Brian Clymer, Attorney at Law

Commission to require notices for 'medical only' claims starting in mid-August

Beginning later this summer, workers' compensation carriers will have to issue a "notice of claim status" when accepting a "medical only" claim. The change will inform injured workers that the carrier has accepted medical liability for the claim. "Medical only" claims are those which pay for the injured worker's medical bills from the injury, but not for lost wages because the injured worker's disability from the injury did not continue in excess of seven consecutive days. 

The Industrial Commission of Arizona issued a "Substantive Policy Statement" in mid-May announcing the change, which should make it clearer to injured workers that the claim has at least been accepted for medical benefits. Previously, carriers were not required to issue a notice of claim status for "medical only" claims because they had the option to accept claim through "informal processing" by indicating acceptance on the notification list to the ICA. The new requirement goes into effect on August 20, 2018. (See announcement of policy change here)

Injured workers, however, should be careful to review any Notice of Claim Status received from the carrier because typically the claimant only has 90 days from the date the notice is mailed to protest it. If there is anything on the notice that the claimant disagrees with, the injured worker should consult a workers' compensation attorney.

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