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      <title>Bill's Legal Cite</title>
      <link>http://www.desmoineslaw.com/blog3/</link>
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      <copyright>Copyright 2008</copyright>
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         <title>New Medicare Directive Affects Work Comp</title>
         <description><![CDATA[Those practicing in the worker's compensation and personal injury arenas should now understand the need to consider and address the interests of Medicare and Medicaid when settling any worker's compensation or personal injury claims.  Any third-party liable for injuries to another must assume and provide for the future treatment that is likely to be borne by Medicare.  No third-party is permitted to try to transfer liability to Medicare to avoid liability for such future medical costs.

The only way to ensure compliance with federal law and ensure that future obligations are discharged is to prepare a Medicare Set-Aside (MSA) proposal and have that proposal reviewed and approved by Medicare's representative.  The Centers for Medicare & Medicaid Services (CMS) is the private contractor hired by the federal government to review and approve the MSA's.

CMS recently issued and released a <a href="http://www.cms.hhs.gov/WorkersCompAgencyServices/Downloads/52008Memo.pdf">new memorandum</a> and directive, dated May 20, 2008, affecting the requirements for submission of Medicare Set Aside (MSA) proposals.  All MSA proposals for future medical care received by CMS after July 1, 2008, must utilize the life expectancy table prepared by the Centers for Disease Control.  The mandatory life expectancy table is "<a href="http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_14.pdf">CDC Table 1, Life Table for the Total Population</a>.

This revision could have significant effects on potential worker's compensation and personal injury settlements and will likey increase the potential future exposure that must be paid on these claims.  In the past, insurance carriers have hired vendors that will prepare a "rated-age" life expectancy for individual injured parties.  These rate ages factored in all illnesses, including the injury for which the MSA is establised.  Because these individuals are injured and may be undergoing significant treatment, medication usage, etc., these injured individuals tend to have a lower "rated age" than perhaps the general population does.

CMS' new directive may have the unfortunately effect of increasing the exposure for future medical treatment and making settlements much more difficult in worker's compensation and personal injury cases.  While it is obviously a good thing for our society as a whole that those responsible for creating an injury pay for the effects of the injury, using the total population's life expectancy may not be reasonable becasue it likely inflates the actual affects and costs that may be incurred in treating any such injury.  ]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/308057890/new_medicare_directive_affects.asp</link>
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         <pubDate>Mon, 09 Jun 2008 08:50:33 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/06/new_medicare_directive_affects.asp</feedburner:origLink></item>
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         <title>Work Comp Settlements In Iowa--Part I--Types of Available Settlements</title>
         <description>Most worker's compensation claims are resolved prior to litigation.  Even those claims that proceed to litigation are most often resolved via settlement before trial is required.  In general, most worker's compensation claims in the State of Iowa can be resolved if the parties are reasonable, realistic, and put forth a good faith effort to resolve disputes.

However, in order for claims to be resolved amicably, the parties need to understand the various types of settlements available and the ramifications of each type of settlement so there can be informed and mutually beneficial negotiations.  This article is intended to introduce the reader to the various types of settlements that can be used to resolve a worker's compensation claim in the State of Iowa.  A subsequent article will follow to explain the pros and cons of various settlements for both the employee and the employer.  

In Iowa there are four general types of settlement agreements that can be used to resolve a worker's compensation claim amicably without the time, expense, and necessity of trial.  Those settlement types include:

1.  The Compromise Settlement.  This settlement results in a "closed file" settlement and closes all past and future claims that the injured worker may have, including medical rights.  This settlement is the most commonly used settlement.  All that is required to obtain approval of this settlement is a bona fide dispute on some issue.  Nearly every claim has some identifiable dispute.  Otherwise, the parties would not have likely proceeded to litigation on the claim.  Yet, the Compromise Settlement has pros and cons, which will be discussed in a subsequent article.  In general, this settlement is used to resolve disputed claims and to finalize all disputes and issues between the employee and the employer.

2.  The Full Commutation.  This settlement also results in a "closed file" settlement.  This settlement is only available if the parties agree that there was a compensable work injury, and the parties agree to the total benefits to which the employee is entitled.  There are specific requirements that must be met to obtain a full commutation, which will be the subject of a subsequent article.  The full commutation is most useful when the employee continues to work for the employer and there is concern about subsequent injuries to the same body parts.

3.  The Agreement for Settlement.  This settlement requires the parties to agree to the total benefits to which the employee is entitled to receive.  However, this settlement results in an "open file."  The employer must admit liability, concede liability to lifetime medical treatment for any treatment related to the initial work injury.  Employees favor these types of settlements because the ensure coverage for future medical treatment, if ultimately needed.  

