The question of how to reopen your Labor and Industries workers’ compensation claim is an important one for many people. Not everyone needs to have their claim reopened, but for those that do, there are some important things to remember.
Why would someone reopen a workers’ comp claim?
If you were injured on the job, had a workers’ compensation claim, and your condition is recurring or getting worse after the claim has closed, you might be able to reopen your claim. However, there are legal stipulations to keep in mind, and we’re here to help you think like a lawyer when looking at your claim.
The first thing to understand is the seven-year rule: From the date you receive the closing order, you will have seven years in which to apply to reopen your worker’s comp claim, whether this is a state fund or self-insured employer. After seven years, the claim will expire.
When does a workers’ comp claim close?
When the Department of Labor and Industries has determined that your industrially related medical conditions are fixed and stable, your claim will be closed. This destination of fixed and stable does not mean that you are back to your pre-injury medical condition. It simply means that there is no more medical care that can be offered to you that is curative, rehabilitative, or diagnostic. When you become fixed and stable, your claim will be closed.
As a practical matter, it is always best to rely upon the date of the closing order itself and not be compelled to engage in an argument about when you actually received the closing order. At the point of the closing order, the seven-year clock begins to run.
It’s important to know that the key to the seven year limit is the date when the Department or self insurer receives the application to reopen, not the date you go to the doctor’s office and complete the application.
Note: If your application is received after the seven-year time limit, your worker’s comp claim can only be reopened at the discretion of the direction of the Department of Labor and Industries, and your benefits will be limited.
What is the process for reopening my claim?
Once your application is received at the Department, your case will be evaluated to determine if there is medical evidence of worsening. In the case of physical impairments, the inquiry will be whether the medical evidence is objective.
Legally, objective medical evidence is that which can be seen, felt, or measured. It does not, however, include subjective complaints of pain. Pain complaints are often what drive people in to see their doctor, and they are relevant to the extent they correspond with the objective medical evidence. However, subjective complaints of pain and discomfort alone are not sufficient to get your claim reopened.
If your impairment is psychological and you have been diagnosed with a mental health disorder, then objective evidence of worsening is not required. The reason is simple: mental health disorders cannot be diagnosed with objective medical science such as MRI, EMG, blood tests, or any other medical tool.
However, you will still need the support of your mental health provider stating that your mental health condition which is related to the industrial injury has worsened compared to when your claim was closed.
Can I apply to reopen my claim more than once?
Some people apply more than once to reopen their claim. This is permitted within the seven-year window. Remember that the seven years begins to run, the clock begins to tick from the date of the first closing order that became final. However, an injured worker, within that seven year time frame, can apply to reopen their claim as many times as they wish.
The prudence of reopening a claim multiple times is another matter. If a person applies multiple times to reopen their claim, the question before the Department will be whether there has been worsening of the industrially related condition(s) relative to the previous application. This often makes getting a claim reopened more difficult when the injured worker has applied multiple times to reopen the claim. Therefore, as a practical matter, it is best to limit the number of times a person tries to reopen the claim until they have solid medical support from their doctor.
For more on how to reopen a workers’ compensation claim, consult the information on the Washington Labor and Industries website.