Get Your Questions Answered Today By Burlington, IA Injury Attorney Nicholas Pothitakis
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Will I have to pay taxes on Workers' Compensation benefits?
Workers' Compensation benefits help workers pay for their medical treatment and help them with lost wages as they recover from an injury. Workers' Comp ultimate goal is to help workers get back on their feet and back to the workplace. For most people Work Comp benefits are necessary to make ends meet during this time and they shouldn't have to worry about whether they will have to pay taxes from these benefits.
Most of the time these benefits will not be taxed by the IRS. The benefits you receive from Workers' Comp are used for necessary expenses (medical and paying bills) and not to make extra money. And so for this reason it's not taxable. Usually, you will receive only a portion of your lost wages for Workers' Comp so the IRS understands this and does not tax these benefits.
It can get a little complicated. If you receive both Social Security Disability as well as Workers' Compensation, you may have a portion of your benefits taxed. If the combination of the two equals 80 percent or more of your normal average income, your Workers' Compensation will be reduced by the amount over 80 percent. In this case, the Workers' Comp benefits are taxable.
For example: You earn $3,000 per month at your job before your injury. The combination of your Work Comp benefits and Social Security Disability amount to $2,500. If we take 80 percent of $3,000 we get $2,400 and so you would be $100 over that amount. Your Social Security benefits would be reduced by $100, and $100 of your Workers' Compensation benefits will be taxable income.
If you make under a certain amount of money total, your Social Security benefits may not be taxable. For a single person the income limit is $25,000 per year and for a married couple $32,000. Making less than this with all of your income (including half of your Social Security benefits) you would not pay taxes.
Workers' Compensation can be very complex in some cases and adding tax issues can make it even more so. Talking to an experienced Workers' Compensation attorney can help you with these types of issues and make sure you are getting the benefits you deserve. Call us to schedule a free consultation. We are happy to meet with you and advise you in your case.
Does an injury have to happen at the workplace in order to be covered by Workers' Comp?
Many times you may not be at the office or your job site when an injury takes place. For example, you may be traveling for work, running a work-related errand, or attending a work-related training or company event. You may not be physically at the office or job site, but you are doing something for the benefit of your employer or a job task required by your employer. As long as it is work-related, it should be covered by Workers' Comp benefits. If you become injured or ill as a result of a job responsibility then you you will be able to receive benefits as long as you meet the other eligibility requirements for Workers' Comp in Iowa.
The first thing you must do if you become injured or ill is to report your incident to your employer in writing. If you are not satisfied with the benefits you receive or if you are denied and feel that Workers' Comp should provide additional compensation, it would be best to consult with an experienced Iowa Workers' Compensation attorney. The term "job-related" can get complicated in some situations and you may need the advice and support of an expert in the field. Most attorneys, such as Pothitakis Law Firm, provide free initial consultations to discuss your particular situation.
Does Workers' Compensation just cover my medical and hospital bills?
You may already know that Workers' Comp covers medical and hospital bills for your workplace injury, but it also provides many other important benefits for employees. Workers' Comp benefits may extend to rehabilitation of an injury such as paying for physical therapy or occupational therapy. It may extend to job and task retraining for specific job duties or retraining for new positions that you are better suited to because of the injury. Workers' Compensation benefits may also provide disability payments while you are unable to work.
It is important to remember that Workers' Comp not only covers accidents on the job, but also provides benefits for injuries caused over a longer period of time such as carpal tunnel syndrome, chronic back and shoulder problems and tinnitus. There are even some illnesses and diseases that are a gradual result of work conditions such as heart conditions, lung disease, occupational skin diseases/injury, and stress-related illnesses. You may need to consider if your job duties are contributing to your health issue that you have developed. If you think it is work related then you need to report this injury to your employer in writing. Your employer has the right to choose your medical provider and it is important to follow instructions regarding medical treatment and restrictions. If you need advice regarding your injury contact an experienced Iowa Workers' Compensation attorney to make sure you are getting the benefits you are entitled to under Iowa law.
How does filing a workers’ compensation claim work?
