I was looking this morning for something to write about on the blog since Attorney Snow has been busy with hearings and I came across this new work safety campaign out of California. It took me by surprise and made me ask, is it too much?
I know they are trying to make a point with how easy injuries can be avoided, and yes; they are trying to avoid serious injuries and even death... but is it too graphic?
Take a look and tell us what you think.
In the absence of Chad Snow, blog posted by:
April Lang-Snow, Business Manager @ Snow and Carpio, PLC
Wednesday, July 13, 2011
Friday, July 8, 2011
Can Workman's Comp Carrier Tell Me Where to Get My MRI?
I recently filed a Motion for a Protective Order in one of these cases and the Administrative Law Judge at the Industrial Commission agreed. Her order relieved the applicant of any duty to attend the studies that had been scheduled by the carrier and instead indicated that the treating doctor has the right to decide where and by whom diagnostic studies are done.
Chad T. Snow is a workers compensation attorney in Phoenix and Tucson, Arizona. For more information on workers compensation claims in Arizona, you can reach Chad through his website at Snow, Carpio, and Weekley, or by calling the offices at (602) 532-0700 or (520) 647-9000.
Tuesday, July 5, 2011
Rules for Employers Regarding Workers Compensation Coverage
Although our firm represents only injured workers, I'll give a little time to providing information for EMPLOYERS regarding their obligations with regard to work injuries and work comp coverage.
Under the Arizona Workers Compensation Act, it is mandatory for employers to carry work injury coverage for their employees. Workers compensation coverage can be purchased from any insurance carrier licensed by the State Department of Insurance to sell work comp policies in the state. A list of eligible carriers can be found by contacting the Dept of Insurance at (800) 325-2548 or on their website.
Some larger employers who meet certain stringent criteria set by the Industrial Commission can self insure themselves for all work injuries. Employers are required to carry this coverage regardless of the number of employees they have, and even if their employees are minors, family members, aliens, or part time.
Employers are also required to display in a conspicuous place in the workplace those bland signs that inform employees that the employer carries workers compensation coverage and of the employee's right to reject coverage if they so choose. Frankly, I've worked in dozens of places and have now practiced workers compensation law for 12 years, and I've never read that sign in my office break room. An employer cannot force its employees to opt out of the workers compensation system, nor can it have its employees pay even a part of the workers compensation premiums.
If an Employer is notified of an injury to one of its workers, it is required by law to provide the worker with certain information about the employer's insurance carrier, policy #, etc. It is also required to notify the Industrial Commission within 10 days (although in practice that rarely happens). If a fatal injury occurs, the Employer must notify the Industrial Commission as soon as possible "by telephone or telegraph". I wonder if the ICA maintains an up to date telegraph in the event of such a reporting........
For more detailed information on Employer's Rights and Responsibilities in work comp claims, go to the ICA website page dedicated to such questions at http://www.ica.state.az.us/Claims/Forms/Claims_FAQs_WorkersCompensation.pdf
Chad T. Snow is a workers compensation attorney in Phoenix and Tucson, Arizona. He can be reached at his offices at (602) 532-0700, (520) 647-9000, his website at Snow, Carpio, and Weekley, or by telegraph at - just kidding, he doesn't have a telegraph.
Thursday, June 30, 2011
Work Injuries Decline With the Economy
I'm a positive guy. I try to see the glass as half full (or just twice as big as it needs to be...). I try to find the silver lining. So I thought I'd pass along the good news about the last three years of the Great Recession - Work Injuries Are Way Down!!! Yes, apparently, the more people who are sitting at home watching Judge Judy and Wendy Williams, the fewer people are falling off scaffolds and cutting off fingers.
I found these interesting statistics on the Industrial Commission of Arizona's website which publishes statistics on the total number of work injury claims in every year.
2005 - 139,121
2006 - 131,904
2007 - 121,699
2008 - 122,101
2009 - 102,870
No stats out on 2010 yet, but I'm sure it will be even lower than 2009, when injuries were down 27% from just 5 years previous. Of course, some of this follows the overall historical downward trend of on the job injuries due to increased technology and emphasis on jobsite safety.
So if you're sitting at home bummed out because the Arizona legislature just cut your unemployment benefits extension, look on the bright side - at least you still have all your fingers!
Chad T. Snow is a workmans comp attorney with offices in Phoenix and Tucson Arizona. He once knew a man with 12 fingers who he called Inigo Montoya, but that's another story. Workers Compensation questions can be directed to the firm's website at Snow, Carpio, and Weekley.
I found these interesting statistics on the Industrial Commission of Arizona's website which publishes statistics on the total number of work injury claims in every year.
