Category: Workers’ Compensation Basics

In Iowa, most employers are mandated to carry workers’ compensation insurance for their employees. Under this “no fault” insurance program, you may file a claim for your workplace accident and have your medical bills paid for by your insurance, regardless of fault.

Here are three frequently asked questions about Iowa’s workers’ comp processes:

Can I go to my own doctor for my injury?

Your employer generally has an approved list of doctors where you can seek medical care. However, if your injury is a medical emergency and your employer or their representative is unreachable, you may choose your own doctor.

Your workers’ comp insurance can pay for all reasonable services and medical supplies, which may include doctors’ fees, hospital costs, surgery expenses, medicines, crutches, dentures, hearing aids, corrective lenses and more.

How long do I have to report my injury?

After your accident at work, you will have 90 days to report your injury or illness to your employer. However, if your symptoms develop gradually, you may report them to your employer at a later timeline, such as when you first discovered your injury or medical condition.

Keep in mind that not reporting your workplace accident within the given period may result in the denial of your claim.

Can I file a workers’ comp claim for an injury that I sustained on the way to work?

If you were hurt in an accident while commuting to work, your medical bills may not be covered by your workers’ comp insurance. However, there are exceptions to this rule. Three scenarios of this are as follows:

• You were on a business trip
• You were traveling between work sites
• You were doing a work-related task on your way to work

Since these situations are complex, it is ideal to consult with a lawyer who can help protect your rights by assessing the details of your accident and informing you of your next steps.

Your path to recovery should be easy

Being involved in a workplace accident is a challenging experience to go through. However, by taking your time to understand how the workers’ comp processes work in Iowa, you can file your claim while following the proper legal timeline and receive fair compensation for your medical costs and/or lost wages.

If you recently experienced a work-related illness or injury and are looking to file a workers’ compensation (WC) claim for financial assistance, you must follow your state’s legal procedures accurately and in a timely manner.

To help provide some insight into the process, here is a four-step guide on how you can file your WC insurance claim in Iowa:

Step 1: Report the accident to your employer

After your workplace accident, you must notify your employer as soon as possible. You will have a 90-day deadline to report your injury or illness, which can be done verbally or in writing.

You should try to avoid delaying your report, as this may raise questions about whether your accident happened at work or not. When this becomes the case, your employer and their insurer may doubt your WC claim’s validity and deny it.

Step 2: Seek medical treatment

Typically, your employer has a list of doctors where you can seek medical care. However, there are some urgent cases where you may choose your own doctor. For example, your injury is a medical emergency and you cannot reach your supervisor or employer.

After you get treated for your condition, make copies of your medical records, prescriptions and receipts. Keep in mind that your WC benefits can also pay for your medical-related travel expenses, ambulance service, hospital meals and/or lodging.

Step 3: File your WC claim

Filing your WC claim involves gathering supplemental documents that can strengthen your case. This can include your medical records, diagnosis results, media recordings of the accident site and witness statements from your workmates.

Step 4: If your WC claim is denied, contest your case

If you receive a denial letter, you can challenge this decision by filing a petition with the Iowa Department of Inspections, Appeals, and Licensing (DIAL) and serving it to your employer. You can do this on your own or with the help of a workers’ compensation attorney.

It is important to note that your petition needs to be filed electronically using DIAL’s workers’ compensation electronic system.

Your right to fair compensation

By understanding your rights and following the legal process involved, you can receive your financial assistance with minimal issues and focus on your recovery period.

Workers’ compensation benefits can be a lifeline for those injured or sickened at work. Unfortunately, many employees do not make use of workers’ compensation when they are eligible. Others make mistakes that limit the benefits that they receive. Learning the truth about the five workers’ compensation myths below can help employees feel empowered to pursue benefits after an injury.

What inaccurate information sometimes misleads injured workers?

Myth one: Employers have to opt into workers’ compensation

There are many different types of business insurance that are technically voluntary. Companies don’t have to carry business interruption insurance to comply with the law. However, workers’ compensation is different. Most of the time, employers have an obligation to carry workers’ compensation coverage. Those that do not want to pay for insurance typically have to qualify to self-insure and must follow appropriate steps with the state. Self-insured employers still have obligations to workers who get hurt on the job.