Most people are familiar with the fact that the workers’ compensation system exists; medical care and wage replacement payments are available to workers who experience an injury or illness on the job. Many workers, however, know little about the actual process of obtaining these important benefits. The system can seem confusing or overwhelming for those who are just getting started, especially during the difficult time after an injury. Here, find out more about how the process works and what you need to do today to protect your rights and obtain the maximum amount of compensation available.
Begin the Process by Reporting Your Work Injury or Illness
The first and most important step to filing a successful workers’ compensation claim begins with reporting the illness or injury to your employer. Iowa law allows workers 90 days to report the injury, but is best to notify your employer as soon as is possible. Benefits will be denied for injuries not reported within the 90-day window.
Most employers will have injured workers complete a written incident report regarding the details of the injury and its details. If your employer does not request this, injured workers should submit a report of their injuries in writing or via email. Keep a copy of the notice. This way, if a dispute arises later, there is documentation of the timeline.
Once an injured worker notifies his employer about a work injury, the employer should provide information about seeking medical care. It is very important to seek medical care; failing to do so will seriously undermine your claim as it may appear as no injury truly exists.
In Iowa, the employer has the right to choose the care provider. Employees should obtain care from an approved provider as much as is possible. Insurance carriers and employers may refuse to pay for care that is not in the approved network.
Iowa Employers Will File a First Report of Injury
From there, it is an employer’s responsibility to file the claim with the state commission. The law mandates that employers file a First Report of Injury within four days of receiving an injury report. This is done electronically with the Workers’ Compensation Commission. Additionally, employers must notify their insurance carrier so that they can begin the claim consideration. It is also possible for the insurance company to file the First Report of Injury.
If an injured employee suspects his claim is being ignored, or his employer does not have workers’ compensation insurance as the law dictates, it is important to contact an experienced attorney. It is still possible to obtain compensation in these situations, but the process would be different from a straightforward claim.
The Insurance Company Will Consider the Work Injury Claim
At this point, the employer’s insurance company (or the employer itself if they are self-insured) will investigate the claim to determine if the injured worker is eligible for benefits. Employees should expect the insurance company to:
- Review medical records
- Consider work history
- Request a medical exam
- Talk with witnesses to the accident or work conditions
Insurance companies are required to respond to all claims in a timely manner, so injured workers should expect to receive a decision on their claim soon after filing.
Appealing a Workers’ Compensation Claim Denial in Iowa
Hopefully, the insurance company approves a work injury claim and pays benefits promptly. Some claims will be denied, however. Insurance companies are out to protect their own interests, and they will attempt to avoid paying as much as possible—even by denying legitimate claims. In those cases, Iowa law allows injured workers to appeal the decision.
The state commission encourages employees to first appeal directly to the employer. The Iowa Guide to Workers’ Compensation states that many disputes can be resolved through open communication between employee and employer. When that fails, however, more official means are available.
Injured workers can initiate a contested case proceeding, which would send the issue to the Iowa State Workers’ Compensation Commission. A hearing is typically held for both sides to present their cases, and the injured worker would have the burden of proving that denying the benefits is incorrect. Claims’ decisions can be appealed through a number of levels, all the way up to the Iowa Supreme Court.
If you or someone you love has suffered a work injury, you may eligible for Iowa workers’ compensation benefits. At Pothitakis Law Firm, our experienced attorneys help injured employees understand their rights and fight for the benefits they both deserve. Call our office today to speak with a member of our legal team and schedule a free, no-obligation consultation.
What workers’ compensation benefits are available if I suffer a permanent injury?
A permanent disability can have a profound effect on your life. Whether it is a full disability or a partial one, it can inhibit your ability to work, earn income, and simply enjoy life as you did before the accident or illness. For many injured workers, life is forever changed and adjusting to the new normal can be difficult. Physical and emotional stress is only compounded by financial concerns. Fortunately, those who suffer a work-related injury can obtain workers’ compensation benefits that will provide the medical care and wage replacement they need to remain stable and successful. If you or someone you love has suffered a permanent injury at work, learn more about the benefits that may be available.
