When an Iowa employee is hurt in an accident at work or falls ill due to job conditions, he is typically eligible for workers’ compensation benefits. Workers’ compensation is a system that provides medical care and wage replacement for injured and ill employees. These benefits are meant to ensure that employees are able to recover as fully as possible, and state law requires most employers to provide this to employees at no cost to the employee. However, when the employer or his insurance company is paying the bill, they are able to exercise some control over the care.
In general, Iowa employers choose the medical providers for injured and ill workers. When an employee sustains an injury, he should file a report with the employer as soon as possible. Once that claim is accepted, the employer will typically provide the injured worker with a list of approved providers. When a worker is treated by an approved provider, the employer is required to pay for the care.
An employee may want to see a doctor not approved by his employer. In some cases, the employee and the employer may agree to an alternate provider. However, the employer is not obligated to do so and may deny the request. Should a worker choose to pursue care outside the approved list, the worker would be responsible to pay that bill out-of-pocket. It is also worth noting that many health insurance carriers will not pay for care if workers’ compensation benefits are available but unused.
There are a few exceptions in which the injured employee is allowed to select his own provider. These exceptions cover situations in which the employee is unhappy with the care for a variety of reasons and those in which the employee disagrees with the impairment rating offered by an employer-selected physician. In both these cases, it can be possible to petition the workers’ compensation commission for a change in care or second opinion by a doctor of the employee’s choosing.