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- Oelwein Workers Compensation Attorneys
- Phone: 641-792-3595
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A workplace injury changes everything. One day you are on the job earning a living for yourself and your family, and the next you are facing medical bills, missed paychecks, and a workers' compensation system that can be confusing and, at times, outright hostile to your interests. Employers and insurance companies are not required to explain your rights to you, and many injured workers in Oelwein and throughout Fayette County discover too late that they accepted far less than they were entitled to or made a procedural mistake that cost them thousands of dollars.
The attorneys at Walker, Billingsley & Bair have been representing injured Iowa workers for over 28 years. This article covers three of the most critical areas every injured worker needs to understand: the four things you should never do when applying for benefits, the truth about workers' compensation settlements and whether you have to accept what the insurance company offers, and how to evaluate whether a settlement offer is fair or whether you are being taken advantage of.
4 Things You Should Never Do When Applying for Workers' Compensation in Iowa
Being hurt at work is already hard enough. Making one of these four mistakes on top of a serious injury can cost you everything you are owed. Each one is entirely preventable with the right information.
Under Iowa Workers' Compensation Law Section 85.23, you have only 90 days to notify your employer of your injury. This is not a suggestion; it is a legal requirement. If you fail to notify your employer within this 90-day window, you forfeit your right to benefits entirely. Do not assume your employer already knows, that your supervisor reported it, or that a co-worker filed something on your behalf. Notify your employer directly and in writing as soon as possible after the injury occurs.
It can be tempting to overstate how badly you are hurt, especially if you are worried about having your claim denied or not receiving your full benefit amount. However, exaggerating your injuries is one of the worst things you can do. A medical examiner may doubt your credibility when discussing your pain or disability and may make an incorrect assessment as a result. The credibility of your complaints is central to the value of your case, and anything that undermines it can cost you significantly. Report your symptoms honestly and completely, and let your medical records speak for themselves.
Your employer has the right to choose the medical provider who will oversee and treat your injuries. It is entirely possible that you will not agree with the medical opinion or treatment you receive from that provider. If that is the case, do not simply accept it. Notify your employer and try to resolve the dispute through direct conversation first. If the dispute cannot be resolved, you have the right to initiate a contested case. Receiving medical care you disagree with, or having a medical opinion that negatively affects your compensation amount, can have long-lasting consequences that are worse than the inconvenience of contesting the case.
As an injured worker in Iowa, you are entitled to payment for the total cost of your medical expenses and treatment, along with disability payments if you have to miss work. Types of disability benefits include temporary total, temporary partial, healing period, permanent partial, permanent total, secondary injury fund, and vocational rehabilitation benefits. If you believe you are entitled to more than you have been offered, you do not have to settle. An attorney can help you appeal your claim and pursue the full amount you deserve under Iowa law.
Do You Have to Accept the Insurance Company's Workers' Compensation Settlement?
There is a tremendous amount of confusion and misinformation given by insurance companies and employers when it comes to workers' compensation settlements. Understanding what a settlement actually is, and what it is not, is essential before you sign anything or cash any check.
The only way to truly settle a workers' compensation claim in Iowa is to agree to a payment of money and sign settlement documents that are submitted to the Iowa Workers' Compensation Agency for approval. If those documents are approved, you have a settlement. More commonly, you will receive a letter from the insurance company stating that you have been assigned an impairment rating percentage and that based on that rating, they will pay you a certain sum. Sometimes the company will not even send a letter but will simply mail a check, which may or may not include information about the rating and the payment of permanent partial disability benefits.
If you are wondering whether cashing that check means you have accepted a full and final settlement, the general answer is no. Cashing a check in a workers' compensation case is generally not the same as entering into a full settlement or agreeing that you have been paid everything you are owed. However, there are exceptions to this, and the safest approach is always to call an attorney and send in the paperwork you received before taking any action.
Why Settling on Your Own Is Almost Always a Bad Idea
Some injured workers attempt to settle their workers' compensation cases without legal help. In almost every situation, this is a serious mistake for several reasons that are easy to overlook if you are not deeply familiar with Iowa workers' compensation law:
- The insurance company and their attorneys are not looking out for your best interests in the settlement documents. For example, if the proper Social Security offset language is not included in the documents, you may lose thousands of dollars in Social Security benefits. Additionally, if you agree to a full settlement that pays you a lump sum and closes your medical file, and your employer fires you the day after the settlement is approved, you will likely have no recourse under workers' compensation at all.
