Rockwell City Workers Compensation Attorneys

If you or a loved one has been hurt on the job in Rockwell City, understanding the Iowa workers' compensation system is essential to protecting your rights. From knowing what benefits you are entitled to, to understanding whether returning to work affects your ability to receive additional compensation, to learning how a serious injury such as a rotator cuff tear is handled under workers' compensation, there is a lot to know before accepting anything an insurance company offers you.

What Qualifies as a Workers' Compensation Case?

A workers' compensation case is any type of claim where a person has been injured or killed while on the job. The legal requirement is that the injury arose out of and in the course of employment, meaning you must be able to show that you were on the job working when you were injured. There are some special exceptions, such as falling in the employer's parking lot, which is generally still considered a work injury, while horseplay generally is not.

Under Iowa law, you only need to prove that a work injury caused a material and substantial aggravation of a preexisting condition for it to be considered a work injury. This means that just because you have had a prior injury to the same body part, you may still be entitled to benefits. Additionally, if you previously sustained a scheduled member injury, such as to an arm or leg, whether or not that prior injury was work related, and then sustain another scheduled member injury, you may be entitled to additional benefits under the Iowa Second Injury Fund. If you qualify for these benefits, the extent of your permanent disability will be based on the same factors used when determining industrial disability for injuries like those to the back, shoulder, neck, or brain.

Three Basic Types of Workers' Compensation Benefits in Iowa

Medical Benefits

If your case is admitted by the insurance company as work related, or if you prove your condition is work related, you have lifetime medical benefits to treat your work injury. If the claim is admitted, the insurance company generally has the right to choose your medical provider, subject to some exceptions. If they designate a treating physician, they are generally required to pay for the medical care and treatment that physician recommends, including referrals to other doctors. Sometimes insurance companies do not follow these rules, which is why an alternative medical care process exists for situations where a worker is not receiving proper treatment.

TTD and Healing Period Benefits

If you are unable to work due to your injuries, you should receive a weekly check while you are off work. This generally requires that a doctor sent by your employer or the insurance company is the one who took you off work. If that doctor says you can return with restrictions, it becomes your duty to contact your employer and make yourself available to work within those restrictions. If your employer does not have work available within those restrictions, you would continue receiving weekly benefits until you are either placed at maximum healing and released from care, or you are able to return to work. If you return to work with restrictions but are earning less money because of reduced hours or a lower paying position, you should receive temporary partial disability, which represents two thirds of the difference between your average weekly wage before the injury and what you are earning now. For example, if your average weekly wage was $750 before the injury and you are now earning $300 per week, you would receive your current wages plus $300 in weekly workers' compensation benefits, since $750 minus $300 equals $450, and two thirds of $450 is $300.

Permanent Partial Disability Benefits

The amount of permanent partial disability benefits owed depends on many different factors. At some point, doctors will determine that you have healed as much as possible, known as maximum medical improvement. At that point, your benefits shift from temporary to permanent. If your condition heals completely with no permanent problems, you likely do not have a claim for permanent disability benefits. However, if you have a permanent impairment rating and or permanent restrictions, you are likely owed permanent disability benefits, and it is worth working with a workers' compensation attorney who understands these specialized laws.

Can You Get a Settlement If You Go Back to Work?

If your work injuries are permanent, you should receive a permanent impairment rating based on the AMA Guides and be paid what some call a settlement. However, being paid for your impairment rating alone, known as permanent partial disability, does not settle your case, and you may be entitled to additional compensation depending on your specific circumstances.

Same or Higher Earnings with the Same Employer

One of the biggest factors in determining additional compensation is whether you are working for the same employer making the same or more money. Even if you have permanent work injuries that have significantly reduced your earning capacity, you may still be limited to only the impairment rating if you are back to work earning the same or more money, even if it is a different job with the same employer.

Even in this situation, you may be able to obtain a higher impairment rating by using your right to an independent medical examination. It is important not to simply use this right with any doctor, and you should avoid getting a doctor's name for a second opinion directly from the insurance company. Keep in mind that even if you obtain a higher impairment rating, the insurance company will often only agree to pay a higher amount if you agree to close your file by settling your case, which may or may not be a good idea depending on your situation. You should not agree to any settlement without first talking to a qualified workers' compensation attorney.

It is also worth considering that if you are satisfied with your impairment rating, you still need to protect yourself in case your employer later terminates you due to your work restrictions or for another reason. Iowa law generally provides that once you have been paid a permanent impairment rating, you only have three years from the date of the check to bring a claim for additional benefits, known as a statute of limitations. Failing to timely file your case can result in receiving no additional money and may also lead to the insurance company refusing to provide additional medical care for your work injury.

Lower Earnings with the Same Employer

If you are making less money after your work injury, perhaps because you were moved to a different job due to your restrictions or are now limited in the number of hours you work, there may be additional compensation owed to you. This depends on the type of injury you sustained. If you sustained what is called an industrial injury, such as to the back, neck, brain, both shoulders, a shoulder plus another extremity, three extremities, or a combination of physical and mental problems, you are likely owed additional compensation for your loss of earnings. If you sustained a scheduled member injury, such as to a hand, arm, foot, leg, or your eyesight or hearing, your compensation may be limited to the permanent impairment rating provided by the company doctor or a second opinion doctor. However, you may also be entitled to compensation under the Iowa Second Injury Fund if you previously sustained an injury to a different scheduled member, and that first injury does not even need to have been work related.

Working for a Different Employer

If you were terminated because your employer would not or could not accommodate your work restrictions, you may be owed significant additional benefits. Once again, the type of injury you sustained matters greatly, whether it was an industrial injury affecting the body as a whole, a scheduled member injury, or a situation involving a prior scheduled member injury that could qualify you for Second Injury Fund benefits. There is no clear cut way to know for certain whether your case is limited to a scheduled member without providing the facts to an experienced workers' compensation attorney.

Rotator Cuff Surgery as a Work Injury

A rotator cuff injury can occur after many types of work accidents, including falling on your shoulder, overextending your arm, or using your shoulder in a repetitive motion. When one of these incidents happens at work and causes a rotator cuff injury, workers' compensation should cover all of the treatment needed to fully heal your shoulder.

The only way to fully repair a rotator cuff injury is through surgery. Anti-inflammatory and pain medications can only mask the symptoms for so long before surgical repair becomes necessary, and the sooner surgery is agreed to, the better, although many workers hesitate because they are unsure of their workers' compensation coverage.

Surgery to Repair a Work-Related Rotator Cuff Injury Is Covered

Workers' compensation benefits are required to cover all reasonable medical costs related to recovery and rehabilitation from a work-related injury. If your doctor recommends surgery to repair a torn rotator cuff, it is considered a medically necessary procedure and should be covered by your benefits. Treatment may be denied, however, if you elect an experimental or elective procedure instead of the doctor-recommended treatment, such as choosing acupuncture over doctor-recommended surgery.

Following Doctor's Orders After Surgery

While receiving workers' compensation benefits over an extended period, it is important to follow all of your doctor's instructions. If surgery is recommended, you should follow through with the procedure, and after rotator cuff surgery, you should follow instructions regarding rest, keeping the shoulder immobilized, and taking medications as prescribed. You should not return to work until your doctor allows it, even if you are worried your employer will not have work available for you. If you run into problems with your employer after a work accident, it is worth exercising your rights by speaking with a workers' compensation attorney.

Getting Legal Assistance In Rockwell City

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 Rockwell City 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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