4.  The Partial Commutation.  This settlement is rather rare in Iowa.  It results in an open file settlement.  Employers have little or no incentive to agree to this type of settlement.  Employees can pursue a partial commutation once they prove entitlement to the underlying claim.  However, the partial commutation is not utilized often in the State of Iowa.

In addition to the above settlements, the State of Iowa also recognizes a "Combination Settlement."  A Combination Settlement is a combination of a Compromise Settlement and an Agreement for Settlement.  Again, a more in depth review of this type of settlement will follow in a subsequent article.  However, this type of settlement is most likely to be used when the parties can agree on all issues pertaining to one alleged injury, while there remains an irreconcilable dispute on another part of the claim.  For instance, the employer may concede liability for a knee injury, while disputing any claims for a low back injury.  Under the Combination Settlement, the employer can concede liability for the knee injury, including future medical treatment, while the employee could relinquish and provide a "close file" on the low back injury to get the claim resolved amicably.

The State of Iowa also permits the parties to enter into Contingent Settlements.  This type of settlement permits the parties to agree to the terms of a Compromise Settlement (based on a valid dispute) and make the final consummation of the agreement contingent upon some future event.  Often, this contingency is approval of a Medicare Set Aside amount by the federal government.  This settlement generally arises only when there are considerations of Medicare interests and can often become complicated settlements.  In some situations, however, this manner of settlement permits the parties to reach an amicable settlement agreement while there remain some "unknowns" that need to be worked out before the settlement is completely finalized.

Each of these settlements will be reviewed and discussed in subsequent articles.  However, if there are any questions about the types or ramifications of the various types of settlements identified above, an employee and/or employer should consult competent legal counsel.</description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/242758617/work_comp_settlements_in_iowap.asp</link>
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         <pubDate>Thu, 28 Feb 2008 07:56:39 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/02/work_comp_settlements_in_iowap.asp</feedburner:origLink></item>
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         <title>Controlling Cost in Iowa Workers' Compensation Claims-"The Mod Factor"</title>
         <description><![CDATA[As an attorney that represents employers and insurance carriers in Iowa workers compensation cases, I am often asked questions about the effect of a settlement, a decision from the Commissioner, or the effect of a decision being made by an insurance carrier.  During my conversations, employers often mention or talk about their experience modiciation factor, or "mod factor," when discussing their worker's compensation claims.  In discussing this issue with employers, I get the impression that most employers have a general idea of the factors involved in the calculation of their "mod factor" buit are not entirely sure how to manage or control their mod factor.

Indeed, probably all employers should be concerned about and monitor their mod factor.  The mod factor is the calculation performed to determine the employer's loss ratio.  The mod factor determines whether the employer is "penalized" or "rewarded" in their worker's compensation premiums based on their loss experience, wage basis, etc.  There are some clearly relevant factors involved in the calculation of the mod factor and some measures that employers can take to reduce their mod factor and control their worker's compensation premiums.

However, in order to manage its mod factor, every employer should understand the factors used to calculate the mod factor and techniques that the employer can use to reduce the mod factor.  I have located a few good articles that can help employers understand, monitor, and manage their mod factor.  I recommend that employers visit <a href="http://scrapmetalinsurance.com/Understanding_your_WC_Exper.html">this article by Watson Insurance Agency, Inc.</a> <a href="http://www.modmanager.com/workerscompensationbasics.htm">This article by insurance consultant, Scott Simmonds</a>, also provides some good insight.  I would also recommend that employers review <a href="http://www.insurancejournal.com/magazines/southcentral/2007/07/23/features/82444.htm">this article by Sam Martin</a>.   It should be helpful to employers desiring additional information about means to reduce their mod factor.  Finally, <a href="http://www.ncci.com/NCCI/SatApps.aspx?satUrl=http://www.ncci.com/nccisearch/training/understandwksht.htm">a link and explanation of the experience modification factor from the organization that actually calculates the mod factor</a> to better help employers understand the mod factor.]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/241299121/employers_must_manage_their_experience_modification_factor.asp</link>
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         <pubDate>Mon, 25 Feb 2008 22:17:55 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/02/employers_must_manage_their_experience_modification_factor.asp</feedburner:origLink></item>
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         <title>New Legislative Initiative in Iowa's Workers' Compensation System</title>
         <description><![CDATA[Thus far, Iowa's legislature has been relatively quiet and does not seem to be pursuing significant revisions or reform to the Iowa workers' compensation scheme.  The only bill that I am aware of at the present time with any significant effect on Iowa's workers' compensation system, is <a href="http://www.iowabar.org/Legieslativebills.nsf/ba76c3fa1d1b7bf486257306005ada0e/6618327b656ff362862573e10059d6ed!OpenDocument">House Study Bill 597</a>. 

