When men and women are injured on the job, I have helped injured workers and their families obtain the compensation and medical care they are entitled to for 35 years in Arizona. If you have had an injury on the job which prevents you from working and earning, contact me for a free consultation concerning your rights. Any time your employer or its insurance carrier make a decision in your case or take an action that you don't agree with, you have the right to have an attorney advise you. However, the time limits for filing a claim or requesting a hearing are strict, so do not delay.
Injuries which are covered by Arizona workers compensation statutes include:
Repetitive stress injuries or cumulative trauma injuries, such as carpal tunnel syndrome, de Quervain's tenosynovitis, or rotator cuff injuries occurring over time,
Toxic chemical or particulate exposures, lung injuries, exposure to blood, bodily fluids, certain diseases, and occupational diseases,
Mental stress injuries, psychological and psychiatric injuries substantially caused by unexpected or unusual or extraordinary stress related to the employment, or physical injury,
Heart-related injuries, heart attacks, strokes or death substantially caused by injury, stress or exertion related to the employment,
Amputation, loss of use of a body part, loss of sight, or hearing.
It is the responsibility of the injured worker to be sure your claim is properly filed with the Industrial Commission of Arizona within one year of the date of injury. You can call the Industrial Commission, at 602-542-4661, giving your name, social security number, date of birth, employer and date of injury and find out if your claim is on file. You may request copies of all the documents in your claim file at a small expense. It is your responsibility to notify your employer of any injury as soon as it occurs, and to file the claim in writing with the Industrial Commission within one year of the date of injury, with some limited exceptions. Forms are available on-line from the Industrial Commission at firstname.lastname@example.org or you may contact me without charge or obligation.
Besides injured workers all over Arizona, for over twenty years I have represented professional athletes in workers compensation claims as a member of the National Football League Players Association (NFLPA) panel of workers compensation attorneys. I am also a workers compensation panel member for the Professional Hockey Players Association (PHPA), National Hockey League Players Association, Arena Football League Players Association, Major League Baseball Players Association, Womens National Basketball Association Players Association, and other professional sports leagues players associations.
On November 21, 2009 I was selected as the PHPA Attorney of the Year at the PHPA annual workers compensation attorneys' meetings in Austin, Texas.
I have prepared a guide for workers compensation issues for professional athlete clients which follows. It applies to all workers suffering injuries on the job and explains the benefits available in Arizona. If there are questions, you may call me for a free consultation by telephone at your convenience, or by email.
Arizona Workers Compensation Issues For Professional Athletes and Others
Professional athletes are covered by workers compensation laws as any other worker. Workers compensation laws are specific to each state. Time limits, filing requirements, benefits and procedures vary from state to state. When a player or worker is injured, contact a workers compensation attorney in the state where the team or employer is located, or where the injury occurred, to learn the specific procedures and laws that apply. Following are general issues to consider in Arizona:
1. A compensable injury must occur within the course and scope of employment.
* Playing in a game or during regular work hours at the employment
* Practicing / training
* Traveling with the team or for employment (Note: going and coming from home usually is not covered)
* Other activities required by the team or employer
* Cumulative trauma: Injuries need not be a single event. Cumulative trauma, or multiple small injuries to the same body part over time, may result in a compensable injury once it is diagnosed and requires treatment. Multiple injuries to different body part at different times may not be combined into one injury claim.
2. Changes in the law in 2013 mean that if an injury occurs while a player is under contract with an Arizona club or employer, the claim must usually be filed in Arizona.
3. Time limits and filing requirement vary by state.
* Usually claims must be filed within a specific time period after the injury by the player or worker. For example, claims must be filed in writing at the Industrial Commission of Arizona within one year in Arizona. Other states have different time limits. Forms for filing a claim may be found online at the Industrial Commission of Arizona website. The form is called Worker’s Report of Injury. A player or worker cannot rely on the team or employer to file the claim. It is the worker’s responsibility. After the claim is filed, the claim must be accepted by the team or employer’s workers comp insurance company.
* In some states, claims must be filed within a specific time period after the injury or after the last period covered by compensation, or after medical treatment was last furnished. Arizona has a strict one year from date of injury filing requirement, with very limited exceptions.
* There may be an extended filing period for injuries not discovered immediately or which later require treatment.
