Author Archives: Roger Moore

Workers’ Compensation Benefits: Iowa vs. Nebraska Law

Posted on June 23, 2014 by Roger Moore

The workers’ compensation benefits under Iowa law for permanent injuries are typically greater than those available under Nebraska law. As such, finding a way to bring a claim under Iowa law can be of primary importance if there is a potential jurisdictional issue between the two states.

Iowa Code 85.71 provides the framework for helping to resolve this issue. Put simply, an injury that occurs inside the borders of Iowa is most likely going to qualify to be brought under Iowa law. However, even injuries that occur outside the borders of Iowa can still be covered under Iowa law in certain common instances as detailed below:

1. The employer has a place of business in Iowa and:
a. the employee regularly works at or from that location;
b. the employee lives in the state of Iowa.

2. The employee is working under a contract of hire made in Iowa, and the employee regularly works in Iowa.

3. The employee is working under a contract of hire made in Iowa and sustains an injury for which no remedy is available under the workers’ compensation laws of another state.

4. The employer has a place of business in Iowa, and the employee is working under a contract of hire that provides that the employee’s workers’ compensation claims will be governed by Iowa law.

An injured employee also needs to be careful about filing in a different state than Iowa. Under Iowa Code 85.72, the Iowa action will be stayed pending the resolution of that claim in another state. This means that the Court cannot take up any issues in Iowa while there is another pending legal action in another state concerning the same date of injury.

The difference in benefits between the two states can amount to tens of thousands of dollars. Additionally, there are a number of differences in the laws of the two states that can play a role in how the claim is handled, including the appropriate statute of limitations, which dictates how soon a claim must be filed in Court. As such, it’s important to contact an attorney licensed in Iowa and Nebraska to discuss these differences so we can help you decide which state’s law is better for you and to help you navigate the relative pitfalls in each state.

How Do Iowa Workers’ Compensation Permanent Benefits Work?

Posted on December 19, 2013 by Roger Moore

Iowa’s workers’ compensation laws classifies permanent injuries to the neck, back, shoulders or hips are as unscheduled, or body as a whole, disabilities. Most other injuries are treated as scheduled member injuries, for which an injured worker can still recover permanent partial disability (PPD) benefits.

A permanent partial disability is a permanent injury that does not totally keep the injured person from eventually returning to work.

How is my percentage of disability determined in Iowa scheduled member cases?

This is initially determined by a doctor chosen by your employer or your employer’s insurance company. The doctor typically looks at a medical text to determine what percentage is appropriate. If that physician assigns you a rating of permanent disability that you think is too low, you have the right to be examined by another doctor whom you choose. The cost of this second opinion is also paid by your employer or their insurance company. However, you must first submit an application to the Iowa Workers’ Compensation Commission to get this second opinion.

How much will I receive in permanent partial disability payments?

The amount of money you receive as a PPD benefit payment depends on several things. First, your average weekly income before the accident or injury affects the amount of your weekly benefits. Injured workers receive 80 percent of their previous weekly pay, up to a maximum benefit amount of $1,419 each week. All workers entitled to PPD benefits will receive a minimum weekly payment of $270, even if their weekly earnings were lower than that amount.

Second, the amount of your disability also affects the amount of benefits. Scheduled members are assigned a number of total weeks by statute. You simply apply the percentage of disability assigned by the doctor to the total weeks. The result is how many weeks the worker must be paid the full weekly benefit.

How is my percentage of disability determined in Iowa body as a whole cases?

Body as a whole injuries have a different compensation package. An injured worker with a permanent body as a whole injury receives a maximum of 500 weeks of PPD benefits. You will receive benefits according to the lost earning capacity. For example, if a back injury left you with a 15 percent earning capacity loss, you will receive benefits for 15 percent of the 500 weeks, or 75 weeks at the full weekly rate discussed above.

When determining the percentage of lost earning capacity, the Commissioner will weigh a number of factors:

age of the worker;
the employer’s ability to accommodate a return to work;
lack of motivation to find a job;
whether the earning capacity changed after the healing period;
psychological conditions impacting ability to work;
employee’s work experience, educational background, and training before the injury;
functional impairment or impairment rating caused by injury;
whether the worker can speak English or has tried to learn English;
inability to engage in other employment because of injury, despite making bona fide efforts to do so;
has the worker retired; and
workers’ refusal to submit to medical treatment or surgery.

None of the factors are determine the issue alone, and all factors will be considered as a whole when determining the earning capacity rate. Typically, a vocational counselor must be hired to evaluate these factors and how they impact a workers’ earning capacity. Anyone with permanent restrictions from a work injury should contact an attorney to ensure they receive all of the permanent benefits to which they are entitled.

Whole body injuries can affect the rest of your life and be incapacitating. The attorneys at Rehm, Bennett & Moore can make sure you receive all of the benefits you are owed, which includes fair compensation for your injury. Contact our office at (800) 736-5503 to set up your free initial consultation with one of the attorneys licensed to practice in Iowa. Find out more about the practice at www.rehmlaw.com.

