This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
You should notify your employer of your injury as soon as possible as seek appropriate medical treatment if necessary. In order to insure you will be entitled to benefits should you proceed with filing a worker's compensation claim, you must notify your employer within ninety (90) days of the accident. After notifying your employer, your employer is expected to complete a written report of injury to be provided to the insurance provider in addition to a medical verification of injury. Your employer is expected to complete and file the first report of injury form with the worker's compensation commissioner within four days of notice of alleged injury.
Most employees who are injured while working in Iowa, either under contract or because their primary employment is within the state, are eligible for workers' compensation benefits.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
Iowa employers are required to provide insurance through private insurance companies or become self-insured providers to deal with potential workers' compensation claims. An employer who doesn't provide some form of workers' compensation coverage may be liable for workers' compensation benefits, damages, and/or criminal penalties under Iowa law.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
Your workers' compensation will be the most successful should you comply with all the appropriate and mandated filing requirements and can establish that your injury occurred within the course of your employment.
4. What benefits might I be eligible to receive?
Medical: Benefits paid related to payment of all reasonably necessary medical care related to the treatment of your injury. This can include necessary transportation expenses.
Disability benefits: Wage replacement benefits. This form of compensation is not to exceed eighty percent (80%) of your weekly spendable earnings (Spendable Earnings defined as amount retaining after payroll taxes deducted from gross weekly earnings. The amount of wage replacement benefit you may be entitled to will depend largely on the extent of your injury and the amount of money you have earned over the past year.
There are several categories of disability benefits you may or can qualify for. They include the following:
- Temporary Total Disability: If your injury causes you to miss more than three days of work, you may be entitled to wage replacement benefits starting the fourth day missed. You will not receive back pay for the first three days missed unless your disability exceeds fourteen days.
- Temporary Partial Disability: If your injury causes impairment or disability to the extent that when you return to work, you are only capable of working a lesser paying job, you may be entitled to benefits under this category. These benefits will compensate you for roughly two-thirds (67%) of the difference between your former wage and current wage.
- Healing Period: Benefits payable to you during time of recuperation of an injury that results in permanent impairment. The benefits are paid beginning the first day of disability until 1) you return to work; 2) you are not expected to make any further medical improvement 3) or you return to a job that is similar to the job you held at the time of your injury.
- Permanent Partial Disability: Benefits paid when an injury results in permanent disability. Benefits will be calculated based upon the degree of the permanent disability.
- Permanent Total Disability: Benefits paid to you if you are incapable of returning to work.
- Secondary Injury Fund Benefits: When you suffer a permanent partial disability to a body member as a result of one injury and then sustain a second injury while on the job, you may be entitled to second injury benefits. These benefits will not be the same or equal to the benefits you receive for the first injury. Instead, the benefits will be limited to the value of the permanent disability that exceeds the two members respectively.
- Vocational rehabilitation benefits: Services provided to you to aid you in obtaining and maintaining employment after suffering from a work-related injury or illness.
- Death benefits: Benefits paid to your dependents should your injury or illness lead to your death. Dependents are entitled to benefits until the age of twenty-five (25). Burial expenses may be covered under this category of benefits.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
If a dispute arises between you, your employer, or your employer's insurance provider, any of the parties may file a contested- case proceeding with a workers' compensation commissioner. Other options may be available and should be considered prior to filing a contested case proceeding. Consult your workers' compensation office.
If you do not receive benefits regularly or are unhappy with the payment of benefits, it is your responsibility to contact the workers' compensation commission to attempt to resolve the matter. If you have not received benefits or filed an application to settle the dispute, you may lose entitlement to benefits. All other claims that could be brought forward to the workers' compensation commissioner must be filed within three years of the date of accident/injury.
6. If I am not happy with the determination, how do I appeal?
Determinations by the workers' compensation commission may be appealed to the Iowa court of appeals. The case will proceed following the applicable law and court rules and procedures.