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  1. #1
    Join Date
    Jun 2017
    Posts
    2

    Default What Happens Now

    My workers compensation claim was made in the State of: iowa. I was injured on the job 2 1/2 yrs ago. My employer offers light duty work so I have never missed work because of my injury. I have had two surgeries on my shoulder and it's still not right. I have been recently been told I have reached my mmi, and I have permanent restrictions. My employer can"t accommodate my restrictions, so what happens now?
    Last edited by Teeter1971; 06-23-2017 at 08:45 AM.

  2. #2
    Join Date
    Oct 1971
    Posts
    4,936

    Default Re: What Happens Now

    Teeter1971
    I have been recently been told I have reached my mmi, and I have permanent restrictions. My employer can"t accommodate my restrictions, so what happens now?
    You should receive a Rating - Permanent Partial Disability benefits are due at the end of your healing period based on your loss of earning capacity.

    Permanent Partial Disability (PPD) [85.34(2)]
    When a job-related injury results in a permanent disability, the employee may be entitled to PPD benefits based upon the degree of permanent disability. The PPD benefits are payable in addition to the HP benefits and are to begin at the termination of the healing period. There are two types of PPD benefits:

    Scheduled Member Disabilities – An employee’s entitlement to PPD benefits when a scheduled member is involved is based on functional impairment. Appendix A sets out a list of the scheduled body members (i.e., arm, leg, etc.) along with the value (in number of weeks) for each member.

    Unscheduled (Body As A Whole) Disabilities – When an injury results in a permanent disability to a part of the person that is not a scheduled member, it is referred to as an industrial disability that is compensated according to the percent that the disability reduced the person's earning capacity. These typically include back, neck, shoulder, and hip injuries. Factors to be considered in determining industrial disability are: any change in the employee's earnings caused by the injury; employee’s medical condition prior to injury, immediately after the injury and presently; the situs of the injury; its severity and the length of healing period; the work experience of the employee prior to the injury, after the injury and potential for rehabilitation; the employees qualifications intellectually, emotionally, and physically; age; education; motivation; functional impairment as a result of the injury; loss of earnings caused by a job transfer for reasons related to the injury; and inability because of the injury to engage in employment for which the employee is fitted.
    There are no specific guidelines that indicate how each of the factors is to be considered. (See Appendix A)
    http://www.iowaworkcomp.gov/frequent...ed-questions#T

    Guide to Workers’ Compensation
    http://publications.iowa.gov/2445/1/guidessixth.pdf

    Call your adjuster, advise him of your situation, if the carrier fails to do the right thing, consult and retain a lawyer.
    Even if they do begin your PPD benefits, it wouldn't hurt to consult a lawyer and have him on standby in case of future problems.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,743

    Default Re: What Happens Now

    Workers' comp lawyers give free, no obligation consultations to people in your situation. Go get one. You don't have to hire the lawyer, just get some advice. Before you talk to the adjuster!
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

  4. #4
    Join Date
    Jun 2017
    Posts
    2

    Default Re: What Happens Now

    Very helpful info, Tony. Thank you. I did seek the advice of a lawyer. I was told there was a statue of limitations of 2 yrs from the date of injury(12-12-14) in order to get any sort of money from work comp insursnce. This why I ask.

  5. #5
    Join Date
    Oct 1971
    Posts
    4,936

    Default Re: What Happens Now

    Quote Quoting Teeter1971 View Post
    Very helpful info, Tony. Thank you. I did seek the advice of a lawyer. I was told there was a statue of limitations of 2 yrs from the date of injury(12-12-14) in order to get any sort of money from work comp insursnce. This why I ask.
    You have two years to file the initial claim - I assumed you already filed, they did pay for the surgeries right?
    Again, PPD payments are to begin at the termination of the healing period (MMI) if they fail to do the right thing - take action.

    If you have an open claim, you have three years from the date of last payment of "weekly benefits" to take action - you still have time.
    See pg.7 in the above link Guide to Workers’ Compensation.
    I agree with Bob, consult a lawyer before contacting that adjuster if you don't know what you're doing - I assumed you already had a relationship with the adjuster and they where doing the right thing, my bad.

    Two-Year Statute of Limitation (85.26)
    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 (85.26)
    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.
    http://publications.iowa.gov/2445/1/guidessixth.pdf

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  6. #6
    Join Date
    Sep 2018
    Posts
    1

    Default Re: What Happens Now

    I hurt myself over a year and a half ago at work. My claim was initially denied but I appealed and "won". I have not seen one dollar. I finally hired a lawyer as it was very complicated. I have been offered a washout. I am deciding what to do. I never got a workmans comp doctor as it had been in the denial process. I just had two surgeries and one major complication. I have medical bills to pay and other expenses related to this. My lawyer stated they may not be paid. I know the responsible thing to do is pay them. I am getting TDI for now but that will soon end. I should be able to return to my job. If I take the washout I will lose my job. What would you do?

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