Can You Reopen a Closed Workers’ Compensation Case in Kentucky?
When you are awarded workers’ compensation benefits in Kentucky, what is called your impairment rating—for instance, you could be medically judged to be 30 percent impaired—figures into the cash benefits you receive for being unable to work. Your medical benefits could also be affected by the rating.
A person’s impairment can worsen over time. If that happens, you might wonder: "Is it possible to go back and reopen my claim so I can increase your benefits?" This is a valid question. Many of our clients wonder what would happen if their original claim was denied, but their condition from a work-related accident or toxic exposure reappears or worsens. Could they reopen the denied claim and start receiving benefits?
The answer depends on how long ago your claim was granted or denied, and also on how strong the medical evidence is that you will submit to justify reopening a claim. There are other reasons established under Kentucky law for reopening a claim, but the primary one is typically that a person’s condition worsens.
If you need to file to reopen a workers’ compensation claim in Louisville or anywhere else in Kentucky, contact the husband-wife attorney team at Slechter Law Firm, PLLC. The process can be challenging, but they can help you assemble the medical and other evidence necessary to bolster your case for reopening.
Mr. and Mrs. Slechter proudly serve clients in Louisville, Lexington, and the rest of the Commonwealth of Kentucky.
What Kentucky Law Says about Reopening a Claim
Kentucky Revised Statutes Section 342.125 lists four reasons for which a workers’ compensation claim, denied or granted, can be reopened:
Fraud
Newly discovered evidence
Mistake
Change in disability (impairment) as shown by “objective medical evidence of worsening or improvement of impairment due to a condition caused by an injury since the date of the award of order.”
Fraud refers to actions by an insurance company to unjustifiably deny a claim. Mistake means the insurer made an error in deciding a claim, whether it was to deny or to misclassify the impairment rating or compensation due. Newly discovered evidence is just that, which would apply to a claim that was either denied or wrongly classified. The last listed reason applies to those whose impairment, or disability, worsens over time.
The section also sets a statute of limitations for reopening a claim, which is “four (4) years of the award or order….” Order refers to either a denial or a previous determination by an administrative law judge (ALJ).
No matter your specific situation, it's important to contact a workers' compensation attorney for guidance.
Qualifying Reasons for Reopening a Claim
By law, the reason to reopen a claim must be one of the above. Suppose you’re out on Permanent Partial Disability (PPD) with an impairment rating of 20 percent. That impairment rating is used to determine your compensation rate. Two years after being awarded PPD at that rating, your condition worsens. Your physician now declares that you have an impairment rating of 40 percent. You could then file to reopen the claim so that your compensation can be increased.
If your original claim was denied and you can show that fraud or a mistake on the part of the insurer led to the denial, or that you have new evidence to justify your claim, then you may be able to file to reopen as well.
How to File to Reopen a Workers’ Compensation Claim
To have your earlier claim reviewed, you will need to file a Motion to Reopen with the Kentucky Department of Workers’ Claims. You will also need to submit, along with the form, supporting evidence for your motion to reopen, including a full and recent medical report that substantiates your motion, a medical release form, an employee affidavit, a copy of the original award, settlement, agreement, or resolution, and other pertinent documents.
From that point on, your motion will be treated like any other dispute over workers’ compensation.
Again, the services of a skilled attorney will be vital here.
How Settlements Can Affect Your Case
If you reached a settlement agreement with your workers’ compensation insurer—for instance, you took a lump-sum payment—this could have a major effect on the possibility of reopening your claim. Insurers will generally require you to waive your right to make any future claims for your injury or illness if they provide you with a lump sum.
This type of settlement is often called “compromise and release.” Unless you can show fraud on the insurer’s part, you cannot reopen a claim stemming from a settlement with a “compromise and reason” component.
Proceed With Confidence With the Slechters at Your Side
Reopening a workers’ compensation claim is a challenging proposition. Both the Department of Workers’ Claims and the ALJ hearing your case are going to demand solid documentation and a solid rationale for reopening.
If you’re in Louisville, Lexington, or anywhere in Kentucky and you’re looking to reopen a workers’ compensation claim, contact Slechter Law Firm, PLLC to help you assemble the documentation needed and then stand by your side as you navigate the system.