Le Mars Workers Compensation Attorneys

Shoulder Injuries at Work and Iowa Workers' Compensation

Many of the jobs that define the Le Mars economy require workers to perform repeated overhead reaching, heavy lifting, or sustained physical exertion involving the shoulders. Over time, this type of work can cause the shoulder joint to break down. One of the most common conditions that results is shoulder impingement syndrome, a painful condition that occurs when a bone in the shoulder rubs against the tendons and the bursa, creating inflammation, pain, and eventual deterioration. Workers may ultimately experience rotator cuff tendonitis or bursitis as a result of this repeated friction.

How Shoulder Impingement Is Treated

When a worker first reports symptoms consistent with shoulder impingement, doctors typically attempt to manage the condition through conservative treatment before considering surgery. That initial course of care usually involves some combination of:

• Rest from activities that aggravate the shoulder
• Pain medications to manage discomfort
• Anti-inflammatory drugs to reduce swelling
• Physical therapy to strengthen the surrounding muscles and improve range of motion

When conservative treatment fails to adequately control the pain, doctors may recommend shoulder decompression surgery. This procedure is used specifically to treat shoulder impingement by addressing the underlying structural cause. Surgeons often perform the procedure arthroscopically, making a very small incision and inserting a tiny camera to assess the extent of the damage, then shaving down the portion of bone that is causing the impingement. Arthroscopic decompression typically leads to a shorter recovery period, with many patients seeing their pain subside within a few weeks of the surgery. If the procedure is performed through open surgery instead, recovery can take several months.

Workers' Compensation Benefits for Shoulder Decompression Surgery

Under Iowa law, workers who undergo shoulder decompression surgery, or any other surgical procedure, to treat a work-related injury are entitled to workers' compensation benefits to cover their treatment. This applies even to cumulative injuries like many shoulder impingement cases, where the condition develops over time through repeated workplace exposure rather than a single traumatic event. The critical requirement is that there be direct causation between the work conditions and the injury.

Medical benefits through workers' compensation cover qualifying medical expenses in full. This includes the cost of the shoulder decompression procedure itself as well as any related expenses such as medication, hospitalization, and post-surgical physical therapy needed to rehabilitate the shoulder. Workers who sustain shoulder impingement may also qualify for disability benefits if they meet the applicable requirements under Iowa law.

What to Do If the Insurance Company Disputes Your Shoulder Claim

An employer's workers' compensation insurance company may dispute that a shoulder impingement was caused by work conditions rather than age, prior injury, or non-work activity. When a claim is disputed, workers have the right to appeal to the Iowa Workers' Compensation Commissioner. Building a strong appeal requires the right evidence. A workers' compensation claim can be supported through medical records documenting the diagnosis and treatment history, testimony from the worker and coworkers, and expert medical opinions that establish the connection between the job duties and the shoulder condition. Having an attorney help prepare and present this evidence significantly improves the likelihood of a successful outcome.

What to Do If Your Employer Did Not Report Your Work Injury

It is unfortunately a common problem that injured workers in Iowa discover their employer has not reported their injury to the workers' compensation insurance company. If you find yourself in this situation, there are specific steps you should take to protect your rights.

Make Sure You Have Reported the Injury in Writing

The first priority is to confirm that you have formally notified your employer about the work injury. Under Iowa law, you have 90 days from when you knew or should have known that your condition was work-related to report the injury. However, the best practice is to report it immediately and in writing rather than waiting. Your employer may have a standard injury report for you to complete. If not, put the following information in writing in a letter to your employer: a general description of how you were injured, the date the injury occurred, the nature of your injuries, and a request for medical care.

This written notice can be delivered in person to HR, your supervisor, or another management representative, or sent by certified mail with return receipt requested. Keep a copy of the letter and document who received it, when they received it, and where the delivery took place.

How to Find Your Employer's Insurance Company

If you have reported the injury and your employer refuses to submit it to their workers' compensation insurer, or will not disclose who their insurance company is, you can look it up yourself. Iowa Workforce Development maintains a resource where injured workers can verify their employer's workers' compensation coverage. You will need to enter your date of injury and the name of your employer as it appears on your paychecks or direct deposit, since many companies operate under a trade name that differs from the actual legal employer name.

Once you know who the insurer is, you can search for the company online and report your claim directly to them. Your employer may be upset that you went around them to file, but if you want to access medical care, temporary disability benefits, and other compensation to which you are entitled, pursuing the claim directly is often necessary.

Additional Questions That Arise After Reporting a Work Injury

Reporting the injury and starting the claims process is only the beginning. Several important questions arise as a claim moves forward, and knowing the answers helps injured workers avoid costly mistakes.

