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News And Updates


NEW DEPUTY WORKERS’ COMPENSATION COMMISSIONER

Erin Q. Pals has been hired as a Deputy Workers’ Compensation Commissioner with the Iowa Division of Workers’ Compensation. She will commence her duties with the division on March 28, 2014.  Ms.  Pals has previously been in private practice in Des Moines, Iowa.  She practiced primarily in the area of workers’ compensation and has represented both claimants and defendants.  Ms. Pals is a 1997 graduate of Central College and a 2000 graduate of the Drake University School of Law.


NEW DEPUTY WORKERS’ COMPENSATION COMMISSIONER

Joseph L. Walsh has been hired as a Deputy Workers’ Compensation Commissioner with the Iowa Division of Workers’ Compensation. He will commence his duties with the division on January 17, 2014. Mr. Walsh has previously been in private practice as a workers’ compensation and employment law attorney in Des Moines, Iowa and has served as the Deputy Director of Iowa Workforce Development from 2007 to 2010. Mr. Walsh most recently held the position of Chief Administrative Law Judge for Iowa’s Division of Unemployment Insurance Appeals. Mr. Walsh is a 1993 graduate of Drake University with Cum Laude Honors and a 1996 graduate with Honors of the Drake University School of Law.


Deputy Retirements

Deputy Workers’ Compensation Commissioner Helenjean Walleser has announced her retirement from the Iowa Division of Workers’ Compensation. Deputy Walleser’s last day of service with the division will be February 27, 2014. Deputy Walleser will have admirably served the state of Iowa for over 30 years as of her date of retirement, having started as a Deputy Commissioner in October 1983.

Deputy Workers’ Compensation Commissioner David Rasey has announced his retirement from the Iowa Division of Workers’ Compensation.  Deputy Rasey’s last day of service with the division will be January 16, 2014.  Deputy Rasey will have admirably served the state of Iowa for over 30 years as of his date of retirement and will have served as a Deputy Commissioner since July 1988. 


SECOND INJURY FUND ASSESSMENT

Sufficient funds are not available to meet the liabilities of the Second Injury Fund. Therefore, an assessment will be imposed upon insurers and self-insured employers in the State of Iowa.  The assessment is $5.8M.  Notices were e-mailed from the Iowa Insurance Division office on September 17, 2013.  The assessment amount is due by October 16, 2013. 

 If you have any additional questions or concerns about the assessment, please feel free to contact Lori Taha at 515-281-5708 or lori.taha@iid.iowa.gov.


ONLINE MODEL WORKER SAFETY PROGRAM – AVOIDING FALLS

The United States Department of Labor has published a new website to assist employers in the protection of their workers from falls.  The three step program, which can be a model for Iowa employers in workplace safety, calls for employers to Plan, Provide, and Train.  The model program can be located at the following website which is compatible with mobile technology for implementation at job sites: (8-5-13)

https://www.osha.gov/stopfalls/



Mileage rate beginning July 1, 2013 is 56.5 cents per mile.

ATTENTION - amended

 

Until Further notice walk-in settlements will not be available. 

 

Parties interested in securing immediate approval of settlements must telephone the Division in advance and secure an appointment time thru the appropriate compliance administrator.  The availability of these appointments will be on a case-by-case basis. (8-28-13)

 

Penny 515-281-8351 (A - H)

Ros 515-281-3960 (I-P)
Ann 515-281-8368 (Q-Z)


Advancing Workers’ Compensation at the IAIABC Forum 2013

(May 7, 2013 – Madison, Wis.) Workers’ compensation reforms have been played prominently in industry news lately, as reform legislation was signed in both Tennessee and Oklahoma. These reforms are just the beginning as legislation is complemented by regulatory and administrative changes within a system. During these times, it is critical for the industry to come together and share effective practices, discuss recent reforms and evaluation metrics, and learn from each other’s successes and failures. Last week, representatives from twenty-six jurisdictions, including participants from Australia, Canada, and Germany, came together for The IAIABC Forum 2013 in Des Moines, Iowa to do just that. more (5-7-13)


The Division of Workers’ Compensation will not approve a second compromise settlement for the approval of an MSA set aside.  A file stamped addendum is all that will be accepted for filing. The addendum can then be attached to the original settlement and send to CMS. If a reliable source informs the division that CMS is not accepting that as compliant, the division will revisit the issue once what CMS actually requires is apparent. (4-13)


Frequently Asked Questions About HIPAA & Workers' Compensation

  1. State law says I may disclose records, relating to the treatment I provided to an injured worker, to a workers' compensation insurer for purposes of determining the amount of or entitlement to payment under the workers' compensation system. Am I allowed to share this information under the HIPAA Privacy Rule?

