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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What If I Get Coronavirus (Covid 19) From My Job?
Under the current law in Iowa you have to prove that your injury, whether it is Coronavirus Covid 19, a back injury, etc. arose out of and in the course of your employment. One would think that your employer and their workers' compensation insurance company would want to help you as you likely are putting your life and livelihood on the line to do your job. However, most of the time your employer and/or their workers' compensation insurance company will look for a way to deny your claim with one or more of the following excuses:
1. How do we know you were infected at work?
2. You have probably been around someone else with the virus?
3. We don't have to pay for Coronavirus (Covid 19) cases because it is a pandemic.
It is your burden of proof as an injured worker to prove that you contracted the virus at work so how can you do this?
1. If your occupation (nurse, doctor, ambulance personnel, orderly, etc.) causes you to be exposed to patients then you should document the date, time, location, name of patient(s) (later on you can use initials if necessary for HIPPA) with Coronavirus and how you may have been exposed;
2. If you have symptoms report them immediately to your employer, tell your employer why you think it is work related and request medical care. If they don't have you fill out an injury report, then prepare a statement yourself and keep a copy of it for your records. Often, if you only give a verbal statement your employer will deny that you notified them and deny, defend and delay your claim;
3. Insist on getting tested to determine if what you have is really Coronavirus or just the flu. If you do not have a test confirming it then later on the insurance company will likely try to blame it on anything and everything that they can in order to not have to pay you benefits.
While a traumatic exposure to Coronavirus should be enough to prove you sustained a work injury, your employer may treat the condition as an occupational disease which can make it more difficult for you to make a recovery. For an occupational disease you have to prove:
1. You developed a disease that arises out of and in the course of employment and have a direct casual connection with the employment and followed as a natural incident thereto from injuries exposure occasioned by the nature of the employment;
2. You developed a disease which follows from a hazard to which an employee has or would have been equally exposed outside of the occupation is not compensable as an occupational disease.
An occupational diseased claim has other legal requirements which make it very important to promptly report your work related Coronavirus (Covid 19) in writing to your employer. For more information about Iowa workers compensation claims request a copy of our Iowa Workers' Compensation Book where we explain the work injury process in more detail and also devote an entire chapter to Your Rights as an Employee, FMLA, ADA, etc Click Here. We offer our book at no cost or risk to you because we have seen far too many hard working Iowans make a costly mistake because they did not have the information they needed. If you have any questions contact us here or call 641-792-3595
What Compensation Could I Receive For A Back Injury At Work?
There are dozens of factors that will determine how much a back injury is worth. Generally, if you have a permanent work-related back injury you will be paid a percentage of 500 weeks of benefits unless you are considered permanently and totally disabled which is a lifetime of benefits.
Some of the important factors in assessing what is known as your industrial disability include the following:
-Did you sustain a permanent injury? If yes, what is your functional impairment rating? (Note: there if you do not know the difference between a functional impairment rating and industrial disability you should read on and also request a copy of our Iowa workers' compensation book that we offer at no cost or risk)
-Did you require surgery and if so, what type (fusion, laminectomy, diskectomy) and how many?
-How long were you off work following your work injury?
-Do you now have permanent work restrictions?
-Do you now have to use an assistive device like a cane or brace?
-What are your current symptoms and how do they affect your ability to earn a living?
-What, if any, ongoing or additional medical care is expected in the future?
-Have you returned to your regular job making the same amount or more money?
-Have you been terminated because your employer does not have work available within your restrictions?
-If you were terminated, have you done a full and complete job search such that you will be considered a motivated worker or not?
-If you were terminated, have you found another job and if so how much does it pay, what are your job requirements, etc.
-How far did you go in school?
-Do you have learning disabilities or other problems with learning?
-Do you speak and read English?
-What, if any, other health conditions do you have that affect your employability?
When considering settlement of your case, we look at the above factors along with other items to provide an estimate of the percentage of industrial disability that we think a workers' compensation judge will do with the case later on. If the case does not settle, then eventually a workers' compensation judge will look at these factors in determining what he/she thinks your industrial disability is caused by the work injury at issue.
