There are some differences between personal injury lawsuits and workers’ compensation cases. We’ll focus on just one here. The ability to reopen a claim is unique. It may be to the chagrin of employers and their insurance companies alike. Most workers’ compensation cases are subject to modification within specific time periods.
It’s not that you can just reopen a workers’ compensation claim because you want more money. Quite the contrary. There must be a legitimate reason to file a reopener. Again, some settled claims can never be reopened. We’ll explain.
Important Information about Reopener Claims
Let’s start with a real case example to help you understand the process. Ancelot Daniel worked for United Airlines as a baggage handler. In 2006, Daniel injured his cervical spine in a work-related accident. His attorney filed a formal Claim Petition and Daniel was awarded 22 ½% of partial total disability for his injuries. The claim was settled with judicial approval on December 6, 2007.
Daniel’s condition deteriorated. In July 2009, new paperwork was filed requesting a review and modification of the 2007 award. Subsequently, Daniel’s partial total disability increased to 30% of partial total disability. This meant that Daniel received the difference between 30% and 22 ½% when the case ended after the reopener claim. The amount paid was in accordance with the rates established for 2006 accidents.
Although his award had increased, this still left Daniel with the ability to reopen his claim. In 2012, Daniel’s attorney did so again and filed a motion requesting additional medical treatment. Daniel was having problems with his shoulder and felt they were related to the original accident. After listening to medical expert testimony, the court denied his application.
The Daniel case is a good one to read as far as understanding reopener claims. We’ve written about modifications to workers’ compensation awards. We suggest reviewing this link for some important details that we will summarize below:
- Cases that cannot be reopened: You cannot reopen a case that has been settled under J.S.A. 34:15-20. We’ll provide you with information about this type of lump sum settlement later this week.
- Modification of agreements: Reopener claims are requesting modification of agreements. According to J.S.A. 34:15-27, the request to reopen a case must be within two years from the last date that the injured party received payment related to the case.
- Reason to Reopen a Case: In addition to reopening the case within the prescribed time period, there must be evidence that the injured worker’s disability has increased since the last workers’ compensation award or settlement.
Contact Us
Have questions about reopening a workers’ compensation case? At the Law Offices of Anthony Carbone, we have helped a number of clients modify existing workers’ compensation awards. Contact us to see how we can assist you.