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If I Was Injured at Work in Iowa, Who Pays the Medical Bills?

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Posted by Dillon Besser

When an individual is injured at work in Iowa, there are certain benefits the worker is entitled to under Iowa’s workers’ compensation laws. One of the most important benefits for an injured worker is the entitlement to medical benefits.

What Benefits Does Iowa Work Comp Insurance Have to Pay?

If an employer and its insurance carrier have accepted an injured worker’s claim for workers’ compensation benefits, the employer must pay for all reasonable and necessary medical services related to the work injury.

This can include services such as:

  • Medical
  • Surgical
  • Dental
  • Chiropractic
  • Physical rehabilitation
  • Ambulance
  • Nursing care.

 This also can include all reasonable devices, crutches, or other appliances necessary for the treatment of the work injury.

In addition to paying for the medical treatment, an employer is reasonable for necessary transportation expenses for any medical treatment that the workers’ compensation insurance company has authorized. The question of authorization is a very important part of your workers’ compensation claim.

Who Gets to Choose My Care After a Work Injury in Iowa?

Under Iowa law, employers that have accepted a claim for workers’ compensation benefits have the right to choose the care for the injured worker. This is true so long as the care that is being authorized is promptly provided and reasonably suited to treat the injury without undue inconvenience to the injured employee.

In other words, if you have been injured at work and the employer’s workers’ compensation carrier has accepted the claim, you must allow the insurance carrier to arrange and authorize the medical treatment of their choosing so long as it is reasonable.

This is why it is important to provide notice to the employer right away of your work injury. Once the employer is given notice, they are obligated to provide necessary medical care and investigate the claim in a timely fashion.

If an Iowa worker seeks medical care on their own with a provider that has not been authorized by the insurance carrier for a claim that has been accepted, it becomes very unlikely that the workers’ compensation insurance carrier will be required to pay that medical bill.

Now, if the insurance carrier has denied your workers’ compensation claim in writing, then an injured worker should seek the necessary treatment through their own health insurance. Under Iowa law, if an employer denies liability for a work injury, and the injured worker is covered by a health insurance plan, the health insurance provider cannot deny payment for medical services on the basis that the employer’s liability is unresolved.

Can I Get Reimbursed for My Denied Work-Related Medical Expenses?

While it is frustrating for an injured worker if their claim is denied, it is still important to receive medical care to treat your work injury.

When a claim is denied, injured worker is then able to select their own providers. It is important to keep track of all medical care and medical expenses.

Even if the claim is denied, an injured worker may be able to seek reimbursement for those medical expenses if:

  1. It can be shown that the injury arose out of and in the course of employment; and
  2. The medical expenses were reasonable and necessary for the treatment of the work injury.

Dealing with medical authorization for your work injury can be difficult and frustrating. The insurance carrier is not always responsive and injured workers are not given all the information necessary to understand whether they should be seeking care on their own or through their employer. 

If you have any concerns with the information you are being given regarding who is paying for your medical care, do not hesitate to receive your free, no-obligation case evaluation by contacting RSH Legal today at 1-800-433-0283.

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