This bill would revise the alloted burial expense from a flat $7,500 to a figure equal to 12 times the statewide average weekly wage.  Presumably, the statewide average weekly wage will increse with time and this will serve as some type of inflationary quotient so the death/burial benefits will increase with time as well.   

This revision will not make a significant immediate change in the death burial benefits.  There are really only a few drawbacks to this statutory proposal.  The first is that it creates more of an administrative burden on carriers to investigate and confirm the statewide average weekly wage on the date of death.  This can be a bit more tedious if the death occurs around the time that new calculations are published by the state but should be no reason to stop this statutory revision.

The second detriment to this statutory revision is that the statewide weekly wage could hypothetically go down if our state economy moves toward a recession.  This would potentially result in less burial benefits being paid to the survivors of an employee killed in the line of duty.  This is an unlikely scenario, however, and is no reason to lobby against this statutory revision.

Finally, the statutory revision (like prior versions) creates an arbitrary figure for death benefits.  There is no reason that someone that dies on June 30, 2008 should have fewer burial costs that someone that dies on July 1, 2008.  However, the worker's compensation statutory scheme is inherently arbitrary in placing a dollar figure on injuries and a death.  Again, this may result in strange results if similar cases are considered on back to back days but is not a sufficient reason to challenge or resist this statutory change.

The only alternative that I would recommend is that the death burial benefit could be based upon a percentage of an employee's actual average weekly wage.  In other words, it may be more equitable, in my opinion, to base the burial expense on a percentage or multiple of the employee's actual earnings.  While those that make more money would receive a higher burial benefit, it is also likely that that those with higher incomes would traditionally be expected to spend more on funerals.  In the end, the statutory revision propsoed is probably a postive step and an appropriate statutory revision.  I would expect the bill to garner support on both sides of the aisle and pass without significant resistance.  More to come if and when the statutory revision is enacted into law.]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/231893735/new_legislative_initiative_in.asp</link>
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         <pubDate>Fri, 08 Feb 2008 16:51:55 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/02/new_legislative_initiative_in.asp</feedburner:origLink></item>
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         <title>The Rise of Wage and Hour Claims</title>
         <description><![CDATA[There has been a recent trend toward litigation in the wage and hour arena.  Employees are becoming more and more aware of their rights and starting to challenge employer practices.  As <a href="http://www.financialweek.com/apps/pbcs.dll/article?AID=/20071210/REG/71206003/1036">this article</a> explains, certification of a class action suit against an employer for a violation of wage and hour practices is easier than certification of most class actions.

Traditionally, wage and hour claims were not considered significant risks and probably not on the radar screen of most employers.  However, as <a href="http://www.uhlaw.com/overtime_claim_explosion_counsels/">this article</a>  and <a href="http://www.whafh.com/modules/press_release/?action=view&id=75">this article</a> note, with the recent increase in wage and hour suits, employers must be leery of their employment practices pertaining to wage and hour issues.

Although there are legal issues to consider when determining whether an employee is exempt from overtime requirements, many employees are legally entitled to receive time and a half for any work performed during a workweek above the 40 hour threshold.  Often times, employers fail to accurate document and record the hours worked by an employee.  The lack of documentation and accurate recording can result in significant wage claims.  

Moreover, when the employer lacks credible, consistent, and convincing documentation pertaining to hours worked and wages paid, a group of employees may be able to present a convincing and credible story that would convince a judge and/or jury that they are entitled to back wages.  For instance, when a small employer fails to adequately document its employees' hours and wages, it becomes difficult for the sole proprietor to refute and convincingly argue that the 4-5 employees are all lying about the employment practices.  There becomes strenght in numbers as employees join together, tell a consistent story, and pursue wage loss.  Without convincing documentation, the employer faces a daunting task of refuting the allegations asserted by a group of employees.

Employers should also underst that suits based on the Fair Labor Standards Act do not requite “bad intent” by the employer.  Even negligence will subject the employer to liability.  In addition to receiving the unpaid wages, an employee can receive liquidated damages equal to the unpaid wages.  Therefore, an employer can be subjected to "double damages" if they have implemented an improper wage and hour tracking system.

The Fair Labor Standards Act also permits a prevailing employee to recover attorneys’ fees.  Therefore, Plaintiffs have every incentive to pursue these claims.  If they should prevail, they recover their lost wages, liquidated damages, and the employer may be required to pay the employee’s attorneys to recover the damages from the employer.

