A workplace injury can put your financial wellbeing in jeopardy. Fortunately, Iowa workers’ compensation insurance should cover your injuries.
No one is ever prepared for a work injury. Luckily, Iowa law requires almost all employers to carry workers’ compensation insurance policies. This should give you some peace of mind that you’ll be protected in the case of an illness or injury at work.
However, certain circumstances can cause delays and denials to your claim, and sometimes enlisting the help of an experienced workers’ compensation lawyer can be the best way to obtain access to your benefits in a timely manner.
Immediately following your injury, you should see a medical professional, both to ensure your condition is stable and for documentation purposes. Your next step will be to notify your employer, both verbally and in writing, of your injury. Failure to do so within ninety days of the incident can result in a denial from the Iowa work comp insurance provider.
After you’ve notified your employer, it will be up to the employer to fill out the workers’ comp claim form. Information the insurer will need typically includes where, when, and how the injury occurred, the extent of your injuries, the treatment you received, whether anyone else was involved, and the specifics of your income, including the number of hours you work each week.
Your employer will only have four days to report your injury and make the claim, which makes the workers’ comp claim process relatively quick. Once your employer has filed your claim, both with the insurance company and the Iowa Division of Workers’ Compensation, an adjuster will begin to review your case, and the insurance company will notify you about the status of your application.
If you are approved, the insurer will discuss with you when you’ll begin receiving benefits and for how long. If you are denied, you should be given a clear reason why and a chance to file an appeal. While denial may be frustrating, the reason the insurer gives for your denial will help us appeal.
You will qualify to receive workman’s compensation benefits in Iowa as long as you were injured while at work and performing your duties as an employee. If you were off the clock, committing a crime, or violating company policies, the insurer or your employer may have grounds to fight your claim.
Some companies, however, are not required to provide workers’ compensation to their employees. For some workers, such as police officers and firefighters, there are other forms of benefits, such as pension funds. For some Iowans, workman’s comp may not be an option, and they’ll need to pursue other options to get their compensation.
Contact a lawyer about your eligibility, especially if you’re one of the possibly ineligible employees listed below:
While anyone who is injured at work in Iowa should be eligible to collect workers’ comp, there are specific circumstances in which a claim can be denied. For example, failing to notify your employer within ninety days of your on-the-job injury is grounds for denial.
Another frequently seen reason a workers’ comp claim could be denied is if you did not provide thorough documentation of your injuries. This can include medical records, diagnoses and medical opinions from your doctors, a complete application, or other relevant information.
Usually, once you provide the appropriate documentation, the insurer is prepared to approve your claim.
Perhaps the most common reason Iowa worker’s compensation claims get denied is pre-existing conditions. If you had a pre-existing condition that you made your employer aware of when you were hired, and your condition worsened due to the work you are paid to do, then you may still be able to collect benefits.
Failure to disclose a pre-existing medical condition, however, will almost always result in a denial, and if you did so knowingly, your appeal may not be successful.
When the insurer acts in bad faith by failing to properly investigate your claim or deceiving you about the benefits and coverage you’re entitled to, your claim has been wrongfully denied. Insurance companies are notorious for greedy tactics like this.
They masquerade as unflinching allies of injured workers, but when you need access to your benefits, they will often do whatever they can to pay you as little as they can get away with so their profits are minimally affected.
Fortunately, you do have the option to take action. If you believe you’re dealing with a bad faith insurance claim, contact our lawyers for help. We’ll investigate the insurer’s actions, find evidence that the actions were unreasonable, and fight for your case.
A primary denial of benefits isn’t the end of the road. Every Iowa workers’ comp claimant who has been denied has the right to file an appeal. By providing the insurer with the information it is requesting and answering any questions it has about your application, you are doing your part to gain access to your benefits.
If your claim was wrongfully denied and we are able to gather evidence of this, we can send a demand letter to the insurance company, accusing it of acting in bad faith and requesting the approval of your benefits. Should the insurer fail to comply or begin negotiations, we are prepared to bring the company to justice in court.
If your insurance company refuses to respond or negotiate, we’ll help you file your contested-case proceeding, which will bring your case before the Iowa workers’ compensation commissioner. The commissioner will listen to both sides of the story and may find that the denial wasn’t fair or push for a compromise.
