With respect to medical benefits, if your claim is accepted and you are paid benefits, you have lifetime medical benefits. This means that if you have an injury that is related to work, all of the treatment you need for that injury is covered for the remainder of your life. Of course, you will have to prove that the treatment is related to the workers' compensation accident and not to a new accident, and insurance carriers will often try to prove that your need for medical care is not because of the work injury, but theoretically you have lifetime medical coverage.

The Iowa workers' compensation statute provides that an employer must be notified of a work injury within 90 days of the date of the injury. If an employer has actual notice of an injury, no specific notice is necessary. Notice of the injury does not need to be written, although it is sometimes better to notify the employer in writing so there is no question that the employer has notice. There is nothing particular that you have to say in a notice to the employer. All you need to indicate is that you had a workers' compensation injury, the date of the injury (if you know the date), and the fact that you are claiming workers' compensation benefits for the injury.

Again, as with other areas of Iowa workers' compensation law, the notice issue, particularly in situations involving cumulative injuries, can be difficult to determine.

The statute provides that the employer is to provide reasonable care for your injuries. This care is to be provided with reasonable promptness, and without undue inconvenience to the claimant. What this means is that if you have a work-related injury, the employer is to provide care promptly, that care must be adequate to address the medical problems you are having, and the care must be reasonably close to where you live (this can be a particular problem with workers who do not live in Iowa, such as truck drivers). All of these issues can raise problems with your Iowa workers' compensation case.

One important thing to realize about medical care in an Iowa workers' compensation case is that the employer has a right to direct the care. This means that in most situations, the employer will get to choose the doctor who provides treatment to you. If a doctor is not authorized by the employer, the employer does not need to pay for the treatment that has been provided, except in very limited circumstances. This means that you cannot go to your own doctor and expect to have the employer pay for the care you receive. The exception is when you are able to prove that care that you have received was "beneficial care." In Bell Bros. v. Gwinn , 779 N.W.2d 193 (Iowa 2010), a case handled by the attorneys at Neifert, Byrne & Ozga, the court held that if the claimant could establish that the care was more beneficial than that being provided by the employer, the employer could be ordered to pay for that care. In certain cases, the employer and insurance carrier may be willing to allow you to see your own doctor, but that is the exception rather than the rule.

The claimant can challenge the adequacy of the medical services provided by the employer in certain situations. This can occur if the care provided is not reasonable to treat your injuries, or if the care is not provided promptly, or if the care is not convenient for the injured worker. The application for alternate medical care is a relatively fast procedure, and a decision must be issued in the case within ten working days of the filing of the application. Mere dissatisfaction with the care provided is not sufficient reason to allow for the substitution of care, but if the employer has failed to provide care, or has not provided care promptly, an alternate medical care proceeding may be a means of changing the care.

In situations where the workers' compensation insurance carrier has denied that the claim should be paid, Iowa law provides that the health insurance carrier is required to pay the bills, if the injured worker has health insurance. This can be a very important fact for workers who are lucky enough to have insurance coverage. On some occasions, this creates difficulties, as the health insurance carrier tries to argue that the claim is a workers' compensation claim, while the workers' compensation carrier argues the claim is not related to work.

The weekly Iowa workers' compensation rate is generally based on your income in the thirteen weeks prior to your injury. The weekly rate is based on the "customary" hours and wages you had at the time of the injury. Generally, the rate is computed by taking the customary hours and wages to compute an average weekly wage. The Iowa workers' compensation rate is usually between 60% and 66% of average weekly wage, and varies depending on marital status and the number of dependents you have.

The rate is based on your "customary" wage, and this generally starts with the income you had in the 13 weeks before your injury. Although overtime hours are considered, they are calculated at the straight time rate, not the overtime rate. For example, if you regularly make $20.00 per hour, but get $30.00 per hour for overtime, the overtime hours are included, but at the $20.00 rate rather than the $30.00 rate.

Rate disputes are fairly common in workers' compensation cases, and sometimes the employer will seek to include weeks in the rate that are not customary weeks.