As we begin calendar year 2008, employers should consider their wage and hour practices, documentation, and consider whether legal consultation should be sought to limit past indiscretions, avoid future violations, and ensure compliance with both state and federal law pertaining to wages.  Similarly, employees who believe they have not been paid for their full hours, particularly if they have not been paid overtime hours, should seek the consultation of a qualified attorney because there are time limitations for asserting claims and past wages may be lost through a delay in pursuing a claim.   
]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/231893736/the_rise_of_wage_and_hour_clai.asp</link>
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         <pubDate>Tue, 05 Feb 2008 09:24:35 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/02/the_rise_of_wage_and_hour_clai.asp</feedburner:origLink></item>
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         <title>New Amendments to the Medicare Secondary Payer Statute May Impact Iowa Work Comp Claims</title>
         <description><![CDATA[It appears that Congress has made some more revisions to the Medicare Secondary Payer Statute that will affect the handling of worker's compensation claims in Iowa and throughout the country.  Starting in July 1, 2009, workers' compensation carriers and self-insured employers are going to be obligated to "identify" claimants within the workers' compensation process that are entiteld to benefits under Medicare and to report those claims to Medicare's representatives.  For a more comprehensive explanation of the new requirements, I encourage you to read an <a href="http://www.nuquestbridgepointe.com/news/uploads/january_2008_settlement_news.pdf">article posted by Mark Popolizio, J.D. with NuQuest Bridge Pointe</a>, a leading source on Medicare Set Aside issues.

Though this appears to be yet another regulatory obligation that will be imposed upon workers' compensation carriers, this appear to be an important issue for carriers to address.  Failure to comply with this new directive will subject a carrier ("primary payor") to a civil penalty of $1,000 for each day of non-complaince with respect to each claimant.  Yikes!]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/219036924/new_amendments_to_the_medicare.asp</link>
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         <pubDate>Fri, 18 Jan 2008 13:28:25 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/01/new_amendments_to_the_medicare.asp</feedburner:origLink></item>
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         <title>Is Iowa’s Workers’ Compensation Notice Defense Fair or Should It Be Amended?</title>
         <description><![CDATA[As I noted in a <a href="http://www.desmoineslaw.com/blog3/2008/01/when_must_an_employee_give_not.asp">prior article</a>, employees in Iowa have 90 days from the date of sustaining an injury to report that injury to their employer.  If the employee fails to report the injury and the employer does not have actual knowledge of the injury, the employee is barred from pursuing otherwise available remedies under the Iowa Workers’ Compensation Act.  Is this really fair?  Could the notice defense be modified to eliminate some of the more common legal disputes that arise because of this statutory notice requirement?

Employers contend that the notice defense is appropriate and fair because they should be entitled to investigate a work injury claim close in time to its occurrence.  In some situations, early investigation is the only means that will generate evidence necessary to refute an alleged injury claim.  For instance, early interviews of witnesses, inspection of work machinery, evaluation of time cards that are otherwise destroyed, or a myriad of other facts could be “lost” if an employee does not timely report a work injury and permit an investigation.

On the other hand, in many instances, the injury will be clearly work related.  There may be no dispute that the injury resulted from work activities.  In those circumstances, injured workers would contend that it is inherently unfair to deny any and all compensation simply because the employee did not report the injury within 90 days of its occurrence.  Similarly, an employee may sustain a relatively minor injury, which could fester and ultimately turn into a larger claim.  Given that the employee did not know or foresee that the injury would result in significant disability, is it really fair to deny coverage under Iowa’s worker’s compensation scheme because the worker failed to report the injury within 90 days?

As drafted, Iowa notice statue does not provide significant guidance in dealing with cumulative injuries and when those must be reported to preserve a claim.  Nor does the statute “fit” all circumstances or effectuate justice in some circumstances.

My query is:  could this notice provision be revised in some manner to make it more fair and workable for all parties?  At the present time, the notice provision is an affirmative defense.  The employer must prove that it did not have actual knowledge of the injury and that it was not provided timely notice of the injury.  Given the harsh results of the notice defense, this is probably a reasonable burden shifting provision of the Code.

I do not propose to shift the burden to the employee.  Instead, I believe that the 90 day notice provision should be “tailored” and perhaps “softened” to prevent injustice to either the employer or the employee.

I believe that most employers, carriers, and defense attorneys believe that, as the notice provision is currently applied, it has little or no detrimental effect on late reporting of injuries.  Proving a notice defense seems to be very difficult in the State of Iowa.  While it is not impossible, the Commissioner appears to disfavor this defense, probably for some of the reasons outlined above.  Therefore, from a practical standpoint, denial on a notice defense is generally considered a relatively weak defense that is not likely to prevail in most litigation unless the facts are egregious.  