Benefits Available to Iowa Workers With Permanent Injuries
All eligible Iowa workers are entitled to benefits from workers’ compensation when they experience a job-related illness or injury. Typically, the benefits come in two forms: medical care and wage replacement. These benefits ensure that injured workers are able to receive the medical treatment necessary for as full a recovery as possible and that they do not suffer any undue financial hardship as a result of their injury. The duration and amount of the benefits depend on the nature of the injury. For those who suffer a permanent injury, two main types of benefits are offered:
- Permanent Partial Disability – Benefits for those who suffer a permanent injury but are capable of returning to the workforce in some manner.
- Permanent Total Disability – Benefits for those who suffer a permanent injury that leaves them unable to work in any capacity.
Permanent Partial Benefits for Injured Iowa Workers
Permanent partial disability benefits are further divided into two main types, depending on the what body part is affected. They are:
- Scheduled member disabilities – A scheduled member disability is an injury to a specific body part as named by the workers’ compensation commission. For each scheduled member, benefits are offered for a specific number of weeks, depending on the nature of the injury. Scheduled member injuries involve the finger, hand, arm, leg, foot, toe, eye, and hearing.
- Unscheduled disabilities – An unscheduled disability occurs when an injury results in a permanent impairment that does not involve a scheduled member. It is known as an industrial disability and is compensated according to the percent that the disability reduced the person's earning capacity. Unscheduled injuries most often involve the neck, back, shoulder, and hip.
Permanent partial wage replacement benefits are typically offered at 80 percent of the employees weekly spendable earnings, not to exceed a state-set maximum, and they begin at the end of the healing period.
Permanent Total Disability Benefits After a Work Injury
In some cases, an injury leaves a worker unable to return to any gainful employment. In these situations, permanent total disability benefits may be available, and they are payable as long as the employee remains totally disabled. For some, this may be a period of weeks or months, while for others it may be years. Permanent total disability benefits are also typically paid at 80 percent of the employee’s weekly spendable earnings, not to exceed a state-set maximum. Employees are eligible for this compensation from the date of the injury.
Impairment Rating and How it Affects Permanent Disability Benefits
All permanent disability benefits are significantly affected by what is known as the impairment rating. The impairment rating is set by a doctor and intended to reflect the degree of the impairment. This rating is determined once the worker has recovered as fully as possible and is expressed as a percentage. In Iowa, injured workers receive compensation that is equal to the impairment rating.
For example, if a worker suffers an injury to his arm that results in limited motion and pain, a doctor will assess the injury to determine how much it affects his ability to perform daily functions. The doctor may conclude that the rating in this case is 75 percent. This rating is then applied to the number of weeks as set by the scheduled member appendix. Iowa law states the loss of use of an arm is equal to 250 weeks of compensation. So, this worker would receive pay for 75 percent of 250, or 187.5 weeks. This makes the impairment rating crucial for workers who suffer a permanent disability. Even a small change in the rating could result in a significant difference in the compensation awarded.
If you or someone you love has suffered a permanent injury, you may be entitled to Iowa workers’ compensation benefits. The compensation available to you depends on the nature and severity of your injuries, and an experienced attorney can help you understand your rights to obtain the maximum compensation possible. To learn more, request a free copy of our book, 7 Things You Must Know if You Get Hurt at Work. After reading this information, call the legal team at Pothitakis Law Firm. We can answer your questions and may be able to help you obtain the compensation you deserve.
Do independent contractors have any rights to workers’ compensation benefits?
Working as an independent contractor can have many perks. More flexible hours, self-determined pay rate, certain tax deductions, and more can make the self-employment lifestyle attractive and effective for many people. As with most things in life, however, it is not without some detractions. One key detriment is the lack of workers’ compensation benefits. Typically, independent contractors in Iowa are not viewed as employees under the law, and employers are not required to provide them with the same medical care and wage replacement benefits afforded to other employees who suffer on-the-job injuries.
For many independent contractors, an injury can have devastating effects on their personal, employment, and financial lives. The medical bills and lost wages can create both physical pain and financial burdens. The benefits provided by workers’ compensation can be critical in maintaining health and stability. Fortunately, independent contractors do have rights that can be protected, regardless of what an employer or their insurance company may claim.