2005 - 139,121
2006 - 131,904
2007 - 121,699
2008 - 122,101
2009 - 102,870
No stats out on 2010 yet, but I'm sure it will be even lower than 2009, when injuries were down 27% from just 5 years previous. Of course, some of this follows the overall historical downward trend of on the job injuries due to increased technology and emphasis on jobsite safety.
So if you're sitting at home bummed out because the Arizona legislature just cut your unemployment benefits extension, look on the bright side - at least you still have all your fingers!
Chad T. Snow is a workmans comp attorney with offices in Phoenix and Tucson Arizona. He once knew a man with 12 fingers who he called Inigo Montoya, but that's another story. Workers Compensation questions can be directed to the firm's website at Snow, Carpio, and Weekley.
Lightning Safety
I heard this morning on the news that starting Sunday, we are in for 5 days of monsoon storms and activity.
It started me thinking; how many of us Zany Zonies don't pay attention to the dangers of the monsoon and the accompanying lightning because we have lived here for years and don't give the lightning a second thought other than the thrill of watching a good lightning storm from our porches at night. We still go on with our regular activities during these storms, especially if they roll in during the late afternoons while we are still at work or making our way through errands on our way home.
So I pulled up some information on lightning safety and it was pretty eye-opening. It was actually pretty scary. Hundreds of people are permanently injured each year, suffering from a variety of long-term, debilitating symptoms like memory loss, attention deficits, sleep disorders, chronic pain, numbness, dizziness, stiffness in joints, irritability, fatigue, weakness, muscle spasms and depression.
Here are a couple pictures of some very lucky people who survived a lightning strike.
Employers also have a responsibility to keep their employees safe. In the event of a storm, employees need to be provided shelter and follow these safety rules as well. If you are an employer, posting a "Lightning Safety" bulletin in your employee breakroom or wherever your standard OSHA and Labor postings are hung is a great idea during the stormy summer months.
Here's what you need to know to stay safe during an electrical storm:
- Seek shelter and keep away from windows.
- Remember the 30-30 Rule: If you can see lightning and can not count to 30 before hearing thunder, go inside and stay there for at least 30 minutes after hearing the last roar of thunder.
- Stay off corded phones, computers and other electrical equipment that put you in direct contact with electricity.
- Avoid plumbing, including sinks, baths, and faucets. Water serves as a good conductor for electricity.
- Turn off your air conditioner. Power surges from lightning can cause serious damage to your home.
- No place outside is safe during a thunderstorm. But, if you are stuck outside, find a low spot away from trees, fences and poles. Crouch low to the ground, but do not lay flat on it.
Even if lightning doesn't hit you directly, it might still have a strong enough charge to injure you.
So remember, when thunder roars, go indoors.
In the absence of Chad Snow, blog posted by:
April Lang-Snow, Business Manager @ Snow and Carpio, PLC
Monday, June 27, 2011
Excessive Heat Warning in Effect
As we face some extreme tempoeratures this week, a reminder to all to stay hydrated, cool and safe. In the event of a heat illness, never delay in contacting 911. Heat Stroke can be fatal.
Another area of concern in the extreme heat is for our pets. Animals should be kept indoors as much as possible during periods of excessive heat.
In the absence of Chad Snow, blog posted by:
April Lang-Snow, Business Manager @ Snow and Carpio, PLC
Thursday, June 23, 2011
And You Thought YOU Got Screwed in Your Comp Claim?
I recently came across an article in my favorite newspaper, the New Times, that made me chuckle as an Arizona Workers Compensation attorney. It had to do with the work injury claim of one of Arizona's most beloved heroes, Jason Schecterle. For those who have lived here a while, you'll remember Schecterle as the Phoenix Police officer who sustained FOURTH degree burns over most of his body when his Crown Vic police cruiser was rear ended in 2001. He was burned beyond recognition and has undergone over 50 surgeries to recover from his horrific injuries.
Remarkably, Schecterle had returned in 2005 as a limited duty detective for the department's homicide unit where he worked on dozens of murder cases in spite of his monumental physical limitations. However, after 18 months, he had to retire because of his diminished eyesight and the toll that working was taking on his body.
To her credit, ICA Director Laura McGrory, who is a fantastic Director as well as person, is personally working to correct the mistake, calling it a good "teaching moment" for her staff.
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| Jason Schecterle - Before and After Accident |
However, a recent Findings and Award issued by the Industrial Commission of Arizona stated that "information in your file indicates that your injury is not affecting your earning ability at this time" and that "no permanent work restrictions (are) noted." Then comes the bureaucratic kick in the crotch: "there are no medical contraindications which would preclude you from returning to the same or similar work, thereby sustaining no loss of earning capacity." Those of us who receive these Awards regularly can only chuckle!