Myth two: Fault influences benefits

Many workers are not eligible for benefits if they are even partially at fault for their injuries. With exceptions for cases where people get hurt because of intoxication on the job or hurt themselves on purpose, fault generally does not influence eligibility.

Myth three: Only total disability leads to financial support

People may believe that only those who cannot work at all are eligible for disability benefits. There are actually four different types of disability benefits that apply in different situations. Temporary partial disability benefits can supplement the wages of those who must perform light-duty work until they recover. Temporary total benefits can help those who cannot work at all until their condition improves. Permanent partial disability benefits can help those who have lasting functional limitations after a work injury. Permanent total disability benefits are available for those who cannot work at all.

Myth four: Health insurance is the same as medical coverage

If an employer provides subsidized health insurance, workers might convince themselves to use that coverage instead of filing a workers’ compensation claim. The medical benefits available through workers’ compensation provide full coverage for necessary care. Workers do not have to cover the deductibles, copays and coinsurance imposed by private health insurance companies.

Myth five: Only on-site injuries qualify

Obviously, workers’ compensation can pay for the cost of treating an injury that occurs because of a job incident. Workers can also qualify for incidents that occur while they are on the clock but elsewhere, such as car crashes that occur while they work. They may also be eligible for coverage if they have occupational illnesses or repetitive stress injuries. Even pre-existing conditions that get worse because of employment may qualify for benefits.

Discussing workers’ compensation rules and personal medical concerns with a skilled legal team can help people determine if they can file a claim. Professionals who have the right support may find it easier to obtain workers’ compensation benefits when they need them.

Many workers are anxious about injuries incurred on the job. They may not want their employer to blame them for a drop in productivity. Oftentimes, workers assume that they can power through the end of their shift and then maybe see a doctor later. But, it’s generally a better idea to report the injury and to seek medical attention right away.

There are numerous rules in place for workers’ compensation claims in Iowa. One of the most basic requirements for a worker is the obligation to report the matter to their employer. How should a worker communicate with their employer about a recent work injury?

Prompt communication is crucial

Particularly in scenarios where workers have seemingly minor injuries, they may delay communicating with their employer. Doing so puts them at risk of losing their eligibility for workers’ compensation benefits. In most scenarios, employees need to notify their employer as soon as possible to ensure that they are eligible for workers’ compensation benefits. Iowa requires that someone notify their employer within 90 days of the injury or risk being ineligible for benefits.

Employers also have certain reporting requirements that they will need to fulfill, particularly when a worker must miss part of a shift or requires hospitalization. Ideally, workers will tell their employer about an injury as soon as they get hurt so that there aren’t any questions about the origin of their injury. That way, they can potentially take the remainder of their shift off and prompt medical evaluation and treatments.

Talking with a direct supervisor is often a good starting point, but workers will need to ensure that they abide by the company’s reporting rules. They may need to provide formal written notice to management or human resources in addition to verbally notifying their immediate supervisor. Proper medical documentation may be necessary in cases where workers need to arrange a leave of absence or require accommodations to return to work.

Knowing how to handle the reporting process can make a major difference for those injured on the job who are likely in need of Iowa workers’ compensation benefits. Seeking legal guidance is always an option for those who have questions and/or need additional support in this regard.

Whether you work in an office, warehouse, manufacturer, or other industry, you should be aware that on-the-job injuries can happen. No matter where you are employed, it is important that you know your rights and responsibilities in case of an injury at work. We often have clients contact us with questions about the timing of the injury and when it was reported, such as this one:

“My employer says I didn’t tell them about my injury in time, so I can’t get workers’ compensation. Is that true?”

Report a Work Injury ASAP

You should report your injury to your employer AS SOON AS IT OCCURS.  Even if you aren’t sure it is a serious injury, you should report it and make sure someone documents it.  However, the law actually allows you 90 days to report the injury to your employer.  Therefore, even if your employer tells you that you only had  24 or 48 hours to report it so you don’t have a claim, that is not true.  As long as you report it within 90 days of the event, you should push the employer to make a report and turn it into their insurance company. While the 90-day time limit for reporting work injuries may be extended for some very narrow reasons, it is best to document the event as soon as you can with your employer.