Given the lack of application of the notice defense and the fact that the Commission tends to disfavor this defense, I ponder whether the notice provision has much effect on when or how employees report injuries.  I tend to favor removal or amendment of statutory provisions that really have little or no application or that are perhaps “ignored” by enforcement agencies or personnel.  I believe that any law on the books probably should be enforced and that if a bad law is on the books, it should be removed or amended to fit the practical side of life.

Because employers have legitimate reasons to want prompt notice of work injuries and because there are legitimate reasons that society should encourage prompt reporting and intervention to promote effective medical intervention, I do not advocate complete removal of the notice statute.  Nor do I think it would be entirely fair to remove the notice statute.

However, I do think that the burden of proof and the basis for assertion of the notice defense could be amended to permit a more fair application of the statutory notice defense.  For instance, I advocate amendment to deny compensation only if the employer can prove that it was prejudiced in some manner by the delay beyond 90 days.  Simply because the injury was not reported for 91 days does not mean that there was any prejudice to the employer during the last 24 hour period.  

Instead, if the employer could prove that it was unable to designate medical care, it should not owe for care sought by the employee.  If the condition worsened because of the lack of care, the employer ought not be liable for the effects of delay in reporting the injury.  Similarly, if the employer is prejudiced because evidence has been destroyed, is no longer available, or the investigation has been hampered in some manner that could have generated a viable alternative defense, then the notice provision should deny coverage.  

I advocate for a standard 90 day reporting period.  However, even if that 90 day reporting period is violated, the employer should be required to prove some prejudice has occurred before the harsh effects of the 90 day notice provision are used to deny all compensation.  I will leave the necessary statutory language for others, smarter than I, to draft.  My interest is to encourage fairness within the system and to avoid harsh, unnecessary, and sometimes unfair results.  Under my proposal, the notice defense may bear more teeth for an employer when they can actually prove prejudice while eliminate the potential harsh denial of a claim and benefits simply because of an injured worker waited more than 90 days to report an injury.
]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/217131426/is_iowas_workers_compensation.asp</link>
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         <pubDate>Tue, 15 Jan 2008 06:54:39 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/01/is_iowas_workers_compensation.asp</feedburner:origLink></item>
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         <title>When Must an Employee Give Notice of a Work Injury?</title>
         <description><![CDATA[An injured employee is obligated to give notice to his/her employer within 90 days of sustaining a work injury.  <a href="http://coolice.legis.state.ia.us/Cool-ICE/default.asp?category=billinfo&service=IowaCode&ga=82">Iowa Code section 85.23</a> provides that an injured worker shall given notice of a work injury within 90 days of sustaining the injury unless the employer has actual knowledge of the occurrence of an injury within 90 days of its occurrence.

The purpose of the 90 day notice provision is to permit the employer to make a prompt investigation of the claimed injury while the events are fresh and the evidence remains available to investigate the claim.  Moreover, an early notice of the injury permits the employer to make an early direction of medical care and presumably early medical intervention will result in better care and quicker healing.  In general, the interests of both the employee and the employer support early notice, early investigation, prompt medical care, and hopefully improved medical outcomes.

That being said, the notice defense can be a difficult issue with numerous legal issues to be resolved.  For instance, when is an employee required to give notice of a cumulative injury.  Often times, the employee will experience some type of repetitive trauma type injuries and may seek treatment with a family physician for a period of time without knowing that the injury is related to work or not believing that it will be a significant injury that should or need be pursued through worker's compensation.  The trouble comes when the treatment continues for months or years before the injury is reported to the employer.  Then questions arise about whether the notice was timely and whether the claim is barred.

For this reason, it is in all parties' interests to encourage prompt reporting of injuries.  Employees should report any physical ailments they may even suspect are work related to ensure that their 90 day notice is covered and the claim is preserved.  Employers should include personnel policies that require prompt reporting of work injuries.  Moreover, employers should repeat this directive to employees, encourage prompt reporting of injuries, and not foster, encourage, or even permit a work environment that discourages or threatens any type of adverse work reaction to the filing of a work comp claim.  In fact, as noted above, early reporting and intervention is likely in both the employee and employer's best interests and should be encouraged to prevent misunderstandings and potential forfeitures of an employee's rights.

