Arizona Worker's Compensation - Help For Injured Arizona Workers

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  1. #1
    Join Date
    Mar 2007
    Posts
    3

    Default Back Injury in Arizona

    Hi every one. I am writing this for my wife Eva who works for Express Scripts and hurt her back on 02/14/03. She has had 2 surgeries and the gamit times 5 of all the tests. She was determined to be 23% whole body impaired, by the surgeon who did the 2nd surgery. It has been a long struggle and we are very tired. Our attorney is a jack ass, and I think that all of them are the samed here in AZ. At any rate, we just went through I think the 3rd set of IME's and of coarse even thou the treating Dr's say my wife can't work, and as a matter of fact, her phsychiatrist has her off now for 90 days, the IC's Dr's all say she can work with no restrictions. So of coarse, now that she has been taken off of work, and we have received maybe 3 or 4 checks, they have stopped because the IC says she can work. Our attorney has gratiously returned one of 6 messages left for him asking where the check is and let us know these little tid bits of info. Guess it would have been nice to have him explain this possibility when she went to the IME's as I'm quit sure he was aware of what may happen. This forum is a great place I have found and is if nothing else letting vent off some steam from have what we feel is a very incompitent attorney. But, so late in the game, do we dare switch? We already fired one clown who did nothing but take 25% of her check that she was already receiving before we talked with him.
    Any way, we are just wondering if anyone knows what we can expect? The attorney at one time a little while ago was saying the IC may want to settle. But what the heck, now they cut off all money? Will she go with out medication? If so we are going to have a very big problem. She can NOT be without her meds, she will die from the pain. Wat, no more Dr? I mean what are we going to do???

    Will and Eva

  2. #2
    Join Date
    May 2007
    Location
    Calif
    Posts
    483

    Default Re: Back injury in Arizonq

    Good morning and welcome to the boards. 1st off I would not suggest that you not give personal details such as real names or ic's or employers --- just not a good idea when posting on an open internet board.

    You might start here with Arizona WC;

    http://www.ica.state.az.us/workersCo...ion/index.html

    If your wife has been declared mmi or p&s have you received a letter from the IC indicating the amount of permanent disability. In CA the WC has 14 days from the date the last TTD is made to advise you and start paying the pd amount.

    Also, since there appears to be a dispute between your PTP and the IC IME has your attorney requested an AME? to resolve the dispute?

    If your ptp says she cannot work, have your applied for SSI/SSDI or any other form of assistance? WC can be a nightmare and your attorney should be working for you. Send him/her a certified letter advising that ALL benefits have been stopped including her medication [if that is the case] and request that he/she immediately file for an expedited hearing, if appropriate with the Div of Work Comp for Arizona and their lack of communication to you is inappropriate. If you feel that your attorney is not working for you, explain that in a professional way and inform them that you will if necessary contact the powers that be.

    If you have private insurance and WC is denying benefits, they may step in and provide coverage while you deal with the wc process.

    I'm sure others more in the know about Arizona Laws can provide better details or more indepth information.

    Again, welcome to the boards.

  3. #3
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Back injury in Arizonq

    generally health insurance will pick up care denied by workers comp.
    I wouldn't advise your wife to go fire her second atty--it'll start to look like the problems are not with the attys. Cases are difficult enough to win without the doctors and judges prejudging the clients.

  4. #4
    Join Date
    Mar 2007
    Posts
    3

    Default Re: Back injury in Arizonq

    Quote Quoting roofinfool View Post
    Good morning and welcome to the boards. 1st off I would not suggest that you not give personal details such as real names or ic's or employers --- just not a good idea when posting on an open internet board.

    You might start here with Arizona WC;

    http://www.ica.state.az.us/workersCo...ion/index.html

    If your wife has been declared mmi or p&s have you received a letter from the IC indicating the amount of permanent disability. In CA the WC has 14 days from the date the last TTD is made to advise you and start paying the pd amount.

    Also, since there appears to be a dispute between your PTP and the IC IME has your attorney requested an AME? to resolve the dispute?

    If your ptp says she cannot work, have your applied for SSI/SSDI or any other form of assistance? WC can be a nightmare and your attorney should be working for you. Send him/her a certified letter advising that ALL benefits have been stopped including her medication [if that is the case] and request that he/she immediately file for an expedited hearing, if appropriate with the Div of Work Comp for Arizona and their lack of communication to you is inappropriate. If you feel that your attorney is not working for you, explain that in a professional way and inform them that you will if necessary contact the powers that be.