- There is no standard settlement amount for injuries to the back, spine, head, or other body parts. There are literally dozens of factors that determine how much your case is worth, and you need the experience of an Iowa workers' compensation attorney who has handled hundreds of similar cases over many years.
- If you have a scheduled member injury involving a hand, arm, leg, foot, or eye, and you previously had a condition affecting another scheduled member, even one that was not work-related or was something you were born with, you may qualify for benefits under the Iowa Second Injury Fund. If you do not settle your case correctly, you will be prohibited from bringing a claim against the Fund, which can provide you with significant additional compensation.
- Medicare's interests must be properly accounted for in every settlement. If this is not handled correctly, you can end up needing medical care in the future that both Medicare and the workers' compensation insurance company will refuse to cover.
Understanding the Types of Workers' Compensation Settlements in Iowa
Not all settlements are the same. Iowa workers' compensation cases generally involve one of several types of settlement structures, and understanding the differences between them is critical before you agree to anything.
This settlement establishes an agreed amount of disability to be paid to the injured worker. Depending on the amount, some money may be paid lump-sum while the rest is paid weekly. If you are still employed with the employer where you were injured, specific accommodation language should be used in the agreement to preserve your right to review and reopening later if your condition worsens. An AGFS leaves your medical file open and, if done properly, protects your case should your employer later terminate you because of the work injury. Your medical care will remain covered for the rest of your life as long as the treatment is needed due to the work injury.
This is the type of settlement your employer and insurance company most want you to agree to, because it closes both your indemnity benefits and your medical care and treatment. All benefits are paid in a lump sum, but you are giving up a great deal in exchange. If you are terminated one day, one week, or one year after the settlement is approved, you are prohibited from seeking additional workers' compensation benefits of any kind.
A compromise settlement also closes your medical care and pays a lump sum. Social Security offset language can be incorporated, but there are very specific requirements that must be followed to preserve your future Social Security benefits. Failing to use the correct language can cost you thousands of dollars. This type of settlement is typically used when an injured worker agrees to leave their job and waive all claims against the employer.
These settlements are rarely used when an injured worker is representing themselves. A combination settlement can close the indemnity portion of the case while leaving the medical file open for future care and treatment. Once again, there are specific requirements that must be included in the documents to properly preserve Social Security benefits and Medicare interests. These are not settlements to attempt on your own.
How to Evaluate Whether a Settlement Offer Is Fair
In Iowa, you do not have to accept any settlement offer, whether it comes from a workers' compensation insurer or a personal injury liability insurer. It is very rare that the insurance company's first offer is their best offer. If you are attempting to negotiate a settlement on your own, keep the following points firmly in mind:
- Anything you tell the insurance adjuster can and will be used against you in your claim or later in litigation. Be careful about what you say, but never lie. Insurance companies share databases, and prior injuries or accidents will be discovered.
- Do not threaten the insurance adjuster. Being professional and reasonable will get you further than showing frustration or anger.
- Know your facts: how the injury happened, every provider you have treated with, and every condition you have been diagnosed with.
When evaluating the actual dollar value of a claim, there are many factors a qualified attorney will assess. These include the severity and extent of the injuries, whether multiple body parts were affected, whether there are objective injuries such as broken bones, whether hospitalization was required, whether surgery was necessary, how much time was missed from work, the claimant's occupation at the time of injury, the insurance coverage available, and whether any claim exists for underinsured benefits. No two cases are identical, but they all share common factors that experienced attorneys know how to weigh correctly.
Before you agree to any settlement offer in a case involving work injuries or any other serious injuries, it is always a good idea to speak with a qualified Iowa injury attorney to find out whether you are being treated fairly or being taken advantage of. Yes, you can ask friends and family what they think, but it is far better to ask someone who deals with insurance companies on a daily basis and who has handled hundreds of cases similar to yours.
Getting Legal Assistance In Oelwein
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 Oelwein 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.