Yes. A covered entity is permitted to disclose an individual's health information as necessary to comply with and to the full extent authorized by workers' compensation law

  1. State law says I may provide information regarding an injured workers' previous condition, which is not directly related to the claim for compensation, to an employer or insurer if I obtain the workers' written release. Am I permitted to make this disclosure under the HIPAA Privacy Rule?

Yes. A covered entity may disclose protected health information where the individual's written authorization has been obtained.  A covered entity would be permitted to make the above disclosure if the individual signed such an authorization.

  1. I am a health care provider and my State law says I have to provide a workers' compensation insurer, upon request, with an injured workers' records that related to treatment or hospitalization for which compensation is being sought. Am I permitted to disclose the information?

Yes. The HIPAA Privacy Rule permits a covered entity to disclose protected health information as necessary to comply with State law.

  1. Does an individual have a right under the HIPAA Privacy Rule to restrict the protected health information his or her health care provider discloses for workers' compensation purposes?

No. Individuals do not have a right under the Privacy Rule to request that a covered entity restrict a disclosure of protected health information about them for workers' compensation purposes if the disclosure is required or authorized by a workers' compensation law.

5.   Further information may be found at Summary of HIPPA rules. (1-28-13)


EIGHTH JUDICIAL DISTRICT HEARING LOCATION CHANGE:

Effective January 1, 2013 Ottumwa venue hearings will be held at a new venue.  They will be held at IHCC North Campus, Iowa Workforce Development Center, 15260 Truman St., Ottumwa, IA  52501.  Hearing assignment orders will reflect this venue change. (12-10-12)


IAIABC Membership Elects 2012-2013 Executive Committee

Announcement from IAIABC  10-9-12


updated Subpoena Form Now Available for Use

The Iowa Division of Workers’ Compensation has updated its subpoena form.  The prior subpoena form will no longer be valid for use before the Iowa Division of Workers’ Compensation after April 1, 2012.  Please destroy all copies of the prior form and obtain new subpoena forms in person at the Division or by letter to the Iowa Division of Workers’ Compensation, 1000 East Grand Ave., Des Moines, Iowa 50319.  Please include a self-addressed, stamped envelope sufficient for the number of subpoena forms you are requesting by mail.  Your cooperation in this transition to the updated subpoena form is appreciated.(2-28-12)


Earned Income Tax Credit Information for Injured Iowans

 Many injured workers will suffer a loss of income as a result of a disability or loss of employment.  That loss of income may lead to entitlement to an Earned Income Tax Credit that can be explored when filing federal and state income taxes for wages earned in any year.  Low-income taxpayers who may qualify for this credit can receive additional information at the following location: 

http://www.irs.gov/pub/irs-pdf/p596.pdf

Information regarding the Iowa state credit can be found at:

http://www.iowa.gov/tax/educate/faqinc.html#11
or by calling 1-800-367-3388. 

Please do not direct questions regarding this Tax Credit to the Iowa Division of Workers’ Compensation. 


UPDATED MILEAGE REIMBURSEMENT RATE

The Iowa Division of Workers' Compensation rule 876-8.1(2) provides:  “For annual periods beginning July 1, 2006, and thereafter, the per mileage rate shall be the rate allowed by the Internal Revenue Service for the business standard mileage rate in effect on July 1 of each year.”  The business standard mileage rate effective July 1, 2013, is to $.565 per mile.  (11-1-11)


No Hearing Room Access For Preparation Of Cases

Recently attorneys have been meeting with clients in the agency hearing rooms hours before scheduled hearings.   This occurs when counsel meet with their clients to prepare them for hearing.  This practice occasionally results in agency staff accidentally overhearing discussions between attorneys and clients.

This practice will no longer be allowed.

In the future, if you need to meet with your client, please do so in a coffee shop, a restaurant, the state historical building, or some other public place.  Please do not expect to be allowed to use the hearing rooms to prepare your client for a contested case before the scheduled time for hearing.  Your understanding and cooperation with this policy is appreciated.


