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Fulton, Marint & Andres, P.C.

Work Comp FAQ

Does my employer really get to pick which doctors I see?

The short answer is yes. Your employer does get to select the doctors that treat you; however, the carrier does not have an unlimited right to control your medical care. Insurance carriers frequently take the position that they are entitled to control which treatment you get. This is not true. If the doctor authorized to treat you by your employer recommends certain treatment, your employer must authorize and pay for that treatment. For example, if the authorized doctor says you need an MRI your employer must authorize and pay for the MRI.

The treatment offered by the carrier must also be offered promptly, be reasonably suited to treat your injury, and not be unduly inconvenient. If the treatment your employer is offering does not meet these standards, Iowa law gives you the right to seek alternate medical care by filing an application with the Iowa Department of Workers’ Compensation. This results in a telephone or in-person hearing with a workers’ compensation judge within 10 business days of the date the application is filed. An attorney can help you file an application for alternate medical care if you are not receiving the medical treatment you need.

How long do I have to report my injury?

Iowa law requires that you notify your employer within 90 days of an injury. If you fail to do so you will lose all rights to compensation you would otherwise have under Iowa law.

What do I need to tell my employer to meet the notice requirements?

The law requires that you inform your employer that you have had an injury and that the injury may be related to your work.

Does a work injury have to happen acutely/traumatically or is it possible to have an injury that develops over time?

Iowa recognizes and provides compensation for “cumulative” injuries, which are injuries that occur gradually over time due to repetitive job duties. These types of injuries are particularly common for people that work in manufacturing.

How long do I have to pursue my claim after I am injured? What is the statute of limitations on a workers’ compensation claim?

If no weekly benefits have been paid on your claim the statute of limitations is 2 years from your date of injury. If weekly benefits have been paid you will have 3 years from the last time weekly benefits were paid to pursue your injury. Payment of medical expenses or mileage reimbursement do not qualify as weekly benefits and do not extend the statute of limitations.

Can my employer fire me for pursuing a workers’ compensation claim?

Iowa is an at will employment state so your employer can normally fire you for nearly any reason it wants so long as the reason is not discriminatory. Fortunately, the Iowa Supreme Court has held that your employer cannot fire you for exercising your rights under the workers’ compensation law.

If I develop other conditions and/or injuries as a result of my work injury am I entitled to compensation for those conditions and/or injuries as well?

Every rational consequence that flows from a work related injury is likewise considered to arise out of the work injury. For example, if you have been limping due to an injury to your knee and this causes an injury to your back, your employer is liable to compensate you for the back injury. Similarly, if your injury causes weakness in your leg and you fall as a result of the weakness in your leg, any injuries suffered in the fall are likewise compensable. Finally, if you suffer further injury as a result of medical treatment of your original injury, the new injury is also compensable.

How do they calculate the weekly rate at which my benefits are paid?

Your weekly rate is calculated by averaging what you earned in the 13 weeks preceding your date of injury. However, any weeks that are not representative of what you “customarily” earn are thrown out. Overtime hours are included in the calculation, but at the straight time rate rather than time and a half. The weekly rate is 80% of the average after payroll deductions. Paying benefits at an incorrect weekly rate is one of the most common methods insurance carriers use to pay you less than what you are entitled to under the law.

The doctor authorized by my employer has released me to return to work with temporary restrictions. I do not think I am able to work at this time. What happens if I refuse to return to work?

If your employer offers suitable work that is consistent with your work restrictions and you refuse to perform the work, your employer will not have to pay you weekly benefits. If you can prove later that you were not capable of working a judge may order your employer to pay you weekly benefits, but you will have to wait until trial and will not have income while you wait for trial. Your employer will also probably fire you if you refuse to work.

My employer has denied my claim. What tools are available to pressure my employer to accept my claim?

Only a judge can order your employer to do something. However, Iowa workers’ compensation law does provide some tools to pressure the insurance carrier into doing the right thing. For example, it is sometimes the case that an insurance carrier denies a case without having a good reason. An attorney can point out to the carrier that this is inconsistent with the law and that penalty benefits may be awarded if the situation is not remedied. Insurance carriers also sometimes deny claims on a medical basis without actually getting the opinion of a physician. A lawyer can talk to your treating doctor to get their opinion that your condition is work related. This is sometimes sufficient to get the insurance carrier to admit your claim.

I have had problems with my back in the past, but had a work injury that made my symptoms worse. Can my employer deny my claim because of the pre-existing condition?

The simple fact that you have a pre-existing condition does not mean that you work injury is not compensable. Instead, your injury is compensable, despite the pre-existing condition, so long as the work injury materially aggravated the condition.

Can my employer force me to return to work before I feel that I am ready?

Your employer cannot force you to return to work; however, if your employer offers you light duty work that is consistent with the restrictions assigned by the treating physician and you refuse that work, you will not be entitled to work comp benefits while you remain off work. If you disagree with the restrictions assigned by the treating physician and another physician opines that you should have additional restrictions, you may be able to prove later that the work offered by your employer is not suitable. Unfortunately, the insurance carrier will refuse to pay work comp benefits in the interim and you would have to go without income. The best advice is therefore to at least attempt the work your employer has offered and, if you find yourself unable to perform the work, to return to the treating physician and describe the ways in which you are unable to perform the work. Ideally, the treating physician will assign additional restrictions.

How much will a lawyer charge to represent me?

We understand that most injured workers are not in a position to pay an hourly fee for representation. We therefore offer contingent fee arrangements. This means that you do not owe us anything for our time if we are unable to secure any benefits for you. We will charge a 1/3 fee on any benefits that you receive as a result of our representation. This also means that we do not charge a fee on benefits you would have received even if we were not representing you. For example, if your claim is admitted we will not charge a fee when the insurance carrier pays you the impairment rating assigned by the doctor it has retained.

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