FAQs - Iowa Workers' Compensation Questions
FAQs - Iowa Workers' Compensation
Who is covered by the Iowa Workers’ Compensation Act?
Generally, employees who are injured in Iowa, working under a contract of hire made in Iowa, whose employment is presently located in Iowa, or who are domiciled in Iowa, are eligible for benefits if they have a job-related injury (85.71).
A few classifications of employees are exempt from the law and therefore are not eligible for benefits. Proprietors, independent contractors and partners are not considered employees but may elect to be covered by purchasing a valid workers’ compensation insurance policy specifically including the proprietor, independent contractor or partner.
Do I have to notify my employer of the injury?
The Iowa Workers’ Compensation Act requires that all accidents occurring in the workplace be reported to the employer within 90 days of the occurrence of the accident. There are exceptions to this rule depending upon whether the injury is due to an accident, an exposure to hazardous substances, or as a result of repetitive trauma.
The notification should be to a supervisor, another company officer/official, or a person designated for such notifications. It is important to note that the filing of an insurance claim form does not constitute notice to an employer. Furthermore, it is not sufficient to just tell the employer that you are hurting, such as, “my back hurts.” You must specifically tell the employer that you got hurt on the job. There are some exceptions to the 90 day rule as mentioned above.
Many employers and their insurance companies provide their own notice requirements pursuant to company policy. These company policy notice requirements do not change your rights under the Iowa Workers’ Compensation Act. You should consult an attorney who is knowledgeable on the Iowa Workers’ Compensation Act to avoid any of these particular problems.
What types of injuries are covered by the Iowa Workers’ Compensation Act?
In Iowa, “injury” is defined very broadly to include any health impairment other than the normal building up and tearing down of body tissues. Health impairment must be the result of employment activities.
Diseases and hearing losses are also considered to be injuries, if they are the result of employment activities or exposures (85A, 85B).
An employee is entitled to benefits where a pre-existing injury or disease is aggravated, or worsened, by the employment.
What medical benefits is an injured worker entitled to in Iowa?
The law provides for the payment of all reasonable and necessary medical expenses incurred to treat the injury. This includes reasonably necessary transportation expenses. Mileage for the use of a private automobile is also reimbursed at a rate set by the State of Iowa.
Under certain circumstances, an employee who has to leave work for medical treatment may be eligible for payment of lost wages.
What disability benefits is an injured worker entitled to in Iowa?
Weekly compensation benefits for any employee are calculated based upon Iowa Code Sections 85.36, 37, 61.
a. Temporary Total Disability (TTD)
When an injury results in more than three calendar days of disability, the employee may be entitled to TTD benefits beginning on the fourth day and continuing until the employee has returned to work or is medically capable of returning to substantially similar employment, whichever occurs first. A three day waiting period becomes payable if the disability exceeds 14 calendar days.
b. Temporary Partial Disability (TPD)
TPD benefits may be payable if the employee returns to work at a lesser paying job because of the injury.
c. Healing Period
During the period of recuperation from an injury that produces a permanent impairment, an employee may be entitled to healing period benefits beginning on the date of the injury and continuing until the individual returns to work, or in the event no significant improvements are medically anticipated, when the employee is medically capable of returning to employment similar to his prior employment.
d. Permanent Partial Disability (PPD)
When a job-related injury results in permanent partial disability, the employee may be entitled to benefits based upon the degree of permanent disability. There are two different types of PPD benefits; scheduled member disability and body as a whole disability. For a clear explanation of the same, you should consult an attorney who is experienced at handling workers’ compensation claims.
e. Permanent Total Disability (PTD)
When a job-related injury leaves an employee incapable of returning to gainful employment, the employee, under certain circumstances, may be entitled to permanent total disability benefits as long as the employee remains permanently and totally disabled.
Who pays workers benefits in Iowa?
Employers subject to the law are required to provide insurance through a private insurance company, unless they are self-insured.
If the employer provides coverage by purchasing an insurance policy, the employer pays the insurance premium charges and the insurance company pays the workers’ compensation benefits to the injured employee. If the employer is self-insured, the, employer or the claims administrator pays the workers’ compensation benefits to the injured employee.
Any employer who fails to provide insurance coverage for eligible employees, as the law provides, may be liable to employees for either workers’ compensation benefits or for damages in a civil action.
An employer shall not engage in business without first obtaining workers’ compensation insurance coverage or qualifying for self-insured status. A person who willfully and wantonly does so is guilty of a Class D felony (87.14A).
What other benefits are available in Iowa?
If an employee has a permanent partial disability with one major body part, such as hand, arm, foot, leg, or eye, and sustains a permanent disability as a result of a job-related injury to a second major body part at a subsequent time, the employee, under some circumstances, may be entitled to benefits from the Second Injury Fund.
What does the Act provide for when an employee dies in a workplace accident?
Death benefits are payable to the dependents of a deceased employee. Benefits are first payable to the surviving spouse and may be payable for life or until remarriage. Children are entitled to benefits until they reach age 18, or age 25 if they are actually dependent on the deceased. Other relations may qualify if there is a showing of actual dependency. If the surviving spouse remarries, there are some benefits that continue if there are no dependent children of the deceased.
How do I file a claim in Iowa?
Often, to enforce one’s rights under workers’ compensation laws, it becomes necessary to file a claim with the Iowa Industrial Commissioner. Claims must be filed within the time allotted by law, otherwise your rights to benefits may be barred. There are numerous deadlines with regard to when a claim must be filed depending upon the particular circumstances of the injury and payment of benefits by the insurance carrier or employer. Consult with an attorney to determine the filing period that would apply for your particular injury.
Promises or statements by the employer, an insurance carrier or its adjuster that you do not need to do anything further and that they have filed a claim for you should not be relied upon. Furthermore, the payment of medical bills for your treatment should not be relied upon as giving an extension of time to file your workers’ compensation claim.
Instead, if you suffer a workers’ compensation injury, you should immediately consult an attorney knowledgeable in workers’ compensation law and find out what your rights are, how you should proceed, whether what you are doing is appropriate, and what time limitations apply for reporting and filing a workers’ compensation claim.