For the thousands of workers who are injured on the job every year, Iowa workers’ compensation is available to provide vital benefits. Through this system, injured workers and their families can obtain medical care and wage replacement to help ease the burdens of a difficult time. For many, however, navigating the workers’ compensation claims process can seem confusing and overwhelming. Too often, workers miss out on benefits they deserve because of simple mistakes and unnecessary denials. Here, we take a look at how the process works to help injured workers find the information and confidence they need to move forward.
Report Your Iowa Work Injury as Soon as Possible
After seeking medical care, the most important step in any Iowa workers’ compensation claim is to report the injury. Iowa law states that injured workers have 90 days to report an injury to their employer. Many employers will require injured employees to complete an incident report, while others will accept simpler written or emailed notice. In either case, injured workers should offer communication of the injury in writing and keep a copy of the notice for their own records. This report should include:
- Date and time the injury occurred
- Location where the injury occurred
- Description of how the injury occurred
- Description of the injury itself
- Witnesses to the incident (if applicable)
If an employee fails to report an injury within the mandated time frame, the claim could be denied. The 90-day window begins on the day the injury occurred or on the day on which the employee should have reasonably known he was suffering from a work-related injury.
Filing a Claim for Injury Benefits in Iowa
In turn, employers are required to file an electronic report with the Iowa workers’ compensation commission within four days of the report of an injury. Additionally, employers should notify their insurance company of the claim. It is typically not necessary for the injured employee to file the claim with the state.
The insurance company will likely begin to investigate the claim promptly after it is received. The state of Iowa requires that employers and insurance companies respond to workers’ compensation claims in a timely manner or face penalties. Injured workers can expect insurance companies to fully examine a claim, and the investigation may include:
- Review of medical records
- Review of employment records
- Medical exam request
- Phone calls to injury victim and witnesses
It is important to note that injury victims should be very cautious when speaking to insurance representatives. Often, insurance companies attempt to minimize their own financial responsibility by convincing injured workers to offer more information than is necessary or to sign unfair settlements.
Appealing the Denial of a Work Injury Claim
After the investigation, the insurance company will either approve or deny the claim. If the claim is approved, compensation will be determined by the state-set schedule. The law is written to encourage prompt payment of benefits, so injured workers can expect to start receiving compensation shortly after an approval.
If the claim is denied, however, it may be necessary to file an appeal. An appeal can be filed with the Iowa state commission. This is known as a contested-case proceeding, and it typically involves a hearing before the commission. At this hearing, the injured worker and his employer are given the opportunity to state their case, offer evidence, answer questions, and more. An appeal must be filed within two years of the date of injury.
Helpful Tips for Your Iowa Workers’ Compensation Claim
Though navigating the workers’ compensation system in Iowa can seem overwhelming at the start, it is possible to successfully obtain benefits. To help your claim, it is a good idea to:
- Seek medical attention. Many claims are denied simply because the worker failed to seek care. If an injury does not prompt a worker to obtain medical care, it can appear to insurance companies and the state commission that it is not severe enough to warrant benefits.
- Take immediate action. Don’t delay in reporting your injury, seeking medical care, answering questions from the insurance company or state commission, or getting the process started. While the deadlines may seem far away, it does take time to gather and file the appropriate information.
- Keep records. Maintain copies of all correspondence you send and receive. This helps keep insurance companies and employers accountable if they make false claims.
- Find experienced legal representation. While not every workers’ compensation claim requires an attorney, if you suffered a serious injury or your benefits have already been denied, a knowledgeable lawyer can help you fully understand your rights and be an aggressive advocate to help you meet your goals.
If you or someone you love has suffered an injury at work in Iowa, you may be eligible for workers’ compensation benefits. At Pothitakis Law Firm, our experienced legal team is here to answer your questions and help ensure that you and your family are able to obtain the care and compensation you deserve. Call our office nearest you to speak with a member of our team and learn more.