This issue comes up after a claim
has been closed. If a work injury or industrial disease condition changes or worsens, the
worker may request that the workers' compensation insurer reopen the claim
for further medical treatment and benefits.
If your job-related medical condition changed after
your claim was closed and you need treatment, or vocational
rehabilitation, you must:
- Provide your doctor's written
statement of your need,
- Ask your claims representative in
writing to reopen your claim. Make sure your doctor's letter gets to
the adjustor. Keep copies of any documents you provide to the
Your Doctor must write a letter which
- Your condition has changed or worsened since claim closure.
- You need treatment.
- A description of the
- That there is a direct relationship between your
worsened condition at the time you ask for reopening and your original
- Your work injury is the primary cause for your need to
reopen your claim.
Effect of Retirement:
retired or voluntarily left the workforce for reasons unrelated to your
injury before you file for reopening, you are entitled only to medical
benefits; not lost wages.
One Year Wait:
claim is closed, or your reopening request is successfully denied, you cannot make
another request to reopen until one (1) year has passed, absent unusual
Request Within One Year:
you originally had no lost time and no Permanent Partial Disability, you
must request reopening within 1 year of the date your claim was closed.
If your claim was closed because your medical
treatment cost less than $800 in the first 12 months, you probably cannot
Reopening for PPD:
You may be
able to reopen for Permanent Partial Disability if you were entitled to
it and your case was closed without the insurer granting you PPD