In Arizona, injured workers are eligible for workers’ compensation benefits, including wage loss benefits, medical treatment, and other compensation. Your benefits will vary, depending on the severity of your injuries and ability to work. Below, we explain how workers’ compensation benefits are calculated in Arizona and how much you might receive. (To get these benefits, you will need to file a workers' compensation claim in Arizona.)
In Arizona, workers’ comp benefits include:
However, state law limits these benefits, and the insurance company does not have to cover all your losses. For example, an injured worker cannot receive compensation for pain and suffering through workers' comp.
Time lost benefits are paid if you are unable to work (or if you have reduced wages) while you are receiving medical treatment for your work-related condition. You are eligible for time lost benefits once you are unable to work (or have reduced earnings) for at least seven consecutive days. If your work-related disability lasts for more than two weeks, the first week’s benefits will be paid retroactively.
If you're unable to work at all, time lost benefits are approximately two-thirds of your average monthly wage. (Depending on how many dependents you have, you might have a slightly higher rate.) Arizona also sets a maximum benefit each year, regardless of how much you make. In 2017, you cannot receive more than $4,521.92 in time lost benefits.
If you can return to work, but you are not able to earn as much, Arizona workers’ comp pays a “differential benefit.” This benefit is two-thirds of the difference between your pre-injury and post-injury wages. For example, if you used to earn $3,000 in monthly wages, but you now can only earn $1,500, you would get $1,000 in temporary partial disability benefits ($3,000 - $1,500 = $1,500; 0.6666 x $1,500 = $1,000).
Once it appears your conditions will no longer improve with treatment (called “maximum medical improvement”), your doctor will evaluate you to see if you have a permanent disability. If you have a permanent and total disability, your benefits will be two-thirds of your average monthly wage, up to the state’s maximum benefit.
Permanent and total disabilities include:
Other injuries and occupational diseases may also qualify if you are unable to work in any type of job.
If your doctor finds that you are only partially disabled after reaching maximum medical improvement, you can receive scheduled or unscheduled benefits. The state’s maximum benefit mentioned above also applies to permanent partial disability benefits.
You are eligible for scheduled loss benefits if you had an amputation of, or lost the functional use of, a body part listed in Arizona’s schedule of losses. Your benefit rate will depend on the severity of your injury and whether you can return to your normal job. The three different rates are as follows:
How long you will receive benefits depends on the number of weeks assigned to the injured body part in the Arizona schedule. The schedule lists the following:
If you have partial loss of use of a listed body part, you will receive a proportionate benefit. For example, if your treating doctor assigns a 25 percent loss of use of your left hand, you will receive 12.5 months of benefits (25% of 50 months).
For disfigurement of the head and face (including the loss of teeth), you can receive 55 percent of your average monthly wage for up to 18 months..
Injuries to organs or body parts not mentioned in the schedule—such as the hips, shoulders, lungs, or spine—and occupational diseases are considered unscheduled losses. In order to receive unscheduled benefits, your permanent limitation must cause a reduction in your wage earning capacity. If your impairment does not cause a wage loss, you will not receive unscheduled benefits.
Unscheduled benefits are 55 percent of the difference between your pre-injury wage earning capacity and your post-injury earning capacity. For example, suppose you suffer a hip injury that reduces your earnings to $700 per month. Before your injury, you earned $1000 per month. You will get $165 in unscheduled benefits ($1000 - $700 = $300; 0.55 x $300 = $165).
If your injury or illness causes additional decreases in your wage earning capacity over time, you may be eligible for an increase in your unscheduled benefits. To request an increase, you must file a Petition for Rearrangement or Readjustment of Compensation with the Industrial Commission of Arizona (ICA). A workers’ comp lawyer can help you file a petition and secure additional benefits.
When an injury or illness results in death, the worker’s spouse, minor children, and other dependents may receive death benefits. Death benefits are two-thirds of the worker’s average monthly wage for 500 weeks (or longer if there are dependent children involved). Additionally, the insurance company must pay up to $5,000 for the worker’s reasonable funeral and burial expenses.
Contact an Arizona workers’ comp lawyer immediately if the insurance company disputes your claim or reduces or denies your benefits. A lawyer can help you evaluate your claim, calculate your benefit rates, and ensure that you receive the proper compensation.