A “reopener” is an informal term for a modification of a workers compensation claim. Either party can request a modification after a workers compensation claim settles.
No party has an unlimited right to reopen a workers compensation claim. The modification may only be requested up to two years after the last time compensation was paid, or from the date of an awarded Judgement.
When may an employee reopen a workers compensation claim?
An employee may reopen a workers compensation claim when one of the following is true:
- They need additional treatment for the same work-related injury.
- They have lost additional time as a result of the same work-related injury.
- They need an increase to the amount of permanent partial disability that they’re receiving.
In other words, somewhere along the way your condition got worse. This can happen even if you’ve reached maximum minimal improvement (MMI) as MMI is a measure as how much your condition will ever improve, not a guarantee that your condition will never deteriorate.
When may an employer reopen a workers compensation claim?
An employer might seek to modify the workers compensation claim when they have reason to believe your disability has diminished. They may also do so in cases where they believe that you are working for another employer while continuing to receive benefits.
How can an employee prove they need a modification of a workers compensation claim?
You will have to provide medical evidence that your condition has gotten worse. This can include:
- MRI results
- X-Ray results
- Other diagnostic test results
“Increased pain” is not generally an objective enough measure to warrant the modification of a workers compensation claim. Pain is too subjective a measure to help you in this particular case, even if you are having more trouble carrying out your day-to-day tasks.
This proof must show some sort of significant change between your condition at the time of settlement and your condition at the time that you are seeking a modification of your settlement.
What is a Section 20?
A “Section 20” is a lump sum settlement. Once you accept a “Section 20” you cannot reopen a claim petition ever again. Your employer and their insurance company will no longer be responsible for providing you with medical treatment.
Rest assured that if you seek a modification of your workers compensation claim your employer will push for a Section 20 as a final solution.
Obviously it is critical to work with an attorney before accepting any sort of lump sum settlement. You will want to ensure that the settlement is fair, that is, sufficient to cover your losses pursuant to the worker’s compensation case.
How to Reopen a Workers Compensation Claim
The best way to seek a modification of your worker’s compensation claim is to reach out to an experienced workers compensation attorney. Ideally you would have been working with an attorney long before seeking modification, but if you haven’t it’s time to start.
Contact Talone Law to schedule a consultation today. We can help you bring your modification action to its best possible conclusion.