Exploring Lost Wage Workers' Compensation Benefits in Arizona

Accidentes de construccion - 08/16/2023

Workers' compensation is a vital safety net that protects employees in the event of workplace injuries or illnesses. If an employee sustains an injury while performing their job duties, they may be entitled to various benefits, including compensation for lost wages. Rios Law, a reputable law firm specializing in workers' compensation cases in Arizona, plays a significant role in helping injured workers understand and access their rights. In this blog post, we will explore the critical aspects of Arizona workers' compensation benefits for lost wages.

Workers' Compensation in Arizona

Workers' compensation is a state-regulated insurance program that benefits employees who suffer work-related injuries or illnesses. In Arizona, employers are required to carry workers' compensation insurance, which offers financial support to employees in need.

Lost Wages Benefits

When an employee is injured on the job and is unable to work, they may be eligible for lost wages benefits. These benefits are designed to partially replace the wages lost due to the injury or illness, helping the injured worker cope with the financial burden during their recovery period.

Calculating Lost Wages

The calculation of lost wages in Arizona varies based on the severity of the injury and the individual's average weekly wage (AWW). The AWW is determined by looking at the employee's earnings over a certain period before the injury. Generally, lost wage benefits are calculated as a percentage of the AWW. The formula for determining the weekly compensation amount typically involves taking a percentage (usually two-thirds) of the AWW. However, the state sets maximum and minimum limits, which may affect the final compensation amount.

Temporary Total Disability (TTD) Benefits

In Arizona, the most common type of lost wage benefit is Temporary Total Disability (TTD) benefits. TTD benefits are available to employees who cannot work due to their injury or illness but are expected to recover and return to work once they heal. The injured worker will receive TTD benefits until they are medically cleared to resume their job duties.

Temporary Partial Disability (TPD) Benefits

If the injured worker can return to work but with certain restrictions or limitations, they may be eligible for Temporary Partial Disability (TPD) benefits. These benefits compensate for the wage difference between pre-injury and reduced earnings while on restricted duty.

Permanent Partial Disability (PPD) Benefits

An employee may sometimes sustain a permanent impairment due to a work-related injury. If the impairment affects the individual's ability to work at their previous capacity, they may be entitled to Permanent Partial Disability (PPD) benefits. The amount of PPD benefits is determined based on the type and severity of the impairment.

Seeking Legal Assistance? Work with the Best

Navigating the workers' compensation system can be complex, and insurance companies may attempt to minimize the benefits provided to injured workers. This is where the expertise of Rios Law comes into play. Their experienced attorneys can guide individuals through the claims process, ensuring that they receive the full compensation they deserve for their lost wages and other related expenses.

Contact Us Today

Workers' compensation benefits for lost wages are essential to supporting injured employees during their recovery period. In Arizona, calculating lost wages involves several factors, including the average weekly wage and the severity of the injury. Rios Law, with its dedication to protecting the rights of injured workers, plays a crucial role in helping individuals navigate the complexities of the workers' compensation system. If you or someone you know has suffered a work-related injury, don't hesitate to seek the assistance of experienced legal professionals like Rios Law to secure the benefits you are entitled to. Remember, you can receive proper compensation and focus on your recovery without added financial stress.

Dedicated Construction Accident Lawyer In Phoenix, AZ

Accidentes de construccion - 06/28/2023

Were You Injured in an Accident at Work on a Construction Site?

Construction is among the highest-risk occupations in Arizona, with workers in this industry often suffering serious or fatal injuries on the job. If you or your close family member was injured in a workplace construction accident, you have the right to seek compensation for medical bills, lost wages, reduced earning capacity, and other qualifying losses.

Filing a construction accident claim can seem daunting, but an experienced construction accident lawyer in Phoenix, AZ, can help you navigate this process. Here at Rios Law Firm, PLLC, we provide compassionate legal support and aggressive representation for injured workers and their families. Contact us for a free consultation today.

Common Examples of Construction Accidents

Construction site injuries happen for various reasons, and many of the accidents are preventable with better training and more rigorous safety protocols. Some frequently occurring construction accidents include:

Fall from heights, such as a roof or scaffold
Slip and falls or injury from heavy lifting
Impact or impaled by a heavy or sharp object
Electrocution or Electrical shock
Heavy machinery accidents and loss of limbs or phalanges
Exposure to toxic chemicals or heat exhaustion

Who’s Responsible for Compensating You?

