Benefit Highlight Workers' Compensation Overview
You may be eligible for Workers’ Compensation benefits for injuries or illness occurring in and arising out of your employment. Workers’ Compensation benefits are provided by law pursuant to Iowa Code §85, 85A and 85B. If you sustain an injury or illness you believe is work-related, you should immediately notify your employer, who will ask you to complete a First Report of Injury (FROI). Your supervisor or Human Resources Associate (HRA) can assist you with this process.
Your FROI will be sent to Sedgwick for evaluation and handling. Sedgwick administers the Workers’ Compensation claims for the State of Iowa. They are responsible for claims intake, evaluation, direction of medical care, benefits payment, and other aspects of handling Workers’ Compensation claims filed by State of Iowa employees.
Your employer has the right and obligation to direct medical care in a Workers’ Compensation claim [§85.27]. An authorized treating provider (ATP) must be utilized in all non-emergency cases for initial treatment. A list of these providers is located here. Note: If a life-threatening or emergency situation arises you should seek immediate medical attention at any nearest provider or contact 911. This list is not exhaustive of all providers or facilities that may be involved in your care. Sedgwick and the ATP will coordinate any referrals for diagnostics, specialists, physical therapy, etc. Contact Sedgwick to discuss special situations. There are no copays or coinsurance for authorized care in an accepted Workers’ Compensation claim.
If your Workers’ Compensation claim is accepted, every effort will be made to assist you in returning to work. When available, you will be given temporary suitable work within restrictions provided by your ATP. The initial period for temporary suitable work is the hourly equivalent of 20 workdays (pro-rated for part-time employees), or until you are medically released to full duty, whichever is less. In certain cases, extensions may be granted. Your job class and rate of pay will not be reduced while you are performing temporary suitable work [IAC 11-59.3(5)]. If you refuse temporary suitable work, your Workers’ Compensation benefits may be suspended [§85.33(3)].
If you are temporarily disabled and unable to return to work, you may be eligible to supplement Workers’ Compensation temporary disability benefits with your accrued leave. Please contact your HRA for further information regarding supplementing.
If your Workers’ Compensation claim is denied, a letter will be sent by Sedgwick directly to you. This letter should be presented to your group health carrier for continued medical care.
The Iowa Department of Administrative Services (DAS) is responsible for the management of the Workers’ Compensation program for State of Iowa employees and the contractual agreement with Sedgwick [IAC 11-1.4(2)(a)].
This general information does not fully address every question or situation which may arise. Please contact your HRA, Sedgwick, or the DAS Workers’ Compensation Coordinator at (515) 725-0732.
All communication and correspondence regarding Workers’ Compensation claims to Sedgwick CMS should be directed to:
Sedgwick CMS
P.O. Box 14628
Lexington, KY 40512
Phone: 515-327-4888
Toll Free: 866-342-3920
Fax: 515-327-4899
All questions regarding administration of the Workers’ Compensation program for State of Iowa employees should be directed to:
Ryan Ihrke, Workers’ Compensation Coordinator
Iowa Department of Administrative Services – HRE
Hoover Building, Level A
1305 East Walnut
Des Moines, Iowa 50319
Phone: 515-725-0732
ryan.ihrke@iowa.gov
Last updated: 07/17/2019