Let's say, for example, it is determined that you have sustained a 30% industrial disability. This means that you are owed 150 weeks of PPD (permanent partial disability) because 30% * 500 weeks = 150 weeks. Keep in mind that these benefits are paid weekly unless you agree to give up your medical and close your file which is rarely a good idea to try to do on your own for a number of reasons including the social security offset alone could costs you thousands of dollars, Medicare, etc. These PPD benefits are paid in addition to the TTD (temporary total disability) benefits that you probably received while you were off work healing from your injuries.
Once we know how many weeks you are owed for your permanent disability, then we will need to make sure that the weekly amount they are paying you, called your weekly rate is accurate.
When looking at your rate we look at:
-What was your average weekly wage in the 13 weeks prior to the work injury? This includes your total number of hours worked each week times your regular hourly wages, plus regular bonuses, tips, etc.
-Are you married or single?
-How many dependents do you claim on your tax returns besides yourself?
-Are you age 65 or older and get to claim an additional dependent?
Your weekly rate is very important because if you are owed 150 weeks of benefits and your weekly rate is $200 compared to $1,000 the value of your case could be very different. If you are owed 150 weeks at $200 the total is $30,000 whereas if you are owed 150 weeks at $1,000 the total is $150,000 or five times as much.
Note: Approximately 80-90% of cases like the ones described in this article will end up settling before trial for a lump-sum sometimes with the medical and case open or other times with the medical and case closed.
Below are 3 examples of what cases may be worth under these very specific facts. Keep in mind that every case is different and there are 12 different judges all of which may evaluate your case very differently. Further, there is an appeals process where the Iowa Workers' Compensation Commissioner can change, modify or eliminate the decision of the judge who hears the evidence. If you would like to discuss the facts in your specific case (if you are not already represented by an attorney) and how much your workers' comp back injury may be worth just give us a call at 641-792-3595 for a no-cost, no-risk work injury evaluation.
A 61-year-old factory worker with a high school education worked for the same company for 30 years. While lifting at work he sustains a serious back injury causing discs in his back and L4-L5 at L5-S1 to herniated putting pressure on his spinal cord. Because of this, he requires an immediate fusion surgery with the placement or hardware (screws and rods to stabilize the area). He completes 6 months of physical therapy and his doctor recommends an FCE (functional capacity evaluation) in order to determine his permanent work restrictions. His test is found to be valid placing him in the light work category with permanent work restriction of no lifting of more than 20 pounds. He is given a 20% functional impairment rating by his doctor. He contacts his employer with his restrictions and is told that they do not have work for him within his restrictions and he is terminated. Presuming that he attempts to find other work within his restrictions and is found to be a motivated worker, the case is probably worth a range between 50% and permanent total disability. If his workers' compensation rate is $750 per week then this would mean either a weekly check for 250 weeks * $750 per week or a weekly check of $750 per week for the rest of his life.
A 34-year-old truck driver with a GED falls on the ice at work resulting in a low back strain. An MRI shows that he has a herniated disc, but he does not require surgery. He has many months of physical therapy, 2 epidural injections and missed a total of 10 months of work after his work injury-related fall. He is released to return to work with a 50-pound weight restriction and because his job requires him to be able to lift up to 100 pounds they terminate his employment. He is given a 5% functional impairment rating. He looks for other work and finds a "no-touch" freight truck driving job that he is able to do, but it pays about 20% less than his prior job. The case is probably worth a range between 20% and 40% disability. If his workers' compensation rate is $800 per week then this would mean either a weekly check for 100 to 200 weeks * $800 per week with open medical benefits.
A 52 year old production supervisor with a 4-year college education falls into an uncovered pit at work after July 1, 2017. He has had back problems for many years, but the fall aggravated his prior bulging discs such that he required a laminectomy surgery. He has 4 months of physical therapy and makes a good recovery. He is able to go back to his normal job without restrictions. The company doctor gives him a 0% functional impairment rating. He hires an attorney who sets him up for a 2nd opinion with an IME doctor. The IME doctor determines that he has a 15% impairment rating because of herniated disc with surgery and residual symptoms. The case is probably worth a range between 0% and 15% disability because he is making the same or more money than he did prior to his work injury and his injury occurred after July 1, 2017, when Governor Branstad lead the Republican charge to reduce compensation to injured workers. If his workers' compensation rate is $1,200 per week then this would mean perhaps up to 75 weeks of benefits at $1,200 per week.
