When an employee is injured on the job, he or she is entitled to workers’ compensation benefits to pay for necessary medical treatment and cover a portion of lost wages. Ideally, the injured worker will recover completely and return to work, and the settlement will remain closed. In many cases, this is exactly how it happens, but sometimes, the worker’s condition may deteriorate, or long-term disability issues may arise. When this happens, it may be necessary to reopen the workers’ comp case so the individual can receive additional benefits.
But not all workers’ comp cases are eligible for reopening. The more you know about the process before you accept a settlement agreement, the more protected you can be in the event that you do need to reopen your case. Here’s what you need to know:
WHICH WORKERS’ COMPENSATION CASES ARE ELIGIBLE FOR REOPENING?
There are several factors that go into reopening a workers’ comp case, and they begin with the original settlement agreement. In California, you can negotiate a settlement that will provide you with a lump sum or one that provides you with weekly payments. The choice will impact your ability to reopen your workers’ compensation case at a later date. The two different types of settlements in a workers’ compensation case include:
- STIPULATED FINDINGS AND AWARD
When you settle your case with stipulations, you are agreeing to receive your benefits in payments every two weeks. If your condition worsens, you can apply for additional payments anytime within five years from the date of your injury. Your rights to future benefits are also fully protected if you have received a life pension or need additional medical care. If you can show hardship, you may be able to convince a workers’ comp judge to agree to a lump sum payment of these benefits.
- COMPROMISE AND RELEASE
A compromise and release (C&R) settlement is paid in one lump sum. That sum may be more than you would receive with a stipulated settlement because you’re giving up your future rights to additional benefits. C&R settlements permanently close your workers’ compensation case and release your employer from all future responsibilities. If you later die as a result of your injuries, your dependents will not receive death benefits. The only benefits you may be entitled to in the future are vocational rehabilitation benefits.
If you’re unclear about your settlement options, it’s best to contact a worker’s compensation lawyer before you sign anything.
HOW TO FILE A PETITION TO REOPEN YOUR WORKERS’ COMPENSATION CASE
In the event that your worker’s comp case was settled with stipulated findings and award, and you have sufficient evidence to support reopening the case, here are the steps you can take to petition for additional benefits.
Step 1: Get a medical report from your doctor saying that your condition has worsened
Step 2: Gather any additional facts that support your case
Step 3: Complete the Petition to Reopen form
If the insurance company won’t voluntarily open your case, you’ll need a hearing. There are a couple of steps you need to take to get one going.
Step 4: File a Declaration of Readiness to Proceed
Step 5: Gather the following documents and put them in this order:
- Document cover sheet
- Document separator sheet
- Petition to Reopen
- Document separator sheet
- Proof of Service by Mail
Step 6: Send the original to your local Workers’ Compensation Appeals Board (WCAB) office and copies to all parties.
Step 7: Keep a copy for your records
Remember, you have five years from the date of injury to petition to reopen your case.
Your best-case scenario depends on the best workers’ comp lawyers in San Diego
Reopening a workers’ compensation case is a complex process, and having a workers’ compensation lawyer on your side will give you the best chance. At The Law Office of Matthew Russell, we have a reputation for fighting hard on behalf of injured workers. If your condition has gotten unexpectedly worse, or you’ve discovered you’re more disabled than you’d realized, we may be able to get your workers’ comp case reopened so you can receive the additional benefits you’re entitled to.
Give us a call today at (619) 544-1506. Consultations are always free.