If you suffered injuries while working on a construction site, seeking compensation from your employer may be the obvious course of action. However, liability for your injuries could also fall on third parties, such as:

Sub or General contractors
Site Safety managers
Property owners or other companies on site
Engineers or Maintenance services
Product manufacturers

Examples of when you may have grounds for a third-party claim in addition to your worker’s compensation claim: (i) If your injury occurred due to a defective safety harness snapping and causing you to fall, you may have grounds for a third-party accident claim against the manufacturer of the harness. (ii) If you fell off a scaffold due to inadequate assembly, and workers of a company other than the one you work for assembled and placed the scaffold. (iii) You are on your way from one job site to another or to delivery materials and you are involved in a motor vehicle accident caused by the negligence or fault of another driver.

Fault in Third Party Construction Accident Claims

Although the workers’ compensation system is a no-fault system, you must prove that the third-party is at fault for the accident/your injuries.

You’d have to show that:

The responsible party breached their duty of care to you
Their breach of duty caused or contributed to your accident
Your accident caused significant and tangible injuries and/or losses

Are Construction Workers Eligible for Workers’ Compensation in Arizona?

All employers in Arizona must carry workers’ compensation coverage. The workers’ compensation system works on a no-fault basis. Like all employees, construction workers may qualify for workers’ compensation benefits in Arizona. However, workers’ compensation does not cover independent contractors, who form a major part of the construction workforce. Oftentimes, construction companies intentionally misclassify employees as independent contractors or subcontractors to avoid paying workers’ compensation benefits in case of a worksite injury. However, there are multiple factors and circumstances that can be used to prove an injured worker is an employee eligible for workers’ compensation coverage. A construction accident lawyer in Phoenix can help you with such a complex case during the litigation process.

Compensation for Undocumented Construction Workers

If you’re an undocumented worker that is injured on the job, you have the right to file a claim for workers’ compensation. Many of Arizona’s construction workers are undocumented immigrants who may face obstacles when seeking compensation for a workplace injury. Employers and insurance companies often try to shirk their responsibility of compensating undocumented workers and may even threaten to retaliate against the injured worker by reporting their immigration status. Do not be intimidated and seek an experienced workers’ compensation attorney by contacting our bilingual law firm immediately.

What to Do After a Construction Accident

The steps you take shortly after a construction accident can impact the outcome of your claim. If you sustain a construction site injury, you should:

Report the injury to your employer immediately by notifying your direct supervisor, or another person in charge. Failing to do this could affect your claim.
Seek medical attention. Ask your employer to send you for medical treatment if they do not direct you to a medical facility. Tell the medical providers you were injured at work. Do not let your employer talk you into telling providers that you were injured at home or elsewhere, as employers often do in an attempt to derail workers’ compensation claims.
File a report with the Industrial Commission of Arizona (ICA) detailinghow the accident happened and injuries sustained, including the date, time, and location.
Collect evidence, including photos, communication or timecard logs, video footage, and witness contact information and statements.
Consult a workers’ compensation attorney to understand the process and your rights and obligations.

The Workers’ Compensation Process

When the Industrial Commission of Arizona becomes aware of your industrial injury, after receiving the Worker’s & Physician’s Report of Injury from the medical provider or after you file a Worker’s Report of Injury, ICA will notify the employer’s workers’ compensation carrier. If the employer does not have coverage, the ICA will notify the Special Fund/No Insurance Division of the ICA of your claim. The insurance carrier or Special Fund will have 21 days from the notification date to issue a notice accepting or denying your claim.

Your employer should also file the Employer’s Report of Injury with the ICA and report the industrial injury to its workers’ compensation insurance carrier.

If the insurance carrier denies the claim, you have the right to protest the notice by requesting a hearing within 90 days of the mailed date on the notice. This does not mean three months from the notice date; it means 90 straight days from the notice date.

