If you are injured at work, your employer’s workers’ compensation insurance evaluates the benefits you are entitled to as compensation. These benefits can include medical expenses, temporary full or partial disability, healing period benefits, and permanent full or partial disability payments. Some of these benefits are payable over a long period of time—even permanently. If your condition changes in the future and your benefits are no longer appropriate for your situation, you may be able to reopen your workers’ compensation claim and request a re-evaluation of your benefits.
When Is a Re-Evaluation Appropriate?
The Iowa workers’ compensation statutes provide that a claimant may petition to reopen a workers’ compensation claim within three years of the last payment of weekly benefits under the award or agreement. If there has been a change of condition in a worker’s situation since the case was settled or went to hearing, the injured worker may be able to receive additional disability benefits. The change in condition must be related to the original injury (for example, a worsening of an original injury, or an additional condition that developed later as a result of the original injury).
The change can be either physical (in the case of an additional or worsening injury) or economic. Workers’ compensation may pay a lump sum amount when an injury results in permanent disability. The amount of this benefit is calculated by determining the degree of your permanent disability and how it impairs your ability to work and enjoy a normal life; a monetary award is determined based on this percentage. If the affect on your ability to work and enjoy a normal life changes significantly, and the change is a result of the original disability, you may be entitled to a re-evaluation of this benefit amount.
How Settlement Can Affect Your Ability to Reopen Your Claim
Your case can only be reopened if it was resolved in certain ways. If your case is resolved in an agreement for settlement, also known as an “open file,” you may reopen your case if your economic or physical condition changes. An open file typically means that your medical expenses remain open and can be paid by the workers compensation insurer.
The other way your case can be reopened is if you received an award from a judge without settlement. The statute of limitations for reopening your case after a decision is three years from the last date of payment of benefits.
You may not reopen your claim if you settled your case in a compromise settlement or “closed file” settlement, in which the insurance company will no longer pay any medical benefits. If you settled your claim on a compromise settlement and signed paperwork to do so, it is possible that you have given up your right to have your case reopened. In this case, it is beneficial to evaluate whether or not there has been a new injury that can be claimed. If you are unsure how you settled your claim or if your claim is eligible for reopening, contact the Platt Law Firm to have us review your case.
Maximum Medical Improvement
You should always wait until you reach maximum medical improvement before you consider settling your workers’ compensation claim so you have a reasonably certain medical opinion about the extent of the permanent damage caused by your injury. Even after you reach MMI, however, you may know that there is a significant possibility of future treatment or impairment, or your physician may recommend ongoing care or physical therapy to mitigate impairment or reduce the recurrence of pain. Consult with an experienced workers’ compensation attorney before agreeing to settle your claim if there is any chance that your condition may worsen in the future. If you sign a “settlement and release” agreement with the workers’ comp insurer, you may lose your right to collect additional benefits or renegotiate your settlement—even if your condition worsens.
If you’ve been injured in a work-related accident, the skilled attorneys at the Platt Law Firm can help you pursue an Iowa workers’ compensation claim. We’ll help you determine the size of your claim, decide whether it’s time to settle, and pursue your best options to get the benefits you deserve.