If you’ve suffered a work-related injury or illness in Arizona, you may be eligible for workers’ compensation benefits, including coverage of your medical bills and payments intended to help make up for part of your lost earnings. In this article, we explain the state's basic rules for calculating the amount of workers’ comp benefits. The actual amount you’ll receive will depend on several factors, especially the nature and extent of your injury.
(To get these benefits, you’ll need to report your injury to your employer promptly, tell the doctor that your medical problem is related to your work, and sign the form you’ll receive. Although the medical provider should turn in the form—which constitutes your workers’ comp claim—it’s your responsibility to make sure that your claim has been filed within a year.)
Can You Get Workers’ Comp Benefits in Arizona for COVID-19?
In Arizona, workers’ compensation covers occupational diseases, but only if they result from on-the-job conditions that are characteristic of and peculiar to particular occupation—not “ordinary diseases to which the general public is exposed.” The state has strict requirements for proving that you contracted an occupational disease at work. Among these requirements, you must trace the illness to exposure at work and prove that it resulted from working conditions that presented a particular hazard for that getting that disease, rather than from a risk that you would have been equally exposed to outside of work. (Ariz. Rev. Stat. §§ 23-901, 23-901.01 (2020).)
In the context of the coronavirus pandemic, it would be difficult for most employees to meet these standards. But that doesn’t mean it’s impossible. Arizona hasn’t followed the lead of some states that have made it easier for healthcare workers, first responders, and some other frontline employees to qualify for workers’ comp for COVID-19. Still, the Industrial Commission of Arizona (ICA, the state agency in charge of workers’ comp) has asked insurers to be “especially diligent” when reviewing COVID-related claims filed by these frontline workers. The ICA recommended that carriers consider a number of factors, including the risk of getting the disease due to the nature of the employee’s job, whether there was any identified exposure at work and/or outside of work, and the strength of the medical and other evidence.
If you believe you contracted COVID-19 at work but your claim was denied, you should speak with an Arizona workers’ comp lawyer who can evaluate your case and help you gather the kind of evidence you would need to fight the denial.
If your doctor says that you can’t work at your normal job while recovering from your workplace injury or occupational disease, you’re entitled to temporary disability benefits to make up for some of your lost earnings. You won’t receive these benefits for the first week you’re off work unless you’re out for two consecutive weeks. Unlike many states, Arizona doesn’t have a set time limit for these benefits. The payments will last until you can return to your regular work or your medical condition has stabilized (more on that below).
If you’re unable to work at all during your recovery, you’ll receive temporary total disability (TTD) benefits equal to two-thirds of your average monthly wage before you were injured or became ill, up to a maximum that changes every year. For injuries that happened in 2020, the maximum wage for purposes of calculating the benefit amount is $4,888.56, which translates into maximum monthly benefits of about $3,259. (See Arizona’s list of the maximum wages for injuries in other years.)
If you have anyone who depends on your financial support, you can also receive an additional monthly allowance of $25 (in total, not per dependent).
If you can return to work but you aren’t able to earn as much while you’re recovering, Arizona workers’ comp pays temporary partial disability benefits. The benefit amount will be two-thirds of the difference between your pre-injury monthly wages (subject to the same maximum as for TTD benefits) and what you’re earning while you’re still recovering. For example, if you used to earn $3,200 a month but now can only earn $1,700, you’ll get $1,000 in benefits (two-thirds of $1,500).
Once it appears your condition is stationary—meaning that it won’t improve any more, even with further treatment—your doctor will evaluate you to see if you have any permanent disability as a result of your workplace injury or occupational disease. Arizona has different ways of calculating permanent disability benefits, depending on the affected part of your body and the extent of your impairment.
Arizona law sets out a schedule for the amount and duration of PPD benefits when you’ve lost the functional use of an extremity (including a finger, toe, arm, hand, foot, or leg) or you suffered loss of hearing or eyesight. The amount of the benefits will be based on a percentage your pre-injury wages (up to the current maximum), as follows:
You’ll receive those benefits for a period of time listed in the schedule for each affected part of the body. For example, the payments will last 15 months for total lost use of a thumb, 20 months for complete hearing loss in one ear, 25 months for lost sight in one eye, and 50 months for loss of your dominant hand.
If your disability to any of the listed body parts is partial, the payments will last for a number of months proportional to the percentage of disability. For example, if your doctor determines that you’ve lost 50% of the use of your dominant hand, you’ll receive benefits for 25 months (50% of 50 months).
If you have a permanent impairment to your organs or other parts of your body that aren’t listed in the schedule—such as the hips, shoulders, lungs, spine, or digestive tract—you may receive PPD benefits only if the disability causes a reduction in your earning capacity. The amount of these benefits will be 55% of the difference between your pre-injury wages and the amount you’re able to earn now.
After you’ve received a workers’ comp award for unscheduled PPD, your benefits may be adjusted up or down if your earning capacity changes as a result of your work injury or illness (not, for instance, because of age or another unrelated injury or illness).
When your injury has caused a permanent disfigurement to your head and face (including lost teeth), the Industrial Commission of Arizona (ICA) will decide on a fair amount of PPD benefits for a period of time up to 18 months.
If you’re permanently and totally disabled as a result of your work-related injury or illness, you may receive benefits for the rest of your life at the same rate as temporary total disability. Certain impairments are presumed to be permanent total disability, including:
Other types of impairments may also qualify if medical evidence shows that you’re completely disabled and unable to work.
The ICA may allow an award or settlement for permanent disability benefits over time to be converted to a lump sum. However, there are dollar limits on these lump-sum awards (depending on the type of disability).
The Arizona workers’ comp system also provides other types of benefits for employees who are injured or become ill because of their work, including
If your employer’s insurance company has denied your workers’ comp claim or is balking at paying benefits on time or in the right amount, you should strongly consider contacting an Arizona workers’ comp lawyer. A local attorney who’s experienced in this legal area can evaluate your claim and work to ensure that you receive all of the compensation you deserve under Arizona law. Learn more about what a good workers' comp lawyer can do for you and what to look for in a workers' comp attorney.