Denied Workers’ Compensation Claims in Iowa City
Ready to Help You Secure the Benefits You Deserve
Workers' compensation is designed to provide financial assistance to employees who suffer job-related injuries or illnesses. In Iowa City, IA, as in many other states, this system is in place to protect the rights and well-being of workers. However, there are instances where legitimate claims are denied, leaving injured workers in a challenging position.
At Affleck & Gordon, we understand the stress and frustration that can come with a denied workers' compensation claim. Our team of experienced attorneys is dedicated to helping workers in Iowa City, who have had their workers' compensation claims denied. If you or a loved one are facing this difficult situation, we are here to provide the legal guidance and support you need to pursue the benefits you rightfully deserve.
Why are Workers' Compensation Claims Denied?
Workers' compensation claims in Iowa, like in many other states, can be denied for various reasons. It's essential to understand these common reasons to avoid potential pitfalls and ensure you receive the compensation you deserve if you're injured on the job.
Some common reasons why workers' compensation claims are denied in Iowa include:
- Failure to Report the Injury in a Timely Manner: In Iowa, injured workers are required to report their workplace injuries to their employer promptly. Failing to do so can lead to a denial of the claim. Reporting should occur within 90 days, but it's best to report the injury as soon as possible to avoid any disputes.
- Missed Deadlines: Iowa has specific deadlines for filing a workers' compensation claim. If you don't file your claim within the statutory time limits, your claim may be denied. These deadlines can vary based on the nature of your injury, so it's crucial to be aware of them and adhere to them.
- Lack of Medical Evidence: To have a successful claim, you need medical evidence supporting your injury. If you don't seek medical attention promptly or fail to follow your doctor's instructions, the insurance company may argue that your injury isn't severe or work-related.
- Pre-existing Conditions: If the insurance company can show that your injury is related to a pre-existing medical condition rather than a workplace accident, your claim might be denied or reduced.
- Disputes Over Causation: Sometimes, the insurance company may dispute whether your injury was caused by a workplace accident or if it's a result of non-work-related factors. This often involves a legal battle to establish causation.
- Injuries Occurring Off the Job: Injuries that happen while you are not performing work-related duties, such as during lunch breaks or while commuting, may not be covered by workers' compensation.
- Intoxication or Drug Use: If your employer can prove that your injury occurred due to intoxication or drug use, your claim may be denied. Employers may have policies requiring drug and alcohol testing after an injury.
- Injuries Resulting from Horseplay or Violation of Workplace Rules: If your injury resulted from engaging in horseplay, violating safety rules, or engaging in conduct that goes against workplace policies, your claim may be denied.
- Independent Medical Examinations (IMEs): In some cases, the insurance company may require you to undergo an independent medical examination by a doctor of their choice. If the IME report contradicts your treating physician's assessment, it can lead to a denial.
- Incomplete or Inaccurate Documentation: Filing incomplete or inaccurate paperwork or providing inconsistent information can give the insurance company reason to deny your claim.
- Employer Disputes: Sometimes, employers dispute the validity of a workers' compensation claim, claiming that the injury didn't occur at work or that the employee wasn't performing work-related tasks when the injury happened.
- Failure to Cooperate: If you fail to cooperate with the workers' compensation process, such as refusing to attend medical evaluations or not providing requested documentation, your claim may be denied.
How Affleck & Gordon Can Help
When your workers' compensation claim is denied, it can feel like a daunting uphill battle. However, with the experienced attorneys at Affleck & Gordon by your side, you don't have to navigate this complex process alone.
Here's how we can assist you:
- Comprehensive Case Evaluation: Our first step is to conduct a thorough evaluation of your case. We will review all relevant documentation, including medical records, accident reports, and witness statements, to understand the reasons for the denial and identify areas that need to be addressed.
- Building a Strong Appeal: If your claim has been denied, you have the right to appeal the decision. Our legal team will work diligently to build a compelling case on your behalf. This includes gathering additional evidence, securing expert testimonies, and addressing any legal issues that may have led to the denial.
- Negotiating with Insurance Companies: We have extensive experience negotiating with insurance companies in Iowa City, IA. Our goal is to reach a fair and equitable settlement that covers your medical expenses, lost wages, and any other benefits you are entitled to under workers' compensation laws.
- Representation at Hearings: In the event that negotiations do not lead to a satisfactory resolution, we are prepared to represent you at workers' compensation hearings. Our attorneys are skilled litigators who will vigorously advocate for your rights in front of the Iowa Workers' Compensation Commission.
- Appeals to Higher Courts: If necessary, we can take your case to higher courts in Iowa to ensure that your rights are protected and that you receive the compensation you deserve.
- Education and Support: Throughout the entire process, we will keep you informed and provide you with the guidance and support you need. We believe in empowering our clients with knowledge so they can make informed decisions about their cases.
Let us put our expertise to work for you and guide you through the process of appealing your denied workers' compensation claim in Iowa City, IA. You don't have to face this challenge alone – we're here to help you every step of the way.
$1 Million Workers Slip and Fall
After hearing, the Deputy Workers’ Compensation Commissioner entered an award fully in favor of the Claimant finding him permanently and totally disabled. The Decision resulted in an award with the present value of in excess of $1 million. In addition, the Defendants were ordered to pay the Claimant’s medical expenses for the remainder of his life.
$450,000 Partial Commutation
In 2013, our client was a truck driver who was fatally injured in a tragic auto accident. He was married at the time and as a result his wife was entitled to Workers’ Compensation benefits. Those benefits would end upon her death or shortly after she were to remarry. The surviving spouse was finding it difficult to live on the weekly Workers’ Compensation benefits and for other reasons wanted to have the money paid in a lump sum.
Workers’ Comp Appeal Results in Settlement
Pothitakis Law Firm pursued this claim for in excess of three and a half years. Mr. Pothitakis conferenced with the claimant’s doctors and obtained reports over those years to put the claimant in the best position to obtain a favorable result at hearing. When the initial decision was inappropriate, Pothitakis Law Firm filed an appeal and was successful on that appeal.