When an injured worker has his/her closed, under RCW 51.32.160, the worker has a right to reopen their claim, with certain requirements and limitations. First, the right to reopen for worsening accrues to the injured worker and last for seven years from the date of the first closing order that becomes final. The Department of Labor and Industries, or the Self-Insured employer, must receive that application to reopen from the injured worker no later than seven years from when the first final closing order. It is important to understand two things here. First, that the burden to see the application is submitted rests with the injured worker, not the worker’s medical provider. Second, the two dates that are important to remember are the date of the first final closing order as this begins the seven year time limitation to file for reopening of the claim, and the date that the application to reopen is received.
Once the application to reopen is received, the Department of Labor and Industries has 90 days to respond. For good cause, the Department may extend this period by issuing an order indicating they need more time to make a decision and by statute, they are given an additional sixty days. If the Department fails to issue an order extending the time to consider the application to reopen, and, fails to issue a determinative order either reopening the claim or denying the reopening, then the application to reopen is “deemed granted”. Similarly, even if the Department extends the time to decide on the application to reopen, this can only be extended once and if the Department fails to issue a determinative order even after the sixty day extension, then the application to reopen is deemed granted.
When applying to reopen a claim, the burden rests with the injured worker to show that there is objective medical evidence that the industrial injury or occupational disease condition(s) worsened. It is important for the worker’s medical provider to document clearly the medical findings which form the basis for reopening. When the medical condition being claimed to have worsened is a mental health condition, by definition there is no such thing as an objective medical finding, findings based upon an x-ray for example. However, the treating psychologist or psychologist will still need to provide a description of the basis for worsening.
If you have additional questions, contact an experienced worker’s compensation attorney.