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- note that mileage changes and may not be up to date); penalties if benefits are unreasonably denied, delayed, or underpaid; interest; costs; payment for a second physician's opinion; and second injury fund benefits.  
    Medical benefits  include medical treatment including doctor's fees, prescriptions, and mileage to medical appointments.
    Healing Period/Temporary Disability (TTD/TPD) benefits:  These benefits are a weekly payment while the worker is recovering from the injury and unable to work or is limited in the number of hours that he/she can work, or for a reduction in income due to the injury.
    Permanent benefits: An injured worker may reach the maximum medical improvement (MMI), allowing the benefits to shift from temporary payments to permanent benefits.  If there is a permanent impairment rating and/or permanent restrictions, an injured worker may receive permanent benefits.  
      Benefits depend upon the part of the body which was injured, the disability, and the determined rate.  If the worker is paid on an hourly basis, the rate generally is based on the average wages for the 13-week period immediately preceding the injury, excluding any short weeks.  The weekly rate is based on marital status, exemptions, and the Average Weekly Wage (AWW) (AWW multiplied by 80% of spendable weekly earnings). Permanent benefits have minimum and maximum rates that are considered.
    injuries are scheduled or unscheduled injuries.  Scheduled injuries include: arm (max 250 weeks), hand (190 weeks), leg (220 weeks), foot (150 weeks), foot (150 weeks), thumb (60 weeks), 1st finger (35 weeks), 2nd finger (30 weeks), 3rd finger (25 weeks), 4th finger (20 weeks).  Scheduled injuries are calculated on the number of weeks times the impairment rating.  Thus for a maximum arm injury with a 10% impairment rating equals 25 weeks of benefits (250 weeks times 10%).
    Unscheduled injuries are also known as Body as a Whole Injuries.  These include shoulders, nervous system, back, mental, neck, respiratory, circulatory, and related injuries.  These can include depression, chronic pain, asthma.  Unscheduled injuries are based on 500 week maximum. However, other factors such as age, restrictions, lost wages, education can increase the number of benefit weeks.
    Second injury fund: If the worker has suffered a previous scheduled member (leg, knee, foot, eye, arm, or hand) injury, and then suffers another work related scheduled injury, payment may be made from the Iowa Second Injury Fund.  It is important to understand that the initial injury need not be work related. 
    Death benefits:  Benefits may be paid to the dependents of the worker, including the spouse and children.  It is important to realize that Iowa has common law and same sex marriages and these can qualify for benefits.  Additionally, the dependents may not even need to be related, but depend upon the worker at the time of the death. 
    


The Process of Filing a Contested Case:

        Notice of Injury: The injured worker must notify the employer within 90 days when the worker knew or should have known that he/she sustained a work related injury.  The employee then generally has 2 years to file a petition with the Iowa Worker's Compensation Commission (3 years if the employee was paid weekly worker's compensation benefits). Benefits can be confusing though, as the payments may not have been worker's compensation benefits but may have been short term disability payments, medical expenses, etc.  

       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.