Have you been injured on the job and received workers’ compensation benefits, but now find yourself needing additional medical treatment? Did you know that you may be able to reopen your workers’ comp claim?
Workers’ compensation is a state-mandated insurance program that provides benefits to employees who are injured or become ill as a result of their job. These benefits typically cover medical expenses and lost wages. However, sometimes the initial benefits may not be enough to cover all of the necessary medical treatment.
If you find yourself in this situation, it’s important to know that you may have the option to reopen your workers’ comp claim. This process can be complicated, and it’s essential to understand the requirements and procedures involved.
In this article, we will discuss the ins and outs of workers’ comp claim reopening and provide you with the information you need to make informed decisions.
Standard criteria for reopening a workers’ compensation case
On a regular basis, our firm receives phone calls from people asking about claim reopening. Here are a few important facts to consider before applying for workers’ compensation claim reopening.
- A claim is not eligible for reopening if less than three hundred dollar was expended by insurer and claim closure was not appealed.
- A claim which did not result in being out-of-work and/or the Nevada injured worker did not have a rating evaluation for ppd can only be reopened w/in 1 year of claim closure
- There is a higher standard to meet for reopening within one year of claim closure. In that case, the application must be:
- Supported by medical evidence demonstrating an objective change in the medical condition of the claimant; and
- Proven by clear and convincing evidence that the primary cause of the change of circumstances is the injury for which the claim was originally made.
- A claim may be reopened for medical investigation only. During this time the insurer will typically arrange for you to see a physician chosen by the insurance company to confirm or rule out claim reopening. As can be expected, some doctors are more likely than others to opt for reopening.
- If the above situations do not apply, reopening should be granted upon application accompanied by a written request for treatment from the physician or chiropractor treating the claimant.
How to Reopen A Settled Workers’ Comp Case?
If you have a settled workers’ comp case, you must take the necessary steps to reopen it.
- Determine the reason for reopening the case, whether it is due to a change in circumstances or a mistake in the original settlement.
- Contact your state’s workers’ compensation agency to inquire about the process for reopening a settled case.
- Provide evidence to support your request to reopen the case, such as new medical documentation or evidence of a mistake in the original settlement agreement.
- Attend any necessary hearings or meetings to present your case and discuss potential options for resolution.
More benefits available post-settlement.
In some cases, it may be possible to receive additional benefits after a workers’ compensation settlement. To do so, it is important to understand the terms of your original settlement agreement and how they may apply to your specific circumstances.
If you believe that you are eligible for more benefits, contact your state’s workers’ compensation agency or an experienced attorney to discuss your options for seeking additional payments.
Get the legal help you need from a qualified attorney today!
Reopening a workers’ compensation claim is often a complicated process and the law can vary by state. If you are considering reopening your workers’ compensation claim, it is strongly recommended that you seek legal advice from an experienced attorney who understands the complexities of the law. Let Shook & Stone be your trusted partners to navigate the reopening process. Contact us for a free consultation.
