Iowa Workers Compensation Claims

Transcription

1 THE LAW GUIDE TO Iowa Workers Compensation Claims 8 Things to Know If You Suffer a Work Injury in Iowa 7 Costly Mistakes Injured Workers Make 6 Smart Questions You Should Ask BEFORE Hiring an Iowa Workers Compensation Attorney FAIRNESS ( )

2 WHAT OTHERS ARE SAYING ABOUT THE LAW GUIDE TO IOWA WORKERS COMPENSATION CLAIMS: This Law Guide helped me better understand my rights and how to protect myself after a work injury. Brian Trinity, Newton, Iowa The Iowa workers compensation system is more complex than you think. It is not easy to understand and this Guide really helps. Heidi Young, Ionia, Iowa I recommend this Law Guide because most workers don t know their rights and getting advice right up front from someone who deals with work comp issues every day is very helpful. Mark Patterson, Evansdale, Iowa This Guide is a great resource that the work comp insurance company will not tell you about. It helped me understand what benefits were available. Kim Speich, Marion, Iowa Without this Law Guide, I would not have pursued my rights as an injured worker and let it go, suffering on my own. Arlo Starbuck, Boone, Iowa

3 I would recommend reading this Guide. It is good to know the facts in order to protect yourself. There were many things I didn t know and some things the company won t tell you unless you know to ask. Kathie Marold, Cedar Rapids, Iowa This Law Guide covers the facts that employees need to know about filing a workers compensation claim. Joy VenHorst, Long Grove, Iowa It answered many questions I had up front. It also helped me set expectations and gave me additional questions to ask an attorney. Jim Tyer, Polk City, Iowa The Guide gave me a better understanding of how work comp works and whether I had a valid work comp case. Joana Millard, Strawberry Point, Iowa This Law Guide is quite informative and it helps you decide what direction you should take. Scott Justason, Rowley, Iowa

4 THE LAW GUIDE TO IOWA WORKERS COMPENSATION CLAIMS: RSH Legal

5 Contents Contents THE LAW GUIDE TO IOWA WORKERS COMPENSATION CLAIMS Author s Note...1 Introduction Should I Be Reading This Guide?...2 Chapter One 8 Things to Know if You Suffer a Work Injury In Iowa...7 Chapter Two 7 Costly Mistakes Injured Workers Make...15 Chapter Three 6 Strategies Work Comp Companies Use to Cheat Injured Workers...21 Chapter Four How to Make Sure Your Work-Related Injury is Properly Documented...25 Chapter Five The Absolute Wrong Way to Pick an Iowa Workers Compensation Attorney...30

6 Contents Chapter Six The Step-by-Step Guide to Find the Right Workers Compensation Attorney For You...33 Chapter Seven 6 Smart Questions You Should Ask Before Hiring an Iowa Workers Compensation Attorney...36 Chapter Eight Our Credentials...39 Chapter Nine What Our Clients Say About RSH Legal...40 Chapter Ten Cases and Verdicts...43 Chapter Eleven What RSH Legal Does For Clients...46 Chapter Twelve What Cases Does RSH Legal Not Accept?...49 Chapter Thirteen What Cases Does RSH Legal Accept?...51 Chapter Fourteen What Does it Cost to Hire RSH Legal?...52 Chapter Fifteen What Can I Do Now?...53

7 Dear Reader: We all know that businesses sometimes mistreat their employees. The sad truth is that the workers compensation insurance industry often continues this shabby treatment when dealing with innocent workers who are injured on the job. The imbalance of power after a work injury is obvious. An injured worker is vulnerable, dealing with unexpected pain, disability and a stack of bills. The workers compensation insurance industry has the upper hand it knows the rules and it has the money. Insurance corporations will often take advantage of this situation by convincing injured workers to do things that will cost them their rights. Whether it is using unnecessary delay tactics, making lowball settlement offers or refusing to accept full responsibility for a work-related condition, the work comp insurance industry s goal is the same paying the injured worker as little compensation as possible. We don t think that is right not morally, ethically or legally. We hope this Law Guide to Iowa Workers Compensation Claims will help injured workers and their families stand up to the bullies of the insurance industry. Sincerely, John Riccolo Tim Semelroth Pressley Henningsen Emily Anderson Farl Greene page 1