    If you have private insurance and WC is denying benefits, they may step in and provide coverage while you deal with the wc process.

    I'm sure others more in the know about Arizona Laws can provide better details or more indepth information.

    Again, welcome to the boards.
    Yes, she was determined to be at MMI years ago. No, no letter indicating the amount of disability. I don't know what p & s is so I can not comment. Also not sure what a PTP is either. What is an AME? Our atty claims he has applied for disability about a year and ahalf ago or 2 years now. Still has no info regarding this. Every meeting we have it's the same answer. "I'll have So and so check on it" and we never hear anything until our next meeting which we get the same answer as the last meeting. We shouldn't need to send our atty any letter stating befefits having been stopped as he sent us the letter indicating the IC's decision. The letter states there is perminent disability, just not how much. It also states they feel there is no loss of wages as her employer has a position for her, which is in fact false. The employer "created" a position for her while on WC, and have already told her she is not producing what they want and they have nothing in writing that indicates she should be treated any different than anyone else. Funny, they do have the list of restrictions. Not sure what that means. They told her she needs to make a decision. Translation? I would guess quit or we'll fire you. So, they have a job for her? I doubt it if the IC settles...I would bet she gets fired the day she returns to work.
    In regards to contacting the powers to be, that would be what is called ACAP. I have contacted them and they agree, he is not acting properly. I have not filed a complaint as of yet because they said if I do, he will most certainly quit representing her. It's too late in the game for that I think.

    W & E in AZ
    Last edited by wtucker; 09-07-2007 at 09:30 PM.

  5. #5
    Join Date
    May 2007
    Location
    Calif
    Posts
    483

    Default Re: Back Injury in Arizona

    Roofs wife here: P&S in CA is permanent and stationary [under the old disability schedule], now MMI - maximum medical improvement [under the new rules] PTP, is your Primary Treating Physician. AME is an Agreed Medical Evaluator/Examiner. An AME process is brought about by the iw's attorney if you are unreppd it is a Panel Qualified Medical Evaluator/Examiner.

    Charles has given you good advice ---

    When you say your attorney has applied for disability? what kind, type etc., if your wife has returned to her job in a modified position and her income is greater than SSA's rules, she may not qualify for SSDI.

    For how long has your wife been preforming her modified duties with her employer? It would appear that they [ER] did engage in some form of the interactive process to find modified work based on her doctors restrictions, which they acknowledged?--- what has changed? since you indicate when she returns to work......

    I do believe that ADA would apply and if your wife's employer has made accomodations and now wants to change their mind, she may have additional recourse against the employer. Others with more legal knowledge should comment on this..........outside my scope......

    In addition, you indicated that your wife reached MMI several years ago, again not sure about AZ laws ---- so are you saying that WC found no % of disability for compensation?

    Sorry to hear of your problems, but those in the know on these boards can provide you with some very good resources, the more you learn the more you will have a hand up, so to say........

  6. #6
    Join Date
    Mar 2007
    Posts
    3

    Talking Re: Back Injury in Arizona

    I have to appologize to all. I thought I was on a board that was specific to Arizona. It is titled "Arizona Workers Compensation".

    Thank you all for the thoughts, but we are much, much further along on this case than you all seem to interpret. I am looking for Arizona specific info. Not California. But thanks any way.

    I will respond the email below however.



    Quote Quoting roofinfool View Post
    Roofs wife here: P&S (What is P&S?, If it's pain and suffering, I'm told there's no such thing in workers comp cases) in CA is permanent and stationary [under the old disability schedule], now MMI - maximum medical improvement [under the new rules] PTP, is your Primary Treating Physician. AME is an Agreed Medical Evaluator/Examiner. No such thing in AZ. An AME process is brought about by the iw's attorney if you are unreppd it is a Panel Qualified Medical Evaluator/Examiner.

