In Arizona, an injured worker with a compensable claim is entitled to coverage for “medical, surgical and hospital benefits or other treatment, nursing, medicine, surgical supplies, crutches and other apparatus, including artificial members, reasonably required at the time of the injury, and during the period of disability.” [1] The Arizona Supreme Court has stated that there are two statutory requirements that must be met for benefits to be covered under the statute. The first requirement is that “the services must fall within one of the categories listed in the statute.” [2] The second requirement is that the services must be “reasonably required.” [3]The reasonable necessity of care is a medical question.
Because the “reasonable necessity” of care is a medical question, the best way to illustrate what potential medical coverage is available is to look at rulings in past Arizona workers’ compensation cases. For example, in Terry Grantham Co. v. Industrial Commission, the Arizona Court of Appeals ruled that modifications to an injured worker’s home and van was reasonably necessary due to his industrial accident which rendered him a quadriplegic. [4] In addition, in Regnier v. Industrial Commission, an injured worker became a quadriplegic as a result of his industrial accident. [5] Due to his injury, he was unable to father children the normal way. The Arizona Court of Appeals ruled that a medical procedure that would allow him to father a child may be covered if it will replace a bodily function lost as a result of an industrial accident. On the other hand, in the case of Patches v. Industrial Commission, the Arizona Court of Appeals ruled that an industrially injured claimant was not entitled to receive housekeeping services pursuant to A.R.S. § 23-1062(A). [6] Thus, as these cases illustrate, the potential medical coverage available is quite vast but does have limitations.
You should contact an attorney from Fendon Law Firm, P.C. to ensure you are receiving the best medical treatment available and are receiving all benefits you are entitled to under the Arizona workers’ compensation system. At Fendon Law Firm, we are a compassionate family workers’ compensation firm that cares about each and every one of our clients. Please feel free to contact Fendon Law Firm for any questions about workers’ compensation, Social Security disability, or employment law issues. We now have offices in Phoenix, Flagstaff, Scottsdale, Tucson, and Prescott Valley.
[1]Ariz. Rev. Stat. Ann. § 23-1062(A).
[2] Carbajal v. Indus. Comm’n of Arizona, 223 Ariz. 1, 3, 219 P.3d 211, 213 (2009)
[3] Id.
[4] 154 Ariz. 180, 741 P.2d 313 (Ct. App. 1987).
[5] 146 Ariz. 535, 707 P.2d 333 (Ct. App. 1985).
[6] 220 Ariz. 179 (Ct. App. 2009).
