When Do You Need or Not Need a Lawyer in an Iowa Work Comp Case?

By: Boffeli & Spannagel, P.C. Workers’ Compensation Attorneys

Here Is When You Do Not Need a Lawyer

You do not immediately need a lawyer as long as the employer and insurance company are providing medical care and you are being paid your regular wages or being paid workers’ compensation benefits for missed work.

If everything goes smoothly your case should generally proceed along the following lines:

1. You should continue to receive medical care.
2. Eventually the doctors will say that you have healed as much as possible and that you have reached maximum medical improvement. Maximum medical improvement does not mean that you are completely cured, but rather that your condition will not improve.
3. Once you reach maximum medical improvement the work comp insurance company should obtain an impairment rating of your disability from the doctor.
4. The work comp insurance company should then voluntarily pay you some amount of money based on the impairment rating from the doctor.

Once the work comp insurance company has told you what they are going to voluntarily pay you, then you should definitely contact a lawyer. The way that our law firm handles these situations is that whatever benefits you have been paid in the past and whatever benefits that the insurance company has promised to voluntarily pay you in the future go 100% to you. Our law firm receives a one-third contingent fee of any additional money that we are able to obtain for you.

Keep in mind that there are time limits in the Iowa workers’ compensation system. If the Defendants never paid you any weekly work comp benefits, then you must file a workers’ compensation Petition within two years of the date of injury. If the Defendants have paid you weekly work comp benefits, then the time limit for filing a workers’ compensation petition is within three years of the last payment of benefits.

Finally, be very careful about entering into settlement agreements. There are two main types of settlements:

1. Closed file settlements. This type of settlement cuts off your right to future medical care. This is potentially a serious problem because private health insurance and/or Medicare may not pay for medical care in the future for work-related injuries.
2. Open file settlements. In this type of settlement your right to future medical care stays open. However, you do not want to enter into an open file settlement until the case has been fully analyzed and litigated. If you enter into an open file settlement in response to a defense offer, you are agreeing to their value of the case and you will not be entitled to seek any additional money. The Defendants are required to voluntarily pay you what they consider to be the value of the case without you having to sign a settlement agreement of any type.

Here Is When You Do Need a Lawyer

1. Your employer will not report the injury to its work comp insurance carrier. Some employers are reluctant to report work injuries because of the potential for the claim to increase the work comp insurance premiums. However, if the employer will not report the injury, the work comp insurance company cannot provide you medical care and weekly benefits. You can report the injury directly to the work comp insurance company. If you cannot figure out the identity of the work comp insurance company, you can contact our office and we can usually find the name of the work comp carrier and provide you contact information to report the injury.
2. The work comp insurance company is delaying providing medical benefits or weekly payments. Sometimes delays are just part of the investigation process. In other situations, it is a sign that the carrier is actually planning to deny the claim, and then you will definitely need a lawyer to represent you.
3. The insurance company has formally denied or rejected your claim. If this has occurred, it is extremely unlikely that you can persuade the insurance company to change its mind. At this point you will need a lawyer to file a petition on your behalf and begin the litigation process.
4. Your employer will not offer you light duty work after you have been released to return to work. This is a strong sign that you are going to be terminated and that you will have to deal with serious and permanent injuries.
5. The insurance company has offered to pay you money in a lump sum rather than in weekly installments. In this situation the insurance company is probably offering you a closed file settlement that will cut off your right to future medical benefits and cut off your right to future cash benefits in case your condition worsens. In some situations, a closed file settlement is reasonable. However, you want to explore this issue very carefully with a lawyer first.
6. You are having problems getting the medical care you need. Lawyers can help to force the insurance company to provide the proper care.