Get Your Questions Answered Today By Iowa Workers' Compensation Attorney Nicholas Pothitakis
After an on-the-job injury, you probably have a number of questions about who was at fault, whether you are owed compensation, and whether you need an attorney to assist you with your claim. Below, we've answered some of the most common questions that we hear at our law firm.
- Page 6
Can you explain the different kinds of disability benefits provided under Iowa Worker's Compensation Law?
Temporary Total Disability (TTD): If employee has a work injury resulting in more than three days of disability then on the fourth day they are entitled to TTD benefits until the employee has returned to work or similar employment. The three-day waiting period becomes payable if the disability period is longer than fourteen days.
Temporal Partial Disability (TPD): These are benefits that are paid if an employee returns to work doing a job for less pay due to his or her work injury. The TPD benefit must be 66 2/3 % of the difference between the employee's average gross weekly pay at the time of the injury and the employee's current lesser pay. The three-day waiting period is also a requirement for TPD.
Healing Period (HP): While an employee is healing from an injury that caused a permanent impairment, he or she may be entitled to HP benefits starting the first day of disability until the one of the following occurs: 1) The employee comes back to work and it has been medically determined that significant improvement of the injury is not expected; or 2) The employee is medically able to return to work performing a very similar job that he or she was doing at the time of the injury. It is important to note that no waiting period applies to HP benefits.
Permanent Partial Disability (PPD): The employee may be entitled to PPD when a work injury results in a permanent disability. PPD benefits are in addition to the HP benefits and begin at the end of the healing period. There are two different kinds of PPD benefits:
1) Scheduled Member Disabilities—This is when a scheduled body member (i.e. arm, leg, hand, eye, etc.) is involved in the permanent partial disability and is based on loss of use. There is a value (in number of weeks of benefits payable) for each member.
2) Unscheduled (Body as a Whole) Disabilities—This is when a work injury results in a permanent disability to the employee, but the injury is not a scheduled member. It is considered an industrial disability and is compensated based on the percent that the disability reduced the employee's earning capacity. It often involves injury to the back, neck, shoulder, or hip. There are many factors involved in determining industrial disability. There are no specific guidelines indicating how each of the factors are to be considered when figuring benefits. An experienced Worker's Compensation lawyer can provide you guidance concerning this.
Permanent Total Disability (PTD): If an employee is incapable of returning to work because of their work injury, then the employee may be entitled to PTD benefits. These are paid as long as the employee is permanently totally disabled.
Second Injury Fund Benefits: An employee has a PPD to one major body member (hand, arm, foot, leg, or eye) and sustains a PPD because of a workplace injury to a second major body member. The employee may be entitled to benefits from the “Second Injury Fund.” Contact the State of Iowa's Treasurer's Office for a claim form.
Vocational Rehabilitation Benefits: The Iowa Division of Vocational Rehabilitation Services (DVRS) aids individuals with disabilities to find and keep employment. Benefits of $100 per week (up to 13 weeks) may be given to employees actively participating in a vocational rehabilitation program. An additional 13 weeks may be paid if approved by the Worker's Compensation Commissioner.
Death Benefits: In Iowa, family members are entitled to death benefits if an employee’s death is a result of a work-related injury under the Iowa Workers' Compensation laws. A surviving spouse is entitled to benefits for the remainder of her life or if remarries, for an additional 2 years after that remarriage. Children are entitled to benefits to the age of 18 unless they are actually dependent beyond the age of 18 and then those benefits can continue under certain circumstances. If a child is in college, they can receive benefits up to the age of 25. Physically or mentally incapacitated children can receive benefits for the time they remain physically or mentally incapacitated. Depending upon the number of dependents (spouse and children), the Iowa Workers' Compensation benefit would be split in some fashion.
In addition to weekly benefits for the decedent’s family, employers are responsible for burial expenses and medical expenses as a result of the injury and death.
If there are no dependents then the only benefits that are provided are medical expenses caused as a result of the Iowa work injury and burial expenses.
For an injury to be covered under the Iowa Workers' Compensation laws, does it have to be one traumatic incident or can it occur over time?
In Iowa, traumatic injuries as well as what are called cumulative injuries are covered under the Iowa Workers' Compensation Act. Many injuries occur as a result of repetitive activities or injuries that occur over time. As long as the injury is related to the work activities, then Iowa Workers' Compensation benefits should be provided.