Employee vs. Independent Contractor
Determining whether a worker is an independent contractor by law can be confusing. There are some basic guidelines, though, that can be helpful in defining this status. The Internal Revenue Service (IRS) offers these questions to consider:
- Who controls how and when the worker does his job?
- How are the business elements of the job handled?—how the worker is paid, if expenses are reimbursed, whose tools and supplies are used.
- Do the worker and employer have a written contract?
- Is the worker offered company benefits?
- Will the relationship between the worker and the employer be ongoing?
The answers to these questions can be very helpful in determining what type of worker you are. However, the IRS states that there is no “magic” formula; every case is unique, and each decision should be based on the specific circumstances of the relationship in question.
Additionally, in some cases, a worker and employer may have signed a contract stating that the worker is an independent contractor. The simple existence of such a document, though, does not automatically mean this is true. It is possible to be legally considered an employee in spite of such a contract if the other elements all indicate otherwise. The IRS says “the keys are to look at the entire relationship, and consider the degree or extent of the right to direct and control.”
Employee Misclassification Can Benefit Iowa Employers
Iowa’s office workforce development notes that misclassifying workers is a growing problem in the state. Employers can reap a number of benefits and save a significant amount of money by labeling a worker as an independent contractor, rather than an employee. Doing this aids employers by helping to:
- Avoid paying certain taxes
- Avoid paying workers’ compensation benefits
- Ignore some wage and labor laws
- Underbid competitors who consider all workers employees
It is illegal, however, to misclassify a worker, and employers who do so can be held accountable. They can face fines, interest on back taxes, and even criminal charges in certain cases. Importantly, they can be compelled to provide standard employee benefits, including workers’ compensation to employees incorrectly labeled independent contractors.
Disputing Your Employment Status After a Work-Related Injury
If you have suffered a work-related injury, you may be concerned about your eligibility for workers’ compensation benefits, especially if the company paying for your work claims you are an independent contractor. Fortunately, it is possible to dispute your status. Iowa Workforce Development operates a misclassification unit that investigates these cases. It can be possible to obtain medical care and wage replacement benefits successfully.
The experienced attorneys at Pothitakis Law Firm have helped many injured workers fight for the compensation they deserved, and they may be able to help you, too. Learn more about who we are and how we may be able to help by calling our Iowa office. You will speak with a member of our legal team and schedule a free, no-obligation consultation.
What facts do I need to know about Iowa Workers’ Compensation?
When it comes to workers’ compensation, it can be difficult to know your rights. Between the legal language of the state laws and the things your employer or its insurance company say, the situation can become confusing very quickly. Many injured workers have little experience with both the law and the workers’ compensation system. It is natural to feel overwhelmed and understandable to believe that the other parties involved are being honest and forthcoming. Unfortunately, this is not always the case. For injured workers and their families, this misinformation can have significant consequences, resulting in missed deadlines, reduced settlements, and denied claims.
Know the Facts About Iowa Workers’ Compensation
To protect your rights and ensure you are able to obtain the maximum amount of compensation for your work-related injury, we have compiled these top five facts about Iowa’s workers’ compensation laws:
- Insurance carriers are not on your side. Regardless of what they tell you, insurance representatives are out to protect their own interests. They want to save their company as much money as possible, and they will try to pay you less than your claim is worth. Additionally, they will investigate you and your claim, trying to find any information that can be used to discredit you. If you must speak to them, never offer more than the basics of your injury—date, time, location, witnesses, and type of injury. Refrain from commenting further on your diagnosis and treatment as your condition may change over time, and only a medical professional should offer those statements.
- Compensation rates are variable. Similarly, both the weekly rate and a settlement amount offered by an employer or its insurance company may not be correct. Do not take their word for it. Compensation rates depend upon a number of factors, and it is important to fully understand your rights before accepting an offer. If you agree to an offer and realize later that your claim was worth more, it may be too late.
- A pre-existing condition does not automatically exclude you from benefits. While it is true that workers’ compensation does not cover pre-existing conditions, it is often the case that employers and insurance companies try to use the existence of any pre-existing condition as a way to avoid payment. A new injury to the same body part or the aggravation of an old injury can be compensated. A worker’s rights are not negated by past injuries.
