Workers Compensation Appeal Process In Arizona

Workers’ Compensation Appeals Process In Arizona

There are a few reasons you may need to appeal a notice or award issued on your Arizona Workers’ Compensation Claim. For example, your claim may be denied. The Industrial Commission of Arizona (ICA) may establish your average monthly wage incorrectly. Your employer’s workers’ compensation insurance company may fail to authorize your medical care in a timely manner. They may close your claim prematurely or improperly. If you disagree with a notice or award issued on your claim, you have 90 days from the mailing date of that document to appeal. You appeal that notice by filing a Request for Hearing with the ICA. Fighting an insurance company is complicated and difficult to navigate on your own. It is important to have an experienced workers’ compensation lawyer by your side throughout the process. Below are the steps you can expect to go through while appealing a notice or award you disagree with:

Step 1- Request a Hearing: If you disagree with a notice or award issued on your claim, then you have 90 days to file a request for hearing with the ICA. When a request for hearing is filed on your claim, the Claims Division at the ICA will refer your file to the Administrative Law Judge (ALJ) division, also known as the hearing division. The ICA will send you a Notice of Hearing with the date, time, and location of the hearing. An initial hearing is usually scheduled about 90 days after the hearing division receives the file. If the insurance company has not already done so, they will hire an attorney to represent them at this time. 

Step 2 – The Discovery Process: In order to properly prepare for the hearing, both sides engage in discovery. Discovery is the process of exchanging information between the parties about the witnesses and evidence they plan to present at the hearing. You will likely be required to sign medical releases, attend a deposition, and answer interrogatories. Another part of the discovery process may require you to attend an independent medical exam (IME) with a doctor of the insurance company’s choice. A skilled workers’ compensation attorney will be able to guide you through this process. 

Step 3 – Submission of Evidence: It is important that the ALJ assigned to your hearing is presented with evidence prior to your initial hearing. An experienced workers’ compensation attorney will ensure that the proper medical records, documents, photographs and witness statements are submitted into evidence in a timely and efficient manner. 

Step 4 - Hearing: Your hearing will be scheduled about 90 days after your case is referred to the hearing division. For the initial hearing, you are required to be present along with your attorney. You will be the first to testify to prove your case. Your attorney will ask you questions. The insurance company’s attorney will cross-examine you. A skilled workers’ compensation attorney will make sure you are properly prepared to assist in presenting your case.  Most cases do require multiple hearings for the testimony of other witnesses such as doctors who have treated or examined you with relation to your injury. Once all hearings are concluded, the ALJ will make his or her decision within 60 days.

Any Further Appeals

There are still options if you are unsatisfied with the ALJ’s decision. You are able to file for a review within 30 days of the decision. You have to submit this request in writing and mail a copy to your employer’s insurance company. At this point, the ALJ will review the evidence in your case to determine if they will confirm or change their initial decision. After this decision is made, if you are still unsatisfied with the decision, you must take your case to the Arizona Court of Appeals within 30 days.

How Fendon Injury Law Can Help

At Fendon Injury Law in Phoenix, Arizona, we have over 40 years of combined experience in Arizona Workers' Compensation Law. We offer a free case assessment so that we can provide you with the best advice possible. Contact us today!