  ]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/215250127/when_must_an_employee_give_not.asp</link>
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         <pubDate>Fri, 11 Jan 2008 16:08:28 -0600</pubDate>
      <feedburner:origLink>http://www.desmoineslaw.com/blog3/2008/01/when_must_an_employee_give_not.asp</feedburner:origLink></item>
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         <title>Top 10 Effective Ways to Get Sued by an Injured Employee</title>
         <description>Employers sometimes are shocked when they get sued by injured workers.  Yet, many of the reasons workers' compensation suits are filed are logical and preventable by employers and insurance carriers.  Most times, injured workers have no intention of pursuing litigated claims against their employer.  Instead, workers generally indicate that they are driven to pursue legal representation for one of really only a few reasons.  To be certain, some employees are simply driven by the desire to obtain financial gain and some are even acting fraudulently.

However, most injured employees only want to be paid what they are entitled and to be taken care of until they are able to return to work.  Accordingly, most litigation in the worker's compensation arena is driven by poor employment practices or by poor case handling by an insurance carrier.

To be certain, employers and insurance carriers possess very effective means to ensure that they get sued by an injured worker.  Among the 10 best ways to get sued are:

1.  Fail to report a work comp injury to the insurance carrier in a timely manner
2.  Deny the injured worker necessary medical care (or at least don't offer it promptly)
3.  Refuse to pay for medical treatment obtained after a work injury (even if you have authorized the care)
4.  Don't worry about, take a personal interest, or even inquire of the employer to see how he/she is doing after a work injury.
5.  Provide the injured employee demeaning work and continually harass the employee upon return to work
6.  Don't timely report the hours worked on light duty to the insurance carrier, causing the injured worker to have a shortfall in earnings.
7.  Refuse to allow the worker to return to work until he/she obtains a full duty release (workers earn less sitting at home than returning to a light duty assignment and often feel the money crunch if not put back to work).  This one might just get you a double award and a suit under the Americans with Disabilities Act as well!
8.  Upon returning to work, start writing the injured worker up for every insignificant policy violation you can think of, regardless of whether you have done so in the past and regardless of whether you are writing up other employees for similar conduct (employees love to be singled out and discriminated against).
9.  Fire or threaten to fire the injured employee immediately upon being advised of the work comp claim (this one gets you the triple or potentially the quadruple whammy because you get teh honor of being sued for worker's compensation benefits, wrongful termination, violations of the ADA, and potentially violations of the Family and Medical Leave Act).
10. Fire the injured worker as soon as you receive a work comp petition (these employers also desire the double whammy of a wrongful termination suit).

If employers implement each of the above ten practices, lawyers on both sides of the table should reap the benefits!  (And I am sure that employees and employers alike enjoy paying their attorneys!)  Realistically, through proper training, implementation of policy, and simple human compassion, many worker's compensation suits can be avoided, employees can receive what they are entitled to receive, and exposures can be reduced both for the employer and the insurance carrier.
</description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/214500922/top_10_effective_ways_to_get_s.asp</link>
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         <pubDate>Thu, 10 Jan 2008 05:48:31 -0600</pubDate>
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         <title>What If An Injured Worker Does Not Like the Physician Selected by the Employer?</title>
         <description><![CDATA[As I discussed in a <a href="http://65.36.221.109/virMT/mt.cgi?__mode=view&_type=entry&id=43&blog_id=3">prior article</a>, employers in the Iowa worker's compensation system have a statutory right to select the treating physician.  However, if an injured worker does not like the physician selected and authorized by the employer, he/she does have potential remedies.  A dissatisfied worker can file an <a href="http://www.iowaworkforce.org/wc/forms/14-0011.pdf">Alternate Medical Care Petition</a> with the <a href="http://www.iowaworkforce.org/wc/">Iowa Workers' Compensation Commission</a>. 

If a Petition is filed, a hearing will be scheduled within 10-14 days of the date the petition was filed.  The hearing can be held live, via telephone, or <a href="http://www.iowaworkforce.org/wc/newsandupdates.htm">via the internet</a>.   

If a Deputy Commissioner determines that the medical care offered is not reasonably suited to treat the injuries, is untimely, or unduly inconvenient (generally an injured worker cannot be expected to travel more than 50 miles one-way to obtain care), care can be shifted by order of the Commission.  Care can also be shifted if the employer fails to follow and authorize the recommendations of the physician it authorized or if there is an irreconcilable breakdown in the doctor-patient relationship.  However, the injured worker must prove the basis for the requested transfer of care.]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/212675349/what_if_an_injured_worker_does.asp</link>
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         <pubDate>Mon, 07 Jan 2008 07:04:49 -0600</pubDate>
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         <title>Who Selects the Doctor in Iowa and Why?</title>
         <description><![CDATA[There has always been great debate about whether it is proper to have the employer retain the right to direct medical care.  Some states permit the employer to select the treating medical provider while some states permit the employee to select his/her own medical providers.  