Commissioner Godfrey Issues Decision in Iowa Workforce
Development Labor Claim

 On Tuesday March 8, 2011 Commissioner Godfrey filed his decision in a wage and hour dispute between the state of Iowa and those doing business as Henry’s Turkey Service.  The Commissioner was acting on behalf of the Iowa Labor Commissioner David Neil, pursuant to rule 875 IAC 1.91(2).  The decision involved questions of whether those doing business as Henry’s Turkey service paid a minimum wage pursuant to Iowa Code section 91D.1, whether they provided a “pay stub” pursuant to Iowa Code section 91A.6(4), and whether they made illegal deductions for room and board and kind care from the wages earned by the disabled workers.   (3-10-11)


  EDI Release 3 tables are now available on the EDI page under the EDI Links section   (7-10)


HEARING VENUES: 

  01 – WATERLOO (WA)
02 – IOWA FALLS (IF)
 03 – SIOUX CITY (SC)
           04 – COUNCIL BLUFFS (CB)
     05 – DES MOINES (DM)
        06 – CEDAR RAPIDS (CR)
    07 – DAVENPORT (DA)
 08 – OTTUMWA (OT)  

                  Hearing locations (12-10-12)

         The venue addresses are as follows:
 

Cedar Rapids - Eff. 1-3-11
Lindale Mall - STE 436
4444 1st Ave NE
Cedar Rapids, IA 52402
Iowa Falls
Ellsworth College
Renewable Energy Center
707 Ellsworth Ave
Iowa Falls, IA 50126
Ottumwa - eff 1-1-13
Indian Hills Comm College
IHCC North Campus
Iowa Workforce Development Center
15260 Truman St.
Ottumwa, IA 52501

Sioux City
IA Workforce Center
2508 4th St
Sioux City, IA 51101

Waterloo
IA Workforce Development
3420 University Ave
Waterloo, IA 50701

 


2013-14 Weekly Minimum and Maximum Rates

Beginning July 1, 2013,

Maximum weekly rate for TTD, HP, PTD and death benefits is $1543.00.

Maximum weekly rate for PPD benefits is $1419.00.

The minimum weekly benefit amount for TTD or HP is equal to either the weekly benefit amount of a person whose gross weekly earnings are thirty-five percent (35%) of the statewide average weekly wage OR the spendable weekly earnings of the employee, WHICHEVER IS LESS.  The minimum weekly benefit amount for PPD, PTD or death benefits is equal to the weekly benefit amount of a person whose gross weekly earnings are thirty-five percent (35%) of the statewide average weekly wage.

Statewide average weekly wage is $771.28.

35% of statewide average weekly wage is $270.00. (9-12)


 copy FEE SCHEDULE – Copy/Information REQUEST

Beginning April 1, 2010, the Iowa Division of Workers’ Compensation will utilize a new fee schedule and updated request forms for outside parties or individuals seeking information or copies from the Division. The new fee schedule can be found HERE and the new copy/information request form can be found HERE. Information about the process for requesting information can be found HERE.


2008 AMA Guides Task Force Recommendations

Guides Process Report

Reports from committee members

Matthew Dake  James Gallagher  John Brooke  Dr. John Kuhnlein  Marlon Mormann  R. Saffin Parish  Sara Sersland - response  Peter Thill


Self-Insured Employer's link

In addition to the ability to check for the employer's workers' compensation carrier that we recently added to our site this link will take you to the Iowa Insurance Commissioner's office and the list of approved self-insured employers in Iowa. (8-12)   http://www.iid.state.ia.us/individual_employer 


how your workers' compensation benefits can affect your social security benefits. (7-31-13)

For Answers to questions on how your social security benefits can be affected by workers' compensation benefits.  (7-31-13)


RESOLUTION OF MEDICAL FEE DISPUTES

Over the past several months the Workers’ Compensation Commission has received numerous inquires regarding the resolution of medical fee disputes.  As required by Iowa Code section 85.27(3), and rules 876 IAC 10.3 and 876 IAC 4.46, insurers and providers who have a medical fee dispute must take the following steps to resolve the dispute:

1.     An insurer who disputes a charge must give a provider written notice of the disputed charge within 60 days of receiving a bill.  Charges not in dispute must be paid to the provider before using the procedures in rule 876 IAC 10.3.

