Medical Benefits Under Arizona Workers' Compensation

A.R.S. §23-1062 is the statute that defines medical benefits in an Arizona workers' compensation claim. It requires the employer — in practice, the insurance carrier or self-insured employer administering the claim — to furnish medical, surgical, and hospital benefits and treatment, along with medicine, crutches, artificial limbs, and other apparatus that are 'reasonably required at the time of the injury, and during the period of disability.' That last phrase matters: the obligation isn't limited to emergency care right after the injury. It extends for as long as the injury continues to cause disability and treatment remains reasonably necessary.

The statute also covers costs workers often don't expect to be reimbursed for. If treatment requires traveling more than 25 miles from home, mileage is reimbursable. If a worker doesn't speak English well enough to communicate with a treating physician, the carrier is required to provide translation services during treatment. Neither of these is paperwork the carrier volunteers on its own — they typically need to be requested and documented.

Medical benefits only attach to an accepted claim, and acceptance isn't instant. Under A.R.S. §23-1061, once the Industrial Commission notifies the carrier of a claim, the carrier has 21 days to accept or deny it. If that window passes without a denial, the law treats the claim as accepted and requires compensation to be paid. Decisions on the claim — including denials of specific treatment — are communicated through what the ICA calls a Notice of Claim Status, sometimes referred to by its form designation, Form 104. Certain treatment, particularly anything beyond routine visits, may also need preauthorization before the carrier will pay for it, submitted on a form the ICA refers to as the MRO-1.1 Medical Treatment Preauthorization request.

The carrier also has the right to require an injured worker to attend an independent medical examination under A.R.S. §23-1026. Refusing or obstructing that exam doesn't just create friction — it suspends the worker's right to compensation, including medical benefits, until the exam takes place. That single provision is one of the more consequential ones in the medical-benefits process, because it means treatment can stop being paid for reasons that have nothing to do with the treatment itself.

• Missing the 90-day hearing deadline. Once a Notice of Claim Status denies treatment, A.R.S. §23-947 leaves only narrow room for exceptions — after 90 days, the denial is generally treated as final.
• Refusing or skipping an independent medical exam. A.R.S. §23-1026 allows compensation, including medical benefits, to be suspended until the worker submits to a scheduled exam.
• Assuming a doctor's referral is the same as preauthorization. Treatment that needs prior approval and doesn't get it can be denied and then has to be separately disputed.
• Letting mileage and translation reimbursements go unclaimed. These aren't paid automatically under A.R.S. §23-1062 — they typically require the worker to request and document them.
• Treating a partial denial as a minor issue. A denial of one treatment or procedure is its own Notice of Claim Status with its own 90-day clock, even if the rest of the claim remains accepted.