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How Do I Appeal My Workers’ Comp Claim in Arizona?

Posted in Worker's Compensation on September 5, 2023

When a person sustains an on-the-job injury in Arizona, they will likely be able to receive workers’ compensation to help with most expenses arising due to the incident. This includes complete coverage of the medical costs as well as a portion of lost wages if the injury prevents the employee from going to work. However, if a workers’ compensation claim is denied, there is an appeals process the employee can go through to have their claim reconsidered.

The Appeals Process

We encourage work injury victims to speak to a Phoenix workers’ compensation attorney who can assist with this process:

Requesting a Hearing

If an employee wishes to appeal a workers’ compensation denial, they must do so within 90 days from the date of the denial notice by filling out a Request for Hearing form. If the injured worker misses this deadline, their claim will almost certainly be permanently denied regardless of why the denial was issued. The Industrial Commission of Arizona (ICA) will send you a notice with a date for a hearing in front of an administrative law judge.

Pre-conference Hearing

The administrative law judge assigned to the appeal could ask the parties to participate in a pre-conference hearing. This pre-conference hearing is usually done over the phone, and it will give the judge a chance to discuss the case with both parties.

Discovery Process

Before the hearing, both parties will need to go through the discovery process, which is similar to other types of personal injury claims. The discovery process allows both parties to request and review all evidence related to the appeal. During discovery, there may also be depositions. The injury victim may be asked a series of questions under oath by the insurance company’s attorney.

The Hearing

The final hearing will be held within 90 days after the referral to the administrative law judge. The worker who filed the appeal will usually be the first to testify, and they have the burden of proof. During the hearing, the administrative law judge may ask questions of the participants. There will be a cross-examination by the other party’s attorneys. In some cases, there may be more than one hearing if additional testimony is needed, such as medical expert witnesses.

Usually, the administrative law judge will issue a decision within 30 to 60 days after the hearing concludes.

Request to Review

If the injured worker is not satisfied with the final decision, they can request a review within 30 days after receiving the decision. The administrative law judge will re-examine the evidence and issue another decision after the review. The decision will either confirm or change the original decision and if an individual is still unhappy with the decision, they can file an appeal with the Arizona Court of Appeals within 30 days after the review.

Working With an Attorney

If you or somebody you love has been injured on the job, we encourage you to reach out to an attorney as soon as possible. The appeals process for a workers’ compensation claim in Arizona can be confusing, but an attorney can step in and handle every aspect of the process on your behalf. This will include reviewing the evidence, obtaining opinions from expert medical witnesses, and handling all of the hearings.