Questions We Are Asked Each Week By Clients...
We are often asked questions like how much should the insurance company pay? How are my weekly benefits calculated?, etc. So we have put together some of the questions we here the most and the answers to them. We hope this helps you avoid making a mistake in your Iowa personal injury, car accident, dog bite, work injury or other injury matter.
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Can I Reopen an Old Workers’ Compensation Claim if My Injury has Worsened?
Have You Settled Your Case Properly?
The first thing to look at is whether you "settled" your case? There are 3 basic types of settlements:
1. Agreement for settlement;
2. Agreement for settlement with full commutation; and
3. Compromise settlement;
The only type of these settlements you can reopen is an agreement for settlement which is what is commonly called an "open file". The other settlements include a lump-sum payment in exchange for a "closed file" which means your medical care ends, your benefits end, and you give up your right to reopen your case. In order to successfully reopen an agreement for settlement the law requires you to prove one or more of the following items:
(1) a worsening of the claimant's physical condition;
(2) a reduction of the claimant's earning capacity;
(3) a temporary disability developing into a permanent disability;
(4) a critical fact existed but was unknown or could not have been discovered by the exercise of reasonable diligence at the time of the prior settlement or award; or
(5) a scheduled member injury later causes an industrial disability.
One of the most common types of what is called a review-reopening petition is when an injured worker has permanent work restrictions which the employer accommodates and then the employer decides they no longer want to or can accommodate the work restrictions and the worker is fired. Also, sometimes we will see a person who has sustained a foot or knee injury for example which causes them to walk differently (called an altered or antalgic gait) develop back or hip pain. This can also trigger your right to review-reopen the case.
Keep in mind that the worsening of your medical condition will need to be documented by doctors. Often it will involve additional medical examinations and an independent medical examination with a doctor of your choice. Generally, the worsening of your medical condition can be proven through an increase in your impairment rating, additional work restrictions, additional medical care in some cases like surgery, etc. These are not always easy cases for injured workers to win as the judges do not necessarily like to hear the same case on more than one occasion.
At our office, we will not rush you into settling your case on a closed file basis giving up your right to review-reopen your case. There are some cases when this is the best option, but there are many others where we recommend either an agreement for settlement or a trial which gets you to the same place, an open file.
What if I Cashed the Workers' Comp Checks?
Keep in mind that if you have not signed any settlement paperwork but have cashed the checks the insurance company sent you then you have not settled your case and the above probably does not apply to you. However, the statute of limitations which can be as short as 2 years still applies to you so at the very least you should seek the advice of a qualified workers' compensation attorney to see if you may be owed additional compensation.
What if I Did Not Settle, But Had a Trial Instead?
In effect, going to trial and receiving an arbitration decision is the same thing as an agreement for settlement. You can successfully reopen your case if you file the petition for review-reopening within the time deadlines and you meet the legal requirements described above.
Have You Waited Too Long?
The general rule in Iowa is to successfully bring a review-opening petition it must be filed within 3 years of when you last received a payment of workers' compensation indemnity benefits such as TTD, TPD or PPD. Most commonly this would be payment of PPD (permanent partial disability) benefits. This is called the statute of limitations and there are few exceptions to get around these strict time deadlines. If you think you may qualify for review-reopening, then you should immediately contact an Iowa workers' compensation attorney with experience to answer your question.
Also, this question is complicated by the fact that in 2017, the Iowa legislature led by Republicans radically changed our workers' compensation laws by reducing compensation to injured workers, making it harder for them to recover, etc. Most of the new laws went into effect on July 1, 2017, such that your date of injury may play a role in the amount of time you have. The only potential good change made to the new law is that if your case is properly resolved, then there is an argument to be made that you do not have a statute of limitations on your case and if you are terminated later on and do not find new employment making the same or more money than you were making at the time you were injured you may be allowed to reopen your case. However, it will be many years before this issue is decided by Iowa appeals courts so do not take it for granted that this right exists. The best practice is to consult with a qualified Iowa workers' compensation attorney to find out how the new laws may apply to your case.
Our office has been handling workers' compensation cases for injured workers throughout Iowa for more than 20 years. We are here to answer your questions, tell you if you even need an attorney or not and help you with the process if you need an attorney and you decide we are best for you and your case.
If you are considering even calling an attorney, the go-to Google and search for the attorney and/or go to an attorney review page like www.Avvo.com and look-up what the attorneys past clients have to say. In addition to what clients have said about us online, we have real clients telling you about their experience at www.OurClientsTalk.com.
I don’t like the workers’ compensation doctor or other medical provider. Can I choose a different one?
You always have the right to choose medical care on your own, but if you want the workers' compensation insurance company to pay for it, then you will generally need to see the medical providers that they choose. However, there is a process called alternative medical care which is discussed in detail in Chapter 4 of our book in which you may be able to obtain a different medical provider under certain circumstances. There are very specific requirements in attempting to change medical care so you should consult with an attorney should you decide this is what you want to do.
To learn more including the 7 Deadly Mistakes to Avoid if You are Hurt at Work order a copy of my FREE Book entitled “Iowa Workers’ Compensation- An Insider’s Guide to Work Injuries”. Why offer a Free Book? I have represented hundreds of Iowans hurt at work and have seen too many clients make mistakes before they had the “right” information resulting in them losing thousands of dollars. Iowans hurt at work are now beginning to realize that they should learn about Iowa's work injury laws. Finally, you can learn about work injuries in the comfort of your own home with no risk or obligation. So to learn how to avoid costly mistakes and your rights Call Now (800)-707-2552, ext. 511 (24 Hour Message) or click the link to request your copy. For immediate assistance or to schedule your NO COST Work Injury Case Evaluation, CALL 641-792-3595 and ask for Corey or Erik.