Serious acute injuries like a smashed finger or a fall are likely to be reported immediately because medical treatment will be required. As soon as you are able, be sure to communicate with your employer to ensure any serious injury has been documented.

Often we think we just pulled a muscle and it will go away with time. Sometimes, employees don’t want to report the injury for fear of repercussions from the employer or co-employees for making a claim.  Or you may realize that the tweak you felt in your back while lifting boxes on Thursday didn’t cause you pain until the weekend.

There are injuries that are due to repetitive work, such as lifting all day every day, standing all day, or using certain tools on a repetitive basis. This may cause the injury to gradually come on and slowly worsens.  You should report those injuries and request treatment as soon as you need medical care or if it causes you to miss work.

Whatever the situation, you need to keep the 90-day deadline in mind and report your injury as soon as possible.  It may also help you write it down and to tell a friend about the accident or event.

Remember to log the date and topic of conversations with your employer. Writing about those conversations will make it much easier to recall details should legal action be required.

When a work injury occurs, you may be entitled to reimbursements for medical care, mileage, healing period benefits, and other temporary or permanent disability benefits. So, when it comes to reporting a work injury, sooner is better. Read more about work comp benefits.

Document Medical Treatment, Mileage, Etc.

It will also help your claim if you document your medical mileage and any treatment you receive related to that injury. We recommend getting a notebook where you can track visits to the doctor, physical therapist, or other medical providers and track roundtrip mileage to those appointments as well.

If your work injury is serious, it may also benefit you mentally and emotionally to keep track of your pain levels and how and why they improve or worsen. Depression is a common side effect of serious work accidents and injuries, and you may be entitled to benefits if you are depressed because you are unable to work.

Take Pictures of Your Injury

Taking pictures of an injury may sound extreme, but they can be helpful for workers’ compensation claims. If an injury is visible, such as one causing bruising or a wound, take photos and start a file. You can then document the healing process and have the photos just in case.

In order to get work comp benefits, report a work injury as soon as you can— within 90 days—and document everything related to the injury. That includes taking and keeping good notes about the event date, details, and all treatment and discussions related to the on-the-job accident.

Know your workers’ compensation rights. Contact Wertz Law Firm for representation.

If you’ve been injured at work or know someone who has sustained a work-related injury, it’s important that you know about the benefits available under Iowa’s Workers’ Compensation law. The following is an overview of the benefits available.

Work Comp benefits include payment for medical treatments, four types of disability benefits, medical benefits, mileage/travel reimbursement and potentially loss of earning capacity (industrial disability) benefits. This article addresses the 4 types of disability benefits.  The disability benefits must be paid by the employer on a weekly basis. If the benefits are not paid to the worker in a timely fashion, the employer may have to pay penalties.

Four Types of Work Comp Disability Benefits

Injured workers who are unable to work while recovering from an injury may be entitled to one of the following types of disability benefits. Please note that an accurate calculation of the weekly amount is critical to ensuring that injured workers receive the compensation they are entitled to receive. Wertz Law often becomes involved in correcting weekly benefit amounts for injured workers and ensuring timely payment of their benefits.

Temporary Total Disability (TTD) — When an employer-approved doctor orders you to be off work for more than three days, even if they are not consecutive days, you are entitled to TTD benefits. Other physician-ordered restrictions can also trigger TTD. Learn more.

Temporary Partial Disability (TPD) — Employers sometimes offer lower wages when injured workers return to work because they can only perform light duty tasks, or you may be restricted to working fewer hours. If you return to work and make less, even if it is because you can’t work overtime, TPD helps compensate you for the loss of income.

Once an injured worker has reached the end of treatment, which is known as Maximum Medical Improvement (MMI), then they may be entitled to permanency benefits.

Permanent Partial Disability (PPD) — Sometimes an injured worker never fully recovers from their injury and is left with some level of permanent disability. Payment of PPD requires a functional impairment rating to be assigned by a physician based on a full evaluation. To learn more about the complexities of PPD and the length of time you can receive weekly PPD payments in Iowa for specific injuries, see our PPD table on the monetary benefits page.

In addition to the impairment rating, some injuries — NOT ALL — may qualify for additional PPD benefits beyond the rating if a workers’ earning capacity and ability to earn a living has been reduced by the injury.

