Understanding Workers’ Compensation - West Des Moines, IA

 

This information has been prepared by LAWYER, LAWYER, DUTTON & DRAKE, LLP to provide you with general information regarding the Iowa Workers’ Compensation Law.  But, heed the warning above about knowing a little bit about a complex area of the law. You are using the internet to gain information and this is fine. But, information alone won’t tell you all that you need to know. 

 

Because each case is different and has many unique features, it is impossible for us to cover all aspects of your individual case in this short information. Please understand that this information is not intended to constitute specific advice on your case. You should only rely upon the specific advice and direction that comes directly from one of our partners.

 

Remember that the law for work comp is different from state to state. What we present here is a brief overview of concepts found in the Iowa law. 

 

Under Iowa law, any employee who is injured on the job or while engaged in activities related to the job may be entitled to workers’ compensation benefits. Whether you are entitled to workers’ compensation benefits can sometimes involve complex legal and medical-legal analysis and any of our partners will be happy to discuss this with you. 

 

The definition of what falls within the category of an “injury” is very broad and includes almost any health impairment (i.e., heart attacks, diseases, PTSD, abnormal stressor other psychological conditions, etc.) If you have a specific question about an injury you have received, feel free to ask us whether or not it is covered.

 

Here are some key concepts to think about as you examine our website.

 

 

            If you have suffered a work related injury, it is important that you give written notice immediately to your employer. Unless the employer has actual knowledge of the occurrence of the injury within ninety (90) days from the date of the occurrence of the injury, you must give written notice to your employer within that ninety (90) day period or you will not be able to pursue a claim for workers’ compensation benefits related to that injury. You should be aware that there are some legal exceptions to this ninety (90) day rule. If you have concerns about this issue you should talk with one of our partners to see if you fall within one of these exceptions.

 

 

            There are variable time limits in which a suit must be filed or you waive your right to any recovery. In some cases, this is two years from the date of your injury. In other cases it can be three years from the date you were last paid weekly benefits. This is very complex so feel free to talk with our partners about this potential problem, especially if you have been paid weekly benefits. And remember, just because they paid for some medical bills, does not mean your time limit is extended. 

BENEFITS

 

            Since many workers do not know their rights, they believe that once they are able to go back to work, they are no longer entitled to benefits. This causes a great injustice to those individuals who have any type of permanent disability, whether it be a limitation of motion, decrease in strength, facial scar, abnormal stress, or a decrease in future job opportunities as a result of an injury. 

 

There are countless examples of permanent injuries that workers are not compensated for merely because they fail to make any claim after they return to work. 

 

Furthermore, you are entitled to lifetime medical benefits related to your injury unless you release that right. Finally, under certain circumstances, you may be entitled to job retraining benefits if vocational retraining is necessary for continued employment.

 

We have listed below a brief description and explanation of the benefits that you may be entitled to.

 

            1.         MEDICAL BENEFITS. The employer, through its insurance company, is required to furnish all reasonable medical services, including but not limited to medical, dental, chiropractic, physical rehabilitation, hospital services, or the supply of prosthetic devices. In addition, the employer’s insurance company is required to pay transportation expenses incurred by the employee going to and from his visits to the doctor.

 

            The employer has the right to choose the physician to whom you will be sent for treatment. However, you may request a different doctor if you have good cause to be dissatisfied with the service obtained from the employer’s doctors. If you are dissatisfied with the medical care you are receiving or you think that additional medical care would be beneficial, feel free to talk to one of our partners about it. Often times, we are able to get the insurance companies to cooperate with us in this regard.

 

            2.         BENEFITS WHILE YOU ARE UNABLE TO WORK DUE TO YOUR INJURY (TEMPORARY TOTAL DISABILITY/HEALING PERIOD). If you were injured on the job to such an extent that you missed work during the time you were recovering from your injury, you may be entitled to what is called temporary total disability payments or healing period payments. These payments commence on the fourth day of disability after your injury. If your inability to work extends beyond the fourteenth day following the injury your employer is required to add an additional three days of payments to your check during the third week to make up for the three day waiting period. Typically, the employer’s insurance company will voluntarily make these payments during the period you are unable to return to work.