Why Workers’ Compensation Providers Deny Claims

Insurers may deny workers’ compensation claims on many grounds, including:

Delayed or not reporting the injury
No medical treatment or evidence of injury
Pre-existing condition or prior complaints of the same symptoms
Employee misconduct or horseplay
Disputing that the accident/injury happened at work

If a workers’ compensation provider denies your claim, contact a construction accident workers’ compensation attorney in your area. Our law firm serves all parts of Arizona and can assess your case and provide reliable legal guidance.

Remedies You May Recover After Your Accident

As an injured construction worker in Arizona, you could claim the following benefits:

Coverage for medical expenses, including emergency care, prescription medications, outpatient appointments, physical therapy, caregiver, durable medical equipment, and the costs of traveling to and from appointments or transportation to appointments
Partial disability (temporary or permanent) if you suffer an injury but may still be able to work with some restrictions
Total disability (temporary or permanent) if you are unable to work in any capacity, as a result of the industrial injury

Additionally, spouses, dependent children, and other qualifying family members who lost their loved one in a fatal construction accident may file a claim for dependent’s benefits and collect death benefits. If the fatality was caused by a third party, the beneficiaries may also file a wrongful death claim against the third party.

Construction Accident Claim Deadlines

Arizona has some of the shortest timeframes for filing workplace injury claims. You have one year to file a workers’ compensation claim, starting either from the date of your injury or the date when you should have reasonably become aware or discovered the injury. The latter rule applies to injuries that may not be immediately obvious, such as the after-effects of exposure to chemicals.

If you are pursuing a personal injury claim against a third party, you have two years to file the claim, but you will require a reassignment from the workers’ compensation carrier after the first year. If the third party happens to be a governmental agency, you must give the governmental agency notice of claim within 180 days of the accident.

Construction cases tend to be very complex, especially when there is a third-party component. Therefore, it is important to consult with an experienced construction accident attorney as soon as possible to ensure you comply with all filing and notice deadlines and gather relevant evidence, such as video camera footage while it is still available.

Do You Need a Construction Accident Attorney?

Construction accident claims are often both complex and high-stake, with a lot of money on the table for employers, insurance companies, and other responsible parties. Insurance companies may dispute your claim or try to exploit your difficult situation and pressure you into accepting a low settlement offer. Employers may discourage you from filing a claim because their premiums rise when they activate their workers’ compensation policy or because they do not have the required coverage. Working with an experienced construction accident lawyer in Phoenix improves your chances of winning at a hearing or achieving a reasonable settlement. Additionally, having an attorney that will aggressively represent you may relieve your stress and concerns about the claim process. With Rios Law Firm, PLLC, you benefit from:

Skilled, assertive legal representation
Working directly with attorney Crystal Rios Ramos, founder of Rios Law Firm, PLLC
Focus on your case and timely, personalized communication and service
A bilingual legal team that cares about you and your recovery
An attorney that fights for your rights and conducts settlement negotiations with ease and integrity.
Efficient strategies for appealing and litigating denied claims and the multiple issues that occur in workers’ compensation claims.

Rios Law Firm, PLLC: The Trusted Law Firm for Injured Construction Workers and Their Families

Are you dealing with physical pain, medical expenses, or have lost your ability to work after a workplace construction injury? You don’t have to face it alone; we are here for you. Contact our skilled legal team at Rios Law Firm, PLLC, and entrust your case to an experienced lawyer that serves Phoenix and all other parts of Arizona.

Call 602-237-6265 or fill out our online form for a free consultation.

economic-crisis-and-unemployment-unrecognizable-b-2022-12-16-07-43-55-utc

Can You Get Workers’ Compensation and Unemployment Benefits at the Same Time?

Accidentes de construccion - 06/27/2023

If you’re out of work after an on-the-job injury, you might wonder: Can you get workers’ compensation and unemployment benefits at the same time?

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How Does Workers’ Comp Work in Arizona?

Accidentes de construccion - 06/26/2023

Workplace accidents can happen whether you work in an office or on a construction site. Depending on your injury, you could face expensive medical bills, loss of income, or even permanent disability. It’s beneficial to know what to expect when falling victim to a workplace accident, so you can avoid losing out on any compensation to which you may be entitled.

The laws and processes can differ depending on your state, so how does workers’ comp work in Arizona?

