If you are an Arizona worker and you have been injured or suffered an illness due to work-related activities, then you’ll find yourself involved in making your way through the Arizona workers’ compensation insurance system. That Industrial Commission of Arizona (ICA) oversees the system, which monitors compliance, mediates disagreements, and processes paperwork.
The Arizona workers’ compensation system works on a no-fault basis, which ensures that no matter who is at fault in causing a workers’ injury that the worker will receive benefits. Benefits include medical assistance for their injuries or illness and monetary compensation for time lost at work.
The ICA has two divisions. The Claims Division, which is charged with much of the day to day operations, and the Administrative Law Judge (ALJ) Division, which is focused on hearing claimant appeals and mediating disagreements between those claimants and insurers.
The Claims Division closely monitors and regulates insurance providers and self-insured employers who are responsible for processing workers’ requests for benefits. They accept claims from workers and physicians and notify insurers of such in order to help facilitate the processing of claims. This is done to help make sure that workers receive appropriate compensation for their work-related illness or injury.
The ICA Claims Division handles about 6,000 forms over the course of each day and makes more than 30,000 judgments on an annual basis. The division decides various issues such as petitions by workers to move out of the state, requests to see another physician on a permanent basis, calculations of a worker’s average monthly earnings, loss of a workers ability to earn a living, and inadequate and/or biased claims processing practices. It makes sure that workers’ compensation claims are processed in conformity with present state laws, regulations, and rules.
The ALJ Division is charged with settling legal disagreements between insurers and workers. Various issues may be referred to the ALJ Division such as those related to additional or supportive care, extension or termination of benefits, capacity in relationship to loss of earnings, and compensation for specific equipment or services. The worker or their legal representative may file a request for a hearing with the Claims Division.
When that occurs the case is transferred to the ALJ’s Hearing Division, which then schedules the hearing. Although a worker is not required to engage legal representation, a hearing with the ALJ does involve aspects of the law that can be complicated and the ALJ’s determination can have a major effect on a worker and their family’s well being. Thus, many people do retain legal counsel, especially due to the fact that the insurance company will come to the hearing armed with legal representation.
If you have found that your Arizona workers’ compensation insurance claim has been delayed, disputed, or rejected, it’s important that you seek legal advice from an experienced and knowledgeable workers’ compensation lawyer. For a free, no-obligation consultation, contact the legal team at Montrose & Chua, Attorneys at Law, PLLC. Call us today at 602-346-9009 for an appointment. Our group of qualified and seasoned workers’ compensation professionals will help to ensure that your claim is properly settled and that you receive the benefits that you deserve.
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