Iowa Injury Absence Report

State:
Multi-State
Control #:
US-AHI-276
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This AHI form is used to document an absence due to work-related injury. The form also includes the number of hours lost due to the injury. This form must be submitted prior to the close each pay period.

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FAQ

In general, the statute of limitations to file your Iowa Workers' Compensation claim is 2 years from the date of your injury. This means you must either have started receiving benefits or have filed an application for arbitration within this time frame.

Does Iowa have a short-term (temporary) disability benefits program? Iowa does not have government sponsored short-term disability, but some employers offer this as a benefit or the individual may be covered by the Family Medical Leave Act or Worker's Compensation.

A Workers' Compensation claim must be made within six months of the date of injury or incident. The sooner you start the claim, the better.

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12

Your employees have 90 days to notify you of an injury or illness. You or your insurance company will then have to electronically file a First Report of Injury or Illness report within four days. Once a claim is filed, your injured or sick employee can receive benefits.

The Family and Medical Leave Act (FMLA) is a federally mandated program that entitles eligible employees to unpaid, job-protected leave for specified family, medical, and military reasons, as well as continued group health insurance coverage under the same terms and conditions as if leave had not been taken.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

Employees in Iowa may take up to 12 weeks of leave in a 12-month period for a serious health condition, bonding with a new child, or qualifying exigencies. This leave is available every 12 months, as long as the employee continues to meet the eligibility requirements explained above.

Step 1: The employee must report the disablement, in writing, to his/her employer as soon as possible or within 12 months from the date the disability occurred. Step 2: The employer must report work-related injury to the Fund within 7 days, or the work-related disease to the fund within 14 days.

Eligibility. Any employee who has been employed by the state for a total of at least 12 months in the past seven years and has worked for at least 1,250 hours in the previous 12-month period is eligible. Eligibility determinations are made as of the date that the FMLA leave is to begin.

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Iowa Injury Absence Report