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  1. #1
    Join Date
    Sep 2010
    Posts
    2

    Default Workers Comp Denied "Because Its Been Too Long Since the Accident Report"

    I injured my knee in February and filed an accident report with my employer and saw the nurse at work. My knee has bothered me ever since and has gotten progressively worse. I cannot straighten or bend all of the way nor walk without a limp. In August I went to my employer and was told that my claim is denied due to the time elapsed since the original injury. I did not go to the doctor in February and did not miss any work. I went to my gp doctor in July and he sent me to an orthopedic specialist who ordered an MRI. I have a torn meniscus that requires surgery.

    I believe that I should have some recourse but am not sure where to start as I have never been injured or dealt with workman's comp in my 25 years of working.

    Is my employer correct regarding the elapsed time? Does anyone know anything about the law regarding such a claim? Where should I go first?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,073

    Default Re: Denied "Because Its Been Too Long Since the Accident Report"

    you have one year to file. unless the employer is self-insured the denial has to be in writing from the carrier. contact the carrier directly if it hasn't been done.
    you can also file/appeal to the comp court.
    more information here:
    http://www.ica.state.az.us/Claims/Cl...g_a_Claim.aspx

  3. #3
    Join Date
    Oct 1971
    Posts
    5,193

    Default Re: Denied "Because Its Been Too Long Since the Accident Report"

    wortham1057
    I injured my knee in February and filed an accident report with my employer
    In August I went to my employer and was told that my claim is denied due to the time elapsed since the original injury. I did not go to the doctor in February and did not miss any work.
    Is my employer correct regarding the elapsed time?
    Nope.
    It is the injured worker’s responsibility to file a claim within one year of the date of injury. The injured worker should also notify the employer as soon as possible that a work-related injury has occurred.
    http://www.ica.state.az.us/Claims/Cl...g_a_Claim.aspx

    If they want to play that game, file another claim, you have one year from the date of injury.
    here's the claim form.
    http://www.ica.state.az.us/Claims/Fo...rtOfInjury.pdf

    Read more here, it explain everything.
    http://www.ica.state.az.us/Claims/Claims_main.aspx

    Or hire an attorney, it sounds like they want to make a game out of it, lawyers love to play.

    Take Care
    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  4. #4
    Join Date
    Sep 2010
    Posts
    2

    Default Re: Denied "Because Its Been Too Long Since the Accident Report"

    Thanks for your insight. I believe that my employer is self insured. It is the largest school district in the state and is my understanding that they are self-insured whatever that means. If they are self-insured does that make a difference?
    I have never had a knee injury nor seen a doctor about my knee. I have been asked to provide the names and addresses of any doctor's that I have seen in the past ten years.

  5. #5
    Join Date
    Oct 1971
    Posts
    5,193

    Default Re: Denied "Because Its Been Too Long Since the Accident Report"

    wortham1057
    If they are self-insured does that make a difference?
    Nope.

    The two divisions within the Industrial Commission which are primarily responsible for monitoring the activities of insurance carriers and for deciding disputes that arise between claimants, employers, and insurance carriers are the Claims Division and the Administrative Law Judge (ALJ) Division.

    The Claims Division is charged with the responsibility to regulate the insurance carriers and self-insured employers that process claims filed by injured workers, and to insure that workers receive those benefits to which they are entitled under the Arizona Workers’ Compensation Law.

    Same rules apply to all
    I would suggest having no further correspondence with them until you consult a lawyer, it cost you nothing up front, they work on a contingency basis.
    Tony
    Last edited by tony; 09-06-2010 at 07:35 PM.
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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