Arizona employers with one or more employees must have workers’ compensation insurance to cover accidents and injuries that happen on the job. When you claim workers’ comp, your employer’s insurance provider has to pay your medical expenses and compensate certain damages, such as a loss of earning capacity due to a permanent injury.

Those are the basics of workers’ comp, but if you keep reading, you’ll learn the details of the complicated process of claiming workers’ comp benefits in Arizona.

What Does Workers’ Comp Cover in Arizona?

Before we get into the essential details, let’s look at what workers’ comp covers in Arizona to give you an idea of the types of compensation you can expect.

Arizona has a no-fault workers’ comp system, meaning any employee covered by their employer’s workers’ comp insurance can receive benefits regardless of who caused the work accident. Workers’ comp benefits cover damages related to your work injury, including:

Medical expenses
Lost wages
Ongoing medical care
Death benefits and funeral costs
Disability benefits

How the Arizona Workers’ Comp Process Works

The process of filing a workers’ comp claim can be very complicated. While you don’t legally need an attorney to file a claim, it helps to have a knowledgeable representative backing you, especially since your employer no doubt has their own workers’ comp lawyer on hand.

Below, we’ll describe the major steps of the Arizona workers’ comp claim process, including reporting your injury, filing a claim, understanding compensation amounts, and receiving ongoing support.

Reporting the Injury and Filing a Claim

If you want to ensure a workers’ comp claim progresses smoothly and quickly through the system, you should report the job-related injury to your employer as soon as it happens. Failure to do so in a timely manner could result in an automatic denial of your claim.

Your employer will have 10 days from the notice of your injury to fill out the Employer’s Report of Injury, which they will send to their workers’ comp insurance provider and the Industrial Commission of Arizona (ICA) for verification, assessment, and approval.

After notifying your employer, you need to file your claim within a year of the date of your injury or when you learned about it.

You should visit a doctor about your work-related injury to file a workers’ comp claim. Let them know you got your injury on the job so they can help you fill out a Worker’s and Physician’s Report of Injury. The doctor’s office will send your report to the ICA and give copies to your employer and their insurance carrier.

If you don’t fill out the worker’s comp form at the doctor’s office, you can get the Worker’s Report of Injury form from the ICA website and submit it yourself to get the ball rolling.

After filing your claim, you should receive a letter from the ICA within 14 days containing information about your employer’s insurance carrier. The ICA will notify the insurance provider, giving them 21 days to deny or accept your workers’ comp claim.

Receiving Notice of a Denied Claim

If your employer’s insurance company denies your workers’ comp claim, you’ll receive a Notice of Claim Status informing you of the denial, and you’ll have 90 days to protest the decision.

Using the Request for Hearing form on the ICA website, you can petition the ICA’s Administrative Law Judge division to organize a hearing for your case. After filing the request, a notice with the date, location, and time of the hearing will arrive in the mail.

Receiving Notice of an Accepted Claim

If your workers’ comp claim receives approval from the insurance provider, the following notice will inform you of your benefits, depending on whether you have a medical-only or time-lost claim.

In a medical-only claim, you’ll receive a Notice of Claim Status that states you’ll receive workers’ comp benefits with no time loss compensation. In that case, the insurance carrier will pay for all medical expenses associated with the injury.

If your injury doesn’t keep you out of work longer than seven consecutive days, the insurance doesn’t have to pay for lost time.

Workers’ comp insurance covers medical expenses such as:

Emergency room expenses
Doctor visits
Prescriptions
Medical equipment (e.g., crutches)

The insurance provider keeps paying the medical bills related to your work injury until your doctor says you no longer need treatment. If you voluntarily stop getting medical treatment, the insurance provider could close the claim, so it’s important to keep receiving care until your doctor discharges you.

If you end up receiving a medical bill for treatment associated with the injury, you should contact the insurance carrier to inquire about the charge and, if you paid the bill, get reimbursement.

For a time-lost claim, your doctor must say you can’t work or can only perform light duty for more than seven days because of your injury. In that case, your employer’s insurance will provide temporary compensation for missed income.

Insurance won’t pay the first seven days after the date of your injury unless you’re out of work for 14 days or longer. For example, if you can’t work for 10 days, you only get paid for the last three days. If you lose more than 14 days, your compensation starts the day after the injury.

