Arizona Workers' Compensation: Deadlines, Benefits and How to File

The state, counties, cities, towns, school districts and every employer that regularly employs any workers in the same business (including part-year work in the employer's usual business) are covered, with no minimum number of employees. Employers of domestic servants are exempt but may choose to come under the law. A person whose work is both casual and not in the usual course of the employer's business is not an employee for this purpose, and true independent contractors are not covered.

The employee must report the accident and resulting injury to the employer "forthwith" (right away). If the accident is not reported promptly, compensation can be denied, but the Industrial Commission may excuse the failure if it finds the circumstances justify it.

A claim must be filed in writing with the Industrial Commission within one year after the injury occurred or the right to compensation accrued. The year starts when the injury becomes manifest or when the worker knows, or reasonably should know, that a compensable injury occurred. Late filing is excused in limited cases, such as reliance on a misleading statement by the Commission, employer or insurer, or legal incapacity, and a late claim is not barred if the insurer or employer has already started paying compensation.

No compensation is paid for the first seven days after the injury. If the disability lasts longer than seven days, payments start on the eighth day; if it continues for one week beyond those seven days, compensation is paid back to the date of injury.

Arizona calculates benefits monthly. Temporary total disability pays 66 2/3% of the worker's average monthly wage during the disability, plus a flat $100 per month extra if anyone depends on the worker for support. The first payment is due within 21 days after the Commission notifies the insurer of the claim (unless the claim is denied), then at least every two weeks during temporary total disability.

The employer may designate a physician of its choosing to conduct one examination of the injured employee. Employers that arrange medical care directly under the statute may direct care; if the treatment furnished by the employer reasonably appears to endanger the worker's health, life or recovery, the Industrial Commission may order a change of physicians on the worker's application.

Scheduled permanent partial disabilities (loss of fingers, hands, arms, feet, legs, eyes, hearing and similar) pay 55% of the average monthly wage for a set number of months listed in the statute (for example, 50 months for loss of a leg), in addition to temporary total disability. Other (unscheduled) permanent partial disabilities pay 55% of the difference between the worker's pre-injury average monthly wage and the reduced monthly earning capacity caused by the injury. Permanent total disability pays 66 2/3% of the average monthly wage for life; loss of both eyes, both hands, both feet, or paralysis of two limbs is presumed permanent and total.

Burial expenses up to $10,000. A surviving spouse with no children receives 66 2/3% of the worker's average monthly wage until death or remarriage (with two years' benefits in a lump sum on remarriage). If there are children, the spouse receives 35% and the children share an additional 31 2/3% until age 18 (22 if full-time students, or longer if unable to support themselves). If there is no spouse, the children share 66 2/3%. Wholly or partly dependent parents may receive smaller percentages if there is no spouse or minor child. For the surviving spouse of a first responder, benefits are paid until the spouse's death.

Report the injury to the employer right away, and file a written claim for compensation with the Industrial Commission within one year. The Commission then notifies the insurance carrier, which must either begin paying or issue a notice denying the claim.

If the insurer or Commission denies or limits a claim, the worker must file a request for hearing with the Industrial Commission within 90 days of the notice; otherwise the decision becomes final. An administrative law judge holds the hearing and issues an award. A party may file a request for review of the award within 30 days after it is served. After review, a party may ask the Arizona Court of Appeals to review the lawfulness of the award by writ of certiorari.

An employee has a claim against an employer that fires the employee in retaliation for exercising rights under Arizona's workers' compensation statutes.

Arizona does not set a fixed maximum number of weeks for temporary benefits. Temporary total disability is paid during the period of disability, and temporary partial disability is paid during the period of partial disability. Permanent total disability is paid for the rest of the injured worker's life. Unscheduled permanent partial disability is paid during the disability and stops when the disability ends or the worker dies.

An accepted claim can be settled in whole or in part, including through a full and final settlement that ends the worker's right to future benefits and to reopen the claim. A full and final settlement is allowed only after the temporary disability period has ended, and it cannot resolve permanent total disability issues. Every settlement must be in writing, signed by both sides, and approved by the Industrial Commission: an administrative law judge approves it if the worker has a lawyer and the legal requirements are met; an unrepresented worker must appear before the judge, who questions the worker about the rights being given up. The section does not apply to denied claims. Payment is due within 15 days after the approving award becomes final.

In Arizona the injured employee must file the workers' comp claim with the Industrial Commission of Arizona within one year after the injury occurred or the right to compensation accrued (the time starts when the injury becomes manifest). If the Commission receives notice of an injury, it sends the employee a claim form. Within ten days after notice of an accident, the employer must inform its insurance carrier and notify the Commission on Commission forms; an insurer or self-insured employer that receives a written injury notice must forward it to the Commission within seven business days and tell the employee to file a claim with the Commission.

In Arizona the Industrial Commission sets a reasonable attorney's fee on application before the case is finally resolved, paid from the claimant's award directly to the attorney. The fee may be no more than 25% up to ten years from the date of the award (in cases involving solely loss of earning capacity, 25% up to five years from the final award), and no more than 25% of any installment may be withheld for the fee. The claimant or attorney may ask for review of whether the fee is reasonable.

Suing the employer: Arizona workers' compensation is the exclusive remedy for a work injury or death against the employer, a co-employee acting within the scope of employment, and the employer's comp insurer or administrator. The exception is an injury caused by willful misconduct, meaning an act done knowingly and purposely with the direct object of injuring another, that is the personal act of the employer (a partner, or an elective officer of a corporation) or co-employee and shows willful disregard of employee safety; the employee may then either claim compensation or sue for damages. Separately, an employer that fails to secure required coverage can be sued and loses certain defenses (see uninsured_employer).

Suing someone else: an injured worker (or dependents) may sue a negligent or wrongful third party not in the same employ. The worker must give the insurer or self-insured employer written notice of intent to sue and keep it informed of pleadings and rulings; the insurer may intervene. If no suit is filed within one year after the claim accrues, the claim is deemed assigned to the insurer or self-insured employer, which may sue or reassign it. The insurer has a lien, without collection fee, on the amount actually collected (after reasonable expenses including attorney fees) up to the benefits paid, and any settlement for less than the benefits needs the insurer's written approval.

Employer without coverage: an employer required to carry workers' comp that fails to do so can be sued by the injured employee, cannot use the defenses of assumption of risk or contributory negligence, and proof of injury is prima facie evidence of the employer's negligence. Instead of suing, the employee may apply to the Industrial Commission for compensation, which is paid from the special fund; the employer must repay with a penalty of 10% or $1,000, whichever is greater, plus interest, enforceable as a lien. The Commission may also enjoin the employer from operating and assess civil penalties up to $1,000, rising to $5,000 and $10,000 for repeat failures within five years.

Denied claims: a request for hearing must be filed with the Industrial Commission of Arizona within 90 days after notice of the insurer's, self-insured employer's or Commission's determination on the claim (late filing is excused only in limited cases). An administrative law judge's award becomes final unless a party requests review within 30 days after the award is served. A party affected by the decision on review may then apply to the Arizona Court of Appeals for a writ of certiorari.