Can you reopen a work comp claim?

May 18 2017

When a worker suffers an injury that leaves them completely disabled for a short period, he or she can look to temporary total disability benefits to help alleviate some of the inevitable financial hardship. Similarly, when an injured worker is only able to perform modified duties with reduced hours or reduced wages, he or she can look to temporary partial disability benefits.

As encouraging as this is, questions naturally arise as to what happens if an injured worker discovers that they will require additional temporary disability benefits and/or medical care after their claim has been effectively closed.

Can I reopen my claim after it’s been closed?

Those who find themselves in this situation can seek to reopen their claim by filing a Petition to Reopen directly with their insurer.

Do I need to state a reason for reopening my claim?

Yes. There are only three recognized reasons for reopening a closed claim: error, mistake or a change in condition.

Is there any sort of deadline?

In general, the Petition to Reopen must be filed either within 1) two years of the date the last work comp benefits became due and payable, or 2) six years of the date of the injury, whichever is longer.

It’s important to note that if these deadlines have passed, but you are only seeking medical care, not temporary disability benefits, you are permitted to petition to reopen your claim provided that this occurs within two years of the date the last medical benefits became due and payable.

What if I signed a written settlement agreement with the insurer waiving my right to reopen the claim?

In this situation, the claim can only be reopened on the grounds of mutual mistake of material fact or fraud, meaning options are limited.

If my claim is reopened, how will temporary disability benefits be calculated?

Temporary disability benefits will be calculated according to your wages at the time of the original injury. Furthermore, if the claim is reopened, it will generally have no impact on amounts previously paid by the insurer.

What if the insurer refuses to reopen?

If the Petition to Reopen is denied or ignored by the insurer, you can file an application for a hearing before the Colorado Office of Administrative Courts.

Consider speaking with a skilled legal professional as soon as possible if you have question or concerns relating to this or another complex work comp-related issue.