* In most states, injury reports must be made in writing to the state’s Industrial Commission or similar authority. It is not sufficient to report the injury to a team trainer or supervisor or employer or workers compensation carrier. The claim must also be accepted by the employer’s insurer. If a claim is denied by the insurer, the player or employee must request a hearing within 90 days of the date of mailing on the Notice denying the claim to prove that an injury occurred within the course and scope of employment. If a hearing is necessary, you should consider hiring an attorney, although a person may represent himself or herself.
* A person does not have to live in a state to make a claim in that state. However, if a player or employee moves to a different state while receiving active treatment, he/she must notify the Industrial Commission or similar authority and the workers compensation carrier and obtain permission to leave the state temporarily or permanently.
* Keep the Arizona Industrial Commission and the workers comp insurer informed of your address at all times.
4. Compensation for temporary disability varies by state.
* Most states provide for payment of a percentage of the player’s or worker’s average monthly wage or average weekly wage during periods of temporary total or temporary partial disability.
* A player’s or an employee’s average monthly wage may be limited by an arbitrary statutory maximum wage set by the Legislature. For example, in Arizona, the current maximum average monthly wage (AMW) for injuries occurring in 2017 is $4521.92. The maximum compensation a player or worker may receive is 2/3 of his/her AMW, or a maximum of $3014.76 per month, paid bi-weekly or monthly. The maximum average monthly wage changes each year. Injuries occurring before 2017 are compensated based on the lesser AMW in effect as of the year of the injury. Benefits such as housing, utilities, etc., are to be included in the AMW if provided by the employer. Earnings from more than one job may be joined to determine the worker’s AMW.
5. Reasonable and necessary medical evaluation and treatment expenses are paid 100%, no deductible and no copayment.
* Medical expenses are paid according to a fee schedule that medical providers in a particular state are required to accept. If a player or worker seeks treatment in another state besides Arizona, medical providers in other states are not bound to accept the Arizona fee schedule payment and they may require the player or worker to pay the additional expense or bill the player’s or worker’s health insurance.
* Players and workers have the right to choose the doctors or medical providers who treat them with some limited exceptions.
* Supportive medical care benefits may be available to pay the cost of medications, therapy, doctor’s visits, etc., after the player / worker is discharged from active treatment, and even after the player / worker is no longer employed with the team or employer. This benefit requires a doctor’s statement of necessity.
* Payment for treatment is usually limited to what is considered medically reasonable.
6. Compensation is paid in stages.
* Temporary disability benefits are paid during periods of active medical treatment. If the player or employee continues to receive his/her contract salary, no temporary disability compensation is payable for the same period.
* Temporary total disability is paid when a physician has the player / employee off work entirely.
* Temporary partial disability is paid when a physician releases the employee to modified work, if there is a loss of earnings compared to the employee's Average Monthly Wage.
* Permanent disability benefits are paid after active treatment is concluded, depending on a physician’s rating of permanent impairment.
* Scheduled permanent disability benefits are paid for a limited number of months, set by statute, for injuries to one extremity or to one body part after active treatment is completed. For example a 20% permanent impairment to the leg after knee surgery for injuries occurring in 2017, for a player or worker with the maximum average monthly wage, results in payment of 10 months of compensation at $2262.46 per month (50% of the average monthly wage), or a total of $22,624.60, if the employee is able to return to playing or to the same job, or $3391.44 per month (75% of the average monthly wage), for a total of $33,914.40, if the player or worker cannot go back to the date of injury job.
* Scheduled permanent partial disability compensation is available for facial scarring, according to a schedule established by the Industrial Commission, depending on the length of scars and the visibility.
* Injuries occurring in previous years are compensated at lower rates due to the average monthly wage ceiling at the date of the injury.
* Unscheduled permanent disability benefits are paid for disabilities to the spine or whole person or to more than one body part, if there is a loss of earning capacity. The monthly amount depends on the player’s or worker’s loss of earning capacity. Unscheduled benefits may continue for life. The maximum unscheduled benefit for an injury occurring in 2017 is $3014.76 per month, continuing as long as the player / worker is unable to work and earn.
* No compensation for temporary or permanent disability is ordinarily available while a player / worker is receiving his/her contract salary.
* Temporary disability compensation usually ends when a player / worker is medically determined to be discharged, stationary or to have reached maximum medical improvement.
* Compensation for permanent disability usually requires a rating of permanent impairment by a physician using AMA Guides for rating permanent impairments.
