Huber, Book, Lanz & McConkey, P.L.L.C. is a Des Moines, Iowa law firm practicing in the areas of bankruptcy, collections law, construction law, debtor and creditor, employment law, insurance law, litigation, personal injury, products liability, professional liability and workers' compensation.

Practice Areas
• Workers' Compensation
• Personal Injury Law
• Iowa Employment Law
• Bankruptcy Law

Iowa Workers' Compensation Law

Our law firm represents clients with respect to claims for workers' compensation benefits brought under the Iowa Workers' Compensation Law.

Our lawyers provide advice and counsel to clients regarding the Iowa Workers' Compensation Law, negotiate settlements of workers' compensation claims under the Iowa Workers' Compensation Law, attend mediations of workers' compensation claims on behalf of clients, draft settlement agreements under the Iowa Workers' Compensation Law and represent clients in proceedings for workers' compensation benefits brought before the Iowa Workers' Compensation Commissioner pursuant to the Iowa Workers' Compensation Law.

Our workers' compensation attorneys have provided some frequently asked questions and answers regarding work comp law:

Work Comp Questions & Discussions

Frequently Asked Questions about Workers' Compensation Law

Questions
• When is an injury considered to be a compensable workers' compensation injury?
• Does an injury have to be the caused by a traumatic incident or an accident in
   order to be compensable?

• What if an employee was injured as a result of horseplay is this compensable?
• Can a negligent employee recover workers' compensation benefits?
• Within what period of time must an injury be reported?
• What types of workers' compensation benefits are available?
• Must an employee be off work for a certain amount of time before temporary
   total disability benefits are due?

• When is the first payment of weekly benefits due?
• If there is a dispute who decides what is owed?

Discussion Questions
• Statute of Limitations for Workplace Injury Claims
• Intoxication Defense
• Violation of Work Rule

QUESTION:
When is an injury considered to be a compensable workers' compensation injury?
ANSWER:
When the injury arises out of and in the course of employment. The term "arising out of" employment means there must be a "causal relationship between the employment and the injury. The "arising out of" element requires that the injury be a natural incident of the work meaning the injury must be a "rational consequence of the hazard connected with such employment." In other words, the injury must not have coincidentally occurred while at work, but must in some way be caused by or related to the working environment or the conditions of . . . employment. Injuries arising out of risks or conditions personal to the employee do not arise out of the employment unless the employment contributes to the risk or aggravates the injury. The words "in the course of" refer to the time, place and circumstances of the injury.

QUESTION:
Does an injury have to be the caused by a traumatic incident or an accident in order to be compensable?
ANSWER:
No. An injury can be due to repetitive or cumulative trauma caused by work activities over time. Such injuries can include carpal tunnel syndrome, back injuries and shoulder injuries such as rotator cuff tears and impingement syndrome.

QUESTION:
What if an employee was injured as a result of horseplay is this compensable?
ANSWER:
No, if the injured employee of his own volition initiates horseplay or practical joking and actively takes part.

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QUESTION:
Can a negligent employee recover workers' compensation benefits?
ANSWER:
Yes.

QUESTION:
Within what period of time must an injury be reported?
ANSWER:
Unless the employer or the employer's representative shall have actual knowledge of the occurrence of an injury received within ninety days from the date of the occurrence of the injury, or unless the employee or someone on the employee's behalf or a dependent or someone on the dependent's behalf shall give notice thereof to the employer within ninety days from the date of the occurrence of the injury, no compensation shall be allowed. Iowa Code section 85.23.

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QUESTION:
What types of workers' compensation benefits are available?
ANSWER:
  1. Reasonable medical expenses including transportation expenses and lost wages
     due to attending medical care.
  2. Weekly benefits for time off work or while healing if do not return to work referred
     to as temporary total disability benefits if injury does not result in permanent
     disability and healing period benefits if it does.
  3. Weekly benefits for permanent partial disability
  4. Lifetime benefits for permanent total disability
  5. Survivor benefits in case of death
  6. Vocational rehabilitation benefits while attending an accredited school.

QUESTION:
Must an employee be off work for a certain amount of time before temporary total disability benefits are due?
ANSWER:
Yes. There is a 3 day waiting period. If an employee is off work more than 14 days than benefits must be paid for the first three days of work that are missed.

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QUESTION:
When is the first payment of weekly benefits due?
ANSWER:
The first of weekly benefits is due 11 days after the injury.

QUESTION:
If there is a dispute who decides what is owed?
ANSWER:
Disputes are decided by the Iowa workers' compensation commissioner, an administrative agency of the state of Iowa which is part of Iowa Workforce Development. Administrative law judges called deputy worker's compensation commissioner preside at the initial hearing and issue proposed agency decisions which become final agency decisions unless appealed to the workers' compensation commissioner. An appeal decision of the workers' compensation commissioner is a final agency decision subject to appeal by filing a petition for judicial review with the Iowa district court. Judicial review decisions of the Iowa District Court are subject to appellate review by the Iowa Supreme Court and Court of Appeals.