- You do have some control over your care provider. In Iowa, employers have the right to choose the medical provider for their employees’ work injuries. However, this does not mean they have complete control over an injured worker’s care forever. Many times, workers are able to request a new provider or a second opinion if they are unhappy with the care provided by the employer-selected physician.
- Filing deadlines must be met in any situation. Even if you are negotiating with an employer or an insurance company, the state-set workers’ compensation deadlines still apply. Until an agreement is officially reached, injured workers should take care to continue the benefits process as dictated by law. This means filing the appropriate paperwork, meeting the stated deadlines, and continuing medical care.
Our Iowa Work Injury Lawyers Can Help
The physical, emotional, and financial stress of a work injury can be a serious burden for any employee and his family. This burden only increases when you are also faced with uncertainty about your benefits and your future. At Pothitakis Law Firm, our experienced legal team represents injured workers in Iowa so they can obtain the compensation they deserve. We will help you learn more about your rights, and find the best way forward for you and your family. While you focus on your recovery, our team will be working hard to:
- File paperwork
- Meet deadlines
- Negotiate with insurance companies
- State your case at a hearing
An experienced and knowledgeable lawyer on your side can make a difference in your workers’ compensation claim. Don’t take the word of insurance companies—be informed and empowered. Call our office nearest you or take a moment to fill out the contact form on this page to get in contact with a member of the Pothitakis Law Firm to get started.
How can social media affect my Iowa workers’ compensation claim?
Social media has become an ubiquitous part of our society. It seems every person and business has an online presence, posting photos, videos, and stories about a wide range of topics and events. As individuals, we use the social media world to help us with everything from keeping in touch with friends to helping pick a restaurant for an evening out. While it is an excellent tool for keeping us connected and informed, social media also provides others with significant insight into our own day-to-day lives, and it can create unforeseen difficulties during a workers’ compensation claim.
Employers and insurance companies are just as savvy at navigating the digital world, and they will investigate an injured workers’ online presence for any information that will undercut the injury claim or reflect poorly on the injured worker. If you have been hurt at work, find out how social media could affect your claim and read our tips for protecting your case online.
Understanding Context and Your Social Media Posts
Insurance companies will do whatever they can to reduce their own liability and protect their bottom line. They will talk to your family, friends, and co-workers, request medical information, and, yes, even search for you online. They are looking for any information that will refute your claims, and they may not be concerned about context. If, for example, you post a photo from a night out with friends looking happy and relaxed, they may argue that you are not experiencing symptoms of pain. Your post, they will say, proves that you feel fine even if it only shows a brief moment and has no relation to the symptoms of your injury. Even a short post or comment that in which you mention money could be twisted to allege that you are only pursuing a claim for financial gain. Regardless of what situation prompted the online post- even if a friend or family member posted it of you- it could be used against you.
Posts About Your Employer and Social Media Defamation
Additionally, if you complain about your employer or share negative comments about them, that attitude may reflect poorly on you during a hearing. Employers and insurance companies may try to persuade the ruling body that you simply dislike your work or employer and are exaggerating an injury to spite them. It may also make you appear petty or mean.
In some cases, negative talk about your employer could have more serious consequences. If you post something that is harmful and untrue, your employer could pursue legal action against you for social media defamation. Defamation is a false, published statement that injures the reputation of a person or business. If you share comments of this nature online, you can be held responsible and forced to pay the party mentioned in your post.
Protect Your Claim and Be Smart Online
Even seemingly innocent comments or posts can have unintended and harmful consequences for your work injury claim. It is important to be especially careful with your online presence while you are navigating the workers’ compensation system. Some helpful tips include:
- Abstain from using social media. The most effective way to prevent social media from interfering with your work injury case is simply not to use it. Suspend or delete your accounts until your case is complete.
- Change your settings to private. Many injury victims just can’t cut social media out of their lives entirely. If this is the case, make sure your accounts are set to private so you can control the members of your audience.
- Keep in mind deleting a post will not make it disappear forever. Even if you delete a post, it is possible that it can still be found on the Internet. It is not a foolproof method for privacy. It is best to think carefully before you post, and avoid potentially inflammatory situations.
