See what's covered and what isn't covered by workers comp in Arizona with this easy-to-follow guide.
When is an employee entitled to workers comp benefits?
An employee who is injured or becomes sick on the job is entitled to receive medical benefits and missed wages no matter who causes the job-related accident. This means that even if the employee was at fault or partially at fault in causing the industrial injury, he or she will, in most instances, be entitled to benefits under the workers’ compensation system.
There are some exceptions, however. For example, an employee is not entitled to workers’ compensation benefits for injuries that are determined to be intentionally self-inflicted.
The major benefits of workers’ compensation are:
The cost of medical care for work-related injuries and illnesses.
Lost wages if an employee is forced to miss time due to the injury. Such payments are calculated based on the employee’s income the month before they were injured or sickened.
Longer-term care for serious injuries such as broken bones, and any physical therapy that is needed to get the employee back on the road to health.
Treatment of repetitive injuries that can occur in the workplace.
Medical care for exposure to hazardous substances or any other unhealthy conditions in the workplace.
Disability benefits, both short-term and long-term, depending on the severity of the injury or illness.
Death benefits and funeral costs for survivors of an employee who dies in a workplace accident.
Workers’ comp comparisons
To help employers understand the workers’ compensation system, the state of Arizona has provided a comparison between what is possible in a workers’ compensation claim as opposed to what could happen if an employee filed a civil lawsuit.
In a workers’ compensation claim, an injured employee is entitled to lifetime medical and compensation benefits but the compensation for lost wages is capped by law. If an employer is sued in civil court, there is no cap on the amount of damages an injured worker can claim. Under the workers’ compensation system, an injured worker cannot seek compensation for “pain and suffering” or “punitive” damages like they can in a civil lawsuit.
A workers’ compensation dispute is decided by an administrative law judge while civil lawsuits are usually decided by a jury. A workers’ compensation claim also has rules of procedure and evidence that differ from those that apply in a civil lawsuit. Certain legal principles such as “contributory negligence” that may apply in a civil lawsuit do not apply in a workers’ compensation claim.
As the state points out, an attorney can advise employers on many other differences between workers’ compensation and a civil lawsuit.
Obtaining workers’ comp insurance or self-insuring
Workers’ compensation insurance can be obtained from an insurance company licensed to issue workers’ compensation insurance in Arizona. For a listing of these companies you may contact the Arizona Department of Insurance at (800) 325-2548 or www.azinsurance.gov.
Employers who meet certain requirements can also apply to the ICA for permission to be self-insured for workers’ compensation. Once an employer obtains insurance or authority to self-insure, the employer is required to post a notice of workers’ compensation insurance advising their employees of the coverage and of the employee’s right to reject this coverage.
The employer is also required to supply “rejection” forms for employees who chose to reject their employer’s workers’ compensation coverage.
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