These days, doing nothing at all is one of the worst things you can do. It's hard enough to make ends meat these days and getting injured shouldn't have to make matters worse.

Iowa Law has recognized the needs of its injured workers for more than 50 years. The law requires every employer to obtain workers' compensation insurance (or be approved as a self-insurer) to cover claims made by their injured workers. Even the best employer, however, is not likely to tell you all you need to know. If you are injured in an accident or suffer from an occupation disease at work, you must report your work injury within 90 days of the date of injury. The law also limits the time in which you have to settle or file your workers' compensation claim. The limits are 2 years from the date of the work injury if the claim has been denied by the insurance company, subject to many exceptions or 3 years from the date of the work injury if the insurance company has paid you weekly benefits.

If you meet the legal requirements for a workers' compensation claim, then the law says you are entitled to receive the following benefits:

Lifelong Medical Care: Your employer and/or their insurance company are responsible for paying for all medical care necessary to treat your work related injury. This includes all forms of care and treatment, whether hospital, medical, therapy, nursing, diagnostic testing, surgery, physical rehabilitation or pain management. However, generally your employer and/or their insurance company get to choose your medical providers. The right to medical care and treatment may continue for the rest of your life for conditions related to your work injury or occupational disease .

Right to Medical Treatment: You always have the right to seek medical care from any medical provider that you choose. However, please keep in mind that your employer and/or their insurance carrier will generally only pay for medical care that they have authorized or approved. Also, if you have health insurance they may reject the claim as being a work related condition.

Payment of Medical Care Including Mileage:

• Medical Expenses: Generally, your employer and/or their insurance company has to provide you with medical care and treatment. This includes them paying for all treatment that they offer to you. However, there are some circumstances that they can be held responsible for paying medical expenses that you incur with medical providers not approved by them. For example, if your work injury claim has been denied then they lose control over your medical treatment. If your injury is later determined to be work related then they would be responsible for the costs. There are other limited circumstances that you can seek medical care with a provider who is not approved and they will be required to pay for it.
• Mileage Expenses: You are entitled to be reimbursed at the rate of $.505 per mile effective July 1, 2008, for all mileage you incur going to and from doctors’ appointments, physical therapy visits, etc.

Right to Refuse Medical Care: You have the right to refuse any medical procedures or care that you do not want. For example, if the company doctor recommends surgery you do not have to proceed with surgery. However, please keep in mind that not proceeding with surgery may have an impact upon your case.

Weekly Check While You Recover And Cannot Work: While you are healing and unable to work, you will receive weekly checks to replace your usual earnings. This applies to both if you are completely unable to work (known as TTD- temporary total disability benefits) or if you return to work, but are working less than 40 hours per week (known as TPD- temporary partial disability benefits). The amount of your weekly payment is called your “rate” which is discussed below.

• Rate: The amount of your weekly payments, also known as your “weekly benefits”, is based upon your average earnings prior to the work injury, known as your AWW- Average Weekly Wage. If you are paid on an hourly basis, generally your rate will be based upon your average wages for a 13 week period prior to your work injury, excluding short weeks (weeks in which you did not work a full 40 hours). Your weekly rate is based upon your marital status, your number of exemptions, and your AWW- Average Weekly Wage multiplied times 80% of your spendable weekly earnings. There are both minimum and maximum rates for permanent disability benefits based upon the statewide average weekly wage.

Your rate is very important because it determines how much compensation you receive. For example, if you are owed 100 weeks of benefits and your rate is $252 then your total compensation is $25,200 paid weekly. However, if you are owed 100 weeks of benefits and your rate is $575 your total compensation is $57,500 paid weekly. Our experience is that in about 50% of our cases, the employer/insurance company has underpaid the employee by using a lower weekly rate than what is owed. That is why in every case we verify that you have been paid the proper rate as it can make thousands of dollars of difference.

Money for Permanent Disability: If your work injury or occupational disease causes a permanent disability also known as a permanent impairment rating or functional impairment rating, then you are entitled to money for the resulting disability. The amount of the benefits is based upon the body part(s) involved, the nature and extent of your disability and the amount of your average weekly earnings prior to your work injury.

Examples of Scheduled Member Injuries:

Shoulder - Percentage based upon 500 weeks of available benefits. For example an 8% body as a whole shoulder impairment rating generally equals a minimum of 40 weeks of benefits. However, depending on many factors, including lifting and activity restrictions imposed, lost wages, etc. an 8% shoulder impairment rating could result in 100 weeks or more in benefits.