8 Introduction Introduction SHOULD I BE READING THIS GUIDE? Have you suffered a serious injury on the job or lost a family member in a work-related accident? Whether you are unable to return to work as a result of a work injury or you are looking at medical bills and disability, this guide can help. You have made an important first step by requesting this guide. The information we give here will help if you have suffered a serious work injury or if a loved one has died while working in Iowa. We personally guarantee it. If you read this entire guide and believe you did not learn something important about the Iowa workers compensation system, send a letter to our office and we will make a $100 donation to the Iowa Foundation for Justice in your name. After a work-related injury, your mind is probably swirling with questions. This guide can answer questions like: How do I protect myself after a work injury in Iowa? What benefits are available to me or my family? How do I know if my employer s insurance company is telling me the truth? How long do I have to take action? page 2

9 Introduction Who is behind this guide and why should I listen to them? Our names are John Riccolo, Tim Semelroth, Pressley Henningsen, Emily Anderson and Farl Greene. We are Iowa attorneys who represent people injured on the job. If you want a divorce, need a will or have a traffic ticket, we are not the attorneys for you. We only handle cases involving serious injury or disability, and we only represent people - not big insurance corporations. John Riccolo is listed in both The Best Lawyers in America and SuperLawyers.com. He has also served as president of the Iowa Academy of Trial Lawyers and the Iowa Trial Lawyers Association. For more, go to JohnRiccolo.com. Tim Semelroth is a board-certified trial attorney, is a past president of the Iowa Association for Justice and has taught as an adjunct professor at the University of Iowa College of Law, one of the top-ranked schools in the country. For more, go to TimSemelroth.com. Pressley Henningsen has served as president of the Iowa Association for Justice and has been interviewed on ABC, CBS, NBC and FOX as part of The Consumer s Advocate television show. For more, go to PressleyHenningsen.com. page 3

10 Introduction Emily Anderson has served in the Young Lawyers Division of the Iowa State Bar Association as co-chair of both the Professional Development Committee and the Mock Trial Committee. For more, go to EmilyAndersonLaw.com. Farl Greene has a degree as a doctor of chiropractic medicine as well as a law degree. Farl serves on the Continuing Legal Education Committee of the Iowa Association for Justice. For more, to go: FarlGreene.com. The Million Dollar Advocates Forum is a national organization of attorneys who have had verdicts or settlements of a million dollars or more. At the time of this guide s publication, only thirty-five Iowa attorneys have been inducted into this Forum. All five attorneys at RSH Legal are qualified members of the Million Dollar Advocates Forum. Why did they write this guide? First, it is disheartening to get phone calls from seriously injured people who have been exploited because they did not understand the Iowa workers compensation system. We are sick of having to tell injured workers they have made early mistakes that cannot be fixed. We believe the solution to these problems is providing helpful information to injured Iowans and page 4

11 Introduction their families before they: Make a significant mistake, like failing to properly notify their employer after a work-related injury; Talk to an insurance representative before they are educated about their rights; or Miss an important legal deadline that will eliminate an opportunity to get workers compensation benefits. Second, we wrote this guide because we believe you deserve to learn about the Iowa workers compensation system in the comfort and privacy of your own home. This guide will allow you to take your time and review information at your own pace. You can read this guide without insurance corporations pressuring you to settle your claim or lawyers pushing you to file a lawsuit. This guide contains helpful information you can use to make your own decisions. It is also a valuable resource you can save for family or friends should they ever face questions about a work injury. Third, this guide saves us time as well. We get phone calls every day from people who want us to represent them in their Iowa workers compensation claims. This guide contains the same general information that we would give you if you called and spoke to one of the attorneys in our office. Writing this guide gives us the chance to talk to you about need-to-know information regarding worker s compensation claims in Iowa. It can assist you in making informed decisions about steps to take in your situation. We cannot accept every case. In fact there are many cases we are not able to accept. Even if we are unable to take your case, we believe you still deserve access to this essential information. page 5