- Ask friends and family members to refrain from sharing photos of you. In some cases, injured workers found themselves having to explain photos and comments made by others about them. Remember those searching for you online may find things that pertain to you but were authored by someone else. Talk to your friends and family members about their online behavior.
- Do not discuss your condition or your injury case. If you do continue to use social media, never share information about your health or the status of your claim. Insurance companies will try to use your own words against you in any way possible, and it is best to avoid talk of your physical, emotional, and financial condition entirely.
If you or someone you love has suffered an injury at work, you may be eligible to file a workers’ compensation claim. Refrain from addressing your injury online, and contact the experienced Iowa workers’ compensation lawyers at Pothitakis Law Firm. Our legal team can answer your questions and help you navigate the system to obtain the maximum compensation for your injuries. Request a copy of our free book, 7 Things You Must Know if You Get Hurt at Work, to find more information and useful tips for a successful work injury claim.
Can I rush my workers’ compensation payments if I need the money now?
The workers’ compensation system exists in part to help employees avoid unnecessary hardship after a work injury or illness. When an injury forces an employee to miss work, he can lose out on wages that are vital to the security and stability of himself and his family. This lost income only adds financial stress to an already painful and difficult situation. The workers’ compensation system aims to help employees avoid that by offering wage replacement and medical care benefits. The timing of these payments can lag, however, and many injured workers and their families worry about when they will be able to obtain benefits.
When to Expect Your Iowa Workers’ Compensation Payments
In Iowa, an injured worker can file for and obtain workers’ compensation benefits within certain time frames. Medical benefits are available for any work-related injury regardless of the amount of time away from the job, if any at all. Wage replacement benefits are offered once an employee has missed three days of work, and payment is typically sent by the 11th day of disability if all the proper paperwork has been filed and approved. More complicated cases or those lacking the appropriate documentation may take longer.
Rushing Workers’ Compensation Benefits in Iowa
Injured workers who find themselves under financial strain before the workers’ compensation benefits are paid may want to expedite the payment process. Unfortunately, it is not possible to rush workers’ compensation payments. Each injury claim must follow the steps through the system, which does not allow for circumstances for faster payment. The most effective way to ensure prompt payment of your benefits is to make sure you:
- Seek medical help right away.
- File an injury report with your employer as soon as possible.
- Respond to all requests for information promptly.
- Retain all documents related to your accident, injury, and medical care and provide them when necessary.
Following those steps will help ensure your claim will not be held up or denied unnecessarily.
Social Security Disability Benefits Can be Expedited
While workers’ compensation benefits cannot be rushed, there are other benefits that may be obtained sooner. Some injured workers are eligible for both workers’ compensation and Social Security disability benefits. For those workers, there are times when the Social Security Administration (SSA) will expedite an injury claim, and they include:
- Compassionate allowances. If you suffer a condition on the list of compassionate allowances, the SSA will most likely approve your case. You must be diagnosed with the condition and meet the listings for impairment for the condition.
- Dire need. If a claimant does not have sufficient means to get food, shelter, and medication, the SSA may choose to expedite a claim. To be considered in dire need, a claimant must let the SSA know that they cannot afford to buy food or medicine, are facing eviction or foreclosure, or have had their utilities shut off due to the inability to pay. Claimants should be prepared to show paperwork supporting the claims.
- Military personnel. Past and present members of the military can get their claims expedited as long as the condition began during active duty and the onset date was on or after October 1, 2001.
- Safety. If a claimant is a threat to the public or themselves, the SSA can expedite a claim.
- Terminal illness. If a claimant has an illness that is expected to result in death, the SSA will flag the claim to be expedited. Conditions such as ALS and AIDS, or enrollment in end-of-life programs such as hospice, would alert the SSA. A claimant on life support, oxygen, a wait list for a vital organ or bone marrow transplant, or with certain cancers would also qualify.
Do I Qualify for Social Security Disability Benefits?