Remarkably, Schecterle had returned in 2005 as a limited duty detective for the department's homicide unit where he worked on dozens of murder cases in spite of his monumental physical limitations. However, after 18 months, he had to retire because of his diminished eyesight and the toll that working was taking on his body.
To her credit, ICA Director Laura McGrory, who is a fantastic Director as well as person, is personally working to correct the mistake, calling it a good "teaching moment" for her staff.
Chad T. Snow is a workers compensation attorney in Phoenix and Tucson Arizona. He and his associates at Snow, Carpio, and Weekley can be reached anytime for questions about Arizona work injuries at (602) 532-0700 or (520) 647-9000.
Snow & Carpio Paralegal Not Appointed to Supreme Court
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| Martha Diaz |
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| Judge Sotomayor |
The workers compensation attorneys at Snow & Carpio want to clear up any misconceptions by stating unequivocally that our longtime paralegal Martha Diaz has NOT been appointed to the Supreme Court by President Obama. There have been several charges of conflict of interest and favoritism since the appointment, but we assure you that any resemblance between Martha Diaz and that other lady are purely coincidental. While they are both "wise Latinas" in their 50's with connections to Brooklyn who work in the legal field, the similarities stop there.
Plus, why would Martha give up her sweet gig at Arizona's number one workers compensation law firm to join the Supreme Court?
Chad T. Snow is a work injury attorney in Arizona. His practice is limited to representing those injured on the job and he is certain that his cases will never wind up in front of the U.S. Supreme Court. He can be reached at (602) 532-0700 or (520) 647-9000 or Snow, Carpio, and Weekley.
Wednesday, June 22, 2011
Recent Decision On Election of Remedies at Court of Appeals
A recent Court of Appeals decision on a workers compensation claim brings to mind an issue that I've never discussed here on the blog - the Election of Remedies Doctrine. In this case, the worker was injured working for an employer who did not carry workers compensation insurance. In such cases, the worker can elect his or her remedy between pursuing a tort (personal injury) claim against the Employer versus pursuing a Workers Compensation claim through the Industrial Commission's Special Fund No Insurance Section. (In cases where the Employer IS insured, the only remedy is a work comp claim).
In this case, the injured worker first filed a personal injury claim against the employer in Superior Court, but later decided to file the workers comp claim at the ICA. The Special Fund No Insurance Section (NIS) accepted the claim and began paying benefits. They later found out about the P.I. claim and tried to claim that the injured worker had elected his remedy. However, the Court found that since their acceptance of the claim had gone final, their election of remedies defense was untimely and thus was waived.
The important part to remember is that workers who are injured working for employers who fail to carry workers compensation insurance, the Employer's typical immunity against tort suits is waived and the employee can file a personal injury suit against the employer if their negligence caused the injury. Many times, these cases are worth more because of additional damages such as pain and suffering that can be paid.
Chad T. Snow is a workers compensation attorney with offices in Phoenix and Tucson. He can be reached through his website at Snow, Carpio, and Weekley and is always available to answer questions on work comp cases.
Tuesday, June 21, 2011
Industrial Commission of Arizona Claims System Down
The Industrial Commission of Arizona, the state agency charged with administering disputes in workers compensation claims and various claims procedures, has announced that their computer system will be temporarily unavailable on June 23rd and 24th for a computer system update. The claims system and optical disk system should be back up and running on Monday June 27th.
The Claims Division handles processing of on the job injury claims, notifies employer's insurance carriers, sets average monthly wage in claims, processes requests of injured workers to change doctors or leave the state, and determines the amount of permanent compensation an injured worker receives.
Chad T. Snow is a workers compensation attorney in Arizona with offices in Phoenix and Tucson. He can be reached through his website at Snow, Carpio, and Weekley.
New Average Monthly Wage for 2010 Arizona Work Injuries
The Industrial Commission of Arizona has come out with the new statutory maximum average monthly wage for all injuries occurring in 2012. The new maximum wage will be $4,062.29. This is the highest monthly earnings that can be considered in calculating any kind of compensation in an Arizona Workers comp case. Temporary compensation is paid at 66 2/3 percent of the average monthly wage and permanent partial at 55% of the difference between the AMW and whatever the injured worker is able to earn thereafter.
As recently as 2007, the max wage was only $2,400.00, meaning that the most an injured worker could receive in compensation per month was $1,600.00. This severely penalized higher wage workers who were injured on the job. The Arizona Association of Lawyers of Injured Workers, of whom Alex Carpio and I are members, fought hard at the legislature to get raises in the maximum wage, to $3,000 in 2008, $3,600 in 2009, and indexed for inflation every year thereafter. This allows higher wage workers to receive more fair compensation for time lost from work for injuries sustained on the job in Arizona.