Permanent Total Disability — If you cannot return to work and earn a gainful living as a result of the injury, you may be entitled to total disability benefits. If you believe you are permanently and totally disabled, you may have to seek legal counsel to get benefits beyond the impairment rating. Insurance companies and employers rarely volunteer this compensation.

Mileage and Travel Reimbursement Benefit

Injured workers are entitled to have all authorized and related medical treatment paid for by the workers’ compensation insurance carrier – including prescriptions. They are also entitled to reimbursement for travel expenses for treatment for the work injury. Even short trips to the doctor can add up when you are injured. Keep track of your mileage and be sure to request reimbursement for all appointments related to a work injury. If you are unable to drive due to the injury, the employer or insurance company should provide you with transportation to and from medical appointments and to and from work, in some cases.

We encourage you to spread the word to others about the different types of benefits for Work Comp injuries.

Please remember, if you get hurt on the job, report the injury immediately to your employer and begin documenting the event and all medical treatment related to the injury. You may also wish to contact a Work Comp attorney at Wertz Law to ensure you get the treatment and benefits you are entitled to receive. Contact us to learn more.

One of the most frequently asked questions we receive at Wertz Law Firm related to Iowa Workers’ Compensation Law is this: What if the work accident is my fault? Do I still get work comp payments? The simple answer is that it doesn’t matter who is at fault—you are still eligible for work comp if you report the injury within 90 days. Iowa work comp is available to help pay for your medical bills and related expenses, no matter if it was your fault or not.

Increasing your knowledge about work comp empowers you and helps ensure you get the benefits you deserve to receive. Learn about your work comp rights.

Fault Isn’t Part of Work Comp

Accidents can happen, and when it comes to accidents that happen while you are on the job, it does not matter if the accident was your fault, your employer’s fault, or co-workers’ fault.   You do not have to prove it was anyone’s fault and you still receive benefits even if it was your own fault.  A couple of examples help illustrate Iowa work comp law.

Let’s say you’re a construction worker and you look away while running a saw and run your hand through a saw blade, suffering a severe cut.  You should still report it to your employer, and you should still receive work comp benefits.

If you lift something you know is too heavy for you. You should still report it to your employer.

If you are a healthcare worker and you slip on water and fall while working, it doesn’t matter if you spilled the water on the floor. The workplace accident and any injury should be reported to your employer immediately. You should receive work comp benefits to treat work injuries, including coverage of medical bills and expenses related to getting treatment.

Note that in personal car accidents, fault is a factor if you have a case against the other driver. However, there are some differences when the vehicle accident occurs while you are on the job. Read more about work comp and work vehicle accidents.

Your employer and their insurance carrier may ask you how your injury happened for the purpose of making the workplace safer for everyone, but even if it was your fault, you should still be entitled to workers’ compensation benefits.

Here are the work comp benefit options, which include medical benefits as well as disability benefits.

Report the Accident ASAP

No matter how the work accident happens, follow these four steps to ensure you get the benefits you deserve. The most important step is the first one—report the accident and work injury right away!

When you know your rights before a work injury happens, you are a step ahead. Remember that Iowa is a no-fault work comp state. And, if you want help with a work comp claim, the experienced work comp attorneys at Wertz Law Firm can help. Contact us for a free work comp consultation.

You may also want to read this blog post

What If My Workplace Injury Is Not My Employer’s Fault?

If an injured worker has an accepted work injury and has been paid benefits through workers’ compensation for time off work (temporary total disability benefits; temporary partial disability benefits; healing period benefits; or permanent partial disability benefits), the injured worker is entitled to lifetime medical benefits for conditions related to the injury. The workers’ compensation insurance carrier is responsible to pay 100 percent of the medical bills and reasonable transportation costs. It is important to recognize the choice of doctors/care is the employer/insurance company’s responsibility. If an injured worker gets care on his/her own, it may be considered unauthorized and may not be paid for through workers’ compensation.

The normal medical course for an injured worker is to go through the authorized medical care, and at some point, the doctor is asked to assign a date of maximum medical improvement (MMI). When this happens, the claim benefits for temporary total disability benefits or healing period benefits will end. At that point, a determination is made by a doctor as to whether any further benefits are owed for permanent damage.