* Scheduled permanent disability compensation is usually paid for a limited number of months established by the state’s legislature, depending on the percentage of impairment rated by the physician.
* Scheduled permanent disability compensation payments can be received even if the player / worker returns to playing or working with no loss of earning capacity.
* Unscheduled permanent total or partial disability benefits depend on the player / worker’s loss of earning capacity.
* Lump sum settlements of temporary or permanent disability compensation awards and medical benefits are possible if both parties agree.
In Arizona, claims that are once accepted may be reopened for the rest of a player or worker’s life, for future medical care or surgery, and additional payments of monthly compensation. It is necessary to have a doctor’s report to reopen a claim, stating that, comparing the player or worker’s condition when the claim was last closed with the present date, the condition related to the employment injury is new, additional or previously undiscovered and requires medical treatment. Objective findings of change or worsening are required. Be aware that it is necessary that the claim first be accepted when it occurs in order to be reopened later.
8. Third party claims (Negligence and Medical Malpractice)
* If a person or business entity (other than the employer or a co-employee) negligently causes or helps to cause an injury which is covered under workers compensation laws, it may be possible to bring a separate, additional claim for damages against that third party. Such third party claims may include claims for damages for pain and suffering, not included in workers compensation claims, and the full loss of earnings or future earning capacity, and medical expenses.
* State laws in Arizona require that the workers compensation carrier be reimbursed for payments it makes from any recovery of damages in a third party case.
* There are special time limits for filing third party claims. In Arizona such a claim must be filed in court within one year of the date of injury, or a reassignment from the workers compensation insurer is required to file the claim in the second year. If you are considering a third party claim, contact an attorney and do not let the first year pass without taking the necessary actions to preserve your rights.
* Medical malpractice claims may be brought against doctors or medical providers for injuries caused by negligent medical care provided for a workers compensation injury. In Arizona these claims must be filed within one year of the injury causing event or within one year of discovery of the malpractice. After one year, a reassignment from the workers compensation carrier is required to file in the second year. Carriers frequently do not reassign claims against physicians, especially team physicians, so the claim effectively must be filed within the first year.
9. When do you need an attorney?
* Actions taken by your workers compensation insurance company or the Industrial Commission are usually accompanied by a written Notice of Claim Status, which is mailed to you. If you disagree with the action taken, you have 90 days in which to file a written request for hearing at the Arizona Industrial Commission, from the date of mailing on the Notice. It is a strict 90 day time limit. While individuals may represent themselves, the insurance company will be represented by a lawyer and you are wise to retain an attorney to prepare and present your case at a hearing to secure your rights.
Contact an attorney immediately if you disagree with any action taken by the insurance company or the Industrial Commission, so a timely request for hearing may be filed.
* Common points at which you may need to hire an attorney:
1. If your claim is denied.
2. If medical care is denied to you, or limited, or not authorized, or not paid for.
3. If compensation is not paid to you and a doctor has you in a limited or no work status, and your employer is not paying you.
4. If your average monthly wage is set too low (usually anything less than the maximum for professional athletes).
5. If the insurance company attempts to close your claim and you are not yet fully recovered, and still in need of active treatment or rehabilitation.
6. If the permanent impairment rating assigned by the insurance company does not match what your doctor told you, or is too low.
7. If you need to reopen your claim and your petition is denied.
Any time you have questions about your rights or the actions taken by the insurance company or the Industrial Commission, feel free to contact Wayne Turley at 480-246-6505 or email@example.com. There is no cost or obligation to discuss your claim. Wayne has 35 years’ experience representing individuals in workers compensation and personal injury claims. He is a Certified Specialist in Injury and Wrongful Death Litigation, certified by the Arizona State Board of Legal Specialization. The attorney fee, if you decide to hire Wayne, is usually a contingent fee of 25% of compensation benefits obtained for you. That means there is no payment of an attorney fee until there is a recovery for you. Costs incurred in handling your case are usually advanced, and then reimbursed when compensation is received, so you have no out-of-pocket expense. If only medical benefits are involved, a flat fee may be arranged. You do not have to meet with Wayne to retain him in your case. Many of Wayne’s clients live in other states and all of them communicate with Wayne by email, phone, fax and mail. He will be available to speak with you whenever questions arise. You will find that he answers his own phone so you can speak with him directly. You will be treated like an individual, not a number or a case.
J. Wayne Turley, P.C. 1941 S. Pierpont, Suite 1117 Mesa, AZ 85206