The doctor they sent me to wants me to have surgery, but the insurance company has not approved it. What can I do?
Unfortunately, it is common for insurance companies to ignore the treatment recommendations made by the doctors they choose. There is a procedure called "alternative medical care" which can be used to seek an order requiring the insurance company to pay for the recommended treatment. The first thing you are required to do is to send a letter to the insurance adjustor requesting that the care be approved. You should keep a copy of the letter as you have to prove you requested the care in writing.
This and other specific legal requirements regarding alternative medical care are explained in Chapter 4 of our Iowa work comp. book available at no cost to you.
I am a truck driver who lives in another state, but was hired by an Iowa trucking company. Where should I file my workers’ compensation claim?
Generally, if your employer has a written employment manual or policy stating that your claim will be handled under Iowa law, then Iowa should have jurisdiction over your claim. However, there are lots of variables in determining the appropriate jurisdiction. Keep in mind that time limitations can be quite short so you should promptly contact an Iowa attorney to discuss the proper state to file your claim in.
If you have questions about where to file your claim or would like a no cost workmans' comp case review, contact our office at 641-792-3595 and ask for Corey or Erik.
Can you ask your employer to do a different or another job if your doctor says you are unable to do your current job?
Yes, you can always ask, but keep in mind that in most circumstances your employer is under no obligation to either provide you with work within your restrictions (however, if they don't have work for you then you should receive a weekly workers compensation check) or provide you with work that you feel is more suitable. In most situations, you are an employee at will and if you reject work that is offered to you within your restrictions then you may be fired and also receive no weekly workers compensation benefits.
What Do I Need to Do to Return to Work after a Work Injury?
If your doctor releases you to return to work with or without restrictions then you should immediately contact your employer. You should request that your doctor provide you with a copy of the written return to work document. You should give your employer a copy, but also keep a copy for your own records. Failing to timely contact your employer after you have been released may result in termination of your employment and your workers' compensation benefits being stopped. It is important to keep your employer informed of changes in your doctor's orders regarding your ability to work so that it does not affect your benefits.
My son died in a work accident, was not married and has no dependents. What happens?
If a deceased worker is not married and has no dependents, then workers' compensation will only pay the related medical expenses and burial expenses up to 12 times the statewide average weekly wage. However, depending upon the circumstances there may be other claims to pursue so a family member should consult with an attorney to find out more information.
To learn more including the 7 Deadly Mistakes to Avoid if You are Hurt at Work order a copy of my FREE Book entitled “Iowa Workers’ Compensation- An Insider’s Guide to Work Injuries”. Why offer a Free Book? I have represented hundreds of Iowans hurt at work and have seen too many clients make mistakes before they had the “right” information resulting in them losing thousands of dollars. Iowans hurt at work are now beginning to realize that they should learn about Iowa's work injury laws. Finally, you can learn about work injuries in the comfort of your own home with no risk or obligation. So to learn how to avoid costly mistakes and your rights Call Now (800)-707-2552, ext. 511 (24 Hour Message) or go to www.IowaWorkInjury.com. For immediate assistance call 515-440-2852 and ask for Corey.
My employer put me on FMLA leave and I did not apply for it. Can my employer do this?
Yes, your employer can run your FMLA time (generally up to 12 weeks of leave if you qualify explained more in our Iowa Work Injury book) at the same time that you are off work due to a work injury.
Should I Receive Any Benefits from Workers Compensation?
If it is determined that you have sustained a work-related injury arising out of and in the course of your employment then yes, you should receive benefits in the form of medical care at no cost to you, weekly checks if you are not able to work and permanent compensation depending upon the nature and extent of your work injuries.
Who Pays the Benefits You are Owed
Most employers purchase an insurance policy that pays for your benefits which means that your employer is not paying anything out of pocket. Some employers are self-insured or have a large deductible meaning that in some cases despite there being an insurance company involved, your employer may be paying for your benefits. Either way, Iowa law requires all employers to provide workers compensation benefits to employees. In exchange for workers' compensation, employees are generally prohibited from suing their employers for negligence causing them to be injured.
Attorneys Help You Get Your Benefits Paid
As long as you have a work-related injury, worker's compensation should be paying you benefits while you are off work. If you are denied benefits or think you are receiving the wrong benefits, the work injury attorneys at Walker, Billingsley & Bair are here to help. Call 641-792-3595 or complete our online contact form to get help from one of our attorneys and find out your options for getting your benefits paid.
Who should you contact if you have questions about your workers compensation benefits?
If you are handling your claim on your own, then you can contact the insurance adjustor assigned to your case. However, keep in mind that the insurance adjustor is not there to help you or assist you. They do not even have to tell you what the law is or even the truth about your case. So use caution when speaking with and agreeing to what the insurance adjustor tells you. If you decide to seek legal assistance with your workers compensation case then you would contact your attorney with questions about your benefits. You may or may not need an attorney in your case.
Learn More About Your Benefits and Rights as an Injured Worker
In our new book entitled Iowa Workers' Compensation, An Insider's Guide to Work Injuries that we tell you whether or not you need an attorney and how the system works in plain English. We offer the book at no risk or cost to Iowa injured workers because we have seen far too many hard working people make costly mistakes in their Iowa work injury claims that cost them thousands of dollars and sometimes their entire case. Request your copy to learn more.