    Charles has given you good advice ---

    When you say your attorney has applied for disability? what kind, (
    Social Security, I assume is the only kind available to workers comp injury)type etc.,

    if your wife has returned to her job in a modified position and her income is greater than SSA's rules, she may not qualify for SSDI. (She had been out of work due to this injury for over a year when we applied. Since then she has been back to work for a year or so, and now is off again)
    For how long has your wife been preforming her modified duties with her employer? (See above response) It would appear that they [ER] did engage in some form of the interactive process to find modified work based on her doctors restrictions, which they acknowledged?--- what has changed? (What has changed with what?) since you indicate when she returns to work......(Because the IC Dr's say she can work with no restrictions.)I do believe that ADA (I have no clue what ADA is) would apply and if your wife's employer has made accomodations and now wants to change their mind, she may have additional recourse against the employer. Others with more legal knowledge should comment on this..........outside my scope......
    (The employer created the position just for her. They are now telling the IC they want to settle this. The IC has indicated they want to settle with a one time lump sum payment in return for stopping all claims for disability and medical and prescriptions etc.....)
    In addition, you indicated that your wife reached MMI several years ago, again not sure about AZ laws ---- so are you saying that WC found no % of disability for compensation? (WC hasen't found anything. The surgeon told her she was 23% whole body impaired)
    Sorry to hear of your problems, but those in the know on these boards can provide you with some very good resources, the more you learn the more you will have a hand up, so to say......(Well, that's why I joined)..

  7. #7
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,930

    Default Re: Back Injury in Arizona

    Wtucker,

    The absolute best thing you and your wife can do to know what she is entitled to under Arizona WC laws is to go to the AZ WC web site and learn all you can from what they have on the web site. Then you don't have to question if someone's information is or isn't applicable for your wife in AZ.


    http://www.ica.state.az.us/workersCo...ion/index.html

    This is an even better site for specific laws and statues

    http://www.workerscompensation.com/r...?state=arizona

    You say her surgeon gave her a 23% whole body impairment right? Has she also been sent for a Functional Capacity Exam, FCE? That is the norm for most states to determine what the level of impairment is and what the lump sum permanent partial disability, PPD will be based on.

    You also have future medical to consider. If you do a compromise and release settlement then funding for her future medical would be included in the lump sum settlement. The IC would be off the hook for any further medical treatment.

    You may also be looking at a stipulated settlement which would pay her the PPD and keep future medical open. This is advised IF she is looking at needing very much medical treatment in the future.

    Has the insurance company, IC, made any sort of offer for settlement. Since she is currently represented has her attorney made any sort of settlement proposal to the IC?

    You also indicate that SSDI is applied for. That being the case and if she is approved or still pending approval ANY settlement agreement MUST take Medicare's interests into account. Usually with a Work Comp Medicare Set Aside, WCMSA or MSA. This is something that you certainly NEED to become very familiar with as Medicare will not cover WC injuries until such time as money put in that MSA is used up. You can learn more about MSA here:

    http://www.jjcelderlaw.com/SSDIOffsetMSABull.htm

    http://www.cms.hhs.gov/WorkersCompAg...wcsetaside.asp

    Good luck to ya'll and let us know how things are going.

    Steel
    Last edited by SteelMagnolia; 09-11-2007 at 09:37 PM.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  8. #8
    Join Date
    Jan 2009
    Location
    arizona
    Posts
    1

    Default Re: Back Injury in Arizona

    I feel for you....we are in the middle of trying to settle with workers comp and are absolutely frustrated!!!! We have been dealing with this for the last 4 years. My husband has had 4 back surgeries in the last 4 years. We went to the doctor for an emg tests last week and the results were that my husband now has permanent nerve damage, there is not much else that they can do for him, we were informed that it will only progress and worsen. The only thing that they can do is to treat it with meds.

    Amazingly workers comp is still trying to fight us saying that he should be able to work. They have no idea what we go through everyday. They are not at our house when he falls and I have to pick him up off the floor. they have no idea......I would love to see them even try to function in our capacity.

    We have lost almost everything and are barely trying to hold on to our house, barely. We are in debt up to our ears, but they do not care. My husband was given the same whole person impairment, even after 4 surgeries. His treating phsycian and pyschical therapist says he cannot work yet the IME doctor says he can.

    We too are dealing with an attorney that seems to be condscending to us and fights against us with everything. We are trying to find out if there is a lump sum settlement, he tells us that there is none only monthly payments. Does anyone know if that is true or not.

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