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Workers' Compensation for a Fractured Toe Suffered at Work
A fractured toe is often regarded as a minor injury, and workers who sustain one on the job sometimes wonder whether it is worth pursuing a workers' compensation claim at all. If the broken toe was a direct result of a workplace accident, workers' compensation should provide both medical and disability benefits, and the injury should be taken seriously from the start.
How Workplace Toe Fractures Happen
A toe contains as many as three bones. A fracture occurs when trauma to one of those bones takes place, most commonly when a worker drops a heavy object onto the foot or slams the front of the foot into a solid surface. Workers in industries involving heavy equipment and materials, such as construction, are particularly vulnerable to this type of injury. To receive workers' compensation benefits, the injured worker must demonstrate that the injury is work-related. The most common symptoms of a fractured toe are pain, swelling, bruising, and stiffness. A physician can diagnose the injury through a physical examination or imaging technology such as an X-ray.
Treatment Options for a Broken Toe
Treatment for a broken toe varies with the severity of the injury. Minor fractures may be managed with self-care at home, such as taping the injured toe to the one beside it and wearing a stiff-bottomed shoe. More serious fractures, particularly those involving the big toe, may require splinting. In the most severe cases, surgery may be necessary, with pins or screws used to realign the broken bones and hold them in position during healing. The majority of broken toe injuries heal within six weeks or less.
Medical Benefits Under Iowa Workers' Compensation
When a broken toe occurs during the course of work, the employer's workers' compensation insurer is required to cover all necessary and reasonable medical expenses. This includes the initial doctor's visit for diagnosis as well as all follow-up treatment, whether that involves taping, a stiff-bottomed shoe, splinting, or surgery. If an injured worker is not satisfied with the care being provided, options exist to request alternative medical care through the Iowa Workers' Compensation Commissioner.
Disability Benefits When a Broken Toe Prevents Work
In addition to medical benefits, a worker who misses more than three days of work because of a work-related injury such as a fractured toe may qualify for disability benefits. If the worker is unable to return to work in any capacity, disability benefits are paid at 80 percent of the employee's regular wage. If the worker is able to return to work in a position paying less than the original job, temporary partial disability benefits apply. That figure equals two-thirds of the difference between the worker's weekly earnings at the time of the injury and the actual earnings received while working in the lower-paying position.
A workers' compensation attorney can assist in preparing the claim, gathering medical evidence to establish the severity of the fracture, and requesting a hearing if the claim is denied. For questions about any aspect of broken toe workers' compensation benefits in Iowa, the work injury attorneys at Walker, Billingsley & Bair are available to help.
Seeking Alternative Medical Treatment Under Iowa's Workers' Compensation System
Some injured workers in Asbury and across Iowa prefer alternative treatments for their workplace injuries. Iowa's workers' compensation system does allow employees to pursue alternative care, but the proper procedures must be followed. Seeking alternative treatment without prior approval will result in those costs not being covered, which can leave an injured worker with unexpected out-of-pocket expenses at a time when finances are already strained.
What Qualifies as Alternative Treatment
Alternative treatments can include acupuncture, massage, and chiropractic care, among others. Workers seek these treatments for a variety of reasons, including a preference to avoid certain medications such as addictive painkillers, or as part of a broader approach to health and recovery. Iowa Code Section 85.27 specifically mentions osteopathic and chiropractic treatment alongside more traditional medical options, and the general requirement is that the employer's workers' compensation insurer must provide reasonable and necessary medical treatment for the work-related injury.
How to Request Alternative Care
When a worker wants to pursue alternative medical treatment, the first step is to discuss it with the treating physician. The question of whether treatment will be approved comes down to whether it will help improve the employee's condition. Because the employer generally chooses the employee's treating doctor, some workers suspect that denials of reasonable alternative care reflect an attempt to please the employer rather than a genuine clinical judgment. Workers have options when this happens, but must formally request the alternative treatment before any other steps can be taken.
What Happens If the Employer or Insurer Denies the Request
If the employer or insurance company does not approve the requested alternative care, the injured worker has the right to petition the Iowa Workers' Compensation Commissioner (IWCC) for approval. The IWCC will review the petition and determine whether the worker may seek the alternative care requested.
A hearing may be scheduled, either by telephone or in person, at which both sides present their positions. The IWCC issues its decision within 10 days of receiving the application in the case of a telephone hearing, or within 14 days in the case of an in-person hearing. When a case becomes contested and a petition to the IWCC is required, having an attorney is particularly valuable. A lawyer can help gather the proper documentation and present the strongest possible case for the alternative care being sought.
Five Things Asbury Workers Must Never Do During a Workers' Compensation Claim
Iowa workers who are injured on the job and pursuing a workers' compensation claim must be careful not to take actions that undermine their own case. Insurance companies are detailed and aggressive in evaluating which claims to pay and which to deny. The five behaviors below are among the most damaging mistakes an injured Iowa worker can make, and each one has cost claimants significant money.
1. Lying About or Exaggerating Injuries
Insurance companies are highly motivated to find grounds to deny claims, and being caught in even a single misrepresentation early in the process can result in a full denial of benefits. That means no further medical care and no money from the insurer. While the worker may still be able to file a petition, schedule a trial, and appeal, that process can take years before any additional compensation is received.
