This webpage covers Workers' Compensation (often called in other states Workmans' Compensation), summarizing the benefits, filing procedures, and appeal procedures in Iowa. Workers' Compensation cases are work related injury cases which involve Iowa statutes, regulations and court decisions. Specific time lines and procedures are required by law. I strongly recommend that persons with work related issues contact an attorney quickly to determine their rights, the proper procedures for processing claims, and what benefits you might be entitled to.
Workers' compensation is a no-fault system of paying for injuries that "arise out of" and in "the course of employment." These two terms are the key to receiving benefits from a work injury. Certain injuries are not covered because they don't fit these definitions, and injuries that you might not consider as being covered may be covered. Negligence is not an issue in workers' compensation, the issue is whether the injury is work related. Thus, even if the employee caused the injury, Workers' Compensation could still be responsible for paying for the injuries, even if the employee was fired because of his/her actions. At the same time, Workers' Compensation may be the only source of payment of the injuries. Thus, the employee may be unable to sue the employer for his/her injuries except through the Workers' Compensation system.
Benefits: A worker with an injury that arises out of and in the course of employment may be entitled to medical benefits; temporary or permanent benefits; vocational habilitation benefits; reasonably necessary transportation expenses incurred for medical treatment (currently 58.5 cents per mile for each medical round trip); penalties if benefits are unreasonably denied, delayed, or underpaid; interest; costs; payment for a second physician's opinion; and second injury fund benefits.
The Process of Filing a Contested Case:
An
initial interview with a attorney is advised if your employer is not paying benefits that you feel you might be entitled to receive. At the interview, the attorney will evaluate your claim and determine if grounds for a contested claim exist to file with the Iowa Industrial Commissioner.
Medical records and X-rays must be gathered from the treating physician. This is the first step to filing a petition.
After gathering the necessary records, an
Arbitration Petition is filed with the Iowa Industrial Commissioner and the employer and the Second Injury Fund of Iowa are provided with service of process.
A
second opinion examination by a physician of your choice is demanded and should be paid for by the employer.
Discovery begins by gathering information from the other parties.
Once this second opinion examination is received, it is
served on the other parties to the action.
If additional benefits are due, a
demand is made upon the employer and the Second Injury Fund of Iowa.
Settlement talks or mediation are conducted to attempt to obtain these benefits. Due to the length of time for hearings and trials, informal settlement is usually the most time efficient method to obtain benefits, but if the case goes to hearing or trial, interest accumulates, and a decision is based upon the facts in the case. Penalties can be awarded if there is no sound basis for denying or delaying the benefits, and thus there is an incentive to the employer to settle the case informally.
If informal settlement methods are unsuccessful, then a
hearing is held with the Industrial Commissioner's Office. This is similar in many ways to a trial in which witnesses can testify and evidence presented. You will have to testify and be subject to cross examination. The Administrative Law Judge in the hearing makes a decision (usually taking 3-6 months).
An
appeal from the Administrative Judge's decision can be taken to the Industrial Commissioner. This may take another 6 months to a year for a decision on the appeal.
The decision of the Industrial Commissioner can then be
appealed to the District Court, and then to the Court of Appeals or the Iowa Supreme Court. This process can take between 1-2 years (for a total time of 3-4 years).
The Iowa Workforce Worker's Compensation site is located at
Division of Workers' Compensation.
Choice of Doctors
Often the injured worker complains about the choice of doctors that the workers' compensation insurance company has selected. Unfortunately, Iowa law allows the insurance company to choose the doctors for the entire healing period. However, the treatment must be offered promptly and reasonably suited to treat the injury without undue inconvenience to the employee. Thus, unless there is an issue with the treatment the Commission which decides the case, would probably decide with the insurance company, but does decide cases based on their merits on a case by case basis. If the injured worker refuses to undergo the prescribed treatment however, benefits could then be denied by the Commission.
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