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Wage Replacement Benefits

Workers’ compensation benefits in Iowa require an employer to provide the employee with three kinds of benefits, including wage replacement benefits (or temporary total disability benefits over the healing period,) medical benefits, and permanent (permanency) benefits.

Wage Replacement Benefits

Under Ia. Code Sec 85.33 – 85.34, the worker must be paid wage replacement benefits if he or she can’t work as a result of a workers’ comp injury. For the weeks that the worker misses work as a result of the injury, the workers’ comp insurance carrier and the employer must pay the worker a check that is approximate to the worker’s net compensation when working. The net pay is less than the worker’s usual gross wages because it’s not subject to any taxes.

If the worker’s doctor places him or her under restrictions and the worker works less than his or her full hours or he or she is paid less than full rate or wages, the worker must be paid “temporary partial disability benefits.” This benefit in Iowa workers’ comp law offers make-up compensation for a part of the wages the worker loses because of missed hours or light duty status.

Medical Benefits

The workers’ compensation insurance carrier and the employer must provide and pay for the worker’s medical care that he or she needs as a result of a work-related injury. Under Iowa law, the employer may choose the physician for the worker but, in addition, the employer and workers’ comp insurer must pay his or her medical expenses. What’s more, the insurer and employer must reimburse the worker for the use of his or her vehicle as well as the cost of fuel for getting to and from medical appointments. This is called the “mileage expense.”

Under Ia. Code Sec. 85.27, if the worker isn’t happy with the insurance company’s physician choice, he or she may petition for the right to see another doctor when certain scenarios are present.

Iowa Workers’ Compensation Permanent (Permanency) Benefits

Under Ia. Code Sec. 85.34, the injured worker is entitled to permanent partial disability benefits if he or she sustains a permanent work-related injury. Permanent partial disability benefits may be provided to the worker based on the gravity of his or her permanent work-related disability when his or her earning capacity is reduced by the injury over the rest of the worker’s life.

The permanent benefits the worker is paid depends on what part of the body was injured in the workers’ comp injury:

• If the worker injured a leg, foot, arm, or hand, the workers’ comp permanent benefits amount is based on his or her loss of use (also called the impairment rating).
• The calculation is generally based on the impairment rating as per the American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment.
• The AMA Guides aren’t the final authority in these matters, though: an Iowa workers’ compensation lawyer uses methods and arguments to obtain more than the rating allowance for the injured worker.
• This permanency rating is referred to as a “scheduled member injury.”
• If the permanent injury is to the worker’s head, back, hip, neck, shoulder or whole body, the permanent benefits entitlement is considered on how the work-related injury affects the worker’s capacity to perform his or her work over the remainder of his or her life and/or earnings capacity. Determining this calculation is a complex task.
• Sometimes, an Iowa workers’ comp insurance carrier will advance payment to the worker, but this is typically a minimum amount that he or she is entitled to receive a work injury by law.
• The worker may be entitled to a significantly higher sum than the insurer voluntarily agrees to pay.
• Workers’ comp insurance carriers in Iowa don’t want to pay workers the maximum amount required for any claim. The goal of the insurer as a for-profit entity is to increase its bottom line profits—not pay workers large workers’ comp settlements.

Contact an Experienced Workers’ Compensation Attorney

If you have been injured in a work-related accident or you’re suffering from a work-related illness, realize that multiple factors are used to analyze how your injury affects earnings capacity, including your work history, age, impairment rating, education, functional restrictions, life expectancy, and others. Because of the many factors used to determine the extent of your injury by the workers’ compensation insurance carrier, this is a complex matter for which you should engage an attorney in Iowa.

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