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Arizona court rules on scheduled injury claim

A ruling handed down by Arizona courts this summer has discouraged some workers' compensation seekers as they find that their injuries are categorized as scheduled losses. Experts say that scheduled injuries are those that are defined by the state using formal treatment terms and costs. Unscheduled injuries, on the other hand, fall outside the scope of those definitions and are generally subject to fewer payment restrictions.

The Arizona case revolved around a man who had injured both his knee and his ankle during a workplace accident. He accepted his employer's workers' compensation claim, and he underwent surgery to repair the damaged extremity. An administrative review concluded that the man had sustained a scheduled injury that comprised a 5 percent impairment of a lower extremity. As a result, the man was limited in the amount he could collect.

A state Court of Appeals affirmed that verdict, deciding that the man's injury was in fact defined under existing provisions.

The legal decision handed down in the case confirms that successive scheduled injuries may not be treated as unscheduled. That is, even though the man argued that the double injury could not be quantified according to the state's existing definitions, judges decided that his ailments could be lumped together into a single scheduled charge.

If the man had injured himself in successive accidents, he would have been able to collect an unscheduled claim. For example, if he twisted his left knee in April and then broke his left ankle in May, he would be able to collect unscheduled benefits. Since the injuries happened concurrently, however, the disability decision and 5 percent impairment ruling stood.

The worker and his legal team had argued that even though his injuries were caused by the same accident, he was entitled to the higher unscheduled amount.

Experts emphasize the importance of retaining a qualified workers' compensation lawyer in such cases to make sure victims receive fair and just compensation. The difference between scheduled and unscheduled injuries is sometimes subtle and difficult for the average worker to define, but legal counsel can help you wade through the complicated language to achieve the best outcome.

Source: Risk & Insurance, "Worker's argument for unscheduled compensation falls flat," Oct. 29, 2012

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