Changes in Iowa Workers’ Compensation law have changed the amount of workers’ compensation benefits you can receive for a shoulder work injury. The benefits you are entitled to for a shoulder injury are now significantly impacted by the date of injury.
If you were hurt before July 1, 2017, and you have a permanent injury, you will receive some portion of 500 weeks of permanent disability benefits. The amount you are entitled to depends on how your injury has affected your ability to work.
If you were injured on or after July 1, 2017, you are still entitled to medical and temporary wage replacement benefits; however, your right to permanent disability benefits is more limited.
The new limitation in benefits for the same injury is due to monumental changes in Iowa’s workers’ compensation law. Large special interest groups such as big business and the insurance companies pushed for harmful changes to Iowa’s workers’ compensation system, and the majority party voted these changes into law. These changes put large caps in place restricting what benefits injured workers can receive, especially when it comes to shoulder injuries.
Unfortunately, shoulder injuries are common in the workplace. It’s a joint that gets used and abused a lot. These injuries have a very significant impact on a worker’s ability to go back to the jobs he or she was able to do before the work injury. Big business and insurance companies know this, so they pushed for legislative changes to cap what injured workers can recover for permanent injuries to the shoulder—even when these injuries are career-ending.
The new law does not change the type or amount of medical care you can receive for your shoulder injury, nor does it affect your entitlement to temporary wage replacement benefits while you’re off work healing. The major changes affect how much permanent disability is owed.
In Iowa, there are two main types of injuries – “scheduled” member injuries and “body as a whole” injuries. Scheduled injuries are injuries to the limbs. Each limb is assigned a maximum amount of weeks of benefits to be paid.
For example, a work injury to the arm is worth a maximum of 250 weeks of benefits according to the “schedule.” How many weeks in permanent disability you receive depends on your physical impairment rating. This is a percentage, assigned by a doctor, which is supposed to reflect the functional loss to the body part. The doctor uses a guide published by the American Medical Association to assign the rating.
Let’s say the doctor assigns an impairment rating of 10% to the injured arm. In that case, the injured worker would receive 25 weeks of permanent disability benefits. There is not a lot of wiggle room in how many weeks you can receive for scheduled member injuries.
In fact, the Iowa legislature also enacted a new law that says only expert testimony can be used to determine the functional impairment in scheduled injury cases. Before, the workers’ compensation judge could consider evidence from other sources, like testimony by the injured worker himself.
This scheduled injury system can be harsh for injured workers because even if the injury is career-ending, the amount of permanent disability received depends solely on the functional impairment to the limb – not on other factors that could result in more compensation.
That brings us to “body-as-whole” injuries. These are injuries to the core of the worker’s body, like the head, spine, and hips. For these cases, if the injured worker is not offered work by the employer, the number of weeks the injured receives in permanent disability benefits depends on the injured worker’s loss of earning capacity.
Loss of earning capacity is an evaluation, not a calculation. There are more than ten factors that must be weighed to determine how much an injured worker receives in permanent disability benefits. The injured worker will receive a percentage of 500 weeks if they are still capable of working in some capacity, or lifetime weekly benefits if the worker can’t go back to work at all.
With that background, now we can talk about what a shoulder injury is worth in benefits both before and after the new Iowa work comp law took effect.
Shoulders were considered “body as a whole” injuries. However, Iowa’s new law has changed shoulders from “body as a whole” injuries to scheduled member injuries. Under the new law, shoulder injuries are now worth a maximum of 400 weeks of permanent disability benefits. The doctor-assigned impairment rating will determine how many of the 400 weeks an injured worker receives. It doesn’t matter if the injured worker is limited in what he or she can do for work. That now plays no part in determining what is owed in permanent disability benefits.
Here’s an example to give some perspective of how drastic this change in the law is: A nurse hurts her shoulder transferring a patient at work. She has two shoulder surgeries and ends up with a permanent 25-pound lifting restriction. She can still work, but she can no longer work as a nurse at a hospital or nursing home. She receives a 15% physical impairment rating and her weekly workers’ compensation rate is $500.
Under the old law, the judge finds she has suffered a 40% loss of earning capacity. This would entitle her to 200 weeks of benefits at $500 per week, for a total of $100,000 in permanent disability benefits.
That same injury under the new law would now be worth just $30,000.
Even with the changes in the law, you still have rights. Protect those rights by avoiding these mistakes:
If you have pain in your neck or back, your injury may actually be to the “body as a whole.” If you have surgery and the doctor operates on a part of your body other than the shoulder, such as the clavicle, this may be considered a “body as a whole” workers’ comp claim. If the injury is actually to your arm, you may have access to a different type of benefit called Second Injury Fund benefits. Before you let the insurance company characterize the nature of your injury, talk to an Iowa workers’ compensation attorney.
Under Iowa law, an injured worker is entitled to a second opinion on their impairment rating. The injured worker gets to choose the doctor who provides the second opinion. DO NOT let the workers’ compensation insurance company choose that doctor for you. Seek out the advice of a knowledgeable Iowa work comp attorney. They can give you advice on the timing for a second opinion and what doctors in your area are trustworthy.
There is a new provision in Iowa work comp law that provides vocational assistance. This vocational rehab is paid for by the employer when an injured worker becomes severely disabled by a shoulder injury. Speak to an Iowa workers’ compensation lawyer about how to apply for these benefits.
Work injuries that come on over time are known as cumulative trauma injuries. Figuring out the actual date of your injury can be tricky. With the changed law, the date of injury may have a huge impact on the amount of benefits to which you are entitled. If you believe you have a cumulative injury, check with a work comp attorney to see if the insurance company’s date of injury is legally correct.
If you have a shoulder injury at work in Iowa, please contact RSH Legal at 1-800-433-0283. For additional information, you can also visit our website and download our free Law Guide to Iowa Workers’ Compensation Claims.
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