Do you have to see the doctors the insurance company selects? Generally, yes, if you want the insurer to pay for your medical care. You always have the right to seek treatment on your own, but the insurance company and your employer may disregard what your personal physician says and rely exclusively on their own designated doctors. There is a limited exception called alternative medical care, but it involves a detailed process with specific procedural requirements that must be followed correctly or the care switch will not be recognized.

Do you have the right to a second opinion? You always have the right to a second opinion if you are paying for it yourself. If you want the insurance company to cover the cost, you must wait until you have received your functional impairment rating. For injuries that occurred after July 1, 2017, the insurer may only pay for the impairment rating portion of the second opinion, potentially leaving you responsible for a significant portion of the cost. Never proceed with a second opinion without first getting written confirmation from the insurer about what they will cover, and make sure the physician you choose is well qualified. A poorly chosen second opinion doctor can actually damage your case.

Can your employer fire you while you are off work due to a work injury? In most cases, yes. Iowa is an at-will employment state, meaning an employer can terminate an employee for any reason or no reason at all. If you are fired after a work injury, you may have claims for additional workers' compensation benefits, an unemployment claim, and potentially an employment law claim under the Americans with Disabilities Act, the Family Medical Leave Act, or similar statutes. If you are a union member, contact your union steward immediately so you can file a grievance. Either way, consulting with an attorney who handles both workers' compensation and employment law matters should be a priority.

Can You Reopen an Old Workers' Compensation Claim If Your Condition Has Worsened?

One of the most important and frequently misunderstood aspects of Iowa workers' compensation law is the question of whether a previously settled case can be reopened if an injured worker's condition worsens over time. The answer depends critically on the type of settlement that was reached.

The Three Types of Workers' Compensation Settlements

There are three basic types of settlements under Iowa workers' compensation law, and only one of them allows for the possibility of reopening the case:

1. Agreement for settlement (commonly called an "open file"): This is the only type of settlement that can be reopened under Iowa law.
2. Agreement for settlement with full commutation: This involves a lump-sum payment in exchange for a closed file, ending medical care, ending benefits, and surrendering the right to reopen the case.
3. Compromise settlement: Like the commutation, this also results in a lump-sum payment and a closed file with no right to reopen.

If you settled on an open file basis and your condition has worsened, Iowa law allows you to file what is called a review-reopening petition, provided you can prove one or more of the following:

• A worsening of your physical condition
• A reduction of your earning capacity
• A temporary disability that has developed into a permanent disability
• A critical fact existed at the time of the prior settlement that was unknown or could not have been discovered through reasonable diligence
• A scheduled member injury that later causes an industrial disability

One of the most common scenarios that triggers a review-reopening petition is when an injured worker has permanent work restrictions that the employer has been accommodating, and then the employer decides they can no longer do so and terminates the worker. Another situation involves an injury to a foot or knee that causes the worker to walk differently, which over time leads to back or hip pain. That secondary development can also qualify as grounds to reopen the case.

How Worsening Condition Is Proven

Proving that your medical condition has worsened will require documentation from your physicians. This often involves additional medical examinations and an independent medical examination with a doctor of your choosing. Evidence that courts look for includes an increase in your impairment rating, additional work restrictions that were not present at the time of the prior settlement, and the need for additional medical care such as surgery. These are not always easy cases to win, as judges do not prefer to revisit cases they have already resolved, which is exactly why having experienced legal representation matters.

Time Limits for Filing a Review-Reopening Petition

The general rule in Iowa is that a review-reopening petition must be filed within three years of when you last received a payment of workers' compensation indemnity benefits, most commonly a payment of permanent partial disability benefits. This is the statute of limitations for review-reopening, and there are very few exceptions. Missing this deadline typically means losing the right to reopen the case entirely.

It is also important to understand that the 2017 changes to Iowa's workers' compensation laws, passed by the Iowa legislature, significantly altered many aspects of how claims are handled and how long workers have to act. Your date of injury may affect the applicable time limits and the amount of compensation you are entitled to receive. The only way to know for certain how these laws apply to your specific situation is to consult with a qualified Iowa workers' compensation attorney. If you think you may qualify for a review-reopening, do not wait. Contact an attorney immediately to evaluate whether your petition can still be filed within the required deadlines.

What If You Only Cashed Checks Without Signing a Settlement?

If you have not signed any settlement paperwork but have cashed checks sent by the insurance company, you have not legally settled your case. The review-reopening rules described above would not apply to you. However, the statute of limitations can be as short as two years in some circumstances, so even if you have not formally settled, you should consult with an attorney promptly to understand whether you may be owed additional compensation and what deadlines you are working against.

Getting Legal Assistance In Le Mars

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 Le Mars 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.

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