Many workers in Iowa sustain disabling injuries as a result of repetitive lifting, bending, twisting, etc. The fact that one specific event does not cause the injury does not preclude their entitlement to receive Iowa Workers' Compensation benefits, including medical care and weekly Iowa Workers' Compensation checks. In fact, many very serious injuries occur gradually as opposed to from one specific event. Both traumatic and cumulative injuries are treated the same under Iowa Workers' Compensation laws. If your Iowa work injury comes on gradually, it is important to report it as soon as you believe it's a more serious condition . Cumulative-type injuries, or gradual injuries, are hotly contested Iowa Workers' Compensation claims and for that reason it may be beneficial to speak with an experienced Iowa Workers' Compensation attorney. There are deadlines that have to be met whether the injury is cumulative (gradual) or in one specific incident.
Can an injury be covered under Iowa Workers' Comp Law if it is such that it occured over time or would it have to be one traumatic injury?
Traumatic injuries as well as what are referred to as cumulative injuries are covered under Iowa Workers' Comp Law. Oftentimes, workplace injuries occur over time or are a result of repetitive activities. If this injury is related to work activities, then benefits from Iowa Workers' Compensation should be received.
Countless Iowans sustain disabling injuries at work from repetitive lifting, bending, twisting, etc. The fact being that one specific event does not cause the injury does not prevent their right to receive Iowa Work Comp benefits, which includes medical care as well as weekly Workers' Compensation checks. Actually, many very serious injuries happen gradually as opposed to suddenly from one specific incident. Traumatic and cumulative injuries both are treated the same under Iowa Workers' Comp laws. If an injury comes on slowly, it is very important to report it as soon as you feel it is a more serious condition. Cumulative-type injuries (gradual injuries) are hotly contested Iowa Work Comp claims and therefore, it may be in your best interest to talk to an experienced Iowa Workers' Compensation lawyer. There are certain deadlines that must be met whether the injury is cumulative (gradual) or one specific event.
How are back injuries compensated under the Iowa workers' comp laws?
When you injure your low back, middle back or in fact any portion of your back while working you are entitled to benefits under the Iowa workers' compensation laws. Low back injuries are significant in the Iowa work comp system because back limitations can have a drastic affect a person’s ability to work. The effect an Iowa work comp injury has on your ability to work is the primary driver of the amount of money the system will pay for a work related injury. If an Iowa employee sustains a permanent back injury, they are entitled to benefits based on how the back injury affects their ability to work and earn money. These benefits are called "industrial disability benefits." Ultimately there is a determination of how the injury affects your ability to work in percentage terms. If you lose 50 percent of your ability to work you would be entitled to 50 percent of 500 weeks (amount set by law) or 250 weeks of Iowa workers' compensation benefits for the injury. Back injuries are frequently pursued under the Iowa work comp system as there are a significant amount of employment positions that are precluded for persons with permanent low back injuries and limitations.
If I have a shoulder injury at my Iowa workplace, how am I compensated?
If you sustain a compensable Iowa Workers’ Compensation injury to your shoulder you are entitled to Iowa work comp benefits. Those benefits include medical benefits (the Iowa employer and insurance carrier pays your medical expenses for the injury), healing period benefits, and permanency benefits. Healing period benefits are benefits paid to you on a weekly basis for each week you are off of work as a result of the Iowa work injury. Those benefits continue until you return to work, are released to similar employment, or placed at maximum medical improvement. Permanency benefits are paid at the end of the healing period benefits. Because the injury is to your shoulder it is considered an injury to your body as a whole. Body as a whole injuries are compensated based on how the injury affects your ability to earn income. This is called “industrial disability benefits." The way an injury affects your ability to earn a living are determined based on your age, education, past work history, restrictions, impairment, and a number of other factors. These benefits are significantly higher than the benefits for scheduled member injury to your arm, hand, leg, or foot. Shoulder injuries can result in significant affects on a person’s ability to work certain jobs and can have a drastic affect on one's ability to work and earn a living.
If I experience a work related injury, who makes the decision regarding what doctor I will see?
In accordance with the Iowa Workers’ Compensation laws for an injury that is acknowledged by your employer as related to your work activities, the employer and Iowa Workers’ Compensation insurance company are allowed to decide what physician you will see. Their right to decide which physician has some limitations. The medical treatment that is chosen by the employer is required to be reasonable, prompt, and reasonably appropriate to treat the condition without unwarranted inconvenience to the worker. In cases that the employer or Iowa Work Comp insurance company choose doctors who are either unqualified or who are located very far from the worker’s residence, there is the possibility that the worker may force the employer and insurance carrier to find a different doctor to treat them.
One more instance where the worker may have a choice of treatment is when the worker has the legal right in Iowa to a second opinion. Under the law, the Iowa Workers’ Comp Insurance carrier must pay for a second opinion when:
1) The Iowa Workers’ Compensation claim is accepted;
2) An impairment rating has been given by the Iowa Work Comp insurance carrier’s physician;
3) The injured employee deems the impairment rating as too low.
