If your workers’ comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can challenge the decision with the Iowa Workers’ Compensation Commissioner. (For an overview of eligibility and benefits, see our article on filing a workers’ comp claim in Iowa.)
To start your appeal, you must file a contested case petition with the Iowa Workers’ Compensation Commissioner and send a copy to the insurance company. Strict time limits apply to filing a petition. If the insurance company has not paid any benefits on your claim, you must file within two years of your injury. If the insurance company has paid some benefits on your claim, you must file within three years of the last payment.
Once the Commissioner’s office receives your petition, your case will be assigned to a deputy workers’ compensation commissioner. You and the insurance company can then agree on a hearing date and email your request to the Division of Workers’ Compensation.
Before your hearing takes place, you can try to informally resolve the dispute with the insurance company. You should first contact the insurance company directly to try to resolve the dispute. If your efforts are not successful, you can ask the Commissioner’s office for assistance by contacting a Workers’ Compensation Compliance Administrator. If you and the insurance company are interested, the Administrator may schedule a “mediation”: an informal meeting where a representative from the Commissioner’s office will try to help you reach a voluntary settlement agreement.
Most workers’ compensation cases in Iowa are settled through informal negotiations with the insurance company. However, if you’re not able to resolve the dispute, you will continue on to an administrative hearing before a deputy workers’ compensation commissioner. Both you and the insurance company will have an opportunity to submit documents, present testimony from witnesses, and make legal arguments. The deputy commissioner will review the evidence and mail a written decision after the hearing.
If you are not happy with the deputy commissioner’s decision, you can file a notice of appeal with the Commissioner by the deadline stated in the deputy’s decision. The Commissioner will typically not hold another hearing, but will make a decision based on the evidence submitted at the original hearing. However, both sides can submit a written brief with legal arguments in support of their positions. The Commissioner will mail a written decision to the parties.
If you are not satisfied with the Commissioner’s decision, you can appeal through the state court system. You must file your appeal in an Iowa district court by the deadline stated in the Commissioner’s decision. Although uncommon, you can further appeal to the Iowa Court of Appeals and finally to the Iowa Supreme Court.
While it’s not a requirement, most workers with contested workers’ compensation cases hire lawyers to represent them in the appeals process. The appeals process requires detailed knowledge of workers’ compensation law and procedural rules, especially when it comes to presenting your case at a workers’ compensation trial. Having a lawyer on your side can greatly increase your odds of success. For help finding a workers’ compensation lawyer, check out our online lawyer directory.