Injured workers are subject to many stresses beyond just the physical harm that they have suffered. In addition to the pain of their condition and their recovery, they are worried about how they will pay for everything. Work-related injuries can be expensive. They could require lifelong care or even expensive short-term medical interventions.
Every bit as devastating is the fact that you may not be getting paid for the time that you miss for work. You may not have sick leave, or you may have exhausted it. When you miss an extended amount of time from your job, it can be financially devastating for your family, putting your credit and even your family home at risk. Financial pressures can make a difficult time even worse. If you were injured while performing your occupational duties, speak with one of our Tucson workers’ compensation lawyers for a free consultation today.
The law is here to help and protect you, so long as you can meet the legal requirements to be eligible for benefits.
Workers’ compensation exists to help injured workers and give them some peace of mind, but first, you must follow the exact legal process by:
- Reporting the injury to your employer within a certain timeframe.
- Getting a medical diagnosis of your injury and evidence that it is work-related.
- Filing a workers’ compensation claim by the deadline.
While this sounds easy, the process is more complicated than you might imagine. There are no guarantees when you are applying for workers’ compensation benefits, and you should never take it for granted that the insurance company will simply grant the benefits that you deserve. Many people hit roadblocks in these cases, and you should not hesitate to contact a Tucson workers’ compensation lawyer from Zanes Law Injury Lawyers.
For a free legal consultation with a workers’ compensation lawyer serving Tucson, call 866-499-8989
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Tucson Workers’ Compensation Lawyer Near Me 866-499-8989
Negligence Does Not Apply to Workers’ Compensation Claims
The workers’ compensation law means that you largely do not have to worry about the cause of the accident. If you were negligent yourself, it would not prevent you from receiving benefits. In most cases, the factual questions will involve other issues. The only time that you may have an issue collecting benefits based on your actions is if someone accuses you of some sort of intentional misconduct. Otherwise, even if you made a bad mistake, you could still qualify for benefits. The law just wants to compensate you.
What You Must Prove to Qualify for Benefits
There are only two things that you need to prove when you are filing a workers’ compensation claim.
- You suffered an injury.
- Your injury was related to your job.
You should not think that each of these elements is a proverbial “layup.” Your employer will have a workers’ compensation insurance policy, meaning that an insurance company is involved in the picture, and they will review your claim. Like any insurance company, they may deny your claim at first and force you to take additional steps.
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What Is an Injury?
The word “injury” can have a broad interpretation when it comes to workers’ compensation claims. Of course, this would include an injury that you have suffered as a result of an accident at work, usually no matter how it happened. However, injuries do not always occur as a result of a single incident.
What happens at your job every day can harm your health.
Your job may have injured or sickened you over time, based on the work that you did or something that you were exposed to on the job, including:
- Exposure to toxic chemicals and substances
- Repetitive motions causing injuries
- Arthritis or the body otherwise breaking down from years of physical labor
- Mental conditions developed on the job
The insurance company may claim that you are ineligible for benefits because your injury is a pre-existing condition. However, this may not prevent benefits if you can show that your job worsened a pre-existing condition and would still qualify as a job-related injury.
What Does Job-Related Mean?
The other major way that an insurance company may challenge your claim is by arguing that the injury was not job-related. For example, if you slipped and fell in the company cafeteria during your lunch break, that would not be considered job-related.
Generally speaking, if you are doing company activities on company time, your injury would be work-related and would cover your employment duties. It could also cover things like injuries at holiday parties and company outings. Usually, injuries suffered on your way to and from work are not covered, but there are some exceptions to the rule. For example, if you were driving the company car to work, this could qualify.
If you can prove the above, you can receive benefits from your company’s workers’ compensation insurance policy. These will not entirely replace your lost income, but they will provide you with payments for necessary medical care and some of what you did not earn from work. If you cannot work again, you may be eligible for a settlement.
Most employers are legally required to issue workers’ compensation insurance for full and part-time employees throughout the state, although there are several exceptions to this rule. According to the Arizona Revised Statutes § 23-901, employers are not required to purchase workers’ comp insurance to cover independent contractors or employees who work on a “causal,” non-regular basis.
Additionally, sole proprietors do not have to provide this type of insurance to their employees. However, if a sole proprietor is working for an employer with workers’ comp coverage allowed by A.R.S. §23-961(P), they must file an independent contractor statement after a workplace accident.
The Compliance Unit of the Industrial Commission of Arizona investigates employers who do not adhere to state employee safety standards. A local attorney familiar with company safety requirements could assist injured employees in filing a worker’s compensation claim.
Whether someone is working in an office or a factory, many types of accidents could lead to personal injuries. Common hazards in the workplace may include:
- Slippery or uneven flooring
- Electrical wires
- Falling objects
- Heavy machinery
- Exposure to toxic chemicals or substances
- Explosions and fires
Regardless of the cause of the incident, individuals who choose to hire a workers’ comp lawyer may have a better chance to obtain damages.
The potential benefits available to an employee depend on the severity of their injuries and the length of time they are unable to work. Under A.R.S. § 23-1062, a worker who suffers a disability that lasts over 14 days may receive back pay for their first seven missed days of work. On the eighth day, workers’ compensation benefits begin.
Benefits are capped at 66.6 percent of the worker’s average monthly income, whether they file for temporary total, permanent total, or permanent partial disability. An injured employee may be denied benefits for a variety of reasons. For example, a worker who was under the influence of drugs or alcohol at the time of the accident may receive a denial of their claim.
