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Edward J. Keane |
"What Do I Do If My Worker's Comp Claim Is Denied?"As is the case with most insurers, Worker's Compensation insurance carriers in the State of Iowa are the most profitable when they are able to minimize the number of claims against their policies. In fairness, worker's compensation insurance companies are as vulnerable to frivolous claims as any type of insurer. However, this reticence to pay out claims often causes the Worker's Comp insurer to deny legally valid claims filed by workers who have been injured on the job. If you have an accident on the job or in the workplace, you should immediately report the injury to your supervisor, manager, or the human resource department. If you are subsequently denied internally or by the insurer, you have the right to know what the reason is. You may be able to resolve your dispute at this level—either because you find the employer’s or W.C. insurer’s reason to be valid, or because once you’ve provided additional information, they re-file your claim. However, if they don’t resolve the matter, your attorney can file a contested-case proceeding before the Iowa Worker’s Compensation Commissioner. (While an attorney isn’t required, the Worker’s Compensation Commission does recommend the practice. In the contested case proceeding:
The worker’s compensation commissioner then has sixty days to review the matter and render a ruling. If you don’t receive satisfaction from the contested case proceeding, your attorney may have to pursue the matter through the Iowa courts. Statute of Limitations and Time Limits on Worker’s Compensation Claims One of the most common reasons for denial on Iowa worker’s comp claims is expiration of the statute of limitations or the deadlines established by law. It’s important that worker’s compensation claims be filed in a timely fashion. The following information comes directly from Iowa’s Division of Worker’s Compensation WorkForce.org website. Notice of Injury – The law provides that the employer must have notice or knowledge of an alleged injury within 90 days of its occurrence, if not, benefits may be denied. The 90-day period begins to run when the employee knew, or should have known the injury arose out of and in the course of employment, and that the injury would likely impact his employment. Reporting Claims – An Employer’s First Report of injury must be filed with the workers’ compensation commissioner when an employee alleges an injury arising out of and in the course of employment, which results in time loss from work of more than three days, permanent injury or death. The report is to be filed with the workers’ compensation commissioner within four days of notice or knowledge of such alleged injury. Two-Year Statute of Limitation – If within two years from the occurrence of the injury the employee does not receive Iowa weekly workers’ compensation benefits or file an application for arbitration, benefits may be denied. Three-Year Statute of Limitation – If Iowa weekly workers’ compensation benefits have been paid, the employee has three years from the last payment of weekly benefits to receive additional benefits or file an action before the workers’ compensation commissioner. If not filed within the three-year period, the benefits may be denied. This statute of limitation does not apply to medical expenses reasonably necessary to treat the injury. Remember, if your dispute with your employers or their worker’s compensation insurer isn’t quickly resolved, it may time to consider retaining the services of a competent Iowa labor attorney who handles worker’s compensation cases. To schedule an appointment with a reputable, experienced Sioux City, IA personal injury attorney, contact the Law Office of Edward J. Keane at 888-501-5628. Mister Keane represents clients in Nebraska, South Dakota, and Iowa.
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