Back - Percentage based upon 500 weeks of available benefits. For example a 10% body as a whole back impairment rating generally equals a minimum of 50 weeks of benefits. However, depending on many factors including lifting and activity restrictions imposed, lost wages, etc. a 10% back impairment rating could result in 120 weeks or more in benefits.

Neck - Percentage based upon 500 weeks of available benefits. For example a 15% body as a whole neck impairment rating generally equals a minimum of 75 weeks of benefits. However, depending on many factors including lifting and activity restrictions imposed, lost wages, etc. a 15% neck impairment rating could result in 150 weeks or more in benefits.

Brain and Mental Injuries - Percentage based upon 500 weeks of available benefits. Sometimes you will not receive an impairment rating for a brain injury or mental health injuries such as depression, anxiety or PTSD- post traumatic stress disorder. However, if you have a permanent condition which has impacted your ability to earn a living then you may be entitled to receive permanent disability benefits.

Nerve Injuries-CRPS- Chronic Regional Pain Syndrome, RSD- Reflex Sympathetic Dystrophy - Even if your work injury is to a scheduled member, if you have been diagnosed with one of the above nerve injuries or another type of nerve injury then your case may be considered an injury to your body as a whole. D epending on many factors including your ability to work, lifting and activity restrictions imposed, lost wages, etc. you may be entitled to a percentage of 500 weeks of benefits.

Respiratory and Circulation Injuries - These injuries include occupational asthma and injuries to arms or other body parts when the circulation has been affected like in Reynaud’s syndrome.

Examples of Scheduled Member Injuries :

• Arm - 250 weeks, e.g. a 10% arm impairment rating equals 25 weeks of benefits.
• Hand - 190 weeks, e.g. a 20% hand impairment rating equals 38 weeks of benefits.
• Leg - 220 weeks, e.g. a 15% leg impairment rating equals 33 weeks of benefits.
• Foot - 150 weeks, e.g. a 30% foot impairment rating equals 45 weeks of benefits.

Fingers - Thumb- 60 weeks, 1st Finger- 35 weeks, 2nd Finger- 30 weeks, 3rd Finger- 25 weeks, 4th Finger- 20 weeks. For example, a 40% impairment rating to the 1st finger would equal 14 weeks of benefits. Please note that injuries to fingers may not count as an injury to a hand for 2nd injury fund or other purposes.

NOTE : If you do not know which category your injury fits into please contact us. Also, you may be entitled to additional benefits for a scheduled member injury depending on whether or not you have sustained previous injuries, etc. For example, you may qualify for 2nd Injury Fund benefits.

2nd Injury Fund: If you previously sustained a scheduled member injury (arm, hand, leg, knee, foot, eye, etc.) even if it was not work related, and then sustain a work related scheduled member injury you may be entitled to additional benefits under the Iowa Second Injury Fund Act. Please keep in mind that prior medical conditions such as arthritis, carpel tunnel, vision loss, etc. followed by a scheduled member work related injury may qualify you for additional benefits. If you think that you may qualify for the 2 nd injury fund, please give us a call and we can help you determine if you qualify.

Permanent Total Disability: If you sustain an unscheduled member injury, injuries to both hands, arms or legs; or a qualifying 2 nd Injury and are no longer able to do any work, then you may be entitled to receive permanent total disability benefits which pay you a weekly benefit for the rest of your life.

Death: Damages for the death of a worker are available for the wife, husband, and/or dependent children of the deceased. This can include a spouse if there was a common law marriage. Also, sometimes people who were not related, but dependent upon the deceased may recover. Damages are compensation for the lifetime of the beneficiary.

(WARNING: CHANGES IN THE LAW CONCERNING DAMAGES OCCUR FREQUENTLY. YOU SHOULD CONSULT WITH AN ATTORNEY WITH RESPECT TO THESE CHANGES.)

If you have recently been injured at work, you are probably confused or worried about what steps to take next:

Will I be paid for the time I'm losing from work?
Will my medical bills be paid?
Will I be compensated for my injuries?
What if I don't make a full recovery and cannot return to my former work?
What will the insurance company offer me for my personal injuries?
How will I know that the insurance settlement is fair for my injuries?
How will I know that the lawyer I've chosen to represent my case is a competent lawyer and will know what to do?

The Workers Compensation attorneys at Walker, Billingsley & Bair are dedicated to protecting the rights of injured Iowans throughout the State of Iowa.  With offices in Des Moines and Newton we are located in Central Iowa, but represent clients throughout the state.