Following is a summary of certain aspects of workers compensation law. Each case is unique. If you have been severely injured, it’s important that you retain an experienced workers’ compensation lawyer so as to be on an equal footing with the insurance company.
What types of injuries or illnesses are covered by workers’ compensation laws?
An injury or illness is covered under workers’ compensation if it is job-related. If the injury or illness is job-related, the injured worker receives payment of medical expenses and temporary compensation for lost earnings. In some cases, he may also receive permanent compensation and vocational rehabilitation (job-retraining).
How is my “average monthly wage” calculated?
Compensation is based on a percentage of the worker’s “average monthly wage” at the time of the injury. The Industrial Commission of Arizona sets the average monthly wage. By law there is a ceiling on the average monthly wage. For 2017 this amount is $4,521.92.
What is the difference between “temporary” and “permanent” compensation?
An injured worker’s claim generally progresses through a two- or three-stage cycle, in which benefits vary according to the stage:
- In the “total temporary” stage, the injured worker’s physician has advised the worker that he cannot work. During the worker’s recovery, he is entitled to payment of his injury-related medical expenses, and to compensation equal to about 2/3 of his average monthly wage. This Compensation is paid every 14 days.
- In the “partial temporary” stage, an injured worker has been released by a physician to light or limited work activity. While the worker continues to receive treatment, he remains entitled to payment of his injury-related medical expenses and to compensation of 2/3 of the difference between his average monthly wage and his earnings, if any, from light or modified work employment.Unemployment benefits are considered earnings. Compensation is paid monthly; however, the injured worker must show that he has made a reasonable effort to find suitable work to continue receiving temporary compensation.
- The final stage, “permanent compensation,” begins when the injured worker’s condition becomes “stationary.” A worker’s condition is considered “stationary” if further treatment will not improve the worker’s condition.
If a worker has a permanent injury, the worker’s physician will advise if “supportive medical care” is necessary to treat the injured worker’s symptoms. The insurance carrier does not pay temporary compensation beyond the stationary date, although the carrier will pay for “supportive medical care,” if indicated.
If a worker has a permanent injury, compensation for permanent disability may be paid, based upon one of two types of permanent disability, “scheduled” or “unscheduled.”
- “Scheduled” disabilities include permitted injuries to the fingers, toes, hands, feet, arms and legs; loss of hearing, loss of sight and facial disfigurement. These disabilities are paid according to a formula which lists various parts of the body and fixes the amount of compensation paid for a total or partial loss of that part. Scheduled permanent compensation is paid for no more than five years.
- “Unscheduled” disabilities are paid on the basis of 55% of the difference between the average monthly wage and the amount the Industrial Commission decides the injured worker is able to earn, considering the effect of the injury. Unscheduled injuries include all injuries other than scheduled injuries. Examples of unscheduled injuries include those to the head, neck, back, hip and shoulder. Some diseases – heart, lung, and psychiatric – are also unscheduled disabilities. Unscheduled permanent compensation can be paid for the employee’s lifetime and does not necessarily end at normal retirement age.
Vocational rehabilitation (job re-training) is sometimes provided in unscheduled injury cases if the worker cannot perform his previous job. Permanent workers compensation is generally paid monthly.
What is the insurance company’s responsibility for my medical expenses?
All medical bills must be paid in full by the insurance company so long as treatment is reasonable, necessary, and related to the work injury.
For an experienced workers’ compensation attorney, contact the Law Office of Stephen L. Weiss today.