulty. That is a misconception that has led to many injured workers losing valuable benefits.
The most important thing to understand is that the worker's compensation benefits are paid through insurance companies. Insurance companies in the worker's compensation system are no different than insurance companies in other aspects of life; they like to hold onto as much money as possible. Should you have a dispute with a worker's compensation carrier, they will be represented by capable defense counsel. Believe it or not, the worker's compensation system can be very complicated and you are at risk of losing valuable benefits if you attempt to represent yourself.
WORK-RELATED PERSONAL INJURY CLAIMS
In some instances, workers who are injured not only have a right to pursue a claim for worker's compensation, they may also seek a civil remedy against others outside of their employment who may be responsible for their injuries. For example, if you are injured by a negligent motorist while on the job, you can pursue both a worker's compensation claim and a personal injury. However, your right to pursue a civil remedy when you are collecting worker's compensation benefits is limited. Unlike the non- work related accidents, your right to file a lawsuit against the responsible party is limited to one year. If you do not file your claim within the one year time period, your right to sue is then transferred to the worker's compensation carrier to allow it to pursue a claim for reimbursement of the medical and compensation benefits paid to you. Although you may request that the worker's compensation carrier reassign you the right to pursue your claim after the one year anniversary and prior to the two year statute of limitations, the worker's compensation carrier sometimes will place unfavorable conditions upon the reassignment. In addition, in some instances, the worker's compensation carrier will not reassign you your right to pursue your claim after the one year anniversary. Accordingly, it is very important that you hire an Phoenix injury attorney that has the experience in both worker's compensation and personal injury matters. The Law Office of Thomas C. Wilmer, P.C. is one of the very few Arizona Law firms that has this combined experience.
There are many circumstances in which an individual may sustain injuries at work or you may sustain injuries caused by machinery, dangerous conditions in the field or as a result of the negligence of others. In such complex cases, an Arizona work injuries lawyer may be required to help you determine who is in fact responsible, so that you know which direction to go in. Those who work in the construction industry face much higher risks of injury than those working in other industries. In fact, there are more injuries and fatalities each year in construction work than in any other type of work. Arizona construction accident experience will help determine whether you have a claim, who should be held accountable, and how to proceed. These types of injuries are often complex; do you hold the property owner accountable, or the general contractor? There are many questions you need answers to.
YOUR WORKER'S COMPENSATION OBLIGATIONS AND RIGHTS
This brief summary should provide you with some of the most basic things that you should know about .
Report your injury ASAP!
First and foremost, it is important for you to inform your employer as soon as possible if you have been injured at work. Under the Arizona Worker's Compensation Act, the injured worker is to report the injury "forthwith" and if he or she fails to do so, the employer and worker's compensation carrier can assert that as a defense should your claim be denied. The failure to forthwith report can be excused under certain circumstances, however, it is always best that you report your injury as soon as possible.
File your claim
In addition to reporting your injury as soon as possible, you must file your claim for worker's compensation benefits within one year from the date of your accident or time within which you should reasonably discover that you have been injured. Injured workers are not expected to possess the skill and knowledge of medical doctors and, in some instances, a worker will not realize that their condition is related to their work employment until a doctor informs them that this is the case. Under those circumstances, once a worker discovers that their condition is work related, they should follow the forthwith reporting guidelines discussed above and report their claim as soon as possible.
In order to file a worker's compensation claim, you must file either a Worker's Report of Injury or a Physician's Report of Injury with the Industrial Commission of Arizona. Do not rely upon your employer to file a claim for you. Although the employer is required to file an Employer's Report of Injury, that form does not initiate a claim on your behalf, nor does it trigger the notification process. All physicians are expected to maintain Physician's Report of Injury forms in their office. The doctor is under the requirement to complete the form and forward it to the Industrial Commission of Arizona if he or she learns that your injury has occurred at work. The system is not perfect and, therefore, this does not always occur. For your best protection, you should always file a Worker's Report of Injury form as soon as possible. These forms can be obtained from the Industrial Commission of Arizona in person or can be downloaded from the ICA website. We also maintain these forms in our office and we would be happy to assist you should you wish to file a Worker's Report of Injury. Remember, if your claim is not filed within one year from the date of your injury, your claim may be time barred.
Do not rely upon advise from non-attorneys
You should never rely upon information which may be given to you by the worker's compensation insurance carrier or the Industrial Commission of Arizona. Insurance company and ICA employees should not give legal advice to injured workers. However, insurance representatives and claims personnel often give information that is incorrect or incomplete. You should not blindly rely upon what you are told. You should always consult with a Scottsdale injury attorney to insure that your rights are adequately protected.
Choosing a doctor
Under the Worker's Compensation Act, injured workers are entitled to receive medical benefits both current and future. If your employer is not self-insured, you have the right to choose your own physician. Some large employers are self-insured and, under those circumstances, you must follow your employer's wishes with respect to whom you treat with However, self-insured employers make up a very small percentage of Arizona employers and, in most instances, you have the right to choose your own physician.
Customarily, once you report your injury, your employer will most likely direct you to an industrial medical clinic to undergo treatment. In this writer's view, many of these industrial clinics adhere to policies which favor employers more than injured workers. Accordingly, you are best served to treat with a physician of your own choice that specializes in treating your condition.
Under Industrial Commission rule, if you treat with the initial doctor on more than one occasion, it is deemed that you have elected that doctor as your treating physician. That does not necessarily mean that you are stuck with that doctor. Industrial Commission rule permits you to file a Petition to Change Physicians and you should do so if you require specialized treatment. The Industrial Commission of Arizona can assist you in filing a Petition to Change Physicians. Our office will be more than glad to help you in this regard as well.