Chad T. Snow is a workers compensation attorney who represents injured workers before the Industrial Commission and Social Security Administration. He can be reached at Snow, Carpio, and Weekley, or through his Phoenix office at (602) 532-0700 or in Tucson at (520) 647-9000.
As recently as 2007, the max wage was only $2,400.00, meaning that the most an injured worker could receive in compensation per month was $1,600.00. This severely penalized higher wage workers who were injured on the job. The Arizona Association of Lawyers of Injured Workers, of whom Alex Carpio and I are members, fought hard at the legislature to get raises in the maximum wage, to $3,000 in 2008, $3,600 in 2009, and indexed for inflation every year thereafter. This allows higher wage workers to receive more fair compensation for time lost from work for injuries sustained on the job in Arizona.
Chad T. Snow is a workers compensation attorney who represents injured workers before the Industrial Commission and Social Security Administration. He can be reached at Snow, Carpio, and Weekley, or through his Phoenix office at (602) 532-0700 or in Tucson at (520) 647-9000.
Positional Risk in Arizona Workers Compensation Claims
This is a very complex part of the workers compensation law in Arizona. It stands for the proposition that a worker's job may place him or her at increased risk of injury just because of the inherently dangerous nature of the job. It's really too complicated to explain in a simple blog post, but let me give two examples:
1. A recent case we had where a worker was on top of a pile of trash on the back of a truck and fell to the ground, sustaining a severe injury. The employer tried to argue that he was diabetic and had probably fainted due to his diabetes which caused him to fall. We argued that, even if that were the cause of the fall, the fact that his work placed him in a dangerous position was the real cause of the injuries, not necessarily the fall. If he were at home sitting on the couch, he wouldn't have been injured.
2. A case I handled a few years ago where a truck driver had a heart attack and ran his truck into a mountain and died. Again, the heart attack itself had nothing to do with his work, but the fact that he's driving 80,000 pounds of cargo 70 miles an hour places him at a greater "positional risk", making the effects of the injury compensable. Again, if he were sitting on his couch at home when the heart attack occurred, he would probably still be with us today.
Just a little interesting part of Arizona Workers Compensation Law from us at Snow, Carpio, and Weekley.
1. A recent case we had where a worker was on top of a pile of trash on the back of a truck and fell to the ground, sustaining a severe injury. The employer tried to argue that he was diabetic and had probably fainted due to his diabetes which caused him to fall. We argued that, even if that were the cause of the fall, the fact that his work placed him in a dangerous position was the real cause of the injuries, not necessarily the fall. If he were at home sitting on the couch, he wouldn't have been injured.
2. A case I handled a few years ago where a truck driver had a heart attack and ran his truck into a mountain and died. Again, the heart attack itself had nothing to do with his work, but the fact that he's driving 80,000 pounds of cargo 70 miles an hour places him at a greater "positional risk", making the effects of the injury compensable. Again, if he were sitting on his couch at home when the heart attack occurred, he would probably still be with us today.
Just a little interesting part of Arizona Workers Compensation Law from us at Snow, Carpio, and Weekley.
Thursday, June 16, 2011
General Worker's Comp Information
Arizona Workers Compensation Information
The attorneys at Snow and Carpio, PLC are an experienced advocate for the rights of Arizona workers. Arizona law requires almost all employers to carry workers compensation insurance. This insurance pays for medical treatment, rehabilitation therapy, lost wages, and some other expenses in the event a worker is injured on the job. While this coverage is for the purpose of helping workers who suffer injuries, it is not always easy to obtain the compensation to which an employee is entitled. To get the full amount of compensation you are entitled to and you deserve, contact Snow and Carpio, PLC for a free case evaluation.
No Fault System
One of the most important aspects of the workers compensation system is that it is a no fault system. Benefits are neither increased nor decreased by whose fault caused the injury. If the injury arises out of and in the course of employment it should be covered. The elimination of any fault issues is one of the ways the system has been designed to insure the delivery of prompt benefits without dispute.
Benefits
Worker’s compensation pays limited benefits. Generally, any medical expense related to the injury must be covered. You are also entitled to a percentage of your lost wages for time off work. In some cases, there is also a permanent disability benefit. In exchange for giving up full compensation for your injuries and losses the system has been designed to provide you speedy benefits. However, sometimes insurance carriers abuse the system with frivolous delays and denials. The hearing process instead of being used for resolutions of good faith disputes gets used as a built in delay mechanism to coerce settlement or claim abandonment. This can be worker’s compensation bad faith.
Reporting a Workplace Injury
Once an on-the–job injury has occurred, the employer has the right to be notified so that it may investigate the circumstances of the injury, and provide treatment to minimize the injury. This legal requirement operates in the interests of both parties. A prejudicial failure to report an injury may act to bar the entire workers compensation claim, therefore it’s important to report an injury to an employer as soon as you reasonably believe you have suffered an injury that will involve medical care or time off work.
