2026 IOWA LEGISLATIVE UPDATE

H.F. 450 (Senate companion bill listed as S.F. 454) - A bill relating to the standards for determination of loss or permanent impairment for purposes of PPD, including applicability provisions.

Explanation: Under the current structure, determinations of the extent of loss or percentage of permanent impairment for purposes of PPD use the AMA guides. This bill would specify that the most recent edition or annual update of those guides will be used. This bill also strikes the requirement that the commissioner adopt the guides by rule. The bill would have the sixth edition of the rules used instead of the fifth edition. This would be achieved by amending the language found in Iowa Code Section 85.34 to reference the most recent edition.

H.F. 450 was introduced by Representative Ann Meyer from Iowa’s 8th District. She has served in the legislature since 2019. Representative Meyer serves on the House Appropriations, Health and Human Services, and Transportation Committees.

H.F. 673 (Senate companion bill listed as S.F. 455) – A bill requiring certain workers’ compensation benefits to be calculated by including employees’ overtime and premium pay, and to include an annual cost-of-living adjustment.

Explanation: The bill requires the calculation of weekly indemnity benefits to include overtime and premium pay. Additionally, this bill requires the basis of compensation for weekly benefits payable for PTD or death benefits to increase annually based on the cost-of-living adjustment made by the U.S. Social Security Administration for disability payments. This would be accomplished by changing the language found in Iowa Code Section 85.36. This bill also makes technical changes to the numbering in this section.

H.F. 673 was introduced by Senators Townsend, Trone Garriott, Donahue, Winckler, Zimmer, Blake, Wahls, and Bisignano.

S.F. 456 – A bill relating to the choice of doctor to treat injured employees under workers’ compensation laws.

Explanation: This bill relates to the choice of physician to treat injured employees under Iowa’s workers' compensation laws. The bill allows employees to choose care by predesignating with their employer a physician as their primary care provider.

The bill gives employees the right to predesignate a physician who is a primary care provider, who has previously provided treatment to the employees and has retained the employees’ medical records, to provide treatment for a work-related injury. The employer is required to provide written notice of this right to employees upon hire, periodically during employment, and upon receiving notice of employees who have not predesignated a physician, in a manner prescribed by the commissioner.

When employees give notice to their employer of an injury, the employer must again provide written notice to the employees of their right to predesignate a primary care provider in the manner prescribed by the commissioner. If the employer fails to provide notice of the employees’ right in this circumstance, injured employees have the right to choose any physician to provide treatment for the work-related injury, and that treatment shall be considered authorized care.

The bill defines, for the purpose of this section, a “physician” as an individual physician, a group of physicians, or a clinic. It further defines “primary care provider” as the employees’ personal physician who is licensed to practice medicine and is a family or general practitioner, pediatrician, internist, obstetrician, or gynecologist. If the physician is not licensed in Iowa, the physician must be located within 60 miles of the location of the work or the location where the injury occurred.

The bill further states that any physician designated by the employees under this new legislation is authorized to arrange for any consultation, surgical consultation, referral, emergency care, or “other specialized medical services as the physician deems necessary to treat the injury.”

The bill also adds that an employer or an employer’s insurer shall not coerce or otherwise attempt to influence injured employees’ choice of physician, but does not provide for any penalties or other guidance on what constitutes coercion.

This bill also modifies the method for alternate care under this new regime. If either party is dissatisfied with the care chosen by the other party, the dissatisfied party must communicate the basis of dissatisfaction in writing to the other party. The parties may agree to alternate care reasonably suited to treat the injury. If the parties cannot agree, the dissatisfied party may apply to the commissioner for alternate care. The bill provides guidelines for proceeding with these applications.

The bill further provides that if the employees have chosen care, when it is medically indicated that no significant improvement from an injury is anticipated, the employees may obtain a medical opinion regarding the extent of the employees’ permanent disability. If the employer believes that the evaluation is off, the employer has the right to obtain another medical opinion from a physician of the employer’s choosing.  All of this is done through amendments to Iowa Code Sections 85.27 and 85.39.

S.F. 456 was introduced by Senators Townsend, Trone Garriott, Donahue, Winckler, Zimmer, Blake, Wahls, and Bisignano.

S.F. 509 – A bill requiring employers to extend company health insurance to employees with compensable injuries after the employees leave employment.

Explanation: This bill provides that if employees are unable to return to work due to a compensable injury, and if the employer provided the employees with health insurance prior to the injury, the employer must continue to provide the employees with health insurance on the same terms for at least six months beginning the day after the employees leave employment. If the employer does not comply, the employer shall be liable to the employees for reimbursement of any medical costs incurred by the employees that would have been covered by the health insurance. The bill requires each employer to include the employer’s policies or procedures for compliance with these provisions in any employment contract, employee handbook, or offer of employment provided by the employer. These provisions apply to employers with 15 or more employees and to injuries occurring on or after the effective date of the bill. This would be executed in the statute by adding a new section to the code, Iowa Code Section 85.27A.

The bill also amends Iowa Code Section 85.61 to define “independent contractor” for purposes of workers’ compensation, wage payment collection, minimum wage, and unemployment insurance. The bill defines an independent contractor as an individual performing work “who is free from control or direction by the employer over the performance of the individual’s services, whose service is either outside the usual course of business of the employer or is performed outside of all the places of business of the employer, and who is customarily engaged in an independently established trade, occupation, profession, or business.” For purposes of this definition, the employer has the burden to establish that an individual is an independent contractor and not an employee.

S.F. 509 was introduced by Senator Townsend, from Iowa’s 36th District. Senator Townsend was elected in 2024 and is serving his first term. Senator Townsend serves on the Senate State Government, Transportation, Veterans Affairs, Ways and Means, and Workforce Committees.

For questions about these bills, please reach out to your Baylor Evnen attorney or call us at 402-475-1075.