Additionally, an employee’s claim may be denied if the worker “unreasonably refused or neglected” treatment. An attorney who focuses on workers’ compensation claims could inform injured parties of other factors that may influence the denial of benefits.
Why You Need a Tucson Workers’ Compensation Lawyer
As an injured employee, you need the benefits that workers’ compensation offers. Workers’ compensation is often the difference between making ends meet and struggling to survive while you are dealing with your injury. Even if it is not your full salary, it is still money coming in at your time of need. There are some technical requirements that you must follow, and nothing can go wrong with your application process.
Other occasions when you would particularly need a Tucson workers’ compensation lawyer include:
- Your employer has taken issue with your claim, and their insurer will not pay you.
- Your case is more difficult in that you need to work to prove the connection between your injury and your work.
- You need to negotiate a one-time settlement for a serious injury.
- You don’t know the value of your claim.
The insurance company may deny your initial claim. Your claim may be missing some information, or the company may have additional questions to ask. When that happens, you are better off not leaving anything to chance. There are strict timelines to appeal and a process that you must follow. Any mistakes could mean the end of your quest to receive benefits.
A conversation with the insurance company can work out some denials. The company will give a reason why it denied your claim, which may reveal it to be the result of a misunderstanding. Other denials could be the result of an issue that simply cannot be worked out through a conversation.
Here is what you need to know about the Arizona appeals process:
- Once an insurance company denies your claim, you have 90 days to request a hearing from the Industrial Commission of Arizona, a strict deadline that you do not want to miss. In the meantime, there is nothing to stop your lawyer from speaking with the insurance company in an attempt to resolve your claim.
- The parties can exchange information through discovery. You may obtain additional evidence from your employer that could help with your case.
- Each side will present the evidence that they plan to use at a hearing in advance, including things such as medical records, witness statements, and photographs.
- An administrative law judge will conduct a hearing, a court-like proceeding where you will testify, and both your lawyer and the insurance company’s attorney will question you. The ALJ will issue a decision within 60 days based on the record and testimony. If you are successful, benefits will be retroactive.
- If you do not win at your hearing, you have the right to ask the ALJ to reconsider their decision in case they made a mistake. You would need to take this step, even though it is rare for an ALJ to acknowledge their own errors.
- Finally, you could file an appeal with the Arizona Court of Appeals within 30 days of receiving the review decision.
Insurance companies may not benefit when they deny your claim and lose in the appeals process. It often costs them a lot more money because claimants could receive even more than the average claimant when their denial converts to benefits.
What Else You Can Challenge in an Appeal
Not only can you contest a denial of benefits, but you could also challenge the calculation of your benefits. The insurance company calculates benefits according to a formula, and sometimes, they get it wrong.
In addition, you may have a dispute about whether you can work again. The insurance company may argue that you can work or retrain for employment in another field. In other words, establishing eligibility for benefits is far from the end of the story.
Can You Sue Someone in a Personal Injury Claim for a Workplace Injury?
Many workers ask whether they must file a workers’ compensation claim. In fact, they may end up financially better off when they file a personal injury lawsuit instead of a workers’ comp claim. Financially, they could recover fully for lost wages as opposed to a percentage, and they could receive payment for things such as pain and suffering. In Arizona, it is very difficult to step outside the workers’ compensation system when dealing with your employer. The purpose of the law is to encourage all employers to have this coverage so it protects them from negligence claims.
There are very limited exceptions to this doctrine. In Arizona, the only way that an injured employee can sue the employer is for willful misconduct with the direct aim of harming the employee. Otherwise, their only option is a workers’ compensation claim.
This is not to say that injured employees cannot sue third parties. While they cannot sue their fellow employees directly, they can file a lawsuit against another company or person that was responsible for their injury.
- A third-party contractor at your job site (and not your employer) is responsible for your injuries.
- You are a delivery person, and you are injured on someone else’s property while making a delivery.
- You suffer an injury due to defective work equipment and want to file a product liability claim against the company that made the product.
You should have an attorney who could quickly get to the bottom of your case and figure out the best course of action. At Zanes Law, we have experience in both workers’ compensation and personal injury law, so we understand how the two work together and whether you have a possible lawsuit. Either way, we will work to fight for your legal rights and advise you of all your options.
How Attorneys Help Your Tucson Workers’ Compensation Claim
There are many reasons why you would need a workers’ compensation lawyer.
An attorney can help you by:
- Negotiating a settlement with the insurance company.
- Communicating with the insurance company on your behalf if there are any issues with your claim.
- Representing you at all phases of the appeal, including arguing your case in front of the judge.
- Calculating your benefits correctly.
- Helping with your claim and ensuring that everything is done correctly.
- Educating you on the process and helping you keep track of all deadlines.
You may be wondering how much the services of an attorney would cost you. Zanes Law Injury Lawyers represent you on a contingency basis, meaning that we do not receive any payment upfront. Injured workers usually do not have the money to pay a lawyer’s hourly fees, and our compensation reflects that. We only receive payment if you win. Therefore, you do not need to worry about writing us a check out of your pocket with money that you do not have. However, if you are having difficulty with your claim, not calling a lawyer very risky.
The one thing that you often do not have in a workers’ compensation case is time. There are tight deadlines, and you need the money, so you are better off getting legal help at the first possible moment that you realize it may be necessary.
4580 E Grant Rd #101
Tucson, AZ 85712