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STATUTE OF LIMITATIONS FOR WORKPLACE INJURY CLAIMS

QUESTION:
The injured worker injured his/her back and shoulder at work.The shoulder was injured performing a specific activity followed by a popping sensation.The shoulder pain came on instantly.However, the back pain came on gradually with no specific event.The injured worker believes the back condition is related to years of hard work for the employer involving bending, twisting and lifting.How long does the injured worker have to file a claim with the Iowa Workers’ Compensation Commissioner for each injury?

ANSWER:
You should note that the time deadline for filing a petition is called the “statute of limitations.” The statute of limitations isfound inIowa Code §85.26which provides that the injured worker must file a petition with the Iowa Workers’ Compensation Commissioner within two years from theoccurrence ofthe injury when no weekly benefits have been paid or within three years from the last date weekly benefits were paid.

For the shoulder injury the injury occurred when the worker performed the specific activity which caused the popping sensation in his shoulder. With respect to the back injury which isclaimed to be a gradual or cumulative injury, the two-year deadline will not begin to run until the injured worker knowsor shouldknow that the condition is serious enough to have a permanent adverse impact on the injured workers’ employment, i.e., the injured worker knows or should know the nature and seriousness, and probable compensable character of his injury or condition.

Ofcourse if weekly benefits were paid than thedeadline for filing a petition with the workers' compensation commissioner is three years fromthe last payment of weekly compensation.

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INTOXICATION DEFENSE

QUESTION:
Following an injury at work, while the employee was at the hospital a post-injury drug test was administered. The results of the test were positive. Can the employer and insurance carrier deny the injury based upon a positive post-injury drug test?

ANSWER:
Maybe. Iowa Code § 85.16 (2) reads “[n]o compensation under this chapter shall be allowed for an injury caused by … the employee’s intoxication, which did not arise out of and in the course of employment but which was due to the effects of alcohol or another narcotic, depressant, stimulant, hallucinogenic, or hypnotic drug not prescribed by an authorized medical practitioner, if the intoxication was a substantial factor in causing the injury.” The Iowa Supreme Court has held that for the intoxication defense to apply, “the intoxication must have been both the cause in fact of the injury and a substantial factor in producing it.” Garcia v. Naylor Concrete Co., 650 N.W.2d 87, 90 (Iowa 2002). The Court in Garcia determined that a worker is intoxicated when one or more of the following apply: “(1) The person’s reason or mental ability has been affected; (2) the person’s judgment is impaired; (3) the person’s emotions are visibly excited; and (4) the person has, to any extent, lost control of bodily actions or motions.”

Therefore, the Iowa Workers’ Compensation Commissioner will address two issues when coming to their decision. First, it must be determined that the level of intoxication affected or impaired the worker’s reason, mental ability, or judgment, or caused the worker to lose control of his bodily actions or motions. This issue typically needs to be addressed by a medical expert. However, witness testimony concerning the worker’s behavior immediately proceeding the injury may be relevant.

Second, it must be determined whether the intoxication was a substantial factor in causing the injury. If the injury would have happened regardless of the intoxication, then the intoxication is likely not a basis for the denial.

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VIOLATION OF WORK RULE

QUESTION:
At the time the worker was injured, he/she was in violation of a work rule. Can the employer and insurance carrier deny the injury based upon the violation of work rule defense?

ANSWER:
Maybe. The Iowa Supreme Court held that a carpenter forfeited his right to benefits under the Iowa Workers’ Compensation Act by engaging in conduct that violated the instructions of the employer. Buehner v. Hauptly, 161 N.W.2d 170, 171 (Iowa 1968). According to the facts of that case, the carpenter was repeatedly instructed by his job foreman to refrain from riding on a hoist that was designed to haul lumber and materials. Unfortunately, the carpenter decided to ride the hoist to the ground and was fatally injured. The Court held: “Under all the facts the deceased employee’s act in attempting to descend by means of the hoist was not only in direct violation of an enforced employer’s rule, but completely rash and outside the reasonable requirements of his job.” Accordingly, the Court held that the fatal injury did not arise out of and in the course of his employment.

If an employer and insurance carrier want to rely on this defense, they likely will need to prove the following: the work rule was in place at the time of the injury, prior to the injury the injured worker had been informed of the work rule, prior to the injury the injured worker or other employees had been disciplined for violating the work rule, the injured worker could not have avoided violating the work rule when performing his/her job duties, and that violation of the work rule was the cause of the injury.

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