If you have any questions regarding any work injuries including back injuries you can give us a call at call at 641-792-3595 or contact us here for a no-cost, no-risk work injury evaluation.
What If I Get Fired While on Workers Comp?
This is a question that we hear often and frankly, it is a very scary part of a work injury case here in Iowa. If you get fired while on workers' comp one question will be why did you get fired? If you were fired because you did not show up to work and did not have a doctor's excuse, then this is bad for your workers' comp case. If you got fired because you had permanent work restrictions that your employer was not willing or able to accommodate, then this can be good for a case and you may have other remedies discussed below.
Please note that your employer can fire you while you are receiving workers comp. I know this will come as a shock to many of you, but you are an employee at will under Iowa law so you can be fired for any reason or no reason at all.
But there may be some protection for you under the FMLA (Family Medical Leave Act), ADA (Americans with Disabilities Act) or a collective bargaining agreement that you may have through your union. However, these laws do not change the fact that you can be fired, they may just allow you, later on, to get your job back along with potentially additional damages.
Now let's discuss in more depth the reason for you being fired.
Terminated because of work injury
There are many different points in time when an employer fires an injured worker. Sometimes, a worker will be fired immediately after the injury for say a safety violation. Other times, an injured worker is fired while they are off work healing from their injuries and have used up their 12 weeks of FMLA time. A common time for an injured worker to be fired is once they have reached MMI (maximum medical improvement) and have been given permanent work restrictions. You should provide your employer with your permanent work restrictions and ask for work. You need to be ready, willing and able to do the work within your restrictions. While you may not yet know if you are able for sure to do the work, you must at least go and try to do the job. One of the worst things you can do for your workers' compensation case is to refuse to do work that is offered to you. This is a very complicated area of the law where there are many traps that have been set for injured workers. In 2017 then Governor Branstad and the Republican party voted to significantly reduce compensation to injured workers in a number of ways including if an offer of employment is made to the worker. Employers know the law and will try to catch you in one of the new traps. If you try to navigate this area of the law on your own, it is very possible that you are throwing away thousands of dollars. We are happy to discuss your workers' comp claim, your employment, your termination, etc. at no cost or risk. If you are faced with being fired, you definitely should talk to an attorney as soon as possible. Also, it is possible that you will want to file for unemployment, but there is a right way and wrong way to do this as well discussed in more detail below.
Terminated for some other reason
There are dozens of other reasons that an employer may fire an injured worker. Keep in mind that your employer will always be looking for a way to fire you that is not related to your work injury in an attempt to reduce the compensation that you receive. For example, often employers claim that injured workers did not do their job properly, were late, missed work due to personal matters, committed employment misconduct, etc. Just because your employer claims you were fired for something other than the work injury does not mean that it is true. If your employer fires you, then you will likely want to consider filing for unemployment, but this is a big topic by itself.
Filing for unemployment
It would literally take hours to explain the entire unemployment system and how it works, but here are some general guidelines:
1. Ready, willing and able to work
This is a basic requirement before you even consider filing. Keep in mind that you do not have to certify that you can return to your old job, but rather that there is work available in the open labor market that you can do. For example, let's say you work in a factory and you cannot return to your factory job, but you could return to a light-duty desk job that your employer had you doing for a period of time. Also, maybe there is work in the past you have done that you can do or you could work at a local grocery or convenience store running a cash register, stocking shelves, etc. Before you have any type of phone interview, you should write down some of the jobs you think you could do.