Filing an Arizona Workers Compensation Claim
It is also important to file an Arizona workers compensation claim as soon as possible, because it generally takes about 30 days to receive an initial determination of the insurance carrier’s acceptance or denial of a claim. The workers compensation claim may be filed with the Industrial Commission of Arizona in one of two ways. The injured worker may file the claim directly with the Arizona Industrial Commission or the physician or hospital attending an injured worker will do so, as they are required to report any industrial accidents to the Industrial Commission.
Claim Acceptance or Denial
Once the Industrial Commission of Arizona (ICA) receives the filed claim, it will notify the employer’s insurance carrier of the claim. There is no limit for the ICA to perform the notification, but it generally takes 7-10 days. Once the insurance carrier is notified of the claim, it has 21 days to formally accept or deny the claim. If the carrier does not respond to the claim within those 21 days, the carrier is responsible to provide benefits from the date of notice as if it had accepted the claim until such time it issues a formal denial.
Workers’ Compensation Hearing Process
If a claim is denied, a hearing request must be filed with the Industrial Commission of Arizona. The claim will then be set for hearing before an Arizona Administrative Law Judge. Both sides have a right to present evidence, including witnesses, medical records, and physician testimony. Once an issue becomes contested and the hearing process has begun, it generally takes a minimum six months and frequently up to one year for resolution by a judicial award. Having an experienced workers compensation lawyer at the hearing is often critical, as there are numerous issues that can be disputed and be presented at hearings in a workers’ compensation claim.
Medical & Disability Stages
Generally, there are three stages to an accepted workers’ compensation claim; temporary total disability (TTD), temporary partial disability (TPD), and permanent partial disability (PPD). Each of these stages is based upon medical decisions. Stage changes will be based on the opinions of your treating physician or from the carrier’s “independent” medical examination physician. While not all medical examiners are biased, carriers will sometimes schedule so-called “independent” medical examinations, with physicians who are reputed to provide biased opinions in favor of insurance companies, in order to avoid medical and disability benefits to its insured workers. This is one of the ways in which disputes arise which need to be resolved through the hearing process, or in some circumstances, through a bad faith action.
Temporary Total Disability (TTD)
TTD means that you are temporarily, totally disabled or unable to work because of your injury. A physician has documented that the injured worker is unable to work, either because time is needed to diagnose the injury and the physician does not want to risk further injury, the injury needs time to heal, or any other reasoning in the physician’s opinion. During this stage, the industrial carrier should pay the totality of medical expenses related to the industrial injury that are provided by the approved physician.
In addition, it should pay 2/3 of lost wages, with checks coming in two-week intervals. The highest wage recognized by the Workers Compensation Act depends on the year you were injured. For 2009 injuries, the highest wage recognized by law is $3,600.00 per month, and therefore the maximum disability benefit payable is $2,400.00 per month. An insurance carrier may dispute a TTD status with the opinion from its own physician that the worker is capable of working. In that event a hearing may be necessary.
Temporary Partial Disability (TPD)
TPD means that you still need medical care, but a physician feels that you are able to return to the duties of your regular work, or perhaps modified or light duty. During this stage, the carrier continues to pay the totality of medical expenses from the approved physician, but now pays 2/3 of the difference between your established average monthly wage (AMW) and the wages you are “able to earn” within your medical restrictions. This is an issue that is litigated with increasing frequency. The worker will often contend that his employer does not have light duty available, and that he has looked for other light duty jobs without success, and therefore, is entitled to continuing full disability benefits. Carriers may respond that the worker could have found other light duty jobs, and the carrier will then reduce disability benefits, taking credit for wages it claims the worker was able to earn, even if no wages were earned. Denial of disability benefits is a tactic sometimes used to force desperate workers to settle for less than what is owed. Disability checks during this stage must be paid at least every 30 days.
Permanent Partial Disability (PPD)
PPD means that the case has closed from further active medical care, but that the worker has suffered a permanent disability as a result of the injury. Either the worker’s physician, or the carrier’s physician, has stated an opinion that the patient has received maximum benefit from medical treatment, and that further treatment will not provide any additional permanent improvement to the injury. Serious injuries may then be awarded a permanent disability through a permanent impairment rating.
Permanent impairments may or may not pay permanent disability benefits. There are two types of permanent disabilities, scheduled and unscheduled. A scheduled disability will pay a “scheduled” amount of money for the disability, without regard to the impact of that disability on your life or ability to work. An unscheduled disability will pay lifetime benefits, on a monthly basis, based on a loss of earning capacity (LEC). Generally, if a worker can return to date-of-injury wages, there is no LEC, and no disability benefit is paid. If the worker can only return to lesser wages, because of the injury, then a disability benefit based on 55% of the recognized loss is paid monthly. These are frequently disputed issues in Arizona workers’ compensation cases.