Employees complain that their employer should not be allowed to select their treating medical providers.  Indeed, there are some good arguments that can and have been advanced by employee representatives as to why the employer should not be permitted to select the treating physician. Among these arguments are the fact that medical care is inherently a private issue and that the employee should be able to treat privately and at his/her own discretion.  Another argument that is often advanced and that has some logical appeal is that the employee is more likely to trust, respect, and follow the medical recommendations and treatment of a physician that he/she selects.

Similarly, there are good arguments why the employer should be permitted to select the physician.  Among those arguments are that work injury claims are mandatory legal obligations placed on an employer.  Unlike private health insurance claims where the employer may elect to decline to provide coverage for employees, employers are forced to provide worker's compensation coverage and treatment for injured workers.  Among the negotiated benefits and exchanges at the inception of the worker's compensation system was this right to select medical care.  In exchange for guaranteed coverage and medical care, employees were willing to give up their private right to select the medical provider.  

Employers will also tell you that they believe the employer-selected physician system is better because employees often obtain treatment from better qualified physicians and in a more timely manner.  Employers have connections and refer numerous workers to physicians.  Over time, they develop rapport with the physicians' offices.  This may enable employers to secure more prompt medical care with the physician.

Over time, the employer can identify specialties among physicians and can watch long-term outcomes of various physicians to identify the best physicians.  In the end, it is most beneficial to both the worker and the employer to have the best possible medical outcome because the worker is "healed" and the employer's liability decreases.

Other arguments that support an employer-chosen medical system are financial arguments.  In those states where the employer is permitted to select the physician, workers tend to return to work sooner and treat for less time.  It is arguable whether this is a good thing.  However, from a financial viability standpoint, it is beneficial to keep premiums down and encourage employers to locate in a state.

In addition, there is inherent benefit in having a rapport between the employer and the physicians treating injured workers.  Over time, the physician learns and becomes comfortable with the work duties performed at particular employment sites.  The physicians may become familiar with reasonable light duty work options and may develop a sense of cooperation (or alternatively a lack of cooperation) from the employer.  If the physician knows the particular job duties and light duty work options, the physician may be able to tailor medical restrictions that will permit an injured worker to return sooner to the employment scene.  While this obviously reduces the employer's liability, this also permits the employee to earn more money.  In fact, as I discussed in a prior article, the employee will earn more by working that by staying at home.  Accordingly, both employees and employers have reasonable, logical, and compelling arguments as to how and why a certain phsycian selection process can and should be implemented.

Although there is <a href="http://www.desmoineslaw.com/blog3/2007/03/dont_turn_the_iowa_workers_com.asp">constantly debate about the issue</a>, Iowa falls into the group that permits the employer to select the medical provider.  <a href="http://coolice.legis.state.ia.us/Cool-ICE/default.asp?category=billinfo&service=IowaCode&ga=82">Iowa Code section 85.27 </a> provides that "the employer is obligated to furnish reasonable services and supplies to treat an injured employee."  However, that statute also provide the employer "the right to choose the care."

This statutory section is sometimes misunderstood or misapplied by employers and insurance carriers.  While this statutory section permits the employer to "choose the care," this statute does not permit an employer to pick and choose which treatment recommendations it will authorize.  In other words, the employer is permitted to select the physician or other medical provider to whom the injured worker must go for treatment.  However, the employer may not dictate what care, the order of the care, or the extent of the care recommended or offered by the treating physician.  The employer's right to "choose the care" is limited to the selection of the medical provider that will render that care.

Often times, an employer or an insurance carrier will select a reasonable and skilled physician to render care. However, after evaluating the injured worker, that physician may recommend a MRI or other expensive diagnostic testing.  The inclination by the employer is to delay or deny that diagnostic testing if there are other alternatives or if there is a chance that this is a strain that may resolve with or without the expensive testing.  However, the law in Iowa is clear that the employer and/or carrier may not interfere with or dictate which testing or treatment is provided.  Once the employer selects and designates the treating physician, its "right to choose" is accomplished and the carrier generally must accept and approve all recommended care from that physician.