12 Introduction THIS GUIDE IS NOT LEGAL ADVICE This guide, which is based upon Iowa law, is designed to inform. It should not be regarded as legal advice. We are offering strategies and identifying traps, but please do not consider anything in this guide to be counsel for your individual case. No person should ever apply or interpret any law without the aid of an experienced attorney who knows the facts, because the facts may change the application of the law. Reading this guide does not make you a client of our law firm or its attorneys. We can only represent you after you have signed a written contract with RSH Legal. If you have any questions about your legal rights after reading this guide, you can contact us at FAIRNESS ( ). page 6

13 8 Things to Know Chapter One 8 THINGS TO KNOW IF YOU SUFFER A WORK INJURY IN IOWA 1. If you are employed in Iowa, you are likely covered by the Iowa workers compensation system. An employee typically qualifies for benefits from the Iowa workers compensation system if he or she was injured while working in Iowa, regularly works in Iowa, or was hired in Iowa. Employees who regularly work in Iowa or who were hired in Iowa may be eligible for Iowa workers compensation benefits even if they were injured outside the state. Some workers are not eligible for Iowa workers compensation benefits, so it is important for an injured worker to consult an experienced Iowa workers compensation attorney to find out whether he or she is eligible for workers compensation. 2. The Iowa workers compensation system covers more than just broken bones. A work-related injury can be more than just getting hurt in an accident. According to Iowa workers compensation law, any health impairment, other than the normal aging process, can qualify as a work-related injury. Iowa workers compensation law covers conditions including disease, hearing loss, and psychological problems as long as these conditions are caused by a work-related activity. Iowa workers compensation law also provides benefits for workers whose pre-existing health page 7

14 8 Things to Know 3. conditions are significantly worsened in the course of performing their normal work activities You can qualify for workers compensation benefits even if the injury was your fault. Iowa s workers compensation system is a no-fault system. That means an injured worker can receive workers compensation benefits regardless of who caused the injury as long as the injury was not intentionally self inflicted. It does not matter if the injury was caused by the mistake of the employer, a fellow employee, a member of the public or even the injured worker him or herself. If a worker is injured while performing work-related activities, workers compensation should apply. 4. You cannot legally be fired for filing a workers compensation claim in Iowa. In Iowa, every injured worker has a legal right to file a claim for workers compensation benefits. If an employer terminates an injured worker for exercising that right, the worker can bring a wrongful termination suit against his or her employer for violating Iowa law. If a worker believes that he or she is being harassed or mistreated by an employer simply because he or she filed a workers compensation claim, that worker should take detailed notes about any mistreatment and consult an experienced Iowa workers compensation attorney. 5. An injured worker may be entitled to several different types of Iowa workers compensation benefits. There are five main types of Iowa work comp benefits: page 8

15 8 Things to Know 1. Medical benefits Employers are required to pay for all reasonable and necessary medical treatment related to a work injury. This includes the actual cost of the medical treatment as well as reimbursement for the cost of the worker s mileage to and from that treatment. In certain situations, an injured worker may also be entitled to payment in some amount for wages that he or she loses while attending treatment appointments. 2. Temporary disability benefits If an employee misses time from work and thus loses wages while recovering from a work injury, then he or she may be entitled to some amount of temporary disability benefits. These benefits begin after the third missed day of work and end once the worker returns to his or her normal work or when a doctor has decided the injured worker s injury is as good as it is going to get. This classification is known as maximum medical improvement. 3. Permanent disability benefits If a work injury causes a worker to suffer a permanent functional loss of part of his or her body, then the injured worker is entitled to some amount of permanent disability benefits. Permanent disability benefits are in addition to temporary disability benefits and begin when the worker reaches maximum medical improvement. The amount of permanent disability benefits depends on the body part affected, the worker s weekly benefit rate, and the degree of impairment or disability. Some parts of the body are called scheduled members and are assigned a specific number of weeks of benefits. page 9

