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As a general rule, a workers’ compensation settlement will not be finalized until the claimant’s medical condition has become fully stabilized so that the severity of the injury and the extent of necessary treatment that will be required is known by all parties. This way, the injured worker can have access to the full extent of fair financial compensation that they deserve. Of course, medical care and physical recovery can be rather unpredictable. You may have cause to reopen your workers’ compensation claim, if you find out later that you need new treatment for your injury or that your related disability has significantly worsened. These are grounds for filing a petition to reopen the case. A petition to reopen must be filed within five years of the date of your injury. After those five years have passed, a petition to reopen can be barred, according to state law.

What Are The Criteria To Reopen A Workers’ Compensation Case?

The general criteria to reopen a Workers’ Compensation case is to prove that an injured worker has new and further disability stemming from their original injury. This generally requires proving some demonstrable change in an employee’s health condition, such as a worsening or deterioration of their health which requires new and/or further medical treatment.

The law does not allow injured workers to re-litigate their workers’ compensation cases multiple times. You cannot reopen your workers’ compensation case just because you did not like the result you were given or you found it to be unfair. Reopening your workers’ compensation claim does not have the same effect as filing an appeal. In order to reopen their case, an injured employee has to prove that something in the case has changed, either because a new type of treatment is required or because the injury is becoming more severe or new injuries have developed as a consequence. Additionally, it is a requirement that the change to the injury must have not have been able to be reasonably foreseen at the time that the initial decision was made in the case.

Can I Reopen A Workers’ Comp Claim If I Was Denied Benefits?

If your claim for workers’ compensation was denied, you will first need to find out exactly why. This information should be contained in the denial letter. You could have been denied for not meeting the basic eligibility requirements due to being injured while engaging in horseplay or while away from the worksite. If you believe that the denial was reached in error, you may not reopen the case, but you may appeal the denial by seeking court intervention. Common reasons for a denial include:

  • The injury was not reported in time
  • The claim was not filed in time
  • The employer disputes the claim
  • The injury is not compensable
  • No medical treatment occurred
  • There is insufficient evidence that the injury is work-related

Once you know precisely why your claim has been denied, you can then decide whether or not to appeal the decision. Before seeking court intervention, you may wish to conduct discovery, such as seeking medical opinions, requesting records or documents and conducting depositions if necessary, in order to help support the merits or validity of your claim. You should of course engage in some form of discussion with the defense as well to see if you can resolve any disputes informally. Ultimately however, you have the right to request a hearing before a workers’ compensation judge to resolve any such disputes. Keep in mind however that a workers’ compensation appeal can be a rather complicated legal process that should be handled by an experienced workers’ compensation attorney. The appeals process will likely involve discovery as well as court hearing(s) before an administrative law judge.

Can A Settled Workers Compensation Case Be Reopened?

If a workers’ compensation case was settled by way of a Stipulated Award or by a Findings and Award issued by a judge, then the injured worker can reopen their case if they have a new and further disability.

A petition to reopen the claim must be filed within five years of the injury date. After five years, the petition to reopen can be barred. In order to successfully reopen their workers’ compensation case, the injured employee must be able to prove that they have either a new disability or additional disability that resulted from the original injury which was settled.

You cannot reopen your workers’ compensation case simply because you did not like the results. Reopening the case is not the same as filing an appeal. To reopen the case, the injured employee must prove that their condition has changed and that the change could not have been reasonably foreseen when the initial decision was entered.

How Do I Reopen A Settled Workers’ Comp Case?

In order to reopen your workers’ compensation claim, you must file a Petition to Reopen within five years of the original injury date. This petition should include an explanation of why the case should be reopened based on new and further disability. You should include copies of medical records establishing the existence of new and further disability and causation to the initial injury. If you are considering reopening your claim, you should consult with an experienced California workers’ compensation attorney.

Can I File A Claim For The Same Injury Twice, If One Is For The Aggravation Of An Old Injury?

If you have already filed a claim for a work-related injury and then subsequently re-injure yourself as a result of the initial injury, you do not need to file a second and separate claim. You should still be eligible to receive medical benefits for the new, related injury.

If your original injury has merely gotten worse within five years, the proper course of action would be to file a petition to reopen your workers’ compensation case. You would need to be prepared to show proof that your condition has worsened or that you now require a different course of medical treatment, in order for the case to be successfully reopened.

For more information on Time Limit To Reopen A Workers’ Compensation Case, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (818) 949-1918 today.

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KCNS Law Group LLP

Understand Your Rights Today
Call Us Now (818) 937-9255
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