Epworth Workers Compensation Attorneys

Receiving Medical Bills During an Epworth Workers' Compensation Case

Unfortunately, unpaid medical bills are very common in Iowa workers' compensation cases. The laws that apply differ depending on whether your claim has been accepted and your care is being directed by your employer or their insurance company, or whether your claim has been denied.

When Your Claim Has Been Accepted

If your claim has been accepted, your employer or their workers' compensation insurance company is likely directing you to their chosen medical providers. Even though they have the right to direct your care, injured workers in Epworth often still receive unpaid medical bills. Under Iowa law, when an employer sends you to a provider for treatment, they are required to pay for that care. Sometimes, however, the insurance company only pays a reduced amount, leaving the injured worker with an outstanding balance. This is not how the process is supposed to work.

If you receive a bill, do not ignore it. Send a copy of the bill to the workers' compensation insurance adjuster and follow up with a phone call a few days later. You should also call the medical provider and let them know this is a work injury, and that any dispute over payment is between the provider and the employer or insurer, since Iowa Code section 85.27(4) requires the employer to hold the injured worker harmless for care the employer chose. Iowa case law has confirmed that an employer who authorizes care is responsible for the cost of that care until the worker is notified that the care is no longer authorized. If you continue to receive bills or are unhappy with how you are being treated, it may be time to speak with a qualified Iowa workers' compensation attorney.

When Your Claim Has Been Denied

Iowa law also provides protection for injured workers when a claim has been denied, though insurance companies, bill collectors, and employers sometimes ignore these protections, whether because they are unaware of them or are attempting to take advantage of workers without legal representation. If your claim has been denied, it is important to keep a copy of the denial letter, since you may need it to get your medical bills paid. If you have not received a written denial, you should contact the insurance company or its attorney to request one.

If your health insurance does end up paying for medical bills related to a denied work injury claim, you may receive a subrogation notice from a collection company seeking reimbursement. However, if your health insurance is provided through the same employer where you were injured, that plan likely does not have a valid subrogation claim, since Iowa Code section 85.38(2) provides a credit for employer-sponsored health plans to prevent a double recovery that would leave the worker with fewer benefits. If your health insurance is not connected to your employer, the subrogation interest is probably valid under Iowa's general subrogation laws. Anyone dealing with unpaid medical bills or subrogation issues in a workers' compensation case should consider speaking with an experienced Iowa workers' compensation attorney before making a costly mistake.

Distal Clavicle Excisions and Iowa Workers' Compensation

Shoulder pain is a common workplace complaint, and it may be the result of shoulder impingement syndrome, which workers who perform repetitive lifting and overhead reaching are especially at risk of developing. A distal clavicle excision is a type of surgery used to treat this condition, and the procedure is covered by workers' compensation. If an Epworth worker runs into trouble with their employer's insurance provider, they have legal recourse to pursue fair benefits.

What Is a Distal Clavicle Excision?

A distal clavicle excision is a surgical procedure in which a surgeon removes the end of the clavicle bone, or collarbone, at the point where it forms a joint with the rest of the shoulder. This can be performed through an open incision, known as the Mumford procedure, or arthroscopically. When the shoulder suffers trauma from repetitive use or another cause, it swells and creates pressure, and bones push against the muscles and nerves in the shoulder, causing pain. Removing part of the bone is intended to relieve that pressure. Distal clavicle excisions are used to treat conditions such as shoulder impingement syndrome, bursitis, and tendonitis.

After surgery, the patient must go through rehabilitation and physical therapy to rebuild shoulder strength. In the best circumstances, a worker may return to the job within a couple of months, though there may be restrictions on the type of work performed. Returning to heavy labor can take considerably longer.

How Benefits Are Calculated

Workers' compensation provides medical and disability benefits equal to 80 percent of average weekly spendable earnings for work-related injuries, and this includes repetitive and cumulative injuries in addition to those caused by a sudden accident. An employer-chosen doctor provides care and may recommend more conservative treatment before surgery is considered. If conservative approaches fail, the doctor may recommend a distal clavicle excision. Workers should not seek care without approval from the treating doctor and the workers' compensation insurer, since unauthorized treatment may not be covered. If a worker disagrees with the care being provided, they can seek alternate care by first discussing the issue with the employer or insurer, and then, if necessary, bringing the issue to the Iowa Workers' Compensation Commissioner.

Eventually, a doctor may determine that a worker has reached a point where they can return to work with certain restrictions, and the employer may assign light duty work that fits those restrictions. If the new wages are lower than the worker's pre-injury wages, workers' compensation pays two-thirds of the difference. If the worker is permanently impaired after reaching maximum medical improvement, they may be entitled to permanent partial disability benefits. Because shoulder injuries are treated as industrial disabilities, factors such as the worker's impairment rating, age, experience, and skill level all play a role in how long benefits continue. Workers who disagree with their assigned impairment rating can also request an independent medical exam.

Dangers Epworth Workers Face at Construction Sites

Construction work is ongoing across Iowa throughout the year, and it remains one of the more dangerous fields to work in because of the many hazards involved. Construction jobs rank as the third highest occupation for injury-related deaths, and for every 100,000 workers nationwide, 15 die from a workplace injury. Although ordinances, regulations, and industry standards require employers to provide a reasonably safe environment, construction workers in Epworth and throughout Iowa still suffer serious injuries at an alarming rate.

Why Construction Sites Are Dangerous

Heavy machinery and equipment, working at heights, loud noises, and holes in flooring can all pose serious threats to construction workers. Equipment that is used every day is subject to wear and tear, and keeping machinery in good working order helps prevent injuries caused by that deterioration. If a tool or piece of equipment begins to show signs of damage, it should be repaired promptly rather than allowed to fail while someone is using it.

Common Types of Construction Site Injuries

Common injuries on construction sites include falls, crane accidents, scaffolding accidents, electrical accidents, fires and explosions, and workers being struck by equipment. The risk of being struck by equipment increases near highways or busy roads. Workers need to remain alert and follow proper safety procedures at all times, since even a small mistake can lead to a serious accident that could have been prevented. Falls are among the most common types of construction accidents, including falls from roofs, falls through holes in flooring, and falls involving cranes.