Workers' Comp Denial in Iowa

Iowa workers may not realize it but if they are injured at work or become ill because of an industrial disease or sickness, they can file a workers’ compensation claim to seek a payment for the financial cost of their workplace injury or illness.

Compensation is limited to medical treatment bills and a portion of the wages that might have been earned. Workers’ compensation claims are not automatic and may be denied for a number of reasons by the employer’s insurance company. Most denials can be reversed after an appeal through the state agency in charge of workers’ comp.

It may be wise to use an attorney to help out if you opt for an appeal.

Workers' Compensation Law in Iowa

The Iowa Workers’ Compensation Commission is in charge of overseeing the way workers’ compensation is administered in Iowa, although injured workers file their claims initially to the insurer used by their employer.

As in other states, timing is important throughout the whole claim process, including appeals. Under Iowa law, workers must notify their employers within 90 days if they are injured or become ill at work.

These illnesses and injuries must be genuinely work related and not pre-existing conditions.

The injured or sick worker must file a claim within 2 years of their injury or sickness developing.

In Iowa, workers’ compensation payments pay for all reasonable medical treatment related to the injury or illness. This may involve long term payments if the disability is permanent.

Compensation is also available to families if a death occurs at work.

Compensation is also available for lost earnings. The actual amount depends on the nature of the illness or injury and how temporary it is, but it can be estimated at around two thirds of what might be expected to be earned.

Iowa Workers' Comp Denial Legal Help

Why You Might Have Had Your Claim Denied

Insurers are never happy about paying out compensation and may try and find ways of denying your claim to save them money. However, they must give a valid reason and back it up with evidence to support it.

Some of the more common reasons for a denial are listed below.

  • The employer was informed after the 90 day cut off point or the claim was submitted too late.
  • The claim did not have enough evidence that an injury really happened, e.g. there is no medical report or doctor’s report showing details of the injury (or illness).
  • It is claimed that you ignored safety warnings or refused to use safety gear provided.
  • It is claimed that your injury or illness did not occur at work or it was pre-existing and did not happen when you claim.
  • It is claimed that you were affected by alcohol or drugs when the accident happened.

The Iowa Workers' Comp Appeals Process

The normal procedure if your claim is denied and you wish to appeal is to file what is called a “contested case proceeding” with the Iowa Workers’ Compensation Commission. The Commission will respond to your request and schedule a hearing with a judge presiding.

The judge will hear evidence from both you and the workers' comp insurer and examine any evidence that you have which supports your claim for compensation.

The insurer will most likely use an attorney to represent them. It is sensible if you do the same.

The judge will make a decision and if this does not go in your favor then you have the opportunity to appeal it further.

Why a Workers' Comp Attorney May be of Help

It’s a pity that workers’ comp. claims are not more straightforward but the reality is that they are not guaranteed to deliver reasonable compensation payments.

If your claim is denied, it is not the end of the world as the state has a set procedure in which the insurer’s decision can be challenged by you and an independent judge allowed to make an informed decision about reversing the denial.

Appeals are complex procedures and it doesn’t do any harm to use an experienced workers’ comp. attorney to help you obtain what you deserve.