Iowa Workers Compensation Claims: Eligibility, Filing and Appeals

Most employees are covered under Iowa Worker’s Compensation laws. Domestic workers are exempt. Sole proprietors, partners and limited liability companies are not required to have worker’s compensation coverage but can purchase optional policies. Employers are required to provide benefits to covered employees, and usually provide these benefits by purchasing worker’s compensation insurance that will cover a worker in the event of an injury.

Work Related Injuries in Iowa

Worker’s compensation covers injuries “arising out of and in the course of employment.” Injury is broadly construed and includes any health impairment other then normal wear and tear on the body. Illnesses, diseases and hearing loss are also defined as injuries if they occur as a result of an employment activity or exposure to a toxin at work. Pre-existing injuries that are aggravated by an employment condition are also considered to be compensable.

The injury must be caused by, or result from, an employment related activity. It does not have to occur on the premises if the employee is in a location where he or she would reasonably be expected to go to conduct business activity.

Filing an Iowa Workers Compensation Claim

You must provide your employer with notice of your injury within 90 days of the injury, or within 90 days from the time when you knew or should have known of the work related illness. If you do not file a claim within 90 days, your benefits may be denied. When you notify your employer of your injury you are agreeing to release all medical information and waiving all privilege relating to this medical information connected with the injury.

Your employer must then submit an Employer’s First Report of Injury with the Division of Worker’s Compensation. If your employer does not pay benefits within 2 years and you do not begin arbitration proceedings, you may be precluded from recovering benefits.

Why Claims get Denied

Common reasons for denial include failure to prove that the injury arose out of the context of employment, and failure to provide sufficient medical evidence of the temporary and permanent disability with testimony from an approved physician.

Appealing an Iowa Workers Compensation Denial

Initially, you should attempt to resolve the dispute through guided arbitration. An arbitrator will be appointed by the Division of Worker’s Compensation at your request when you receive a denial of benefits. Arbitration is designed to facilitate settlement.

You may also file a request for a contested-case proceeding before the worker’s compensation commissioner if your benefits re denied. The Division of Workers Compensation oversees disputes and makes decisions on contested cases. The Division of Workers Compensation is a part of the Iowa Workforce Development.

The commissioner will be assigned to your case and conduct a hearing in which you present evidence and arguments regarding your claim for benefits. Following the hearing, a decision will be issued in writing.  If you are unsatisfied with the decision of the Division of Worker’s Compensation, you may file an appeal with the appellate court.

Collecting Iowa Workers Compensation Benefits

Benefits include payment of medical costs incurred as a  result of the injury, as well as death benefits in the event of a death. Temporary or permanent total or partial disability resulting from the injury is also compensable. Medical benefits must be obtained from a provider approved by the employer, as long as the employer provides reasonable medical care.

Disability payments are set at a maximum of 80% of the employee’s weekly spendable earnings. This is calculated by looking at the wages you took home after payroll taxes were deducted. These benefits consider your average daily wages based on a seven-day calendar week, up to a weekly maximum of $1257.00 for permanent partial disability or $1366 for temporarily total disability or permanent total disability. Temporary total disability begins to pay after three days of work are missed.

Temporary partial disability pays at 65 2/3 percent of the difference between the pre-injury wages and the post-injury wages. Permanent partial disability payments are determined by a schedule of impairments that sets specific dollar amounts based on the functional impairment.

Hiring an Iowa Workers Compensation Lawyer

It is advisable to hire a worker’s compensation attorney, especially if benefits are contested. An attorney can help ensure you comply with filing deadlines and help you build a case, including finding medical experts to testify at contested-case hearings.

Iowa Workers Compensation Office Locations

Division of Workers' Compensation
1000 East Grand Avenue
Des Moines, Iowa 50319-0209
Telephone: (515) 281-5387 or (800) JOB-IOWA