When maximum medical improvement (MMI) is assigned, in many cases the workers’ compensation insurance carrier acts as if no further medical care is necessary. Not true! Even though a doctor has released an injured worker from the medical care, that does not mean medical care is over. If an injured worker is still having problems, they should not accept there is nothing more that can be done. If the injured worker knows of other treatment or care that might help their condition, it should be brought to the attention of the workers’ compensation insurance company. If the workers’ compensation carrier refuses the care, it should be communicated by the injured worker that he/she is dissatisfied with the care being offered. If the workers’ compensation carrier still refuses, the injured worker can apply for alternate medical care with the Iowa Division of Workers’ Compensation. It is likely, prior to applying for alternate medical care, the injured worker should consult with an attorney who is knowledgeable and experienced in Iowa workers’ compensation.

The major point here is if an injured worker continues to experience problems, even if the company doctor says no more care is necessary, do not accept this, do not give up. There may be other doctors with more expertise or experience that can provide beneficial care. However, further treatment may be resisted by the workers’ compensation insurance carrier. If this happens, the injured worker would likely benefit from consulting with a workers’ compensation attorney. The attorneys at Wertz Law Firm have the knowledge and experience as workers’ compensation specialists to assist in getting the medical care an injured worker deserves. If you’ve been injured and have questions, contact Wertz Law Firm for a free consultation about your case.

If you believe you have suffered from a work-related injury or illness, the first thing you should do is report the injury to your employer.  Iowa law requires injured workers to report an on-the-job injury within 90 days of the injury.  There are circumstances which can alter this 90-day requirement, however, as soon as you suspect you have suffered from a work-related injury or condition, you should report that injury right away.  If your employer has a work-injury reporting form, you should complete that form and keep a copy for your records.  If no form is available, you should tell the employer about the injury and provide them with something in writing explaining that you were hurt at work and that you would like medical treatment for your injury.  Keep a copy of any written notice you provide and take notes about who you told, when, and what they said in response.

When reporting an injury in a non-emergency situation, you should request approval to see a physician and ask the employer where they would like you to obtain treatment.  In Iowa, the employer and its workers’ compensation insurance carrier have the right to direct your medical care.  Generally, this right includes the ability to select the first physician who provides treatment.  Many injured workers unknowingly choose to see their own family physician or go to a local clinic for treatment.  However, unless the employer or the insurance company have directed you to a particular place for treatment, they may be able to avoid paying for your medical treatment.  Additionally, they may refuse to honor restrictions or work-releases from unauthorized physicians.  It is very important you obtain authorization for any non-emergency medical treatment you seek.  If your employer refuses to submit your claim to the insurance company or refuses to direct you to an authorized doctor within a reasonable time period, you should contact an attorney.

Your rights and obligations under the workers’ compensation system can be complicated and highly dependent on your specific circumstances.  It is important that you gather as much information about the system as possible following an injury by reviewing the information on this website or by contacting an experienced workers’ compensation attorney.  Contact us for a consultation.

Many people have questions about whether they are entitled to workers’ compensation benefits. The basic triggers under Iowa law require that you establish that you were actually an employee and that you sustained an injury that arose out of and in the course of your employment. If you have established these facts, you are entitled to workers’ compensation under Iowa law. The types of compensation and the degree of compensation to which you are entitled are separate matters. However, with the above facts proven, you will be entitled to at least medical benefits. If you miss more than three days from work or have a permanent condition following your injury, you will be entitled to weekly compensation.

Occasionally, some employers will incorrectly inform their injured workers that they do not qualify for workers’ compensation benefits. They will make this determination based on the fact that the injured worker has not followed some internal company policy with regard to reporting the injury, with regard to pursuing medical treatment, or various other misconceptions about Iowa law. It is also important to note that Iowa workers’ compensation law is a no-fault system. Therefore, you are entitled to workers’ compensation benefits even if it was not the employer’s unsafe actions that caused your injury. There are many routes to full compensation that an attorney with experience can help you obtain. If you are unsure as to whether you are entitled to benefits or want a better understanding of what benefits may be available to you, contacting a workers’ compensation attorney experienced with these issues will, at a minimum, provide you useful information at no charge, and at best will produce a meaningful amount of compensation for you and your family.