Change of Address
All clients must notify our office of a change in address or phone number immediately so that as required by law, it can be reported to the Industrial Commission of Arizona and the Insurance Carrier and any/all interested parties to the claim. It is also very important because as your attorney, we must have current information on file for you so that we may contact you regarding Depositions, Hearings, Medical Appointments and any information relating to your case.
Surveillance
Clients must be aware that Insurance Carriers can and will conduct surveillance on clients to confirm that the injuries and restrictions they are claiming are true. Clients must be aware that all of their actions may be videotaped and used as part of the court process.
Supportive Care
Serious injuries in Arizona may be awarded supportive care. This is generally a right to return to the physician several times a year to receive medications, or other minor treatments for flare-ups or exacerbations of the residual injury. Under supportive care, the claim remains closed, but treatment is authorized to the injured worker. In addition, once the claim has been accepted, if that medical condition is ever found to present something new, additional, or previously undiscovered from the time the claim was closed, the claim may be reopened for additional medical care to treat that condition. Reopening begins the process for payment of medical and disability ben
To speak with either myself or another attorney at the firm, please call and schedule your free consultation. You can reach us at 602-532-0700 or contact us through our website at Snow, Carpio, and Weekley.
The attorneys at Snow and Carpio, PLC are an experienced advocate for the rights of Arizona workers. Arizona law requires almost all employers to carry workers compensation insurance. This insurance pays for medical treatment, rehabilitation therapy, lost wages, and some other expenses in the event a worker is injured on the job. While this coverage is for the purpose of helping workers who suffer injuries, it is not always easy to obtain the compensation to which an employee is entitled. To get the full amount of compensation you are entitled to and you deserve, contact Snow and Carpio, PLC for a free case evaluation.
No Fault System
One of the most important aspects of the workers compensation system is that it is a no fault system. Benefits are neither increased nor decreased by whose fault caused the injury. If the injury arises out of and in the course of employment it should be covered. The elimination of any fault issues is one of the ways the system has been designed to insure the delivery of prompt benefits without dispute.
Benefits
Worker’s compensation pays limited benefits. Generally, any medical expense related to the injury must be covered. You are also entitled to a percentage of your lost wages for time off work. In some cases, there is also a permanent disability benefit. In exchange for giving up full compensation for your injuries and losses the system has been designed to provide you speedy benefits. However, sometimes insurance carriers abuse the system with frivolous delays and denials. The hearing process instead of being used for resolutions of good faith disputes gets used as a built in delay mechanism to coerce settlement or claim abandonment. This can be worker’s compensation bad faith.
Reporting a Workplace Injury
Once an on-the–job injury has occurred, the employer has the right to be notified so that it may investigate the circumstances of the injury, and provide treatment to minimize the injury. This legal requirement operates in the interests of both parties. A prejudicial failure to report an injury may act to bar the entire workers compensation claim, therefore it’s important to report an injury to an employer as soon as you reasonably believe you have suffered an injury that will involve medical care or time off work.
Filing an Arizona Workers Compensation Claim
It is also important to file an Arizona workers compensation claim as soon as possible, because it generally takes about 30 days to receive an initial determination of the insurance carrier’s acceptance or denial of a claim. The workers compensation claim may be filed with the Industrial Commission of Arizona in one of two ways. The injured worker may file the claim directly with the Arizona Industrial Commission or the physician or hospital attending an injured worker will do so, as they are required to report any industrial accidents to the Industrial Commission.
Claim Acceptance or Denial
Once the Industrial Commission of Arizona (ICA) receives the filed claim, it will notify the employer’s insurance carrier of the claim. There is no limit for the ICA to perform the notification, but it generally takes 7-10 days. Once the insurance carrier is notified of the claim, it has 21 days to formally accept or deny the claim. If the carrier does not respond to the claim within those 21 days, the carrier is responsible to provide benefits from the date of notice as if it had accepted the claim until such time it issues a formal denial.
Workers’ Compensation Hearing Process
If a claim is denied, a hearing request must be filed with the Industrial Commission of Arizona. The claim will then be set for hearing before an Arizona Administrative Law Judge. Both sides have a right to present evidence, including witnesses, medical records, and physician testimony. Once an issue becomes contested and the hearing process has begun, it generally takes a minimum six months and frequently up to one year for resolution by a judicial award. Having an experienced workers compensation lawyer at the hearing is often critical, as there are numerous issues that can be disputed and be presented at hearings in a workers’ compensation claim.
