Reopening a Workers' Compensation Claim

Reopening a workers’ compensation claim is possible under certain specified conditions. When a worker’s physical condition related to the claim gets worse, additional medical benefits are worthy of consideration. Other matters that may allow or require the reopening of a claim include cases in which an error was made or the worker received excessive compensation. Fraud is a very justifiable reason to reopen a claim. Omission or mistaken matters of material facts also form a basis for reopening a claim. If you wish to reopen a workers' compensation claim, there are some things to keep in mind.

Meet time requirements

Time limits that affect your ability to reopen your claim have specific guidelines that you have to follow. If you are seeking more compensation, you have to file a petition within six years of the time you were injured. You may also pursue it within two years of the date that you received your last compensation payment. If you are seeking medical benefits, you have six years from the time you were injured or two years from the last payment you received for medical benefits.

Full and final payment

Some cases are considered closed if they are judged to have received a full and final payment. In cases like this, neither you nor your insurance company can reopen the claim. Some exceptions do apply if fraud was involved or if mutual mistakes in the claim were made. You have to provide compelling evidence of either of these conditions to have a chance of reopening your claim. At that time, the participation of an administrative law judge is required.

Guidelines are clear if you choose to reopen your claim. Certain conditions allow you to do so if you make a petition within the time periods that are specified.

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