Last Updated: 5/25/2023

Under Iowa workers' compensation law, if you sustain a work injury that occurs over days, weeks, or months then you have what we call a "cumulative trauma injury," sometimes referred to as a repetitive stress injury

Cumulative injuries can be more difficult to prove because they occur over some time instead of a traumatic injury which occurs at a set time and date. Also, some Iowa employers tell employees that Iowa does not cover cumulative injuries which is simply not true.

If you have or think you have sustained a work-related cumulative trauma injury, then there are several things for you to consider:

Notice to your employer

Under Iowa law, you are required to report your work injury within 90 days of when you knew or should have known that you were injured. If you go see your own doctor about a medical condition before reporting the injury, then you need to make sure that if you and/or your doctor thinks it is related to your job that you immediately notify your employer (preferably in writing by completing an incident report) that you were injured and are requesting medical care. If you delay in reporting your injury too long, you will not only damage your claim but may lose your claim completely based upon your employer’s notice defense.

Note: If you are going to try to report a work injury on your own before getting proper legal advice consider bringing a copy of your job description to your appointment with your doctor. If you don’t have a job description, then you can consider asking your employer for one or writing one of your own that accurately describes your normal work. Also, it is important to note that the pain you are experiencing is when you are doing your work-related duties. It is possible that start to have symptoms from a cumulative trauma work injury while you are not working, but this will make your claim more difficult. Also, consider reporting your work injury while you are at work doing the activity that causes you pain and problems. If you have specific pain while doing your job this can be considered a traumatic injury in addition to being a cumulative work injury as well.

Prior medical history

When it comes to all Iowa workers’ compensation cases the insurance company will scrutinize your prior medical history for the same or similar problems that you may have had in the past. If you have had prior problems in the area at issue, be truthful and don’t try to hide prior injuries. If they are in your medical records, they will eventually get the records and you’re lying about prior problems will just make things worst for you and your claim.

Aggravation of prior condition

Maybe you have had prior problems with the body part that you believe was hurt at work by cumulative trauma. The best thing that you can do is to be able to accurately describe your symptoms before the problems started at work (for example, you had arm pain 5 years ago, but it has been fine since your surgery), the specific work activities that you did that caused increased pain and problems and how your symptoms are now different. If you can prove that your work activities made your condition worse, then your work injury may be accepted. However, insurance companies are very skeptical about cases involving cumulative trauma that causes an aggravation of a prior medical condition. These claims are often denied by insurance companies sometimes even without an adverse medical opinion which they are supposed to have under Iowa law when denying a claim.

Denied claims

If your cumulative work injury claim is denied by the insurance company that does not mean your claim is over. If you need medical care and treatment like surgery, then you should be able to use your health insurance to get the treatment that you need. Iowa law states that if there is a workers’ compensation denial that your health insurance company is required to pay for the medical care and treatment. Also, if you are going to miss work for your treatment make sure to check with your human resources department to see if you have short-term disability or A & S (accident and sickness) benefits available which will pay you a portion of your wages while you are not able to work. If your claim is denied, then you should contact a qualified Iowa workers’ compensation attorney to see if it makes sense to file a petition or use your own health insurance. Much of this will depend upon how you heal up after your medical treatment and if you are able to return to employment with the same employer making the same or higher income.

Offer to work within your restrictions

Regardless of if your claim is denied or accepted, it is very important that if you are given a return to work, you provide this work release to your employer and attempt to return to work. If you get back to work and the job causes too much pain, then you need to report this to your employer and get back to see your doctor to see if your restrictions should be changed.

Following Medical Recommendations

It is important for several reasons to follow the recommendations made by your medical providers including your doctors, physical therapists, etc. This is not only so you heal as fast as possible, but it can also have a significant impact on the value of your workers’ compensation case.

For example, if your physical therapist recommends that you do a set of exercises every day, but when are asked about doing your home exercises you say that you did not bother doing them, then this can create issues with both your medical condition and your perceived motivation. The judges who handle Iowa workers’ compensation cases look closely at the injured workers' motivation to get better and to get back to work. If you are found to be unmotivated then chances are that you will receive less compensation.

Cumulative trauma examples

Cumulative trauma work injuries happen often from doing the same repetitive motion throughout a workday. They can happen in an office setting or more commonly in a production or factory setting. They occur in many different areas of the body, but the most common areas are carpel tunnel syndrome, cubital tunnel syndrome, rotator cuff shoulder injuries, low back injuries, and knee injuries.

Whether you are running a machine all day using your arms and developing overuse syndrome or are lifting boxes all day long and developing low back pain cumulative trauma injuries are real and sometimes can be devastating to a worker’s ability to earn a living.

This is just a partial list of things you need to know if you have sustained a cumulative trauma work injury. If you have questions and would like to speak with our workers’ compensation team, then call 641-792-3595 or use our LiveChat feature by clicking here 24 hours a day/7 days per week.

There is no cost or obligation, and your information will remain confidential. If one of our qualified workers’ compensation attorneys is not available, then you can schedule an appointment right away, so you have a set time and date to ask questions. Note: If you are currently receiving benefits and you decide to hire us then we will not take any portion of your ongoing weekly benefits, or any other benefits voluntarily paid by the insurance company.


If you are not ready to speak with an attorney but would like more information about your rights and responsibilities, then request a copy of our Iowa Work Injury Book which we offer at no cost or risk to you. We offer it at no cost because we have seen far too many Iowa workers make costly mistakes which resulted in the loss of thousands of dollars. 

Corey Walker
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With over 28 years legal experience, Corey has been recognized for his work as an injury attorney.