2. Work credits
You have to have enough quarterly work credits in order to qualify. Keep in mind that if you were off work for 3 or more quarters because of your work-related injury, then Iowa Workforce is supposed to skip those quarters and look at the time prior to your work injury. However, rarely do they get this right. Usually, they will send out a notice that you do not qualify because you do not have enough credits. If this happens you need to timely provide Iowa Workforce with the correct information. You can try to do this on your own, but they are looking for very specific things such as your first report of injury, a letter from the insurance company stating TTD and PPD paid, medical records showing your date of MMI, etc.
Under Iowa law, you are not allowed to receive both TTD (temporary total disability) benefits and unemployment at the same time. If you file for unemployment too early in your case, then you are wasting the benefits that you otherwise may have received. However, if your workers’ comp claim has been denied and the employer is not offering you work, then it may make sense to go ahead and file.
We are happy to discuss any of the above topics with you at no cost or risk. Just give us a call at 641-792-3595 or Contact Us Here
What Does it Mean When Workman Comp Closed My Case?
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.
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.
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.
Can I be Fired While on Light Duty?
Under Iowa law, unless you have a written employment contract then you are most likely an employee at will. This means that you can be fired at any time for any reason or no reason at all. However, if you are a union member you can file a grievance in an attempt to try to get your job back. Also, if your employer violates an employment law such as the ADA (Americans with Disabilities Act), FMLA (Family Medical Leave Act), etc. then you may be able to successfully get your job back by filing a complaint with the EEOC (Equal Employment Opportunity Commission) or Iowa Civil Rights Commission.
There are short time limits to file these complaints, follow specific rules and then potentially file a lawsuit so you should definitely consult with an attorney who is qualified to discuss not only your workers' compensation case but also your potential employment law case. Our attorneys can discuss both of these aspects with you to see what may be done in addition to your workers' compensation claim. However, if you are already represented by a workers' compensation attorney then you should start by talking to your current attorney.
Tips For Your Workers’ Compensation Claim
Do Not Leave Your Job Voluntarily
Please under almost no circumstances should you quit your job, resign and/or agree to leave your job while you have a workers' compensation claim pending. This can be devastating financially to you for a number of reasons including it will likely reduce the value of your workers' compensation case, you may not receive unemployment benefits, you will likely not receive weekly work comp checks, etc. If they want you to leave the job, make them fire you because this will help your claims in a number of ways.
Keep in mind that if you are fired while on light duty it may have a significant impact on your workers' compensation case. Hopefully, you are not fired for "cause" because if you are then chances are the insurance company will deny paying you TTD (temporary total disability) benefits while you are on restrictions prior to reaching MMI (maximum medical improvement).
It is common for the insurance company to initially deny these benefits until an Iowa attorney sends them the law about this and explains that they may be subject to penalty for failing to continue paying TTD. We have helped hundreds of injured workers get their TTD benefits started and also help them decide if, and when, they should file for unemployment.
What About Filing For Unemployment?
You should not immediately file for unemployment if your ongoing TTD request is not granted. This is because you may be wasting your unemployment as you are not allowed to receive both TTD and unemployment benefits at the same time. However, you can eventually receive unemployment and PPD (permanent partial disability) benefits if certain legal requirements are met. These requirements are very specific, and we have helped hundreds of injured workers eventually receive both unemployment and their PPD benefits at the same time. Although, if you try to do it on your own and it is not done properly then chances are, we are not going to be able to fix things after the fact.
On another note, even if Iowa Workforce says you do not qualify because you do not have enough work credits, don't assume they are correct. If you have missed 3 or more quarters while receiving TTD then we can help file an appeal so that the correct quarters are used prior to your work injury in an attempt to obtain your unemployment benefits. Keep in mind that your unemployment claim is very important to your workers' compensation case. If you have an attorney who says "we don't handle unemployment claims" this should raise a big red flag. Obtaining your unemployment not allowing gives you another source of income for up to 26 weeks, but also can increase the value of your workers' compensation case by tens of thousands of dollars. If we are helping you with your workers' compensation case, we do not charge you any fees while handling your unemployment claim. If we are successful in your workers' compensation case then you pay us a flat fee at the end of your workers' compensation case.