Overpaid Disability Benefits by Social Security: Now What?

Posted on September 9, 2013 by Roger Moore

What can I do if the Social Security Administration (SSA) says I have been overpaid disability benefits?

This is a very common problem, unfortunately. There are a number of factors that cause these issues to come up so frequently.

First, the rules about how much one can make differ, depending on what type of disability benefit is received. Social Security Disability Insurance (SSDI) recipients can earn over $1,000 per month without jeopardizing their monthly benefit. But almost every dollar earned by Supplemental Security Income (SSI) recipients can affect the amount of their monthly benefit, as this benefit is partially based upon a recipient’s financial situation. These amounts can change over time.

Second, there are many different rules about when you can earn money from working above what is called the substantial gainful employment level and not jeopardize your continued entitlement to disability benefit. It’s difficult to summarize all of the circumstances, yet alone know all of the rules, for a claimant. What’s more, simply providing the SSA your wages doesn’t absolve you from having to repay overpayments. The SSA doesn’t look at this information on a regular basis. Years later, you may get a “Dear John” letter advising you that you were overpaid thousands of dollars.

Finally, you may simply get wrong or bad information from someone when you meet with or speak with the SSA. It’s important to document when you spoke with the person and who that person was. If possible, get them to put their advice in writing.

When faced with an overpayment, there are two things you should always do. First, Continue reading →

Are Medical Doctors Willing Puppets for Cross-examination?

Posted on January 31, 2013 by Roger Moore

It used to be that the most to fear from an examination scheduled by an insurance company would be an unfair or incomplete assessment of the work injury. Now it seems insurance companies are using doctors to essentially cross-examine injured workers and delve deeply into irrelevant issues in an attempt to embarrass, harass and probe where they do not belong.

-Do you have painful, frequent, or difficulty urinating?

-Do you have painful breasts, periods or intercourse?

-Have you suffered physical, sexual or emotional abuse?

-Do you have erectile difficulty?

-Do you get along with supervisors and other employees?

-Do physical or mental problems run in your family?

-Is anyone in your family disabled?

-Did you smoke, drink or use illegal drugs in the past?

These are some of the more disturbing questions asked by a doctor of a patient in a pre-exam questionnaire sent directly from the doctor’s office to the injured worker. You might surmise that this was a case of some sort of reproductive injury associated with mental duress of some type by looking at the questions. In fact, this worker only alleged carpal tunnel syndrome! Most assuredly, embarrassing facts about this worker would just happen to show up in the defense doctor’s final report for the Court’s review at trial.

Any time anyone other than your lawyer sends you something to complete, you should be very careful about filling it out. It’s probably unethical for doctors to send these reports to injured workers who are represented, but we’re seeing more and more of these go out. They are becoming more and more intrusive; in fact, this questionnaire was 11 pages long. It’s my practice not to have clients complete any of these pre-exam questionnaires from doctors.

What Medical Expenses Are Covered In A Workers’ Compensation Case?

Posted on January 24, 2013 by Roger Moore

In Nebraska and Iowa, as is the general rule, an employer is liable for all reasonable medical services incurred as a result of a work injury. This is interpreted fairly broadly to include plastic or reconstructive surgery, prosthetic devices, and medicines, among other treatments. As long as the treatment is designed to relieve pain or promote and hasten the employee’s restoration to health and employment, the employer is liable. When a treatment meets these conditions, an injured worker should not be responsible for any portion of the medical bill.

The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker’s family doctor), that doctor can dictate the medical care and refer them to others for treatment. If no election is made, then like in Iowa, the employer can choose the doctor to treat a work injury as long as the employer accepts compensability for that injury. However, in Iowa, if the worker can establish that the medical care furnished is unreasonable, then the worker can choose another medical provider. In both states, if a claim for a work injury is denied, the worker can choose their own doctors to treat with.

If no Petition is filed in Nebraska, an employer continues to be responsible for medical care as long as there is less than a two-year gap in the payment of a medical bill by the employer or insurance company or the payment of temporary or permanent benefits to the injured worker. Also, if the Court enters an order finding the injured worker entitled to future medical care, there is technically no time limit for seeking medical care.

In Iowa, medical benefits cannot be used to extend the deadline to file a claim for benefits. There is no time limitation in seeking medical care relating to an injury either before or after an Award for benefits.

However, in practical terms, large gaps in treatment will likely be met with skepticism from the employer – and possibly the Court – concerning the relationship between the work injury and the medical care. We recommend you seek consistent medical care where there is a need for it to avoid such issues.

Do I Qualify For Social Security Disability Benefits?

Posted on November 15, 2012 by Roger Moore

In order to qualify for Social Security disability benefits, you have to prove that you have one or more physical and/or mental impairments that are severe and that prevent you from engaging in substantial gainful activity.

Substantial gainful activity is measured by the amount of money per month that you can earn.