Employers contnue to cherish and urge retention of the employer-selected physician system.  While I concur that the employer's right to select the physician is important and makes sense for many of the reasons outlined in this article, I often wonder if some of the desire and drive to change that system isn't simply because employers and carriers overstep their bounds and attempt to manipulate their use of the "right to choose" rather than simply directing employees to well-respected physicians and encouraging vigorous and prompt medical care.  ]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/212675350/who_selects_the_doctor_in_iowa.asp</link>
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         <pubDate>Fri, 04 Jan 2008 10:47:12 -0600</pubDate>
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         <title>New Edition of the AMA Guides to the Evaluation of Permanent Impariment Released</title>
         <description><![CDATA[As of January 2008, the American Medical Association is releasing its latest (6th) edition of its Guides to the Evaluation of Permanent Impairment.  For all attorneys practicing in the workers' compensation arena or physicains evaluating patients within the worker's compensation scheme, use of these Guides is important.

Like it or not, those of us working in the Iowa workers' compensation system, are intimately familiar with and spend countless hours reviewing the AMA Guides to the Evaluation of Permanent Impairment.  The Guides are recognized in Iowa as prima facie evidence of the total permanent disability owed for scheduled member injuries.  See <a href="http://nxtsearch.legis.state.ia.us/NXT/gateway.dll/IAC?f=templates&fn=default.htm">876 IAC 2.4</a>.  The impairment raitngs offered by these Guides are also recognized factors in determining industrial disability awards in unscheduled injury claims.

Issuance of the 6th Edition of the AMA Guides will likely cause some upheavel within the Iowa worker's compensation system.  More likely, the new edition of the Guides will simply cause additional headaches and research for those of us trying to interpret and apply the new Guides to existing and future claims.  All employers and insurance carriers should immediately begin asking the treating or evaluating physicians to utilize the 6th Edition of the AMA Guides when rendering impairment ratings to ensure that the most current medical evidence is obtained.  

<a href="http://amaguides.com/6thEdition.htm">Here</a> is the cheapest place that I have found to purchase the 6th Edition of the AMA Guides.  Happy reading to all of you lucky individuals that get to read this 600+ page book!

 ]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/209969818/new_edition_of_the_ama_guides.asp</link>
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         <pubDate>Wed, 02 Jan 2008 06:35:36 -0600</pubDate>
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         <title>Happy New Year!</title>
         <description>So long 2007 and hello 2008!  May '08 be prosperous and pleasant for all my friends, collegues, and clients!</description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/209003090/happy_new_year.asp</link>
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         <pubDate>Mon, 31 Dec 2007 08:45:10 -0600</pubDate>
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         <title>Return to Work Issues in Work Comp-Part III:  Remember the ADA</title>
         <description><![CDATA[When pondering return to work issues and potential termination issues, an employer dealing with a worker's compensation claim must also be cognizant of potential rights and obligations arising from the Americans with Disabilities Act and/or the Iowa Civil Rights Act.  Obviously, not all employees qualify for coverage under the ADA, though employers with as few as four employees are obligated to honor the requirements of the Iowa Civil Rights Act.

If an injured worker has a <a href="http://www.eeoc.gov/types/ada.html">qualifying disability</a>, he/she may be entitled to reasonable accommodations upon return to work.  No blanket statement can be given as to when a reasonable accommodation must be extended by an employer.  Nor can a blanket statement be offered to determine whether a particular modification of the work duties or work environment will be considered a "reasonable accommodation."  Instead, the facts and circumstances of each situation must be considered.

In some instances, an injured work comp claimant may be able to return to the pre-injury job with a modification that lowers stock to below shoulder level or provides some type of lifting assistance.  In other instances, an employee may need more than the 12 weeks of FMLA leave, despite having a pending offer of employment to fully recover and return to work.  A reasonable accommodation may requite transfer to a different job for which the employee is qualified.  Of course, this case get complicated if there is a union contract or seniority rules in place that may affect another employee that also has certain legal rights.

The size and financial ability of an employer is important in making this decision.  The expense, hassles, and effects on production of a particular accommodations must be considered.  Therefore, whenever an injured worker requests some type of modification of his/her job after a work injury, the employer should be congnizant of the potential application of the ADA and/or Iowa Civil Rights Act.  Pre-emptive action may be indicated and consultation with corporate counsel early in the process is wise.]]></description>
         <link>http://feeds.feedburner.com/~r/BillsLegalCite/~3/207612853/return_to_work_issues_in_work_1.asp</link>
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         <pubDate>Thu, 27 Dec 2007 09:49:31 -0600</pubDate>
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         <title>Merry Christmas!</title>
         <description>Merry Christmas to all of you that I am privileged to call my friends in the Iowa Workers' Compensation Bar.  A warm holiday greeting also goes to all of you who are kind enough to send me business and feed my family!</description>
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         <pubDate>Mon, 24 Dec 2007 09:02:56 -0600</pubDate>
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