The Arizona Workers’ Compensation system was adopted to place the burden on business, rather than individuals or society as a whole, for injuries sustained by their employees. Employers and their insurance carriers are required to pay for an injured worker’s medical treatment and related medical expenses when an injury is suffered arising out of and in the course of the employees job. Compensation must also be paid for a portion of the employee’s lost wages or earning capacity, subject to certain limitations. Workers’ compensation is a no-fault system, meaning that it does not require a worker to establish the employer was at fault for causing the injury. It does not deny benefits for a worker who caused her/his own injury by negligent conduct. It is intended to be an inexpensive alternative to a civil lawsuit. In fact, participation in the system precludes an injured worker from filing a valid lawsuit against his or her employer for damages unless the employer intentionally injured the worker. The claim is presented to the Industrial Commission of Arizona.
Disability Benefits under Workers’ Compensation
All covered expenses are reimbursable without regard to monetary limits or time. Attorney Alan Schiffman, a State Bar of Arizona Certified Specialist in Workers’ Compensation, explains that a severe injury may render the employee unable to work for an extended time which can result in entitlement to temporary total (TTD), temporary partial disability (TPD) benefits, permanent total disability (PTD) or permanent partial disability (PPD).
Compensation while on temporary or permanent total disability status is at the rate of 66-2/3% of the injured worker’s loss of earning capacity. Permanent partial disability for an unscheduled injury (, including scheduled injuries that are converted to unscheduled under certain rules) is compensated at the rate of 55% of the worker’s loss of earning capacity.
Workers’ Compensation vs. Social Security Disability
Workers’ compensation is exclusively for job-related injuries, but if the injury prevents the worker from working (at a level that is considered to be substantial gainful activity) for 12 months or longer, the injured employee may also file a claim for Social Security Disability Insurance Benefits (SSDIB) and/or Supplemental Security Income Benefits (SSI). It is a complex matter, but as the expert workers’ comp and Social Security Disability attorneys at Schiffman Law Office, P.C. explain, an individual may be eligible for both workers’ comp benefits (TTD, TPD, PTD or PPD) and SSDIB and/or SSI benefits, subject to the workers’ compensation offset provisions and the SSI income limitations in the Social Security Act.
Filing Requirements for Workers’ Comp
A workers’ compensation claim begins when the injured worker completes and signs the necessary paperwork at the doctor’s office or hospital which is then filed at the Industrial Commission of Arizona (ICA) OR if the worker files the necessary paperwork at the ICA. The injured worker must also give prompt notification of the injury to the employer.
The SSDIB and SSI applications must also be filed with a signed application. As noted by our lawyers Alan Schiffman and Anna Schiffman, to qualify for Social SSDIB or SSI it must appear that the claimant will be prevented from working and engaging in substantial gainful activity (as that term is defined by the Social Security Administration) for at least 12 months or that the medical impairment is expected to result in death.
Why Legal Representation is Important
Although the workers’ compensation is intended to be an inexpensive alternative to civil litigation (a lawsuit), insurance carriers and employers often deny claims based on an employer’s objection or will seek to limit benefits based upon the opinion of a doctor hired by the employer or carrier. Our workers’ compensation lawyers often see these efforts to limit benefits by use of doctors whose opinions are pretty much a foregone conclusion. You have the right to hire a lawyer to protect your rights. Hiring our State Bar of Arizona Certified Specialist in Workers’ Compensation may make the difference between obtaining or losing lifetime benefits.