           

            In the event you are unable to return to work but you have reached your maximum level of recovery, then the insurance company will attempt to cut off your temporary total disability benefits and attempt to settle your claim for permanent partial disability with you. If you cannot return to work the employer must give you 30 days notice of their intent to cut you off.

 

            3.         BENEFITS FOR PERMANENT PARTIAL DISABILITY (PPD). If you return to work, there is usually little dispute regarding the amount of temporary total disability payments to which you are entitled, and therefore, the insurance company will usually pay these fairly and voluntarily. At the point you have either returned to work or the doctors believe that no further improvement in your condition may be reasonably anticipated, the insurance company will determine what it thinks is a fair number of weeks, if any, that it will pay you for your permanent disability.

           

            You must remember that the insurance companies are not in business to protect your interest. The goal of the insurance company is to pay as little on your claim as possible. We believe it is important to place your case on file with the Iowa Workers’ Compensation Commissioner so that your case can be promptly tried if you are cut off from your benefits. Sometimes we will file cases while you are still in your healing period. Other times, we will wait until you have actually been terminated from your benefits.

           

            If you are able to return to work of some kind, but you continue to have some permanent disabling condition, then you may be entitled to permanent partial disability payments. There are two types of permanent partial disabilities under the Iowa law. 

 

The first type of permanent partial disability involves an injury to a “scheduled member”. If you suffered the loss or loss of use of a finger, hand, arm, toe, foot, leg, eye, permanent disfigurement to the face or head, or loss of hearing, then your disability falls within this category. If you suffered a compensable loss or loss of use of a scheduled member, you will be entitled to a certain number of weeks of compensation. The number of weeks is unrelated to how it affects your ability to earn wages.

 

            For example, a plumber who permanently injuries his wrist so that he can no longer engage in his occupation would receive the same amount as a lawyer with the same injury to his wrist who could continue with his occupation. Although this is a very inequitable and arbitrary manner in which to handle workers’ compensation for a scheduled member injury, it is what the Iowa law currently provides.

 

            The second type of permanent partial disability involves an injury to the “body as a whole.” This occurs when an injury produces a permanent disability that extends beyond a scheduled member into the torso/trunk or head. The most typical injuries of this kind would be an injury to the back, shoulder, hip, or a psychological injury. 

 

If you suffer an injury to the “body as a whole”, you will be entitled to benefits based on your “INDUSTRIAL DISABILITY” caused by the injury. Industrial disability takes into account not only the doctor’s rating of functional impairment, but also the employee’s age, education, training and the employee’s inability, because of the injury, to engage in employment for which he or she is fit. Because a severe scheduled member injury usually causes a psychological injury also, you may be entitled to compensation based on an INDUSTRIAL DISABILITY even though your original injury was to a scheduled member. 

 

IT SHOULD BE NOTED THAT PERMANENT DISABILITY PAYMENTS ARE AVAILABLE EVEN THOUGH YOU HAVE GONE BACK TO WORK OR HAVE FOUND WORK IN A DIFFERENT TRADE OR JOB.

 

            4.         BENEFITS FOR PERMANENT TOTAL DISABILITY. If you are unable to return to work for the rest of your life because of a compensable injury other than a scheduled member injury, you are entitled to permanent total disability benefits as long as you remain disabled or for life.

           

            5.         DEATH BENEFITS. These benefits are payable to the dependents of an employee in the event the compensable injury results in the employee’s death. These benefits are first payable to the surviving spouse for life or until remarriage. Dependent children are entitled to the benefit until they reach the age of 18 or age 25 if they are full-time students in an accredited institution. Others may also qualify if there is a showing of actual dependency. Upon remarriage, if there are no dependent children, these payments cease but the spouse is entitled to a two year lump sum settlement.

 

 

            The amount of weekly payments is dependent upon the amount of your gross earnings at the time of your injury and the number of deductions for federal and state income tax that you would be entitled to if you claim the maximum number of exemptions to which you were entitled. Call us and we can quickly check to make sure you are receiving compensation at the appropriate rate.