If you are injured on the job as a result of your employment, you may be eligible for Workers’ Compensation benefits. Workers’ Compensation benefits are provided to you by law and do not require any action by you to obtain coverage. Under Workers’ Compensation, you may be eligible for wage replacement and medical care. If you sustain an injury or illness that you believe is work-related, you must notify your employer,who will ask that you complete a first report of injury. Your supervisor or personnel assistant can help you with this process.
Your first report of injury will be sent to Sedgwick Claims Management Services (Sedgwick CMS) for evaluation and handling. Sedgwick CMS, a national third party administrator in the area of Workers’ Compensation, assumed responsibility for the state of Iowa Workers’ Compensation claims on July 1, 2001. They are responsible for claims intake, evaluation, direction of medical care, benefits payment, and all other aspects of the day-to-day handling of Workers’ Compensation claims filed by state of Iowa employees.
If your Workers’ Compensation claim is approved by Sedgwick CMS, every effort will be made to assist you in returning to work. When available, you will be given a restricted duty assignment until you recover enough to return to your regular job. Your job class and rate of pay will not be reduced while you are performing your restricted duty job. If you refuse to accept a temporary restricted duty assignment, your workers’ compensation benefits may be suspended. The original period of restricted duty 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.
If your claim is denied by Sedgwick CMS, a letter will be sent directly to you. This letter should be presented to your group health carrier if they deny medical coverage based on the Workers’ Compensation filing. The Iowa Department of Administrative Services is responsible for the management of the program and the contractual agreement with Sedgwick CMS. This agreement became effective on July 1, 2001.
All communication and correspondence regarding Workers’ Compensation claims to Sedgwick CMS should be directed to:
P.O. Box 14628
Lexington, KY 40512
Toll Free: 866-342-3920
After Hours New Report Call Center: 866-222-8768