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Does Workers Comp Pay for Emergency Room Visits?

On Behalf of | Jun 5, 2023 | Firm News

Workers’ compensation insurance is a type of insurance that provides benefits to employees who are injured or become ill on the job. These benefits can include medical expenses, lost wages, and permanent impairment. One of the benefits that workers’ compensation insurance typically does not cover is the cost of emergency room visits.

However, there are some exceptions and restrictions to keep in mind. In this article, we will explore how workers’ compensation insurance covers emergency room visits and what you should know if you find yourself in this situation.

Here are some of the key points that we will discuss:

  • When is an emergency room visit covered by workers’ compensation?
  • What are the exceptions to coverage?
  • What should you do if you are injured on the job and need to go to the emergency room?

What is Workers’ Compensation Insurance?

Workers’ compensation in Iowa is a state-mandated insurance program that provides benefits to employees who are injured or become ill on the job. In Iowa, all employers with one or more employees are required to carry workers’ compensation insurance. The insurance premiums are based on the employer’s payroll and the type of work that is performed.

If an employee is injured on the job, they should report the injury to their employer as soon as possible. The employer will then file a workers’ compensation claim with the Iowa Division of Workers’ Compensation.

Does Workers’ Compensation Insurance Pay For Emergency Room Visits?

Not in all cases. Workers’ compensation insurance in Iowa does not typically cover emergency room visits for work-related injuries, unless you are directed by the insurance company to go to the emergency room. For example, workers’ compensation will not cover emergency room visits that are not medically necessary. The insurance company and your doctors determine whether or not your visit was medically necessary. If you were under the influence of drugs or alcohol at the time of your injury, your workers’ compensation claim may be denied. Additionally, if your injury occurred while you were engaging in illegal activities or working or performing your job recklessly, you may not be covered by workers’ compensation insurance.

If you truly need emergency treatment for a work injury, you should get the care that you need. You should always inform your employer and/or work comp carrier if you can before you go to get treatment. This increases the chances that the visit will be covered.

If you have any questions about emergency room treatment and worker compensation, you should talk to an experienced workers’ compensation lawyer. They can help you understand your rights and make sure that you get the treatment you need.

What Should You Do if You Need Emergency Medical Treatment?

If you are injured on the job and require emergency medical treatment, there are several steps you should take to ensure that you receive the medical care you need and that your workers’ compensation claim is properly documented.

1. Call 911 or go to the nearest emergency room.

If you are experiencing a medical emergency, call 911 or go to the nearest emergency room. Your health and safety should be your top priority. The nearest hospitals from downtown Des Moines, Iowa are

  • MercyOne Des Moines Medical Center (1.7 miles)
  • UnityPoint Health-Iowa Methodist Medical Center (2.2 miles)
  • Blank Children’s Hospital (2.4 miles)
  • Broadlawns Medical Center (2.8 miles)
  • Mercy Medical Center – West Lakes (3.9 miles)
  • Methodist West Hospital (4.2 miles)

2. Inform the medical staff that your injury is work-related.

When you arrive at the emergency room, inform the medical staff that your injury is work-related. This will ensure that your medical records are properly documented and that your workers’ compensation claim is properly processed.

3. Notify your employer as soon as possible.

In Iowa, it is crucial to promptly notify your employer about a work-related injury. According to the Iowa Workers’ Compensation Act, you are required to inform your employer of the injury within 90 days of its occurrence. Failing to provide timely notice may result in a denial of your workers’ compensation claim.

4. Keep detailed records of your medical treatment.

Keep detailed records of your medical treatment, including the names of the medical staff who treated you, the tests and procedures you underwent, and any medications you were prescribed. This information will be important when filing your workers’ compensation claim.

5. Follow up with your employer and insurance provider.

After you have received emergency medical treatment, follow up with your employer and insurance provider to ensure that your workers’ compensation claim is properly processed and that you are receiving the medical care and financial support you need.


In conclusion, the workers’ compensation system in Iowa provides coverage for emergency room visits only under certain circumstances. When an employee sustains a work-related injury or illness that requires immediate medical attention, including emergency room services, they may be eligible for workers’ compensation benefits.

However, it is essential for workers to promptly report their injuries to their employers and follow the necessary procedures to ensure that their workers’ compensation claims are properly filed and processed.

It is also advisable to consult with an experienced workers’ compensation attorney to navigate the complexities of the system and maximize the chances of receiving the full benefits entitled to them. Ultimately, the availability of workers’ comp pay for emergency room visits in Iowa aims to protect and support workers who have suffered injuries or illnesses in the course of their employment.

Call the Platt Law Firm for more information about your rights after a work related injury at 515-346-6659.