16 8 Things to Know If a work-related injury is permanent, a doctor will measure the loss of function by assigning an impairment rating. For example, if a worker loses half of his or her thumb s function as a result of an injury, a doctor will give the thumb an impairment rating of 50%. Had the worker lost all of his or her thumb s function, the doctor would assign the thumb an impairment rating of 100%. Scheduled Member Weeks Scheduled Member Weeks Thumb 60 Any other toe 15 First Finger 35 Foot 150 Second Finger 30 Leg 220 Third Finger 25 Eye 140 Fourth Finger 20 Hearing in one ear 50 Hand 190 Hearing in both ears 175 Arm 250 Great Toe 40 Permanent disfigurement of face, head Body as a Whole (industrial disability) Generally, the assignment of an impairment rating is the final step for calculating permanent partial disability benefits for a scheduled member injury. The impairment rating multiplied by the value of scheduled member determines the number of weeks of permanent disability benefits to which the injured worker is entitled. See the Second Injury section on page 11 to see if other benefits are available. page 10

17 8 Things to Know Body as a Whole : Not all body parts have been assigned a specific value. Any injury to a part not mentioned on the chart - such as the back, neck, shoulder, hip or mind - is considered to be an injury to the body as a whole. An impairment rating is only the last word in calculating the value of scheduled member injuries. However, for injuries to the body as a whole a different process is used. An industrial disability analysis is used if the worker has suffered any permanent disability to his or her body as a whole. Industrial disability is not a calculation; it is an evaluation. It measures the loss of earning capacity of the injured worker. This evaluation can be complex because it requires assessing an injured worker s earning capacity both before and after the work injury. Iowa law allows multiple factors to be considered when doing this evaluation. These factors range from the worker s age and education to his or her motivation to return to work. Since many of the factors can be subjective and weighed differently from person to person, it is extremely important for an injured worker to consult an experienced Iowa workers compensation attorney after a body as a whole work injury. 4. The Second Injury Fund: This type of benefit may be available to workers who have a qualifying first injury, which is a pre-existing permanent disability to a hand, arm, foot, leg or eye. This pre-existing disability does not have to be the result of a work injury. If the worker then suffers a work injury resulting in permanent partial disability to a different hand, arm, foot, leg or eye, this new injury is referred to as the second injury. The Second Injury Fund pays additional benefits to injured workers whose page 11

18 8 Things to Know industrial disability after the work injury is greater than the combined scheduled member disability from both the first and the second disabled members. If an injured worker qualifies for a Second Injury Fund claim, the employer is required to pay all the scheduled member Law Guide Tip: If you have suffered from a scheduled member injury, but find yourself unable to work due to a previous injury, the Second Injury Fund may provide more compensation. Consult with an attorney to find out if you have a Second Injury Fund claim. permanent disability benefits due on account of the second injury. The Second Injury Fund will then pay weekly benefits for the amount the industrial disability is greater than the combined scheduled member disability from both the first and second disabled members. 5. Death Benefits Work-related injuries that result in a worker s death entitle a surviving spouse and children to receive weekly benefit payments and some amount of reimbursement for funeral expenses. There are other types of workers compensation benefits, but the majority of work-related injuries qualify the injured worker for one or more of the five main types of benefits described. page 12

19 8 Things to Know 6. If your employer or its work comp insurance is paying for your medical treatment, they have the right to choose who provides the treatment. The employer must pay for all reasonable and necessary medical care required to treat an employee s work-related injury. While the employer must provide medical care reasonably suited to treat a work injury, the employer has the right to choose where the injured worker goes to receive that care. If an injured worker wants treatment for a work injury to be covered by workers compensation, he or she must make sure that the treatment and its provider are authorized by the employer. 7. If you are unhappy with your employerchosen doctor, you may be entitled to alternative medical care. While Iowa workers compensation law allows an employer, rather than the injured worker, to decide who will provide medical treatment for a work injury, this is a limited right. If injured workers find themselves in a situation where they are dissatisfied with their medical care, their first step should be to inform their employer (or its workers compensation insurance corporation) in writing. If the employer or its insurance corporation will not offer alternative medical care, the injured worker s next option is to file a petition with the Iowa Workers Compensation Commissioner. Typically, written evidence of inadequate medical care such as a conflicting opinion from a different doctor is necessary to get the Commissioner to rule that you are entitled to different medical care. It is usually necessary to consult with an page 13

