What Qualifies as a Workers Comp Claim? Do I Qualify?

Last Updated: 8/10/2023

Keep in mind that every state has different laws, but here in Iowa there are several requirements to qualify as a workers comp claim including:

1. Prove That You Have An Iowa Workers Compensation Claim.

The first step is to prove that you have an Iowa Workers Compensation Claim. If you were hurt within the state of Iowa, then it is clear that you have an Iowa claim.  However, if you work for an Iowa company and were injured in another state then you may still have a claim here in Iowa.  There are very specific legal and factual requirements to prove that Iowa has jurisdiction over your claim. Keep in mind, that just because they are paying you Iowa benefits does not mean that you have an Iowa claim. There are things to consider such as where the "contract of hire" was made, did you "regularly work" in Iowa, does your employment contract contain a provision that Iowa has jurisdiction if you are hurt at work, etc. 

We have many potential clients who contact us who were paid Iowa benefits but were injured out of the State of Iowa. Some of them we have had to tell that Iowa does not have jurisdiction and they need to promptly file their claim in another state. If you have questions about whether you truly have an Iowa claim or not, you should immediately contact our office as the time limits to file cases in other states can be one year or less. 

2. Prove An Employer-Employee Relationship

If Iowa has jurisdiction over your claim, then you need to prove an employer-employee relationship. This means that you are not an independent contractor. There are several factors to determine if you are an employee or not including:

1.  If taxes are being taken out of your wages, then chances are you are considered an employee;

2. If there is a contract between the parties for a certain piece or kind of work to be done at a fixed price. For example, if you are paid a flat amount of money to complete a certain job then that would be a factor to show you are an independent contractor.

3. The independent nature of the business. For example, if you are hired to work in a factory compared to go do a roofing project on a house will affect if you are an employee or not;

4. If the person you are hired by has the right to supervise the work that you do. An example would be if the person who hired you is directly how you are doing your job compared to just looking at the finished product;

5. Along the same lines is the right to control the progress of the work. If the person you are hired by is micromanaging the project, this would make it more likely that you are an employee;

6. An additional factor is who provides the equipment, tools, supplies, and materials. If you are the one providing these items that weight towards you being an independent contractor, but keep in mind that this is only one of the factors;

7. The amount of time in which you are doing the job.  If this is the first time you have been hired to do the work and it is only a one time project then this would be evidence that you are an independent contractor;

8. Whether you are paid by the amount of time you work or by the job.  If you are paid on an hourly basis this shows that you are more likely an employee;

9. If the work is a part of the regular business of the employer then you are more likely to be considered an employee.

3. Prove You Were Injured While Doing Your Job

If you have proven that you are an employee and Iowa has jurisdiction of your claim, then the next step is to prove that you were injured basically while doing your job. The legal requirement is arising out of and in the course of your employment.  Basically, this means that you were either on the clock working or doing something benefiting your employer. Generally, this includes injuries for work done on, in, or about the premises which are occupied, used, or controlled by the employer. For example, a fall in the parking lot while a worker is going into work or leaving to go back to their car is considered to be work-related. However, if you are driving from your home to go to your normal work shift and are injured in a car crash then chances are that it would not be considered work-related. 

4. Did Work Activities Cause Or Aggravate Condition

Once you are past these legal requirements, then the medical aspect of your case will be the focus. The question will be, did your work activities cause and/or materially aggravate your medical condition such that you now need medical care and treatment. These questions are for the doctors that the insurance company sends you to, your other medical providers and the doctors that you may see for an independent medical examination can answer. If you are able to prove that your injuries are work-related, then there are three different basic types of compensation available to you:

            1. Medical care and treatment including mileage to and from your medical providers and the pharmacy at the direction of your employer and/or their insurance company;

            2. Healing period benefits which are paid while you are either taken completely off work because of your injuries (TTD- temporary total disability) or do not make as much as you did before being injured because of your work restrictions (TPD- temporary partial disability).

            3. Permanent benefits are paid if your injury is determined to be permanent in nature.  The amount of, and duration that you will receive these benefits depends on many factors. These factors are discussed further in our Iowa Workers' Compensation book that we offer a no-cost or risk to you. 

Read Next

How Long Can You Be Out On Workers Comp?

Story of Struggle with in a Iowa Workers’ Compensation Case

Do I Have to Accept My Work Comp Insurance Settlement?