addresses are as follows:
Cedar Rapids - Eff. 1-3-11
Lindale Mall - STE 436
4444 1st Ave NE
Cedar Rapids, IA 52402
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
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
Reports from committee members
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)
workers' compensation benefits can affect your social security
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)
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.
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 Frequently
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Contact and Staff | Decisions | EDI Handbook | Electronic Data Interchange (EDI)
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Forms and Publications | Related Legal Statutes and References
Related Links | Settlements | 535.3 Interest | 2001 IWD Annual Report
Workers' Compensation Home Page | Iowa Workforce Development
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
| Reporting Requirements
| Hearing Schedule |