20 8 Things to Know experienced Iowa workers compensation attorney in order to successfully exercise your right to alternate medical care. 8. Determining your fair entitlement to workers compensation benefits may require an expert. Determining fair compensation for a work-related injury can be a complex process. There are a number of tasks - like calculating the appropriate weekly benefit rate, deciding when and where to seek a second opinion on an impairment rating, or evaluating an injured worker s industrial disability - that require legal and medical expertise. The average person (and for that matter, the average attorney) is not going to know how to navigate a system like this. After a serious work injury, seeking advice from an Iowa attorney with real workers compensation experience is almost always the right thing to do. page 14

21 7 Costly Mistakes Chapter Two 7 COSTLY MISTAKES INJURED WORKERS MAKE No one likes to hear about Iowans injured in the workplace. It especially pains us to tell injured workers they have made mistakes that may endanger their ability to receive fair compensation for their injuries. Here are seven costly mistakes that prevent injured workers from receiving the workers compensation benefits they deserve: 1. Failing to promptly notify your employer about your work-related injury. Iowa law requires an injured worker to notify his or her employer of a work-related injury within 90 days. Failure to notify an employer within 90 days may prevent the injured worker from ever qualifying for benefits. This 90-day notice requirement applies to both traumatic injuries (injuries that come on with a sudden event), as well as cumulative injuries (injuries that appear over time). With a cumulative injury, there is often a question as to when the injury occurred. Iowa law states that the date of injury is the date on which a reasonable employee would know three things: 1) that there was an injury; 2) that it is work-related; and 3) that the injury impacts the employee s ability to work. page 15

22 7 Costly Mistakes In some cases, the official date of injury counts as the first day of work the employee has to miss because of the injury, but this is not always true. To be safe, we recommend that an injured worker provide notice to his or her employer in the form of a written letter that includes both the date and a written description of the work-related injury. 2. Missing the legal deadline for filing a workers compensation claim. If a work-related injury has caused temporary or permanent disability and the injured worker has not received the benefits to which he or she is entitled, the worker can file a claim with the Iowa Workers Compensation Commissioner. However, Iowa law only gives the injured worker a limited amount of time to file such a claim. If the injured worker has never received weekly benefits (medical benefits or mileage reimbursement alone does not count), the worker must file a claim within two years of the injury date. Missing that deadline can result in losing the right to disability benefits. If an injured worker has received a workers compensation check for temporary or permanent disability (again paying for medical treatment alone does not count), the worker must file a claim with the Iowa Workers Compensation Commissioner within three years of the date the worker s last disability benefit check was mailed. Missing that deadline can result in losing the right to additional disability benefits for that injury. If you believe you have a valid Iowa workers compensation claim but the time for filing the claim appears to have expired, talk to an attorney before abandoning your claim because a valid legal exception may apply. page 16

23 7 Costly Mistakes 3. Failing to confirm that injury-related medical treatment is authorized by your employer. As has been mentioned before, Iowa workers compensation law gives the employer or its insurance corporation the right to choose who provides medical treatment to an injured worker if they are paying for that treatment. Refusing to go to the doctor chosen by an employer or getting treatment from a doctor not authorized by an employer comes with consequences. First, injured workers who refuse to see a doctor selected by the employer run the risk of having their weekly benefits stopped during the period of that refusal. Second, the employer or its insurance corporation is likely to refuse to pay for medical treatment that it does not authorize. That means the injured worker could be personally responsible for paying for the unauthorized medical treatment, even if the treatment was for a work injury. If an injured worker is dissatisfied with the medical treatment authorized by his or her employer, it is recommended that the worker talk to an Iowa workers compensation attorney about filing a petition requesting alternative medical care. 4. Failing to save letters, check stubs and envelopes from the workers compensation insurance corporation. Keep copies of all letters and check stubs from a workers compensation insurance corporation - as well as the envelopes that the letters and checks came in. These documents are important because they provide proof of when important payments and notices were made. page 17

