Reopening a Closed Workers' Compensation Case

If you're within certain time limits, you might be able to get additional workers' comp benefits.

Under certain circumstances, you may reopen a closed workers’ comp claim. Typically, you must show that your injury worsened or you have new evidence. Every state has different rules about how and when you can reopen a case. If you do not follow these rules, you may become ineligible for workers’ comp benefits.

Do You Have a Qualifying Reason?

You cannot reopen a claim simply because you had a change of heart. In most states, you may reopen a closed claim if:

  • your medical condition has worsened
  • your wage-earning capacity has decreased
  • there is newly discovered evidence (for example, a newly developed medical test that diagnoses or explains your condition)
  • there was a legal or factual mistake, or
  • the insurance company acted fraudulently.

To reopen a workers’ comp claim, you must have medical records or other evidence documenting your changed condition, mistake, or the fraudulent behaviors. Without supporting evidence, your statements may be insufficient grounds to reopen. It is important to gather your evidence before filing a request to reopen your workers’ comp claim.

How Did You Resolve Your Workers’ Compensation Claim?

Your ability to reopen your claim also depends on how it was resolved. If you were awarded benefits by a workers’ compensation judge after a hearing, you typically can reopen your claim if your condition worsens. If a workers’ comp judge denied benefits after a hearing, it can be more difficult to reopen your workers’ comp claim: Typically, you’ll need to show that there is new and compelling evidence that was not available at the time of your previous hearing.

You can also reopen your workers’ comp case if you settled your case, unless your settlement was considered “full and final” (also called a “compromise and release”). With this type of settlement, which is common in many states, the worker receives a lump sum in exchange for releasing all claims related to the injury. If you have agreed to a full and final settlement, you typically will not be able to reopen your claim—even if your condition has worsened.

Some states impose limitations on all types of settlements. For example, a few states prohibit the settlement of medical benefits. In these states, all future medical care is covered without the need to reopen your workers’ comp case. Other states restrict settlement to known injuries or injuries on specific dates, meaning you can claim additional benefits if you discover another medical condition or reinjure yourself. These rules can be complex; if you need help understanding your state’s workers’ comp laws, contact a lawyer or your state workers' compensation agency.

Are You Within the Time Limits to Reopen Your Claim?

States have different deadlines for reopening a closed workers’ comp claim. In New Jersey, you must reopen a Section 22 settlement within two years of the settlement; In New York, you must reopen a Stipulation & Award settlement within five years of your date of injury. (These settlements are not full and final settlements.) In California, you have five years to reopen a workers’ comp case after a judge has issued an award after a hearing.

In some states, there is a limited time period when you can cancel a settlement agreement—even one that is considered “full and final.” For example, if you settle a Michigan workers’ comp claim, there is a 15-day period where you can ask the state agency to overturn your settlement if you have good cause (such as a worsening of your condition or the discovery of a new work-related injury). After 15 days, your claim is permanently closed and you typically cannot reopen it.

How to Reopen a Workers’ Compensation Claim

Insurance companies usually don’t agree to reopen workers’ comp claims voluntarily, so you’ll need to file a request to reopen with your state workers’ comp agency. The passing of time, subsequent non-occupational injuries, and other factors can complicate the reopening of a claim. You should file your request as soon as possible. You should also contact the workers’ comp lawyer who helped you with your original claim. (If you didn’t have a lawyer, or you need a new one, see our lawyer directory.)

The reopening process varies from state to state. Typically, you must file a form or letter with the state workers’ compensation agency and send a copy to your employer or its insurance company. You should attach documents that support your claim (such as medical records showing your worsened condition) to your request to reopen. A hearing may also be scheduled to determine your eligibility for benefits.

Filing a New Workers’ Comp Claim

If you cannot reopen your old workers’ comp claim, you may be able to file a new claim in some cases. This option is available if the worsening of your condition can be considered a new injury altogether. You may be able to file a new claim, for example, if:

  • you aggravate your injury at a new employer’s workplace, or
  • you have a new injury that is unrelated to your previous claim.

You must follow your state’s notice and claim rules. If you do not follow the correct procedure and meet your state’s deadlines, you may be ineligible for workers’ comp benefits. See our page on filing a workers’ comp claim for more information.

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