In certain cases, where an injury has a very significant impact on the individual's ability to continue to work, permanent total disability benefits can be paid to the individual for the remainder of the injured worker's life. Permanent and total disability is the result of many factors. These factors include functional disability resulting from the employee's physical condition, age, education, experience, and the inability, because of the injury, to engage in employment for which the employee is fitted. Permanent and total disability occurs when an injury "wholly disables the employee from performing work that the employee's experience, training, intelligence, and physical capacities would otherwise permit the employee to perform." Total disability does not require a state of absolute helplessness. The pertinent question is whether there are jobs for which the injured worker can realistically compete.

Although the courts in Iowa workers' compensation cases have made it clear that an individual does not have to be absolutely helpless in order to be permanently and totally disabled, in many cases, employers and insurance carriers take the position that unless a person is totally helpless, they will not pay permanent and total benefits. Representation is therefore often a necessity to maximize the benefits received by the individual.

When a person dies as a result of a work accident, the individual's spouse can receive benefits for the remainder of his or her life. In the case of remarriage, the surviving spouse receives a lump sum of two years of benefits, if there are no surviving children entitled to benefits. Surviving children may receive benefits until age 18, or until age 25 if they are a student. If a person does not have dependents, no benefits are payable at death, other than benefits that may have been owed from a permanent impairment that occurred before death.

Death benefits can be paid even if the death was not the result of a specific accident. In some cases, such as those involving heart attacks, suicide as a result of depression caused by work activities, or infection caused as a result of treatment provided for a work injury, death benefits can be provided even though death does not occur because of a specific event.

The workers' compensation statute sets up a situation where the employer and insurance carrier can be subject to a penalty of up to 50% of certain benefits. This situation occurs when an employer and insurance carrier delays, denies, or terminates benefits "without reasonable or probable cause or excuse." This statute was modified in 2009 by the legislature to make clear that if the employer or insurance carrier delays, denies or terminates benefits without reasonable or probable cause or excuse, penalty benefits shall be awarded by the commissioner.

In order to avoid the imposition of penalty benefits, the employer and insurance carrier must make a reasonable investigation of the claim. The employer and insurance carrier must also rely on the reason that they provide the injured worker as the reason for denying, delaying or terminating benefits. The employer and insurance carrier must also tell the injured worker why they are denying, delaying or terminating benefits at the time of that action.

An example of how the penalty section works is as follows: Suppose the injured worker hurt his or her back while lifting a heavy object at work. Further suppose that the doctor to whom the worker has been sent has indicated that the back injury is related to the work activity. If the employer and insurance carrier do not pay benefits because they indicate that they do not believe the injury happened at work, without having any support for this contention, penalty benefits should be awarded because there is nothing to support the view of the employer that this is not a work injury.

After you have notified the employer of your injury, but the employer has not paid benefits to which you think you are entitled, you have the right to file a petition with the Iowa Workers' Compensation Commissioner. A copy of the petition can be found at the Iowa Workers' Compensation Commissioner's website, which is found at http://www.iowaworkforce.org/wc/. The petition can be found at the "Forms and Publications" link on the website.

The filing of the petition starts a formal legal process. Typically, after the petition is filed, a hearing is to be set within one year of the filing of the petition. Because this is a fairly complicated procedure, it is wise to consult an attorney if you wish to file a petition.

This is an area where there is a good deal of misinformation which can lead to confusion. The general answer is that you can be fired even if you have been injured at work. This is because Iowa is what is called an "at will employment" state, which means that an employer can fire an injured worker (or any worker for that matter) at their discretion.

There are situations in the workers' compensation setting where a worker has some protection, but these situations are fairly narrow. In Springer v. Weeks & Leo Co, Inc., 429 N.W.2d 558 (Iowa 1988), the Iowa Supreme Court held that an employer's discharge of an employee simply because they had filed a workers' compensation claim was against public policy. The court allowed the injured worker to pursue a claim against the employer.