Not every employee who suffers a work injury is eligible for Social Security disability benefits. The benefits are meant for workers who are injured before they reach retirement age. There are a number of criteria to meet to obtain these benefits, and they include:
- Worker must have worked in jobs covered by Social Security (those that pay Social Security tax).
- Worker must have worked for a certain number of years in the covered job(s).
- Worker must have a medical condition that meets the SSA’s definition of disability, which typically means you are experiencing a long-term, total disability.
Filing for Iowa workers’ compensation or Social Security disability and having payments expedited can be a complicated process. If you or someone you love has suffered a serious, job-related injury, contact the experienced lawyers at Pothitakis Law Firm to learn more about your rights and legal options. Make sure your family is able to obtain the maximum amount of compensation in the timeliest manner so you can move forward from your injury successfully. Take a moment to fill out the contact form on this page, and you will receive a prompt response from a member of our team who can answer your questions and get you started today.
My work injury has worsened—can I reopen my old workers’ compensation claim?
After a work injury, you successfully navigated the workers’ compensation system to obtain medical care and wage replacement benefits. You secured a settlement that you anticipated would meet your needs and the needs of your family. Now, your condition has worsened, and you feel you need additional compensation to receive the proper care and remain financially stable. Is it possible to revisit your old claim and get additional benefits? The answer is both yes and no. The unique details of your claim and settlement will dictate the options available to you.
Revisiting a Settled Iowa Workers’ Compensation Claim
It can be possible to re-open an old claim to apply for additional benefits. In Iowa, this is known as a review-reopening claim. However, specific conditions must be met in order to do so successfully. A review-reopening claim is not intended to simply review the original claim. The injured worker must have experienced some type of change or worsening of the injury. To pursue a review-reopening claim, the worker must have experienced:
- Worsening of the medical condition
- Decrease in wage earning capacity
- Newly discovered medical evidence (such as a new related diagnosis or unforeseen complication)
- A legal or factual mistake
- Fraud by the insurance company
The burden of proving that one of these elements exists does fall on the injured worker, and specific criteria must be met depending on the type of injury. The following is a brief overview:
- Scheduled loss – Injured worker must show that the functional disability has increased.
- Unscheduled loss – Injured worker must demonstrate that either the functional disability has increased or his earning potential has decreased.
Certain Types of Settlements Cannot Be Reopened
If you want to take a second look at an old claim simply because you are dissatisfied with your benefits, it is typically not possible. Injured workers must meet the stated criteria to revisit an old claim. Additionally, there are times when even workers who are eligible under those guidelines may be prohibited from a claim review. There are a number of different types of settlements in Iowa, and the type of settlement that was originally accepted will dictate eligibility for a review-reopening claim. Some claims are settled in a manner that is considered “full and final,” which means that the injured worker is barred from a review of the claim once the agreement is reached. In other situations, an employee may be able to obtain payment for medical costs only, while there are still other times that full compensation is available.
The terms of the original settlement should be discussed with an experienced lawyer who can help you understand your rights and help you explore ways to be successful if a review-reopening claim is possible.
Pursuing a Review-Reopening Claim in Iowa
Employers and insurance companies are usually reluctant to review an old claim once it has been settled. They are interested in saving as much of their money as possible, and they will try to avoid further payments if at all possible. Typically, a review-reopening claim requires paperwork to be filed with supporting documents. It will be considered by the state commission, and a hearing may be necessary to examine your case further.
It is important to note that a review-reopening claim must be filed within three years of the final payment of weekly benefits for the original case.
Filing a Second, New Claim Can Be Possible
Even if a review-reopening claim is not an option in your case, it may still be possible to obtain further compensation. An injury can be classified as a new injury, and a new workers’ compensation claim can be opened. This is typically possible if:
- The injury is aggravated in a new employer’s work environment.
- The injury is unrelated to a previous claim.
Workers’ compensation law can be complex, and it can be difficult to know if your injury meets the conditions appropriate for a review-reopening claim, a new claim, or no claim at all. At Pothitakis Law Firm, our experienced legal team has helped injured Iowa workers just like you fully understand their legal options and obtain the maximum compensation possible. Call our office or take a moment to fill out the contact form on this page to get in touch with our lawyer and schedule a free, no-obligation consultation.