Q: Question regarding Arizona workers comp law
if there is an open (accepted) work comp claim, but carrier is denying/delaying treatment, can one proceed with treatment under private insurance until authorization is received for treatment by workers comp carrier? Additionally, if there is an open accepted workcomp claim and carrier is delaying authorizing treatment, if an individual proceeds with treatment under private insurance, without waiting for authorization from carrier, can carrier then come back and deny responsibility because of this, specifically if they were not given the opportunity to evaluate and perform IME? I looking for general guidance on AZ work comp laws, not a specific case.
A:
There aren't a lot of lawyers answering workers' comp questions in AZ, but you can use the find a lawyer tool to look for one to contact.
Please Take Notice: I am not your lawyer unless we enter into an engagement agreement in writing. This is only general information. It is NOT legal advice, and it may not work for your specific situation. It is impossible to evaluate a legal problem without a comprehensive consultation and review of all the relevant facts and documents. I strongly encourage you to consult with a local lawyer to get...
A: The choice to rely on private insurance for payment of medical bills from a work injury depends on what is and is not covered by the private insurance plan, many of which include work injuries and illnesses in the excluded conditions section. You may find that the private carrier denies coverage after you have had the medical care. The answer depends, again (sorry, but everything depends on facts) on what medical care is at issue, if the denial is supported by any medical opinion (including one you don't like), if the delay is to get a second medical opinion, the seriousness of the medical condition, and the risks from the delayed treatment. The first thing to do, with or without a lawyer, is to request a hearing at the Industrial Commission of Arizona because the insurance company is denying or delaying treatment recommended by a qualified health care provider.
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