Attorneys
This is a question we hear all the time because the insurance adjuster will tell injured workers "I am closing your case".
These words from an insurance adjustor really mean nothing at all, but they hope that you will believe them and not going any further with your claim. The reality is that in Iowa if you are hurt at work then you have lifetime medical benefits for the work injury.
That sounds great but is really not as great as it sounds because often they will end up denying medical care blaming your condition on arthritis, etc. However, this still does not mean you should just believe what the insurance adjuster is telling you.
Understanding Workers’ Compensation Case Closure
Workers' compensation claims in Iowa go through various stages, from the initial injury report to medical treatment and financial benefits. Your case may be considered closed for several reasons, including:
1. Full Recovery and Return to Work
If your doctor determines that you have fully recovered from your workplace injury and are able to return to your job without restrictions, your workers' compensation benefits may end. This is one of the most common reasons for case closure.
2. Maximum Medical Improvement (MMI)
If your doctor concludes that your condition is not expected to improve any further with treatment, you have reached Maximum Medical Improvement (MMI). At this point, your case may be closed if you can return to work or if no additional benefits are deemed necessary. However, if you have a permanent impairment, you may still be entitled to ongoing benefits.
3. Settlement Agreement
Some workers opt to settle their workers' compensation claim for a lump sum or structured payments. If you have signed a settlement agreement, your case is typically considered closed once the terms of the settlement are fulfilled.
4. Denial of Benefits
Your claim may have been denied by the insurance company for reasons such as insufficient evidence, pre-existing conditions, or employer disputes regarding the injury. If your claim was denied, your case may be closed unless you appeal the decision.
5. Missed Deadlines or Lack of Action
Workers' compensation claims involve strict deadlines for filing reports, submitting documentation, and following up on treatments. If you miss deadlines or fail to comply with medical recommendations, your case may be administratively closed.
What Are Your Options After a Workers' Compensation Case Is Closed?
Just because your case has been closed does not necessarily mean you have no further options. Here are some steps you can take depending on the reason for closure:
1. Appeal a Denied Claim
If your workers' compensation claim was denied, you have the right to appeal the decision. In Iowa, you can file a petition for reconsideration with the Iowa Workers' Compensation Commissioner. This process allows you to present additional evidence, such as medical records or witness statements, to support your case.
2. Seek Additional Medical Treatment
If your case was closed because you were deemed to have reached MMI but your condition worsens, you may be able to reopen your claim to receive additional medical treatment or benefits. Seeking an independent medical examination (IME) can provide evidence that further treatment is necessary.
3. Reopen the Case for Permanent Disability Benefits
If you have a permanent impairment, you may still be entitled to benefits even after your case is closed. In Iowa, permanent partial disability (PPD) benefits or permanent total disability (PTD) benefits may be available depending on the severity of your impairment.
4. Challenge a Settlement Agreement
If you believe you were misled or pressured into signing a settlement, you may be able to challenge the agreement under certain circumstances. Consulting a workers' compensation attorney can help you determine whether you have grounds to dispute your settlement.
Are You Owed More Money?
For example, you may be owed significantly more money than what they have paid you for PPD (permanent partial disability) despite the fact that they have told you your case is closed. Also, if you have been paid workers' compensation benefits then you have up to 3 years from the date of last payment to bring a petition for benefits. The fact that they told you your case is closed is not what Iowa law provides for.
The best way to find out if what you have been paid is fair is by speaking with a qualified and experienced Iowa workman comp attorney. You can start with a phone conversation and if it appears that you may be owed additional benefits then a more detailed meeting and records review will usually occur next. There is no cost or obligation to speak with any of the workman comp attorneys at our office.
Questions To Ask If You Are Owed More Money
Some of the information we look at when determining if an injured worker is owed additional benefits or not are as follows:
1. When were they injured and when were they last paid a workman comp check?
2. What type of injuries did they sustain? (back, neck, hand, brain, foot, CRPS, etc.)
3. What, if any, permanent work restrictions have been imposed?
4. Did they have an FCE (functional capacity evaluation) test and what did it show?
5. Did they receive an impairment rating, who was the doctor that provided it and how much is it?
6. Have they returned back to their normal job making the same or more money?
7. Have they been terminated or asked to leave their job because of the work injury?
8. If they have sustained a scheduled member injury (hand, arm, leg, foot, eye, etc.) did they previously sustain another scheduled member injury to another body party and may qualify for additional compensation under the Iowa Second Injury Fund Act?
The above are just a few of the questions we ask in order to see if we can help an injured worker obtain additional workman comp benefits that they are owed, but not being paid because the insurance adjustor has closed their file.
Why You Should Contact an Iowa Workers’ Compensation Lawyer
Navigating the workers’ compensation system can be overwhelming, especially if your case has been closed and you are unsure of your next steps. A knowledgeable workers' compensation attorney can help you:
Appeal a denied claim
Gather and present medical evidence
Negotiate with insurance companies
Reopen a case for additional benefits
Ensure you receive the compensation you deserve
What Can You Do Now?
During the course of your workman comp case, you should keep the letters that the insurance company sends to you and keep the medical records and reports that your medical providers generate and provide to you. However, don't worry if you don't have these documents as we can obtain them from the insurance company at no cost under Iowa law.
If you have any other questions or want to see if you are owed more, Contact us here, Chat Here Now, Call Us At ((641) 792-3595) , or Read More In One Of Our Free Books!
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