Without the help of an attorney for workers comp in Iowa, this can be overwhelming. The insurance company will have its own team of lawyers. A lawyer can defend your case and fight to make sure you get the Iowa workers’ comp benefits you deserve.
Once you are approved for workers’ compensation benefits in Iowa, you will be able to receive income to supplement your lost wages while you recover. State law will allow a maximum of 80 percent of your weekly earnings, not to exceed approximately $1,500.
The severity of your injury and the length of time you will need to be out of work will also have an impact on the amount you will receive. For example, someone with a broken arm may be off work for weeks to heal, but healing is a possibility. A person with a permanent traumatic brain injury, however, may never be able to return to his or her previous position.
The medical expenses that result from your work injury should be taken care of by the insurer. This should include transportation costs to and from treatment, prescription medications, hospital bills, surgeries, and rehabilitative services, among various other healthcare costs.
To make your recovery a little easier, if your claim is currently in dispute, your medical provider cannot bill you for your treatment and recovery until the status of your claim becomes final.
In some cases, you may find that your condition has only worsened and you’re in worse shape than you were before. When that happens, you may need to make changes to your benefits to fit the changes you’ve experienced. A workers’ comp lawyer can help you do that.
Typically, you’ll have three years after the last payment of your benefits to take action or request further compensation for your injuries. This should give you time to determine whether your injury or illness has fully healed. If this time has passed, you may be denied further compensation, so be sure to act fast if you’re getting close to that deadline.
Once you’ve filed for further action, your case will be investigated again, as it was during your initial claim. If the insurer finds evidence that your benefits will need to be extended, it should offer further benefits and discuss how much workers’ compensation you’ll receive and for how long you’ll receive it.
Payment of benefits will stop under two conditions. One condition is if you are able to return to work and complete the same job responsibilities as you were able to before you were injured. The other is if you reach the number of weeks allotted based on Iowa’s guidelines on factors determining disability.
For example, if you were injured and lost a hand in your work accident, you would be entitled to 190 weeks of disability benefits. If you became permanently disabled, you would be entitled to 500 weeks of benefits.
Once this time limit has been reached, your situation will be reevaluated to determine whether you are still unable to work or working in another industry is a possibility.
Many deserving Iowa work injury victims do not file for the benefits they need because they are afraid of retaliation from their employers. Because Iowa is an at-will state for employment, any employee can be fired at any time.
This rule does not apply to employees who have filed for workers’ compensation, however. It is illegal for an employer to terminate your employment or retaliate in any other way, and if your employer does retaliate, he or she may face serious consequences, including substantial fines.
You may still have questions, and that’s OK—we understand how difficult dealing with a work injury can be, and we want to help. See the questions below for more answers or call us today to ask questions about your situation and how we can help. Our lawyers can explain what steps you’ll need to take next and begin fighting for the compensation you’re owed.
Generally, your workers’ comp benefits should cover any injuries caused by your employment, including any work-related illnesses. While illnesses may be more difficult to prove, you should be compensated. Pre-existing injuries won’t generally be compensable, but you may receive compensation if your work conditions agitated your pre-existing injury or illness.
Generally, it doesn’t matter if you caused your accident. Workers’ comp covers anyone who was injured at work and needs benefits. The few exceptions to this rule include intentionally harming yourself or abusing drugs or alcohol at the time of the accident.
Most people choose to receive their benefits as a weekly benefit, much like their pre-injury income. In some cases, however, you may wish to receive your benefits as a lump sum settlement. While this is an option, keep in mind that you may lose your right to change your benefits if your condition worsens.
Suffering a work injury shouldn’t leave you and your family in a financial situation you will be unable to recover from. As if recuperating from a work injury isn’t challenging enough, dealing with an insurance company that makes you jump through hoops to obtain your workers’ comp benefits can be exhausting and incredibly frustrating.
Get help from an experienced Iowa workers’ compensation lawyer at Pothitakis Law Firm, PC. We will fight hard for every benefit you’re entitled to. To schedule your free, no-obligation consultation today, give us a call at 1-866-PLF-IOWA (753-4692) or fill out the contact form.