86.13 Compensation payments.
1. If an employer or insurance carrier pays weekly compensation benefits to an employee, the employer or insurance carrier shall file with the workers’ compensation commissioner in the form and manner required by the workers’ compensation commissioner a notice of the commencement of the payments. The payments establish conclusively that the employer and insurance carrier have notice of the injury for which benefits are claimed but the payments do not constitute an admission of liability under this chapter or chapter 85, 85A, or 85B.
2. If an employer or insurance carrier fails to file the notice required by this section, the failure stops the running of the time periods in section 85.26 as of the date of the first payment. If commenced, the payments shall be terminated only when the employee has returned to work, or upon thirty days’ notice stating the reason for the termination and advising the employee of the right to file a claim with the workers’ compensation commissioner.
3. This section does not prevent the parties from reaching an agreement for settlement regarding compensation. However, the agreement is valid only if signed by all parties and approved by the workers’ compensation commissioner.
4. a. If a denial, a delay in payment, or a termination of benefits occurs without reasonable or probable cause or excuse known to the employer or insurance carrier at the time of the denial, delay in payment, or termination of benefits, the workers’ compensation commissioner shall award benefits in addition to those benefits payable under this chapter, or chapter 85, 85A, or 85B, up to fifty percent of the amount of benefits that were denied, delayed, or terminated without reasonable or probable cause or excuse.
b. The workers’ compensation commissioner shall award benefits under this subsection if the commissioner finds both of the following facts:
(1) The employee has demonstrated a denial, delay in payment, or termination of benefits.
(2) The employer has failed to prove a reasonable or probable cause or excuse for the denial, delay in payment, or termination of benefits.
c. In order to be considered a reasonable or probable cause or excuse under paragraph “b”, an excuse shall satisfy all of the following criteria:
(1) The excuse was preceded by a reasonable investigation and evaluation by the employer or insurance carrier into whether benefits were owed to the employee.
(2) The results of the reasonable investigation and evaluation were the actual basis upon which the employer or insurance carrier contemporaneously relied to deny, delay payment of, or terminate benefits.
(3) The employer or insurance carrier contemporaneously conveyed the basis for the denial, delay in payment, or termination of benefits to the employee at the time of the denial, delay, or termination of benefits.
[S13, §2477-m25; C24, 27, 31, 35, 39, §1436; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §86.13; 82 Acts, ch 1161, §23]
98 Acts, ch 1061, §7, 11; 2009 Acts, ch 179, §110
Referred to in §85.26, 85.72, 86.12, 86.14
Structure Iowa Code
Title III - PUBLIC SERVICES AND REGULATION
Chapter 86 - DIVISION OF WORKERS’ COMPENSATION
Section 86.1 - Workers’ compensation commissioner — term.
Section 86.2 - Appointment of deputies.
Section 86.3 - Duties of deputies.
Section 86.4 - Political activity and contributions.
Section 86.5 - Political promises.
Section 86.6 - Recommendations of commissioner.
Section 86.7 - Interest in affected business.
Section 86.10 - Records of employer — right to inspect.
Section 86.11 - Reports of injuries.
Section 86.12 - Failure to report.
Section 86.13 - Compensation payments.
Section 86.13A - Compliance monitoring and enforcement.
Section 86.14 - Contested cases.
Section 86.17 - Hearings — presiding officer — venue.
Section 86.18 - Hearings — evidence.
Section 86.19 - Reporting of proceedings.
Section 86.24 - Appeals within the agency.
Section 86.26 - Judicial review.
Section 86.27 - Settlement of controversy.
Section 86.29 - The judicial review petition.
Section 86.32 - Costs of judicial review.
Section 86.36 - Notice and service — resident and nonresident employers.
Section 86.38 - Examination by physician — fee.
Section 86.39 - Fees — approval.
Section 86.42 - Judgment by district court on award.
Section 86.43 - Judgment — modification.