These kinds of questions need to be answered by an attorney who has considerable experience in Iowa Workers’ Compensation law.
Iowa Workers' Compensation Law- Do I have to be injured in Iowa to receive benefits?
There are a number of ways that Iowa has jurisdiction over an work injury. If the injury happens in Iowa, you can bring an a claim for benefits in the Iowa Workers compensation system. If the employer has a place of business in Iowa and the employee regularly works at or from that place of business and the employee lives in Iowa also supports Iowa Workers Compensation Law covering the claim. If the employee is working under a contract of hire made in Iowa and regularly works in the state also satisfies Iowa jurisdiction. There are other ways to be covered by Iowa Workers Compensation law even if injured outside of the state. For that and other reasons, it is important to talk to an Iowa Workers Compensation Lawyer if you have sustained an injury and either you or your employer has some connection with Iowa.
What compensation do I have a legal right to if I experience a work related injury?
You have the right under Iowa law to three types of compensation if you experience a work related injury: Medical Benefits, Wage Replacement, and Permanency Benefits.
1. Your right to Medical Benefits include having your medical bills paid for treatment received due to the injury. Your employer gets to decide what doctor you will see, however, they are responsible for bills related to your injury under Iowa Workers’ Comp law. As well, they should be responsible for gas and mileage expenses of getting you to your physician’s office and back.
2. Wage Replacement Benefits is another compensation if you have to miss work because of your injury. You have a legal right in Iowa to receive a salary close in amount to your take-home pay for every week that you miss work due to a work related injury. The basis on which it “approximates” your take home salary is that is not subject to taxes.
3. Lastly, you have the right under Iowa law to have permanent partial disability compensation. This amount is based on the severity of your Iowa worker injury and, in some circumstances, upon how this injury impacts your future income. This is the compensation that is usually considered for determining an Iowa Workers’ Compensation claim settlement.
You are entitled to additional benefits if you have experienced a work related injury. An attorney that is experienced in Iowa Workers’ Compensation law would be able to help you determine which benefits you may be entitled to.
What are some important recommendations to keep in mind if involved in an Iowa Workers' Compensation claim?
1) Know that the Iowa Work Comp insurance carrier is not your ally. They are trying to settle the claim as efficiently and cost effectively as possible. If they compensate you less than the full value of the claim, then this is definitely more cost effective and helpful for them.
2) The weekly payments and the settlement amount they are inclined to pay may be inaccurate. Just because the Iowa Workers’ Comp insurance company says it is right and just, doesn’t mean it is true.
3) Your right to Iowa Workers’ Compensation benefits does not cease because of the presence of a pre-existing condition or prior physical limitation. Many of my clients were told that because they had a prior back injury that their new back injury or new aggravation at work is not eligible for Iowa Work Comp benefits. However, that is not true.
4) Even though your workplace may choose your doctor for your first appointment, the employer is not allowed to be in charge of your subsequent medical care free from limitations. In several cases, you are allowed to request a new physician when you are not satisfied with the one they have chosen.
5) Even though you are in discussion of a clime with the Iowa Work Comp insurance company, you still must meet the deadlines set by Iowa Workers’ Comp laws. By law you must file a claim within two years of the date your injury occurred; or three years from the date of the final payment of weekly Iowa Workers’ Comp benefits.
It is important to talk over these matters with an attorney who is accomplished in the field of Iowa Workers’ Compensation law. Several Iowa Workers’ Compensation law firms, such as the Pothitakis Law Firm, P.C., will arrange a free initial meeting to discuss your case.
If I gradually sustain an injury at work based upon my work activities as opposed to one single specific incident, am I entitled to receive Workers' Compensation benefits?
Workers' Compensation injuries in Iowa can either be traumatic incidents or what are called "cumulative injuries." Cumulative injuries are Iowa work injuries that develop over time based upon a work activity. Both traumatic injuries and cumulative injuries are compensable under the Iowa Workers' Compensation laws.
Your employer and the Iowa Workers' Compensation carrier in many cases try to deny the cumulative injury (gradual) claims. It's important that in situations where you have a physical condition that you relate to your work activities that you discuss this with your physician when you initially seek care. It's also important that you inform your employer that your condition may be related to your work activities.
You should prepare an incident report or accident form that is provided by your employer so that notice is provided to them of your potential Workers' Compensation injury claim. Your entitlement to benefits would be influenced by whether the doctors believe that your Iowa work injury condition was either caused or aggravated by your Iowa workers compensation injury activities. For questions such as these, it is important that you contact an experienced Workers' Compensation attorney.