If you have a lasting impairment from your work-related injury or illness in Arizona, you may be eligible for permanent workers' compensation benefits. How much you'll be compensated depends on the type of injury. (See our article on eligibility and filing for workers' comp in Arizona.)
Arizona considers there to be two different kinds of permanent injuries, Scheduled and Unscheduled. A Scheduled injury is one that is listed in the workers' compensation law as being entitled to a certain compensation rate.
Scheduled injuries include permanent injuries to an arm, leg, hand, foot or eye. For a partial loss of one of these body parts, you'll receive half your average monthly wage. For an amputation or complete loss of use of the body part, you'll be paid 55% of your average monthly wage, and if your doctor says you can't return to your regular job due to the injury, then you'll get 75% of your average monthly wage.
If you have permanent scarring on your face or have lost teeth, you'll receive 55% of your average monthly wage for up to a year and a half.
All other types of permanent injuries are considered Unscheduled injuries. Unscheduled injuries include hip, shoulder, and back injuries as well as occupational diseases. The Industrial Commission will determine whether you will receive compensation for these types of permanent injuries, and in what amount. Factors such as whether you can return to work and how much you can earn will impact this decision, as well as how old you are and what type of work history and education you have.
If you are awarded permanent compensation for an unscheduled injury, you will be compensated for the difference between what you were able to earn before the injury and what you are able to earn now. If you are found to be totally disabled, you'll be paid two-thirds of your average monthly wage, and if you are found to be partially disabled, you'll be paid 55% of your average monthly wage.
If you do not agree with the decision of the ICA or the amount of benefits awarded, you have three months to request a hearing. (See our article on appealing an ICA decision in Arizona. )
If you have been awarded benefits for an Unscheduled Permanent Partial Disability and later your earnings ability increases or decreases, you or the insurance company can file a petition to reevaluate your compensation amount. Whoever files the petition has to prove an increase or decrease in compensation is warranted. It is the Industrial Commission that decides whether your monthly benefits should continue, be increased, or be decreased.
It is a good idea to file this petition, called a Petition for Rearrangement or Readjustment of Compensation, if your injury has worsened or if your earning capacity has otherwise been reduced. But if your earning capacity is less because you are getting older or due to a non-work related injury or illness, you will probably not be successful with this petition.
After a Petition for Rearrangement or Readjustment of Compensation is filed, the ICA will send a letter letting both parties know about it, and you will receive a questionnaire asking you about your current employment. Then the Industrial Commission will review the petition and the file and either approve or disapprove the petition.
If either you or your employer disagrees with the decision, a hearing can be requested by filing a hearing request form within 90 days from the issuance date of the decision or award.
Sometimes the Arizona Industrial Commission will allow you to receive your permanent disability benefits in a lump sum rather than on a monthly basis. This is only possible for a Scheduled award of $25,000 or less and does not require the insurance company approval or an Unscheduled award of $150,000 or less and the insurance company does have to agree to it.
The Commission will only allow a lump-sum payment if there is a reasonable reason for it, such as your financial need or rehabilitation needs. A lump-sum payment won't be made until all parties have signed a waiver saying they will not file an appeal.
Contact the ICA and ask for lump-sum commutation forms. Complete and submit these forms and then the Commission will either grant or deny the request. If the request is denied, you have ten days to file a hearing request form with the ICA. You will then receive a letter telling you when your hearing will be held.
If you received the permanent disability benefits you were entitled to and then your claim was closed, in some cases you may wish to have it reopened. For example, a new medical condition related to your injury may arise. In that case, you will want to ask the ICA to send you a Petition to Reopen a Claim form. When you send in the petition, include a medical report from your doctor that explains how your current condition is related to your original work-related injury or illness.
If your claim is reopened, you can be eligible to receive new benefits. If the claim is reopened, your medical expenses can be paid, but no medical benefits or compensation will be paid prior to the date the petition was filed.
The insurance company will either accept or deny your petition to reopen. If it's denied, you have 90 days to file a hearing request with the Industrial Commission. The Commission will then send you a letter telling you when your hearing before an Administrative Law Judge will be held.