INJURY
An injury is covered under Workers’ Compensation if it is job related. It is the your responsibility to make sure the injury is reported to your supervisor/employer as soon as possible. The prompt reporting of the accident to your supervisor/employer will accelerate the processing of your claim and avoid unnecessary delays or denial of possible benefits.
FILING A CLAIM
When you were treated for your injury at either your doctor’s office or an emergency room and you told them you were injured on the job, you should have been given a “pink form” to complete and sign. The “pink form” is a combination form entitled “Worker’s and Physician’s Report of Injury.” By signing that form, you were applying for Workers’ Compensation benefits.
The hospital or doctor sends the original of the form to the Industrial Commission (ICA), a copy to your employer and a copy to the insurance company that wrote the policy for your employer. If you did not complete this pink form at the doctor’s office or at the hospital, another form, entitled “Worker’s Report of Injury,” can be completed and filed with the Industrial Commission. This form will be sent to you by the ICA upon request.
Your claim is officially filed when one of these forms is received by the Industrial Commission. Without a claim signed by you or your legally authorized representative and received by the Industrial Commission, the insurance carrier is not legally required to take any action on your injury or to make any payments. You will know that the claim form has been received because the Industrial Commission will notify you by letter. If you are not notified of the receipt of your claim within a reasonable period of time, (two weeks), please contact the Industrial Commission and a claim form will be sent to you to complete and return.
Remember, that your claim must be filed within one year of the date of injury and that you are responsible for making sure that the claim is filed.
When your claim is received by the Industrial Commission, the insurance company is officially notified by the ICA that you have filed a claim. The insurance company must then either accept or deny your claim within 21 days from the date of the notification. If your claim is denied, you will receive a “Notice of Claim Status” from the insurance company. If you disagree with the insurance company’s denial, this notice will have a 90 day protest period within which you must file your request for hearing with the Industrial Commission by means of a letter or on a form available from the ICA upon request. This request for a hearing must be signed by you or your legal representative. If you file a request for hearing, you will receive a Notice from the Industrial Commission which will tell you when a hearing before an Administrative Law Judge will be set. If you do not file a request for hearing during the 90 day protest period, the decision of the insurance company becomes final.
Remember, it is your responsibility to understand all notices and documents which allow for hearing requests in the event of disagreements, and it is also your responsibility to make your current address known to the Industrial Commission and the insurance company.
For more specific information regarding your Phoenix workers compensation claim contact Chris T. Johnson a Phoenix Workers Compensation Lawyer.
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