Medical & Disability Stages
Generally, there are three stages to an accepted workers’ compensation claim; temporary total disability (TTD), temporary partial disability (TPD), and permanent partial disability (PPD). Each of these stages is based upon medical decisions. Stage changes will be based on the opinions of your treating physician or from the carrier’s “independent” medical examination physician. While not all medical examiners are biased, carriers will sometimes schedule so-called “independent” medical examinations, with physicians who are reputed to provide biased opinions in favor of insurance companies, in order to avoid medical and disability benefits to its insured workers. This is one of the ways in which disputes arise which need to be resolved through the hearing process, or in some circumstances, through a bad faith action.
Temporary Total Disability (TTD)
TTD means that you are temporarily, totally disabled or unable to work because of your injury. A physician has documented that the injured worker is unable to work, either because time is needed to diagnose the injury and the physician does not want to risk further injury, the injury needs time to heal, or any other reasoning in the physician’s opinion. During this stage, the industrial carrier should pay the totality of medical expenses related to the industrial injury that are provided by the approved physician.
In addition, it should pay 2/3 of lost wages, with checks coming in two-week intervals. The highest wage recognized by the Workers Compensation Act depends on the year you were injured. For 2009 injuries, the highest wage recognized by law is $3,600.00 per month, and therefore the maximum disability benefit payable is $2,400.00 per month. An insurance carrier may dispute a TTD status with the opinion from its own physician that the worker is capable of working. In that event a hearing may be necessary.
Temporary Partial Disability (TPD)
TPD means that you still need medical care, but a physician feels that you are able to return to the duties of your regular work, or perhaps modified or light duty. During this stage, the carrier continues to pay the totality of medical expenses from the approved physician, but now pays 2/3 of the difference between your established average monthly wage (AMW) and the wages you are “able to earn” within your medical restrictions. This is an issue that is litigated with increasing frequency. The worker will often contend that his employer does not have light duty available, and that he has looked for other light duty jobs without success, and therefore, is entitled to continuing full disability benefits. Carriers may respond that the worker could have found other light duty jobs, and the carrier will then reduce disability benefits, taking credit for wages it claims the worker was able to earn, even if no wages were earned. Denial of disability benefits is a tactic sometimes used to force desperate workers to settle for less than what is owed. Disability checks during this stage must be paid at least every 30 days.
Permanent Partial Disability (PPD)
PPD means that the case has closed from further active medical care, but that the worker has suffered a permanent disability as a result of the injury. Either the worker’s physician, or the carrier’s physician, has stated an opinion that the patient has received maximum benefit from medical treatment, and that further treatment will not provide any additional permanent improvement to the injury. Serious injuries may then be awarded a permanent disability through a permanent impairment rating.
Permanent impairments may or may not pay permanent disability benefits. There are two types of permanent disabilities, scheduled and unscheduled. A scheduled disability will pay a “scheduled” amount of money for the disability, without regard to the impact of that disability on your life or ability to work. An unscheduled disability will pay lifetime benefits, on a monthly basis, based on a loss of earning capacity (LEC). Generally, if a worker can return to date-of-injury wages, there is no LEC, and no disability benefit is paid. If the worker can only return to lesser wages, because of the injury, then a disability benefit based on 55% of the recognized loss is paid monthly. These are frequently disputed issues in Arizona workers’ compensation cases.
Change of Address
All clients must notify our office of a change in address or phone number immediately so that as required by law, it can be reported to the Industrial Commission of Arizona and the Insurance Carrier and any/all interested parties to the claim. It is also very important because as your attorney, we must have current information on file for you so that we may contact you regarding Depositions, Hearings, Medical Appointments and any information relating to your case.
Surveillance
Clients must be aware that Insurance Carriers can and will conduct surveillance on clients to confirm that the injuries and restrictions they are claiming are true. Clients must be aware that all of their actions may be videotaped and used as part of the court process.
Supportive Care
Serious injuries in Arizona may be awarded supportive care. This is generally a right to return to the physician several times a year to receive medications, or other minor treatments for flare-ups or exacerbations of the residual injury. Under supportive care, the claim remains closed, but treatment is authorized to the injured worker. In addition, once the claim has been accepted, if that medical condition is ever found to present something new, additional, or previously undiscovered from the time the claim was closed, the claim may be reopened for additional medical care to treat that condition. Reopening begins the process for payment of medical and disability ben
To speak with either myself or another attorney at the firm, please call and schedule your free consultation. You can reach us at 602-532-0700 or contact us through our website at Snow, Carpio, and Weekley.
Wednesday, June 15, 2011
What Compensation Am I Entitled To?
There are three stages to an accepted workers' compensation claim: temporary total disability (TTD), temporary partial disability (TPD), and permanent partial disability (PPD).