If you continue working light duty and receive temporary compensation for loss of income, you’ll have to submit monthly reports on your earnings.

Calculating Compensation

You’ll receive your first temporary compensation check along with the Notice of Claim Status, which will also tell you the monthly wage the insurance provider recommends. The notice will have an attached wage calculation sheet explaining how the provider arrived at the wage, which also goes to the ICA for review.

The wage isn’t officially set until the ICA reviews the insurance carrier’s calculations and sends you a Notice of Average Monthly Wage. If there’s any question about the accuracy of the wage calculation, the ICA might request verification from you.

If you disagree with the established monthly wage, you can contact the ICA’s Claims Division to ask about the accuracy of the calculations or request a hearing to challenge the wage calculation.

When you get paid for lost time, your compensation is 66.6 percent of your average monthly wage, typically based on your earnings during the 30 days before your injury. There’s a maximum monthly wage for calculating compensation, and even if you make more than that amount, you can only receive 66.6 percent of the maximum wage.

Big Choosing a Doctor

In most cases, you can choose your doctor. However, your employer has the right to request that you see a doctor of their choice for one visit. If your employer is self-insured, which only a select few companies in Arizona are, they have the right to direct care to their doctor.

You can’t change to another doctor without the approval of your current doctor, the insurance carrier, or the ICA. You should contact the insurance carrier if your doctor doesn’t authorize the change. If the carrier doesn’t approve, you can apply for approval from the ICA.

The ICA will review your case and contact the carrier or doctor for their opinion on the change, after which they’ll approve or disapprove it. Before requesting a change, you should already have a doctor picked out who has agreed to take you as a patient, and you shouldn’t see a new doctor until the change is approved. You can request a hearing if you disagree with the ICA’s decision.

Closing the Claim With or Without Permanent Impairment

When your doctor discharges you from active care, they must provide the insurance provider with a medical report confirming you’re done with treatment. You’ll receive a Notice of Claim Status saying the insurance carrier is ending your active benefits, with or without permanent impairment.

If you need continuing medical support, your doctor should indicate this in the report, prompting the carrier to issue a Notice of Supportive Medical Maintenance Benefits. If your work injury resulted in permanent impairment, you could receive compensation for one of two permanent injuries: scheduled or unscheduled.

Compensation for scheduled injuries lasts for a limited time. The types of injuries that qualify as scheduled affect a certain part of the body, such as an arm, leg, eye, or hand. The amount of compensation you receive for disability benefits depends on the extent of your injury, as described below:

Partial loss: 50% of your average monthly wage
Amputation or total loss of use: 55% of your average monthly wage
Permanent injury that prevents you from resuming your regular work duties: 75% of your average monthly wage

An injury that doesn’t qualify as a scheduled injury is an unscheduled general disability. Examples of unscheduled injuries include occupational diseases and injuries to your back, shoulder, or hip. The amount you receive for your disability, if any, is up to the ICA. Their decision is based on how the injury affects your ability to work and the wages you can earn compared to your income before the injury. The ICA also considers other factors, such as age, education, and previous occupation (if any). For partial loss of use, you might get 55% of your reduced earning capacity, which is the difference between your previous wage and current earning capacity. As for total loss of earning capacity, you’ll receive 66.6 percent of your average monthly wages.

Can You Still Sue Your Employer After Claiming Workers’ Comp Benefits?

In most cases, you can’t sue your employer if you claim workers’ comp benefits. However, you can file a lawsuit against your employer if they didn’t have workers’ comp insurance on the day of your injury. You can then apply for workers’ comp benefits from the ICA’s Special Fund, which provides medical benefits to injured workers with uninsured employers.

Consult With an Experienced Workers’ Comp Attorney

Hopefully, we’ve answered your question, “How does workers’ comp work in Arizona?”

While you technically don’t have to work with an attorney to file a workers’ comp claim, the laws are complex, and you’ll likely have many questions during the process. At Rios Law Firm PLLC, our founding attorney, Crystal Rios Ramos, has extensive experience guiding injured workers through filing for workers’ comp.

Want to learn more? Call us today at 602-237-6265.

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