What Does Workers Comp Pays For And When Do Benefits Start Paying?

First of all, there are 3 basic types of benefits that you should receive if you have sustained a work-related injury in Iowa and they include:

1. Medical care and treatment

Iowa is an employer choice state which means your employer and/or their insurance company gets to send you to the medical providers that they choose. However, this is not an unlimited right by your employer. For example, if the doctor they send you to recommends an MRI, surgery, physical therapy, etc., then the insurance company is not allowed to ignore what the doctor they chose says. Also, if the doctor they send you to sends you to another doctor or to your family physician then those also become authorized doctors. Medical care often creates problems in a worker's comp case and there is a procedure called alternative medical care that can be used to attempt to force the insurance company to provide medical care and treatment. For more information about alternative medical care, we have an entire chapter devoted to this in our book entitled Iowa Workers Compensation- An Insider's Guide to Work Injuries. We offer our book at no cost or risk to you because we have seen far too many hardworking Iowans make costly avoidable mistakes which is why the book reveals 7 Deadly Mistakes to avoid if you are hurt at work.

2. Temporary total disability (TTD) benefits

If you are taken off work by the company doctor or if the company doctor gives you work restrictions that your employer is not able to accommodate. The amount of your weekly benefits (also called your work comp rate) can be determined in a number of different ways. If you are paid hourly, then it is likely that your rate is based upon your earnings during the 13 weeks before you were injured. Weeks that are non-representative such as you were sick a day, took a personal day, etc. are supposed to be skipped. All of the hours that you worked are to be included at your normal hourly rate. You are allowed to include shift differential and regular bonuses. Once we have your average weekly wages (AWW) during the 13 weeks we look at a chart for the year in which you were injured which represents 80% of your spendable earnings. Your weekly rate is based upon your AWW, marital status and the total number of dependents.

3. Permanent partial disability (PPD) benefits

These are paid to you if your injuries are considered permanent. The amount of PPD benefits you are owed depends upon many factors including the what type of injury you sustained (back (herniated or bulging discs), neck, rotator cuff, arm, leg, hand, carpal tunnel, torn meniscus, etc.); the medical care and treatment you have received (surgery, MRI's, pain management, physical therapy, etc.); if you are back to work making the same or more money; if you have been terminated because your employer is not willing or able to accommodate your restrictions; etc. For more information about how PPD benefits are determined, feel free to give us a call or request a copy of our book at no cost to you.

When Do Your Workers Comp Benefits Start?

Medical care

Medical care and treatment benefits start immediately and are supposed to continue for the rest of your life so long as they are work-related. However, keep in mind that often the workers' comp insurance company will eventually deny that your condition is work-related and stop paying your bills.

Temporary Total Disability (TTD)

In Iowa, there is a 3 day waiting period meaning that you are not paid for the first 3 days that you miss because of your work injury unless you miss 14 or more days. If you miss 14 or more days the insurance company is supposed to go back and pay you for the first 3 days. Your TTD benefits will often be paid several days later than when you would have received your normal paycheck. If you believe your benefits are being paid late then you should keep copies of the envelopes that you receive your checks in as later on you may be able to pursue penalty benefits. Your TTD benefits should continue until your employer brings you back to work or you reach MMI (maximum medical improvement). Note: if your employer offers you work within your restrictions it is your duty to go and try to do the work. If for some reason you do not think you are able to do the work that they are offering you, then you are required under Iowa law to send your employer a letter describing why the job being offered is not appropriate. Also, do not quit your job or you will likely cost yourself thousands of dollars and may not be able to receive unemployment either. If you are in a situation like this, it is very important that you consult with an experienced work injury attorney because above are just a few examples of costly mistakes that you may make. Keep in mind that many of the commons mistakes can be dealt with if you receive the right legal advice, but may not be able to be undone if you don't.

Permanent Partial Disability (PPD)

These benefits are to begin once you have reached MMI (maximum medical improvement) and you are provided with a functional impairment rating by the authorized company doctor. Keep in mind that these benefits are often intentionally delayed by the insurance company for a number of reasons. Note: If you are sent a check for your functional impairment rating, this does not mean that your case is over. You should contact an attorney to discuss the specific facts in your case and if you may be entitled to receive significantly more compensation than what the insurance company voluntarily pays you. Under no circumstances should you negotiate or try to settle your workers' compensation case on your own without at least talking to a qualified Iowa work comp attorney. Besides that you probably do not know the fair value of your claim, there are many pitfalls with trying to "settle" a work comp case on your own which can cost you thousands of dollars including:

1. Is Social Security offset language being included in the documents?

2. How is Medicare's current or future interests being protected in order to avoid you being stuck with future medical bills?

3. Is there a provision stating that the insurance company will pay for all authorized care so you do not receive a surprise later on in the form of a medical bill that you will be responsible for?

If you or loved ones have been hurt at work and have questions about any of the above we are here to help. If you would just like more information then request a copy of our Iowa Work Comp book that we offer at no cost or risk.

If you would like immediate assistance then call our office at 641-792-359 as we also offer a no-cost or risk workers’ comp consultation and evaluation. We will answer your questions, explain the work comp system and give you advice about what is the best way to handle your matter.