Arizona workers’ compensation pays benefits to employees who are injured on the job. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. To collect benefits, you must meet certain requirements—including reporting your injury to your employer and making a timely claim for benefits.
In Arizona, most employers must have workers’ compensation coverage, either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The Industrial Commission of Arizona (ICA) oversees all workers’ comp claims in the state.
Like all other states, Arizona has a no-fault workers’ compensation system. This means you do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.
Eligible workers may receive a variety of benefits, including:
Notifying your employer is the first step to starting a workers’ compensation claim. In Arizona, you must promptly notify your employer of a work-related injury—either orally or in writing. If you do not notify your employer of the injury right away, you may lose some or all of your benefits.
When you notify your employer, provide as much detail as possible, including:
Your employer may also ask you to fill out a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims and any inconsistencies may be used against you.
Once you report an injury, your employer should send you to an occupational doctor. It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. When evaluating claims, insurance companies rely heavily on medical records of initial treatment. Either downplaying or exaggerating your symptoms may result in a denial of benefits. (For more information, see Seeking Medical Treatment for a Work-Related Injury.)
Reporting a work injury does not automatically start an Arizona workers’ compensation claim. You must file a formal claim with the ICA in order to receive benefits. This is often done during a visit to the occupational doctor. You and the doctor can complete a Worker’s and Physician’s Report of Injury (the “pink form") and submit it to the ICA. However, if the doctor is unwilling to complete the pink form, you may file a Worker’s Report of Injury with the ICA.
It is your responsibility to make sure your workers’ compensation claim is filed. Your claim must be filed within one year of your workplace injury. If your injury or illness developed over time, you must file a claim within one year of discovering its relationship to your work.
Once the ICA receives your claim, it will forward it to your employer’s insurance company or workers’ compensation administrator. You should receive a letter acknowledging your claim and identifying the insurer within 14 days of filing a claim.
Once it has received your claim, the insurance company will determine your eligibility for benefits. Its investigation may involve:
You should provide accurate and honest information during the claims investigation. If you have concerns about how the claim is being handled, contact a workers’ compensation lawyer for assistance.
Under Arizona law, the insurance company must either approve or deny your workers’ compensation benefits within 21 days of receiving your claim. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (To learn the common grounds for a denial, see Denied Workers' Compensation Claims.)
If your claim is denied, you have the right to appeal. To begin the process, you must file a Request for Hearing with the ICA. Appeals must be filed within 90 days of a denial of benefits. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney. Arizona also offers an Ombudsman Program that assists injured workers with their claims.