The Social Security Administration will take into account your educational background, job history, and the skills you have acquired in determining whether or not you meet this standard. The fact that you cannot go back to the job you have done for most of your life does not necessarily mean that you can qualify for Social Security disability payments.

I am licensed in Nebraska and Iowa and handle workers’ compensation, personal injury, and Social Security disability appeals for the firm. If you have questions about Social Security disability benefits or the appeal process in another state, I can refer you to another expert attorney.

“I’m In It for the Money!”

Posted on September 13, 2012 by Roger Moore

Surprisingly, many employers and insurance companies actually believe workers hurt themselves on purpose or at the very least put themselves in positions where they think an injury is likely. We hear this a lot as a basis for not settling claims for existing employees. Employers are worried that it will encourage other employees to get injured as well. What does that say about the particular employer who believes this? Either they are downplaying lots of injuries or they truly believe employees are willfully getting hurt.

The reality is that most of our clients come to us because their injury-related medical bills are not being paid or they’re not being paid for time off from work due to their injury.

In this age of limited, and in some cases very limited, workers’ compensation benefits, you would have to be an imbecile to actually believe people are willingly causing permanent injuries to themselves to cash in on the “windfall” that is workers’ compensation. Who would honestly trade even thousands of dollars for a lifetime of uncompensated pain and suffering? The reality is that most of our clients come to us because their injury-related medical bills are not being paid or they’re not being paid for time off from work due to their injury. The vast majority of them don’t even ask how much they could get for their injuries in their initial meeting with us, as I’m sure is the case with most workers’ compensation law firms.

This is one of a long line of personal-injury myths perpetrated by the insurance industry to make filing a workers’ compensation claim a stigma. It’s similar to the one about “if you file a claim our premiums will go up and they’ll have to shut down the plant.” Shouldn’t the question really be: are we requiring too much physically of our employees, and if so, what can we do to make things safer? Instead, Continue reading →

Is Insurance Still For Policyholders?

Posted on May 21, 2012 by Roger Moore

Insurance began in the Middle Ages, and policies could be written for almost anything. Policies were taken out to protect risks of trade, against the death of a head of state, and for many other forms of speculation. There was almost no limit on what a policy could be written for. Additionally, there was no shared risk as these policies were taken out only by individuals.

In the early 18th century, mutual insurance was created. Instead of individuals essentially placing bets that would pay off if tragedy struck, these policies created communities of members who were concerned with offsetting risk with reward. The lack of tragedy led to the payout of dividends to the members. Gradually, governments forced the transition of insurance from legal gambling on misfortune to companies behaving more like public utilities. Mutual-insurance companies helped the betterment of society with innovations like workplace-safety measures.

Over the last four years Edmund Kelly, former CEO of Liberty Mutual, has pocketed over $200 million in compensation.

In 1911, the first workers’ compensation insurance was written in Massachusetts in the form of a state-subsidized mutual-insurance company. Like most mutual insurance, the aim was the mitigation of risk by providing incentives to reduce risk and demanding small sums from each participant that were then combined into large sums for the victims or beneficiaries of the policy.

In the mid-1990s, insurance companies began pushing for legislation to authorize them to place their assets into holding companies that could then sell stock. Critics believed the policyholders were being divested of their ownership in such an arrangement, but little true resistance was brought to bear. What has transpired as a result of this shift is that increasingly the profits from insurance companies were being captured by its executive leadership instead of being reflected as profits and returned to its policyholders as dividends.

As such, 200 years after mutual insurance was created, history reversed itself. No longer was insurance sold to people who had a stake in the assets and risks on which they bet. The community no longer bore the rewards of mutual insurance as company profits were put in the hands of the elite leadership and not distributed across policyholders. One can surmise that policyholders also lost more control over how claims were handled than was anticipated when mutual insurance was created. Policyholders also likely see little incentive to follow risk-averse practices as they receive no return benefit in the form of dividends as they used to. When profit is the only goal in business only the business itself and, more specifically, its executives truly gain. One indication of this is Edmund Kelly, former CEO of Liberty Mutual. Over the last four years he has pocketed over $200 million in compensation.

Source: The Atlantic

Workers' Compensation Watch

Published by Rehm, Bennett, Moore & Rehm

Published by:

Author Archives: Roger Moore

Workers’ Compensation Benefits: Iowa vs. Nebraska Law

How Do Iowa Workers’ Compensation Permanent Benefits Work?

How is my percentage of disability determined in Iowa scheduled member cases?

How much will I receive in permanent partial disability payments?

How is my percentage of disability determined in Iowa body as a whole cases?

Are Medical Doctors Willing Puppets for Cross-examination?

What Medical Expenses Are Covered In A Workers’ Compensation Case?

“I’m In It for the Money!”

Is Insurance Still For Policyholders?

Share this:

How is my percentage of disability determined in Iowa scheduled member cases?

How much will I receive in permanent partial disability payments?

How is my percentage of disability determined in Iowa body as a whole cases?

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this: