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Workers' Compensation Program Overview Statutory Benefits Explanation-Current.doc

Workers' Compensation Program Overview Statutory Benefits Explanation-Current.doc

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DEPARTMENT OF ADMINISTRATION WORKERS’ COMPENSATION PROGRAM OVERVIEW Statutory Benefits Explanation and Notification Policy Manual
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ADOA – Workers’ Compensation Program Overview Statutory Benefits Explanation and Notification Policy Manual INTRODUCTION In July 1983, by legislative mandate, the State of Arizona became self-insured for workers’ compensation. On January 1, 1994, the Workers’ Compensation Unit of Risk Management became responsible for claim administration including medical benefits, compensation, rehabilitation, subrogation, and litigation management. Workers’ compensation provides benefits for work-related injuries or occupational illnesses arising out of and in the course and scope of employment, in accordance with A.R.S. 23-101 through 23-1091 and the Industrial Commission’s Workers’ Compensation Practice and Procedures. The Arizona Department of Administration, through Risk Management has statutory responsibility to manage the self-insurance of the Workers’ Compensation Program pursuant to A.R.S. 41-621 ET.SEQ. The Workers’ Compensation Unit ‘Unit’ is headed by the claims manager, who reports to the State of Arizona risk manager. The management includes an administrative assistant II, two claims supervisors, who respectively oversee the tasks performed by claims specialists, adjusters, clerks and a trainee. It is the responsibility of the Workers’ Compensation Unit to implement cost-effective measures and enhance communication with employees and agency personnel without jeopardizing benefits as provided by law. The need for excess insurance is reviewed annually. The Arizona Workers’ Compensation Law is administered by the Industrial Commission of Arizona (ICA). Workers’ Compensation is a “no-fault” system in which the injured worker receives medical care and compensation benefits without consideration as to fault. Under Arizona Workers’ Compensation Law, a claim must be filed by the injured worker or his legal representative within one year of becoming aware of a work-related condition. In some situations, exceptions to this requirement are considered by the ICA. When the injured worker seeks medical care for a work-related WC Program Overview | 09-12-2014 2
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ADOA – Workers’ Compensation Program Overview Statutory Benefits Explanation and Notification Policy Manual condition, they should notify the medical provider that the claim should be filed with State of Arizona – Risk Management – Workers’ Compensation ‘Workers’ Compensation’. The injured worker and the medical provider should each complete their respective section of the form titled the “Worker’ and Physician’s Report of Injury” (generally, the form is pink). The provider’s office will send the original of the form to the ICA, a copy to the employer and a copy to the State of Arizona – Risk Management. Once the ICA receives the properly completed form, the ICA will notify Risk Management that the injured worker has properly filed a workers’ compensation claim.
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