So while you can be fired while on light duty, as you can see with the legal help you have several options that we can pursue in order to keep an income source for you, potentially getting your job back, and/or getting you additional workers’ compensation benefits. If you have questions about any of the above, please feel free to contact or call our office (641-792-3595) at no cost for your Iowa work injury evaluation. We will take the time to speak with you (usually by phone at first and then often later in person), answer your questions, explain how the process works.
What Qualifies as a Workers Comp Claim? Do I Qualify?
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.If you have questions about any of the above, please feel free to call our office (641-792-3595) at no cost for your Iowa work injury evaluation. We will take the time to speak with you (usually by phone at first and then often later in person), answer your questions, explain how the process works and even tell you if we think you need an attorney or not.
Do Workers Compensation Benefits Stop at 65?
In Iowa, work comp benefits do not automatically stop when you reach age 65. However, keep in mind that there are a few different types of benefits and they work differently. There are temporary benefits referred to as TTD (temporary total disability), permanent benefits called PPD (permanent partial disability) and medical benefits which include paying for the entire cost of the medical care you are provided at the insurance company's discretion, plus your mileage and time you miss from work that you are not paid for. Also, keep in mind that the receipt of Social Security benefits can have a big impact on benefits paid up until the time that you reach your full retirement age discussed more below.
TTD- These are paid to an injured worker regardless of age when after a work injury they are taken off work by the authorized treating physician or given work restrictions that the employer cannot accommodate. These are paid until the injured worker reaches MMI (maximum medical improvement) or otherwise known as you are as good as you are likely to get from the doctor's standpoint.
PPD- These benefits are paid based upon your impairment rating in scheduled member only cases or your industrial disability in other cases. You are paid a number of weeks of benefits which can extend past age 65. The number of weeks you will be paid depends upon the type of injury you sustained, your functional impairment rating under the AMA Guides and in some cases your age, education, loss of actual earnings, along with many other factors. One of the biggest factors in how much you will be paid is if you have a scheduled member injury (arm, hand, leg, foot, eye, etc.) or an unscheduled (also known as an industrial injury like a back, neck, hip, CRPS, certain injuries around the "shoulder" joint, etc.). We have other articles on our webpage and book that we offer at no cost which explains PPD compensation in much further detail.
Medical Benefits- If you were injured at work then technically you have lifetime medical benefits in addition to what they paid you for weekly benefits. This is assuming that you did not "settle" your case which another topic in itself. Also, often time insurance companies will end up denying medical care and treatment for things such as:
1. You no longer work for the employer;
2. They can blame arthritis for your ongoing problems instead of the work injury; and/or
3. They just don't want to spend any more money on your medical care.
Social Security Benefits- If you are receiving SSI (supplemental security income) then any compensation that you receive in wages or a workers' compensation check will reduce your benefits. Whereas, if you receive SSDI (Social Security Disability) there will be an offset evaluation done in order to determine what, if any, amount your monthly Social Security disability payment are reduced by. The SSA (Social Security Administration) only allows you to make up to 80% of your highest year earnings in the 5 years prior to your work injury. For example, if your highest year of wages is $40,000 you are only allowed to received up to $32,000 per year/$2,666.67 per month ($40,000 X 80% = $32,000). So if you are receiving $500 per week in work comp which is a monthly amount of $2,166.67 then the maximum you can receive each month in Social Security is $500 before the rest of your SSDI benefits are offset. Keep in mind that you are allowed deductions for attorney fees, litigation costs, but the offset will continue until you reach your full retirement age or your case is properly settled with the proper Social Security offset language used. It is very dangerous for an injured worker to try to settlement almost any case on their own and is downright not smart to try to settle a case without an attorney when they are receiving SSDI.
If you have any more questions you can always call us at 641-792-3595 or contact us here!
How Much Time Do I Have to File a Workers Comp Claim in Iowa?
Keep in mind that there are really two-time deadlines. The first deadline is called notice and it is when you report your injury. The other deadline is called the statute of limitations and it is when you must have a petition on file with the Iowa workers' compensation agency.