Temporary total disability should pay two-thirds of lost wages, with checks coming in two-week intervals. The highest wage recognized by the Workers Compensation Act depends on the year you were injured.
Under temporary partial disability, the carrier continues to pay the total medical expenses from the approved physician, but now pays 2/3 of the difference between your established average monthly wage and the wages you are able to earn within your medical restrictions. Temporary partial disability is paid while you are still receiving active medical care, but have been released to work with restrictions, often referred to as "light duty" work. If your employer cannot accommodate your restrictions, you will receive full compensation of 2/3 of your regular wage, but paid every 30 days.
Permanent partial disability means that the case has closed from further active medical care, but the worker has suffered a permanent disability as a result of the injury. Depending on the type of injury you have sustained, you may be entitled to either a one time lump sum payment to compensate you for your injuries, or you may receive a permanent monthly pension if you are unable to return to your regular work and have a "loss of earning capacity" as a result of your injuries.
For more information or to schedule a free consultation with an attorney, contact Snow, Carpio, and Weekley at 602-532-0700.
Monday, June 13, 2011
Are You Confused About Filing a Workers' Compensation Claim in Arizona?
You should never be reluctant to report an injury that you suffered while on the job. In fact, Arizona's Workers' Compensation Law requires that workers who sustain an on-the-job injury "forthwith report" their injury to their employer. "Forthwith" means that as soon as you realize you have an injury that may be related to your work, you must report it to a supervisor or manager immediately.
Arizona's "no fault" system means that it does not matter how or why you were seriously injured. No one can be blamed for your accident. Even if you placed yourself in harm's way during a work day and were hurt because of it, this aspect of your case is irrelevant under state law.
Still, you should report your work injury to your employer as soon as possible. Failure to "forthwith report" an on-the-job injury can result in the insurance company denying liability for your injuries.
Inform Your Employer of Your Serious Injury — Then Inform Snow, Carpio, and Weekley.
Another reason it is important to report your injury and file an Arizona workers' compensation claim as soon as possible: It generally takes about 30 days to receive an initial determination of the insurance carrier's acceptance or denial of a claim. Your claim may be filed directly with the Industrial Commission of Arizona, or your attending physician or hospital will do so. They are required to report any industrial accidents to our state's Industrial Commission.Once your serious injury has been reported, we can start the hard work of investigating the details of your accident and strive for the results you need.
Sunday, June 5, 2011
Tiebreaker IME's in Arizona Workers Comp Cases
One issue that is frequently litigated in Arizona work injury claims is whether or not additional medical care is necessary or not and whether or not it is related to the industrial injury. Usually there is a treating doctor on the side of the applicant wanting to perform additional care and a defense medical expert on the side of the carrier saying either that no further care is needed, or that any additional treatment is not related to the work accident.
The problem with litigating these medical issues is that they can often take forever to litigate, often up to 10 or 12 months. Meanwhile, the injured worker is suffering and not receiving any compensation. One solution that I often recommend to my clients is proposing a "tiebreaker" IME to the carrier/employer's attorney. A tiebreaker is a truly "independent" medical exam where the physician is agreed to by the two parties and a joint letter sent explaining the tiebreaker agreement.
There are positives and negatives about these kinds of agreements. On the positive side, the injured worker gets a decision about their claim much sooner and it is made by a doctor, not a judge. On the negative side, if the doctor indicates that no further treatment is needed, the injured worker is bound by that opinion.
Tiebreaker IME's aren't always the best option, but in cases where I feel that the diagnostic testing is strong and my client is very credible, I'm comfortable recommending them as an alternative to the lengthy litigation process.
Chad T. Snow and his associates at Snow, Carpio, and Weekley are workers compensation attorneys in Phoenix and Tucson Arizona. Their office can be reached at (602) 532-0700 or (520) 647-9000.
The problem with litigating these medical issues is that they can often take forever to litigate, often up to 10 or 12 months. Meanwhile, the injured worker is suffering and not receiving any compensation. One solution that I often recommend to my clients is proposing a "tiebreaker" IME to the carrier/employer's attorney. A tiebreaker is a truly "independent" medical exam where the physician is agreed to by the two parties and a joint letter sent explaining the tiebreaker agreement.
There are positives and negatives about these kinds of agreements. On the positive side, the injured worker gets a decision about their claim much sooner and it is made by a doctor, not a judge. On the negative side, if the doctor indicates that no further treatment is needed, the injured worker is bound by that opinion.
Tiebreaker IME's aren't always the best option, but in cases where I feel that the diagnostic testing is strong and my client is very credible, I'm comfortable recommending them as an alternative to the lengthy litigation process.
Wednesday, June 1, 2011
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