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Im a 26 year veteran Civil Service law enforcement officer,

 
Mary M.,  Esquire's Avatar
  • Answered by:Mary M., Esquire
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I'm a 26 year veteran Civil Service law enforcement officer, recently placed on disability retirement as a result of an in the line of duty injury. Having been assaulted while making a lawful arrest. My injury being a TBI - traumatic brain injury. This incident occurred 02/04/2010. My cities work comp carrier is IMWCA- Iowa Municipal Workers Comp Agency who have covered all medical expenses (mileage, meals, lodging and my wife's loss in wages). Because she has to take time off from work to drive me to my medical appointments as I am not able to drive because of seizures. IMWCA had a $250,000 / 2year which ever come first cap for medical coverage. At which time the city has to assume medical coverage responsiblity. On 03/2011 the city elected to have me placed on disability retirement, through the MFPRSI - Municipal Fire and Police Retirement System of Iowa where I lost 26% of my income and my employee plus spouse health insurance cost rose 1000% from $138 a month to $1,100 a month which I have been paying since. This takes about half of my pension check. My wife and I approached the city Mayor in 10/2011 to seek some help from the city for this health insurance cost raise. I asked if they could continue to pay as if I were still employed, with my paying the $138 a month for my wife's coverage. I have yet received a call back from the Mayor as he said he would. Around 03/2012 my wife and I along with my Chief of Police went before the city council to make this same request. The council advised they weren't even aware I was still off work let alone retired, they would look into it. My wife and I met with several representatives of the city last week, they are willing to pay for my health insurance coverage as they found out they were required to by state code. But I would have to pay for my wife's health insurance coverage $700 a month. We asked for a copy of the financial breakdown for this spouse coverage cost so we know they are being factual on the cost as well as being able to do comparsion shopping for lower rates if possible. The city attorney advised they will be happy to pay my medical costs accept for mileage, meals, lodging and wife's loss in wages as they are not able to find any case law under chapter 411 that so requires them to do so. If we can show them some case law under the Iowa code chap. 411 for this they would be more than happy to pay it, but other words no. This is what I get after 26 years of committed service to my job and my city. I guess my question is incidental to Iowa Code 85.27 sec.1 . The Iowa Workers Compenstaion chap 8 substantive & interpretive rules 876--8.1(85) sec. 2,3. and through the Iowa Code chap. 411.15 can you advise of any case law that states the employer is responsible for the medical costs incurred for transportaion / fuel, meals, and lodging if necessary for continued medical care?

 

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Country relating to Question: United States
State (if USA): Iowa

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Submitted: 308 days and 15 hours ago.
Category: Legal
Value: $79
Status: CLOSED

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Expert:  Mary M., Esquire replied 308 days and 14 hours ago.

Hello there

 

The city attorneys have put the ball back into your court because they know that such case law does not exist. Under the worker's compensation laws of every state, the employee is entitled only to their paycheck (at a rate of between 60% and 100% depending upon whether or not you have union protection and if the union has negotiated something higher than the statutorily required 60%) -- and the paycheck lasts only as long as the Disability lasts (temporary total Disability Benefits) unless the employee's doctor has signed off that the injury is permanent and the employee is not likely to recover to return to work in which case the weekly paychecks will last on a permanent basis (called permanent total disability). In addition to the paycheck, you are entitled to medical coverage for anything to do with the injury for the rest of your life and this does include payment of reasonable mileage expenses to and from medical appointments. The medical coverage does not extend to anything more than the area of your body that was injured in this worker's compensation Accident. If you are receiving full medical coverage at this point it is most likely a function of the disability retirement that you are receiving and has nothing to do with the worker's compensation laws. You see, the way the worker's compensation laws work is that the company or agency you are working for negotiates with your union to try to get its members the best possible deal that they can if you are injured on the job and then the agency must purchase a worker's compensation policy to cover all of it OR the agency (or city or county) can self-insure the worker's compensation program so long as they have enough funds set aside in Escrow in order to pay any claims. It sounds to me like your employer purchased a good policy that covers you with some additional benefits not required under the general state worker's compensation laws -- but that good policy had a time limit and once it ran out, you were subject to the same worker's compensation laws that cover everyone else who is injured in the state of Iowa -- and those basic state laws do not cover meals, your wife's lost wages for medical appts or anything else that you were receiving from the original WC policy that is beyond what the state law requires them to cover. This is why they seemingly "caved" and agreed to provide you the medical care -- because, as you said it yourself -- state law requires them to do it for you. But Iowa state law (and the WC laws in all states) provide nothing more than a paycheck that is 60% of your gross wage and medical coverage for your injury (and no other medical coverage), and mileage to and from the medical appointments. Nothing else is included (and the fact that you were able to receive reimbursement for your wife's lost work time on any WC case shows me that whatever your union negotiated was a good deal (even if it only lasted a little while) -- because this is the first I have seen of ANY employer actually willingly paying for something like that on a WC case against them). I wish I could tell you that all of these things are still reimbursable under state WC laws, but they simply are not reimbursable and as I said -- the city attorney knows this (he was being cute when he told you to do this -- as lawyers, we have seen this happen many times -- however, you should go back to him with information from the Iowa WC site I linked you to below about being reimbursed for mileage expenses for your medical appt travel - because that is actually in the statute for WC in Iowa and you do not need case law for it). You can also verify this information by simply contacting the state WC board and speaking with an investigator there. http://www.iowaworkforce.org/wc/

Here are frequently asked questions: http://www.iowaworkforce.org/wc/faq.htm#?

 

From what you have told me, it appears that your injury happened a few years ago -- but you still might be able to make it under a Statute of Limitations for personal injury cases and you can actually bring a personal injury case against the agency IF you can prove to a court that what happened to you was more than just simple negligence -- if you can show that the agency was grossly negligent in the training of employees or selection or equipment or anything else that a lawyer can think of, you may be able to bring a separate lawsuit for this gross negligence. Iowa state law also permits you to bring a lawsuit against any third party who may be more responsible for your injuries than your employer -- for example, if you were hit by a car on duty and the driver of the car has a million dollar umbrella policy -- if you can prove that the driver was negligent you can sue her for personal injury. So, if you have not yet spoken with a local worker's compensation lawyer who handles gross negligence claims and third party claims, you might want to do that at this point to see if perhaps there may be any kind of additional compensation that you might receive. I added this bit of information because you never know -- a private WC lawyer may see more to your case than just the WC claim and wish to pursue additional items. It does not happen often, but when it does happen the claimant can claim millions of dollars. To find a local WC attorney you should contact your local county bar association and you can get a number of names for local atty's who handle these items and you can go from there.

 

---MARY

 

Please rate my answer to you below. Please keep in mind that I have told you what the law is in Iowa, so I have done what you have asked me to do -- and I ask you to be fair and not deliver a poor rating of 1 or 2 (which leaves negative feedback for me and results in no payment to me) because I could not tell you what you wanted to hear (you would not believe how many people do that). A 3 rating delivers a neutral and a 4 or 5 rating deliver varying degrees of positive and I will receive credit for this answer. If you have additional questions, please let me know in a response box and I will assist you further. THANK YOU !!

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Category: Legal
Pos. Feedback: 98.4 %
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Answered: 6/19/2012

Experience: 15 years exp all aspects of general law

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