Following your injury, as long as you require active medical treatment, your claim is considered to be open. If you are unable to work or your physician places work restrictions upon you, you may be entitled to compensation benefits. You do not qualify for worker's compensation benefits unless you have been totally or partially disabled for more than 7 days. If you are disabled for less than 15 days, you are not entitled to compensation benefits for the first seven days. If, however, your disability goes beyond 14 days, you are then entitled to receive benefits which cover the first week that you are disabled. If your physician places you on a no-work status, you are entitled to receive compensation benefits every two weeks. If your doctor indicates that you are released to perform light duty status, you should contact your employer to determine if they have work that is available for you. If they do, you must perform that work and, if you refuse to do so, the money that you would have received from that work can be counted against your worker's compensation benefits. If your employer does not have light duty work available for you, you are obligated to search for work that is within your restrictions. While on light duty status, your compensation benefits are paid every thirty days. Prior to receiving payment, you are required to fill out forms which reportS the earnings that you have obtained or, alternatively, places you have looked for work. If you have earnings while on light duty status, the earnings are subtracted from your average monthly wage and you then receive two thirds of the monies that you have lost.
Average monthly wage calculation
The average monthly wage calculation is one of the most important determinations and has a tremendous impact on your entitlement to benefits. The average monthly wage is the measuring stick from which your benefits are measured. While you are completely off of work, you receive two thirds of your average monthly wage to compensate you. If you have partial earnings while on light duty status, you receive two thirds of the deficiency representing your loss of earnings after taking into account your partial earnings. In addition, once your claim is closed, if you are entitled to a permanent disability, the average monthly wage calculation is again used to measure those benefits.
Because of the importance of the average monthly wage calculation, you must be sure that your wage calculation is correct. The average monthly wage calculation is initially made by the insurance carrier but then reviewed by the Industrial Commission of Arizona. Once reviewed, the ICA will issue a Notice of Average Monthly Wage: Under Arizona law, all wages earned by you at the time of your injury are to be considered. Many people work more than one job at any given time. The earnings from both employments should be combined to determine your average monthly wage. Some average monthly wage calculations may not reflect your actual average monthly earnings. There are many different ways to calculate your average monthly wage and, in some instances, the insurance carrier will do its best to come up with the lowest calculation. The wage calculation reported by the insurance carrier to the Industrial Commission of Arizona will result in an ICA Award setting your average monthly wage. If it is incorrect, request a hearing as soon as possible.
All of the determinations relative to claim process are subject to your protest if you are in disagreement. For example, the Industrial Commission Notice of Average Monthly Wage provides that you must file a Request for Hearing within 90 days of the date the Notice is issued if you disagree with the calculation. In addition, insurance companies issue Notices of Claim Status which inform you as to their decision making. This may include a Notice of Claim Status denying your claim for benefits or a Notice of Claim Status attempting to close your claim. These Notices provide that, if you disagree with the determination, you must file a Request for Hearing with the Industrial Commission of Arizona within 90 days of the date the Notice issued. If you fail to file a timely protest, the Notice is deemed final.
Permanent disability payments
At the time your claim is closed, if your injury results in a permanent impairment, you will be entitled to one of two different types of disability. Scheduled disabilities are calculated based upon a formula set forth in the Worker's Compensation Act. These benefits are limited to a payment over a number of months and, once the payment is completed, that is the end of your compensation. Unscheduled benefits are paid based upon any loss of earning capacity that you may have sustained. Some scheduled injuries may be converted to an unscheduled disability which is certainly more favorable in the event that you have sustained a permanent loss of earning capacity and will have diminished earnings over the remainder of your life. You should definitely seek advice of counsel at the time of the closure of your claim to insure that you are receiving adequate compensation benefits.
Adjustment of long-term permanent disability payments
In addition to reopening your claim, if you are receiving long term permanent partial disability worker's compensation benefits, if your condition should change such that your employability changes in the future, you can petition to rearrange your disability payment. Again, the change in benefits is effective from and the date you file your Petition and, therefore, it is important that you seek that remedy as soon as possible.
Right to future treatment
Once your claim is closed, you nonetheless have the right to seek benefits in the future should there be changes in your circumstances. The Arizona Worker's Compensation Act allows you to file a Petition to Reopen your claim in the event there is something new, additional or previously undiscovered. In many instances additional medical needs develop well after a worker's compensation claim is closed. Under these circumstances, you can file a Petition to Reopen your claim. However, it is important that you file your Petition to Reopen prior to undergoing hospitalization or surgery unless it is a dire emergency. If that is the case, you must still file your Petition to Reopen within 7 days of the emergency treatment and 15 days of any other medical treatment. All benefits generally run from and after the date the Petition to Reopen is filed and, therefore, it is of utmost importance that you file your Petition as soon as you wish to reopen your claim.
Maintenance medical benefits
In addition to entitlement for future treatment, the Worker's Compensation Act of Arizona also provides for supportive care which consists of pre-approved treatment set aside to help maintain your condition. This may consist of an award that allows for annual office visits with medication. In some instances, supportive care is much greater and provides for repeat testing, injections, etc. Your entitlement to supportive care is guaranteed under the Worker's Compensation Act and is available at any time after your claim is closed. In many instances, it is necessary to seek the assistance of the Industrial Commission of Arizona, to include requesting a hearing with an Administrative Law Judge, to obtain these benefits. You are best served by hiring an experienced attorney in this regard.
Injuries in the workplace may be serious, disabling or even life-threatening. Those who are injured at work are urged to contact Thomas C. Wilmer, P.C. We work aggressively to protect the rights of employees in the workplace.
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