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Steps to ensure you receive the workers’ comp benefits you deserve
The first workers’ compensation laws in Iowa were passed in 1913 in response to growing public concern for the safety of workers in dangerous jobs, including manufacturing and mining.
Although the laws have undergone sweeping changes since 1913, the goal of Iowa’s workers’ comp laws remains the same: To provide appropriate financial compensation to workers who are injured on the job.
Let’s take a look at workers’ compensation in Iowa, including the steps you need to take to file a claim.
What is workers’ compensation?
Workers' compensation is a type of insurance that provides financial benefits to employees who are injured on the job. It is a no-fault insurance system, which means injured workers can receive benefits regardless of who's at fault for their injury.
Workers' compensation is also an exclusive remedy, which means that—in most cases—you must file a workers’ compensation claim in lieu of a personal injury lawsuit.
Does my Iowa employer carry workers’ compensation insurance?
Almost ALL Iowa employers are required to carry workers’ compensation insurance for their employees.
There are only a few classifications of employees who are exempt from the law:
- Domestic and casual employees (nannies, house cleaners, etc.) who earn less than $1,500 from their employer over the course of a year.
- Agricultural employees whose employer has a cash payroll of less than $2,500 per year.
- Certain family members of the employer.
- Employees who are part of a labor exchange in the agricultural industry (i.e., agricultural workers who only receive non-monetary payments).
- The president, vice president, secretary, and treasurer of a family farm corporation and their family members.
- Police officers and firefighters who are entitled to benefits under the state’s pension fund.
- Members of a limited liability company.
Independent contractors are NOT required to be covered by workers’ compensation insurance. An independent contractor is defined as someone who meets all of the following criteria:
- Has an express contract to perform services;
- Is free from direction and control over the means and manner of providing services;
- Incurs most of the expenses for tools, labor, and other operational costs;
- Has an opportunity for profit and loss from the services performed;
- Is free to hire and fire employees to help perform the services for the contracted work;
- Has all business, trade, or professional licenses required by federal, state, or municipal authorities of an individual or business engaging in the same type of services; and
- Follows Internal Revenue Service requirements by obtaining an employer identification number and filing business income appropriately.
Employers who are required by law to carry workers’ compensation insurance for their employees are also required to pay the insurance premiums. Iowa law prohibits employers from taking deductions from their employees’ earnings to pay the workers’ compensation premiums.
Is my injury covered by workers’ compensation?
Your injury or illness is covered by workers' compensation insurance so long as it arose out of and occurred during the course and scope of your employment.
An injury is NOT considered to have arisen out of your employment if it occurred at work but would have occurred anywhere. For example, if you have a heart attack at work due to coronary heart disease, you probably won't receive workers' compensation benefits because the heart attack did not necessarily arise strictly out of your employment. The heart attack could have just as easily occurred while you were watching a movie at the theater, for example.
Are injuries sustained during a lunch break or commute covered by workers’ compensation?
If you’re injured during your lunch break in Iowa, you won’t be able to receive workers’ compensation benefits. The only exception is if you remain subject to certain restrictions during your lunch (for example, you’re not allowed to leave the premises to eat).
Similarly, injuries are typically not covered by workers’ compensation insurance if they’re sustained on the way to or from work. However, an exception exists in Iowa for injuries that occur close to the workplace in an area owned or controlled by the employer (for example, a car accident that occurs in the parking lot of the workplace).
Workers' compensation covers both traumatic work injuries and occupational work injuries:
- Traumatic work injuries are those that result from a one-time accident at work (e.g., suffering a back injury as a result of a fall from construction scaffolding).
- Occupational injuries occur over a period of time (e.g., repetitive movement injuries).
What are the procedures for making a workers’ compensation claim in Iowa?
Both the injured employee and the employer are responsible for taking certain steps to ensure that a workers’ compensation claim is filed. Here are the steps:
- Notice to the employer. The injured employee must report their injury to their employer within 90 days of the injury. It’s a good idea to send an additional copy of the notification letter by certified mail with a return receipt requested (so there are no disputes about when the notice was received).
- Employer files claim. Within 4 days of receiving notice about an injury, the employer must file a First Report of Injury - Form 1 with the workers’ compensation insurer even if the employer disputes the claim.
- Pay the claim. The employer must pay or deny a claim within 11 days. When a claim is denied, a letter must be sent to the employee stating the reasons for the denial.
