ARIZONA WORKERS' COMPENSATION SUMMARY
As indicated above, a claim can be closed once it is determined that the worker is "stationary" and has received all the "active" medical care necessary for the particular injury. After the closure notice is final, the worker, at any time in the future, can file a PETITION TO REOPEN the case, if the job-related injury causes some new, additional, or previously undiscovered problem. Due to a recent court decision, under certain circumstances, a person with a claim denied by a NCS that has become final may now be able to reopen that claim just like someone whose claim had previously been accepted and closed. WE DO NOT ADVISE ANY CLIENT TO ALLOW A DENIAL OF A CLAIM TO BECOME FINAL despite this case because the circumstances that allow you to later reopen that denied claim are very limited!
A worker who experiences a new problem should go to a doctor. If the doctor relates the new, additional or previously undiscovered problem to the industrial injury, the worker should file a Petition to Reopen within 15 days after seeing the doctor. A report of the doctor relating the present problems to the previous injury should be filed with the Petition to Reopen if it can be prepared within that 15-day period; otherwise, it can be filed after the petition has been filed.
IT IS CRUCIAL TO REMEMBER THAT THE RIGHT TO COMPENSATION AND FULL MEDICAL CARE FOR THE WORKER DOES NOT START UNTIL THE PETITION TO REOPEN IS FILED AT EITHER THE ICA OFFICE IN TUCSON OR PHOENIX. A change in the law provides some exceptions where a surgery was an emergency, but it is always safer to follow the above rule. Certain tests and other non-surgical procedures can be covered 15 days before the filing, but it is always best to file the Petition to Reopen immediately after seeing the doctor. (The Petition to Reopen should be filed on a special form available at the ICA and at many doctors' offices and must actually be received by either the Tucson or Phoenix office of the ICA before the time limits begin to run.)
The Petition to Reopen is processed just like a new claim, and the insurance carrier/employer has 21 days after receiving notice of the Petition to Reopen from the ICA to accept or deny the Petition to Reopen by issuing a Notice of Claim Status (NCS). A NCS denying reopening must be protested within 90 days or it will be final. Failure to protest the denial of a Petition to Reopen will probably make it more difficult to reopen in the future.