2.    The notice should contain: names of employee and employer; date of injury; date of disputed treatment; the amount of the charge the insurer agrees to pay; the amount of the charge in dispute; the reason the charge is believed to be excessive or unnecessary, and the documentation relied on; the address for directing correspondence; and the procedures available through the Workers’ Compensation Commission to resolve the dispute.

3.    If the provider does not accept the amount the insurer agrees to pay, the provider must give written notice, and ask the disputed amount go to a reviewer for review. 

4.    The person chosen as the reviewer cannot be the Workers’ Compensation Commission. If the parties cannot agree upon a reviewer, each shall submit a name to the commissioner, and the commissioner shall decide who is to act as a reviewer.

5.    The reviewer, as soon as practicable, is to determine in writing the amount of the charge that is reasonable and necessary.  Costs of the review are to be paid as agreed to by the parties.

6.    A dispute over a charge can include the reasonableness of the charges.  It may also include the necessity of the charge.

7.    A contested case proceeding may be commenced only after these steps for dispute resolution have been followed, and good faith efforts to resolve the dispute have failed.  Such a proceeding must be commenced within 30 days after written determination is made by the reviewer.

8.    Rule 876 IAC 10.3 does not prevent providers and insurers from developing other procedures to informally resolve their disputes, if those procedures aid in the resolution of a medical fee dispute.

If the process, detailed in rule 876 IAC 10.3, does not resolve the dispute and the parties have attempted resolution in good faith, a contest case may be initiated, pursuant to rule 876 IAC 4.46.  The following applies to contested cases regarding medical fee disputes:

1.   Evidence is filed at the time the contested case is initiated and is limited to that provided by the reviewer, and the determination made by the reviewer. 

2.   The commissioner may request or allow additional evidence.

3.    If a brief is to be filed, it needs to be filed at the time the matter is commenced.

4.    The opposing party has 30 days from the date of service of the petition, to file a response and optionally a brief.  (8-4-08)


SETTLEMENTS

When submitting settlements for approval please following these requirements:
 
1.Compromise Settlements under ICS 85.35(3) - please be specific in your dispute.  Make it clear exactly what the dispute is.  Nature and extent are not sufficient without supporting medical to clearly describe the dispute.

2. Please remember that PPD benefits begin at the end of the healing or TTD period and not on a stipulated date or the date in which the doctor issues his rating.

3.  Please remember that accrued benefits cannot be commuted.

4.  PARs are not required except with Agreements for Settlement, and commutations, unless they are requested by the Workers' Compensation Compliance Administrator (WCCA).

5.  Do not include language in violation of rule 876 IAC 6.1(2) regarding any and all injuries and do not include language that says in other states or jurisdictions.  Settlements with this language will be lined out and denied by the WCCA and the settlement will be approved.  (10-19-07)


FULL AND PARTIAL COMMUTATIONS

Please note that full and partial commutations will no longer be approved for accrued benefits, those benefits that were due at the end of the healing period.  Stipulations by the parties as to a date on which permanent benefits commenced in lieu of those benefits commencing at the end of the healing period, will no longer be accepted. A commutation of less than 10 weeks is not considered in claimant's best interest.  (5-1-07)


Present Value Discount Table is now available on the 535.3 Interest page.


First Report of Injury Compliance Hearings:

 Procedure for Judicial Review of the Division’s findings:

 The deputy’s ruling on a penalty in a “FROI” compliance hearing is not subject to review by the workers’ compensation commissioner.  Pursuant to Iowa Code section 86.26, any petition for judicial review arising from a deputy’s order assessing a penalty under Iowa Code section 86.12 shall name the Iowa Division of Workers’ Compensation and the injured worker as respondents.  Proper service of the petition for judicial review shall be made on the Iowa Division of Workers’ Compensation, 1000 E. Grand Ave., Des Moines, Iowa 50319 and upon the Office of the Iowa Attorney General/Special Litigation Division, 1305 E. Walnut Street, Des Moines, Iowa 50319.


Relief from Insurance

An employer required to provide compensation under Chapters 85, 85A and 85B may apply for relief from insurance and to become self-insured pursuant to Chapter 87.11. The employer must make application for self-insurance to the Insurance Commissioner. The application includes furnishing satisfactory proof of solvency and financial ability to pay the compensation and benefits as by law required. Requests to become self-insured shall be directed to the Insurance Commissioner at 1-877-955-1212 or though their website at www.iid.state.ia.us.


October 16, 2003

EDI Annual Reporting Requirements


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