Workers' Compensation Dispute Resolution ProcessMany times, workers’ compensation disputes can be resolved with direct and open communication among the employee, the employer, and the insurance company. Iowa employers are required to be clear about the reasons for a decision and present evidence that supports that decision. There are penalties for denying a claim unreasonably, and employers and their insurers have a duty to provide benefits when appropriate. Often, when addressed directly about the situation, employers will recognize their responsibility to provide compensation. If this is not possible, a more formal process can be pursued.
Handling Workers’ Compensation Disputes at the State Commission LevelThe Iowa Division of Workers’ Compensation maintains files on all claims and can help all parties understand their rights and options. When an employee and an employer cannot resolve their disagreement, the office can suggest ways to seek a resolution. A compliance administrator can evaluate the case. While compliance administrators cannot represent the interest of either side, they can and do provide information on state law, the rights of both parties, and state procedures. They can also offer:
- Mediation services
- Alternate medical care
- Health services dispute resolution
Formally Challenging When an Employer Disputes Your Workers' Compensation ClaimWhen other resolution methods fail, however, injured employees can file a formal dispute with the Workers’ Compensation Commissioner. This is known as a contested case proceeding. In a contested case proceeding, the commissioner or a commissioner’s deputy will hold a hearing. At that time, both sides will offer their version of events and provide evidence to support their claims. In these situations, the burden of proof is on the injured employee to prove that he is entitled to the benefits sought. While a workers' compensation attorney is not required, the office does often suggest seeking representation to ensure that an employee’s rights are fully protected. An experienced workers’ compensation attorney can help injured workers understand their rights, gather evidence, prepare for the hearing, secure expert testimony, and present a thorough case to the commissioner. If a claim is again denied, the injured employee would not have any further recourse in the workers’ compensation system. The case would have to be further pursued through the state court system.
Protect Yourself from Workers' Compensation Disputes
It is important to report a work injury and file a claim as soon as possible. In Iowa, failure to meet the stated deadlines will result in the denial of your workers’ compensation claim. Many times, claims are denied and benefits lost simply because the injured employee waited too long to file or appeal a claim. In cases where an employer lied to the workers' compensation commission or his or her insurance provider, it's important to act fast and involve a skilled attorney in the process. If you or someone you love has suffered a job-related injury or illness, the experienced workers’ compensation lawyers at Pothitakis Law Firm may be able to help. Our skilled legal team has helped many injured Iowa workers obtain the care and compensation they deserve. Contact us today for a free copy of our book, 7 Things You Must Know If You Get Hurt at Work, to learn more about your rights.