A Refresher: Common Defenses to a Workers’ Compensation Claim
There are a number of statutory affirmative defenses available to an employer upon the filing of a workers’ compensation claim. The employer has the burden of proof to establish such defenses. Cedar Rapids Cmty. Sch. v. Cady, 278 N.W.2d 298, 299 (Iowa 1979).
Notice of Injury; Statute of Limitations:
Upon the filing of any claim, it is important to consider whether an employee gave an employer proper notice of injury and whether the filing is within Iowa’s two-tiered statute of limitationsscheme. An employer must be given the opportunity to investigate an employee’s injury, and therefore, the Iowa Workers’ Compensation Act requires an employee to give the employer or the employer’s representative actual notice of the injury within 90 days of the injury. ICA §85.23. If an injured worker has not received weekly benefits, she must file her claim within two years of the date of the injury. ICA §85.26. If an injured worker has received weekly benefits, she must file her claim within three years of the date of the last payment. Id.
Willful Injury; Intoxication:
There are other statutory defenses available which relate to the circumstances under which a particular injury occurred. For instance, certain willful acts preclude compensation under the Act. No compensation is allowed for an employee who willfully intends to injure herself or another. ICA §85.16. There must be evidence that the employee intended to cause the injury she suffered, as opposed to an injury that is an unintended consequence of the act of the employee. See, e.g. Lause v. United Parcel Services. Inc., 2009 WL 505611 (Iowa Workers’ Comp. Comm’n 2009).
Moreover, an employee cannot recover for injury resulting from the willful act of a third partyagainst an employee for reasons personal to the employee. ICA §85.16. The Supreme Court of Iowa shed light on this defense in in Xenia Rural Water Dist. v. Vegors, 786 N.W.2d 250, 258 (Iowa 2010). The Court first determined that the term “third party” can include co-workers. Id. The Court also interpreted the phrase “for reasons personal” rather narrowly and held that the third party action must be the consequence of circumstances outside of the work environment that were subsequently imported into the work environment. Id.
The Act also states that an employee shall not be compensated for injury caused, “…By the employee’s intoxication, which did not arise out of and in the course of employment…” ICA §85.16(2). (emphasis added). The intoxication itself must cause the accident or injury. Id. See, e.g. Garcia v. Naylor Concrete Co., 650 N.W.2d 87, 90 (Iowa 2002).
For questions regarding Iowa Workers’ Compensation matters, please contact Emily R. Motto at emotto@baylorevnen.com or 402-475-1075.