Beyond the insurance company, the treating physicians, who were likely chosen by the insurer, are specifically trained to identify patients who are not being fully honest. The vast majority of injured Iowa workers are straightforward and simply want to recover and get back to work. Workers who exaggerate symptoms risk being branded as dishonest in a system that already views claimants with a degree of skepticism. Honesty throughout the entire claim process is not only the right approach but the one that protects the claim's value.
2. Working Outside of Medical Restrictions
Workers' compensation insurers commonly hire private investigators to film injured workers both at medical appointments and at home. If a doctor has restricted an employee from lifting more than ten pounds, that restriction applies at work and everywhere else in daily life. Being videotaped violating a restriction carries three serious consequences: the risk of an additional injury, a reduction in the value of the claim, and the likelihood that the video will be shown to the treating physician, who may then release the worker back to full duty with no restrictions.
Workers should keep a written copy of their restrictions on them at all times. If a supervisor or coworker asks them to perform tasks that fall outside those restrictions, the worker should immediately notify the supervisor, the medical provider, and the insurance adjuster if no attorney is yet involved. If the employer refuses to honor medical restrictions, that refusal itself creates legal issues that an attorney can address.
3. Refusing Work Offered Within Restrictions
Under Iowa law, employers are required to provide a written offer of work following a workplace injury. If the employer offers a position that falls within the employee's medical restrictions, whether in writing or verbally, the worker should accept and attempt to perform the work. Refusing a valid offer of work carries serious financial consequences:
- The worker can be terminated and will likely lose weekly workers' compensation benefits
- Unemployment benefits will likely be denied because the worker turned down an available job
- The value of the workers' compensation case will typically be reduced significantly due to what the system treats as a voluntary quit
If the offered work falls outside of the documented restrictions, the worker should notify a supervisor immediately rather than simply refusing. The distinction between refusing appropriate work and declining inappropriate work can have a major impact on the claim. Read more about reasons Iowa workers' comp claims are denied.
4. Quitting the Job
A hostile or difficult workplace can make it genuinely hard to continue showing up after an injury. However, voluntarily quitting carries consequences that often surprise injured workers:
- Weekly workers' compensation benefits will stop because the employer will report to the insurer that the worker quit even though work was available
- Unemployment benefits may be denied because the burden falls on the worker who quits to prove good cause attributable to the employer
- The total value of the workers' compensation claim can be substantially reduced, even when the underlying injuries are severe
An attorney can advise on whether circumstances at the workplace create legal grounds that mitigate the consequences of a separation, but quitting without that guidance is a decision that can cost an injured worker tens of thousands of dollars.
5. Doing Side Work While Receiving Temporary Total Disability Benefits
When the insurance company is paying weekly temporary total disability (TTD) benefits, it means the worker has either been fully taken off work by the treating physician or has been given temporary restrictions the employer cannot accommodate. Performing other work for cash or for a paycheck while collecting TTD creates two serious risks. The insurer may videotape the activity and use it as grounds to reduce or eliminate weekly benefit payments. Alternatively, the insurer may learn of the work through other means and reduce payments by the amount being earned on the side. Neither outcome benefits the worker, and this particular mistake has cost represented clients tens of thousands of dollars even after being specifically warned against it.
- A fractured toe from a workplace accident entitles the injured worker to medical benefits and potentially disability benefits if work is missed for more than three days
- Disability benefits for total inability to work are paid at 80 percent of the regular wage; temporary partial disability equals two-thirds of the earnings difference
- Iowa Code Section 85.27 requires employers and their insurers to provide reasonable and necessary medical care, including chiropractic and osteopathic treatment
- Alternative treatment must be requested and approved before being pursued; unauthorized care will not be reimbursed
- If alternative care is denied, the injured worker may petition the Iowa Workers' Compensation Commissioner, which issues decisions within 10 to 14 days
- Lying, working outside restrictions, refusing appropriate work, quitting, or doing side work while on TTD can each result in claim denial, reduced value, and loss of benefits
Getting Legal Assistance In Asbury
Navigating the complexities of Iowa workers' compensation laws can be daunting, especially during the recovery process from a workplace injury. Seeking guidance from a seasoned Asbury Workers' Comp attorney is invaluable in ensuring your rights are protected and maximizing your chances of a favorable outcome.
Legal professionals play a pivotal role in gathering evidence, preparing documentation, and advocating for your interests throughout the claims process. Don't risk missing out on the compensation you deserve – enlist the support of a qualified attorney to navigate the complexities with confidence.
The Iowa Workers' Compensation attorney team at Walker, Billingsley & Bair know the importance of protecting your work injury claim from the get-go. That's why we provide this FREE book; Iowa Workers' Compensation - An Insider's Guide to Work Injuries: 7 Deadly Mistakes To Avoid If You Are Hurt At Work. To learn more about what our legal team will do to help you protect your Iowa work injury claim, contact Walker, Billingsley & Bair to schedule a no-cost consultation - 641-792-3595.