Notice- Iowa Code Section 85.23 was changed effective July 1, 2017, and currently provides that you have 90 days to report your workers' comp. claim from when you "knew or should have known that the injury was work-related."
In the case of a traumatic injury, it is always the best policy to report your work injury as soon as it happens. Many employers have requirements in their employee handbook requiring 24-hour notice. This does not change the law that you have up to 90 days to report the injury, but the longer you wait to report it, the less likely that the insurance company will admit the claim and pay benefits. For example, if you are at work and while lifting something your back hurts, report it right away by telling your employer what you were doing at work and that you are injured. You should also ask for medical care and to fill out a work injury incident report. Not all employers have reports such as these, but it is always best to put your work injury in writing and keep a copy of what you submitted to your employer.
With injuries that occur over time, what are called cumulative trauma injuries notice is a little different. Often you do not have an exact time and date when the pain started. However, keep in mind that it is always better to report a specific work incident that caused pain. For example, if when you do your job your back hurts then you should report exactly what you are doing at work that makes your back hurt. If you tell your employer "I don't know" this can create problems later on. Also, you may be seeking medical care and treatment on your own before you now the condition is work-related. For example, sometimes your doctor will tell you "I think this is work-related". If they tell you this, then it is time to report your work injury because it is very likely that the 90-day time limit is counting down.
There are a couple of pointers to keep in mind when reporting work injuries:
1. In order to report a work injury, you need to notify your employer that you were doing a work-related activity and when you were injured. Just telling your employer "my back hurts" without telling them it is caused by your work may not be enough notice and your claim may be denied because of it.
2. If you hurt your back on Friday and want to see how things go over the weekend before reporting it, this is a bad idea. Employers are very suspicious of injuries reported after you have not been at work. The chances that your claim will be unjustly denied increase if you report it after a weekend, vacation, etc.
3. Always put something in writing about your work injury and keep a copy for your own records. Sometimes employers will claim we never received an injury report as somehow it get's "lost". Also, remember to write down in detail how your work caused you to be injured.
Statute of Limitations
Iowa Code Section 85.26 is the law dealing with the time limit you have to file a petition with the Iowa Workers' Compensation Commissioner. The general rule is that you must file a petition with 2 years of your date of injury, not when you provided notice. Failing to properly and timely file a petition will result in the case being dismissed and you receive no compensation. This is true regardless if you are still treating with your doctors, regardless if you are unable to work, etc. The biggest exception to this rule is if you are paid indemnity workers' compensation benefits. These could be either TTD (temporary total disability), TPD (temporary partial disability), and/or PPD (permanent partial) benefits.
We recommend at the very least that you speak with a qualified workers comp attorney within 18 months of the date of your injury to determine if your case qualifies for the exemption. We have had to tell far too many clients that just because they provided medical care, your 2-year statute of limitations is not extended or you may have received disability benefits, but they were not workers' compensation benefits. We will evaluate and help you make this determination at no risk or cost to you.
If is it confirmed that you have been paid workers compensation benefits within 2 years of the date of injury, then your statute of limitations is extended to 3 years from the date of last payment. This does not mean that you should wait that long to file a petition because most injured workers heal from their work injuries within 2 years of their injury. At the present time, it takes around 1 year from the time you file a petition until when you have a hearing before a workers compensation judge. Then it will take an additional 3 to 12 months for the judge to provide his/her decision. That decision can be appealed to the judge's boss, the workers' compensation commissioner which adds an additional 18 to 24 months and sometimes there can even be further appeals.
My point is that the longer you wait to file a petition, the longer you will wait for either a settlement or a trial. We do not rush to file your petition like some attorneys do because we want to do what is best for you, not just your case. Sometimes when you are back to work making the same amount of money this may mean waiting several months or longer before filing a petition to see how things go. What you don't want to have happen is for your case to be rushed to settle and then after your settlement, you lose your job. We will help you through the process and give you the best legal advice for your specific situation. Our promise to you is that if you decide we are the right workers' compensation attorneys for you that we will treat you like family. We have 4 fulltime offices in Central Iowa, but have branches office and represent injured workers throughout the State of Iowa.
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.