You can reopen a closed workers’ compensation case to get more benefits under specific circumstances in Pennsylvania. In general, your condition must have gotten worse to be able to open your case.
That decrease in function or ability must be the result of the original work injury, too. You cannot reopen a claim for a new injury or an old injury that may just be the result of aging, for example.
A continuing work injury may affect your ability to return to work. Reopening a case will let you get additional wage replacement benefits while you heal and are unable to work. In some cases, you may be able to get medical benefits regardless of whether you can get additional wage payments.
Criteria for Reopening an Old Workers’ Comp Claim
You must meet two general requirements to reopen a workers’ compensation claim.
1. Your condition must have worsened.
Imagine that you hurt your knee in a work accident. You have surgery on the knee, but you have damaged it so badly that the doctor notes that the operation may only be a temporary solution for your knee injury and that you may eventually need to replace your knee.
Everything seemed fine immediately after knee surgery. But, things quickly turned worse after continued use. Your doctor is now recommending a total knee replacement.
The doctor attributes the replacement to the original work injury. He notes that if you had not injured your knee at work, knee replacement would not have been necessary for you.
In that situation, the knee replacement is the result of your original work injury for a couple of reasons. First, your doctor noted back when you had your first surgery that your knee may need to be replaced in the future. Second, your doctor specifically stated that the replacement is because of the work injury.
Under those circumstances, your condition has clearly gotten worse, and it is because of the original work injury. Reopening your case to get additional benefits will likely be an option for you if you meet the second criteria, below.
2. You did not fully close out your workers’ compensation case previously.
In some cases, you will enter a “closed settlement” as part of your workers’ compensation settlement. This type of agreement means that your settlement is the total amount that you can receive for your case.
Unfortunately, if you entered this type of compromise, then reopening your case to get more benefits is likely not an option.
How to Reopen a Workers’ Comp Claim
To get additional benefits, you may need to file a “Petition for Reinstatement.” This petition will request workers’ compensation benefits that are in addition to what you have already received. These are often filed after a worker was previously on light duty or had returned to work but can no longer work or needs additional medical care.
A petition for reinstatement is similar to your first petition requesting workers’ compensation benefits. The difference is that instead of simply showing that you were injured at work, you must also show that your injury is worse than it was before and that your condition was the result of the original injury.
In general, a worker can request reinstatement of benefits within 500 weeks (about nine and a half years) of the date that he or she last received workers’ compensation benefits. If you do not file your petition before this deadline, then you likely will not be able to reopen your case.
How Difficult Is it to Reopen a Closed Workers’ Compensation Case?
The type of injury and your condition will have a huge effect on whether reopening your case is an option for you. If your condition has worsened to the point that it affects your employment, then you are more likely to be able to reopen your case to get more benefits.
The ability to reopen the case is also increased if your condition is serious enough to require additional surgery or other significant medical care. It is certainly not impossible to reopen a case without a serious medical event, but it can make it more difficult.
Reopening a case after a settlement is also an option in some circumstances. However, if you entered a “closed” agreement, that may not be possible. You will be able to tell whether a case is considered closed based on whether you can still get medical benefits.
Completely closed cases do not have the option to get medical benefits at all—and you likely received a lump sum settlement for your claim.
Let Us Help You Reopen Your Workers’ Compensation Claim
If you are unsure whether you can reopen your workers’ compensation case, call the workers’ compensation attorneys at Krasno Krasno & Onwudinjo.
We can take a look at your situation and even review the settlement paperwork that you signed to determine if filing a petition for reinstatement is something that you can do under Pennsylvania law. We can also review the facts of your case and let you know how likely you are to be successful in your claim.
Use the form to your left to schedule a free appointment with a member of our team.