If there’s a dispute about workers’ compensation benefits, the injured worker must file an administrative claim (called a contested case proceeding) within 2-years of the injury date.
Workers’ compensation benefits
In Iowa, injured workers can receive the following workers' compensation benefits:
• Medical expenses. Injured workers can receive “reasonable and necessary medical expenses.” These expenses include things like doctor’s visits, hospital bills, prescriptions, and physical therapy sessions.
• Wage loss benefits. You can receive wage loss benefits if you’re unable to return to work or you’re unable to return to the same type of work.
Wage loss benefits are calculated according to the nature of the injury, with injuries falling into one of the following categories:
• Temporary partial disability (TPD). If you're able to return to part-time or light-duty work while you're recovering but earn less than your normal wages, you may be eligible for TPD benefits. TPD benefits are typically 66 ⅔ percent of the difference between your average weekly wage before your injury and your average weekly wage after returning to work (subject to an ever-changing statutory maximum).
• Temporary total disability (TTD). If you're temporarily unable to work, you may be eligible for TTD benefits. These benefits are paid weekly and are typically 80 percent of your average weekly wage before your injury.
• Permanent partial disability (PPD). If you suffer a permanent injury but are still able to work in some capacity, you may be eligible for PPD benefits. Your award will be based on the permanent impairment rating assigned to you by your doctor, among other factors.
• Permanent total disability (PTD). If you're totally and permanently disabled, you may be able to receive PTD benefits. These benefits are paid weekly and are typically 80 percent of your average weekly wage before your injury.
It’s not always clear what wage loss benefits you should receive and for how long. DO NOT assume that your employer or the insurance carrier correctly calculated your wage loss benefits. An experienced workers’ compensation attorney can help make sure you receive the benefits you deserve.
• Death benefits. In the case of a fatal work injury, the insurer is required to pay approximately $10,000 for funeral expenses (the exact amount changes every year). What’s more, weekly benefits must be paid to the employee’s spouse and dependents.
• Vocational rehabilitation benefits. Iowa workers with a permanent injury may be entitled to vocational rehabilitation benefits in the amount of $100 per week during each week the worker participates in an approved vocational rehabilitation program.
Can I appeal an unfavorable workers’ compensation decision?
If your workers’ compensation claim is denied, you’re entitled to an appeal. In fact, you’re entitled to several appeals. Here’s what the appeals process looks like:
- Administrative hearing. The initial hearing will be presided over by a deputy workers’ compensation commissioner. The parties have the right to introduce evidence to support their case.
- Administrative rehearing. If either party is unsatisfied with the decision by the deputy workers’ compensation commissioner, they can request a rehearing within 20 days of receiving the decision.
- Iowa Workers’ Compensation Commissioner. If either party is unhappy with the administrative rehearing, they can appeal the case to the Iowa Workers’ Compensation Commissioner within 20 days of receiving the rehearing decision. Generally, no new evidence is submitted at this point. Rather, the Commissioner bases their decision on the record and briefs already on file.
- District court. If either party is unhappy with the decision of the Workers’ Compensation Commissioner, they can file an appeal with the district court. In Iowa, each of the 99 counties has a district court.
- Iowa Court of Appeals. The next step in the appeals process is the Iowa Court of Appeals. An appeal to the Iowa Court of Appeals can take up to a year.
- Iowa Supreme Court. The final step in the appeals process is the Iowa Supreme Court. No further appeal can be made after the case is heard by the Iowa Supreme Court (unless the case involves a constitutional issue, in which case it may be heard by the United States Supreme Court).
Hiring an Iowa workers’ compensation attorney
You’re allowed to hire an attorney at any point in the workers’ compensation claims process. An attorney can present your claim and handle an appeal if your claim is denied.
Most workers’ compensation attorneys accept cases on a contingency fee basis, which means they receive a percentage of what you receive (and nothing if your claim is unsuccessful).
To find an experienced workers’ compensation attorney in Iowa, visit our free online directory.
Did you know that workers' compensation law varies by state?
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The basis for personal injury law is fairly straightforward:
If you're injured because of someone's negligence, then you're entitled to recover for your financial losses related to the injury.
The premise for the workers' compensation system is similar:
Your employer is required to have specific insurance that provides benefits if you're injured at work.