24 7 Costly Mistakes The postmark on an envelope is particularly important when workers compensation benefit checks are arriving late. Iowa law requires workers compensation benefits to be paid in a timely manner. An injured worker may be entitled to interest payments and penalty benefit awards if workers compensation benefits are paid unreasonably late. Proving the late arrival of those benefits is easy if the injured worker saves all check stubs and the envelopes that the checks arrived in. Also, check stubs and postmarks are an important reference when determining how long an injured worker has to file a claim with the Iowa Workers Compensation Commissioner. 5. Failing to get legal advice before quitting or retiring from a job after a work-related injury. Generally speaking, the employer at the time of a work-related injury will continue to be responsible for all medical treatment related to the work injury, regardless if the injured worker stays with that employer. This same employer will also be responsible for paying any additional benefits related to permanent disability caused by the work-related injury. Choosing to leave a job after a work-related injury, however, can have negative consequences. An injured worker takes a risk if he or she moves to a new job that requires the use of the same body part injured at the old job. If the worker s symptoms get worse on the new job, the old employer may quickly claim that the new job has aggravated the old injury to the point that it is now a new injury for which the old employer is no longer responsible. Retiring too soon after a work injury can also jeopardize a worker s ability to receive fair compensation. An employer or page 18

25 7 Costly Mistakes its insurance corporation often argue that the decision to retire was a lifestyle choice rather than a consequence of the work injury. They make this argument to limit the amount of permanent disability benefits they owe. That is why it is usually in the best interest of an injured worker to attempt to return to his or her old job before making the decision to retire. If an injured worker soon finds that he or she can no longer tolerate the old job because of the work injury, it is essential that this discovery is communicated to the employer before making the decision to retire. 6. Not speaking to an attorney before signing workers compensation settlement documents. Just like any other business, workers compensation insurance corporations want to make a profit. This motivation often leads insurance corporations to offer unfair settlements to injured workers. Most injured workers do not know what they deserve under Iowa law and a profit-driven insurance corporation is not likely to tell them the whole story. The Iowa workers compensation system can be very complex, and the amount of benefits to which an injured worker is entitled can vary a lot based on medical condition and personal situation. There can be over a dozen factors to consider when calculating benefits for a permanently disabled worker. Due to the complexity, it is unlikely that anyone other than an experienced workers compensation attorney will be able to say whether an employer s settlement offer is fair. The sad truth is that injured workers agree to low-ball settlements every day because they have not taken the time to get an evaluation of their claim from a qualified workers compensation attorney. page 19

26 7 Costly Mistakes 7. Failing to talk to an attorney licensed to practice law in Iowa. Each state has its own set of workers compensation laws. Filing deadlines, legal terms and benefit calculations that are important in Iowa may differ from those in Missouri, South Dakota or Illinois. Workers compensation laws vary between states, so if an injury occurred in Iowa, it is important for an injured worker to talk to a workers compensation attorney practicing in Iowa. If a worker was injured outside of Iowa but his or her employer is principally located in Iowa, it is also important for that worker to talk to an Iowa attorney. Contacting an attorney who practices in the wrong state will probably waste an injured worker s time and, ultimately, could prevent him or her from receiving full compensation for a work injury. page 20

27 6 Strategies Used to Cheat Injured Workers Chapter Three 6 STRATEGIES WORK COMP COMPANIES USE TO CHEAT INJURED WORKERS 1. Work Comp company denies the claim because the injury was pre-existing. A pre-existing condition does not mean that a worker is not entitled to workers compensation benefits. Under Iowa law, an injured worker is entitled to workers compensation whenever a work activity significantly aggravates, accelerates, worsens or reveals an underlying or pre-existing condition. Whether or not a particular claim is covered depends largely on the medical evidence - in particular, the treating doctors opinions. Many cases involving an aggravation of a pre-existing condition which were initially denied are ultimately determined to be covered after an experienced attorney properly questions a treating doctor. 2. Work Comp company lets health insurance pay for medical treatment related to a work injury. As mentioned previously, Iowa law requires work comp companies to pay for all reasonable and necessary medical treatment related to a work injury. Sometimes, however, work comp companies will allow a worker s health insurance company to pay for those medical bills. page 21