Your condition might have stabilized when you received your workers’ compensation court award or settlement for work-related injuries or illnesses. Therefore, you could have a general idea of the magnitude of ongoing limitations or pain from the injury, plus any requirement for additional medical care.
What if you experience a change in condition? For example, your case can worsen, or new evidence can show you are more injured or disabled than the doctors that examined you said.
You may wonder: “can my workers’ compensation case be reopened?”
While you may assume a worsening condition can entitle you to extra compensation, you may be wrong.
Depending on how you settled your initial medical claim, the law can forbid you from reopening your workers’ compensation case. The good news is you may reopen the workers’ compensation case in some circumstances. We’ll explain below.
Under What Circumstances Can You Reopen a Workers’ Compensation Case?
If you are worried that a worsening condition will hamper your return to work, you may consult an attorney and consider reopening your old workers’ compensation case. South Carolina laws permit injured workers whose conditions worsen to reopen their comp claims.
For example, maybe you had a brain injury while working. Once you get the necessary treatment, you can seek a workers’ compensation settlement or court award. After the compensation, the brain injury might need additional treatment than anticipated, or you may lack the capacity to return to work.
South Carolina laws permit you to request the reopening of your workers’ compensation case within 12 months after getting your last compensation payment. Contacting a lawyer quickly allows you to obtain and file the necessary paperwork to request the reopening of your workers’ compensation case before the stipulated window lapses. It’s advisable to contact an attorney early to avoid the last-minute rush when your condition worsens.
When there’s no clincher agreement, and you’ve had a change of condition, the Commission can diminish, end, or increase your previous workers’ compensation award. S.C. Code Ann. § 42-17-90 outlaws any attempt to reopen an old workers’ compensation case 12 months after receiving their last comp payment.
Consult your attorney regarding filing the necessary forms, going to court with your claim, and showing a judge that you are still hurt.
What’s Essential To Reopen an Old Workers’ Compensation Case?
South Carolina laws have some requirements before reopening an old workers’ compensation case. They include:
- The worsened illness or injury should be causally linked with the compensable accident. This condition must be a new symptom of your original injury.
- Your change of condition shouldn’t be a distinct injury that you may have included in your original claim, but you excluded it.
- Your change of condition should have happened after the original award. If the worsening state occurred when you might have included it in your original application, the law forbids you from using it to reopen an old workers’ case.
- You should seek to reopen the workers’ compensation case within the stipulated timeline (12 months after your last workers’ comp payment).
If your case meets these requirements, you can start the process of reopening your old workers’ compensation case. An attorney can help you gather the necessary evidence to prove your condition worsened.
Your lawyer can also show your request to reopen the workers’ compensation case was within the specified window, and you couldn’t have included the worsened state in your original workers’ comp claim. For example, you may need daily updates on your health and a doctor’s exam as evidence in your case to reopen an old workers’ comp claim.
Your attorney can represent you before a judge who reviews the evidence and decides whether the proof is sufficient to show you’re still injured and require extra benefits.
Are There Any Exceptions?
You might have no legal recourse for restarting a workers’ compensation case if you settled the original workers’ comp claim using a clincher agreement. This arrangement frees employers and their representatives from the additional responsibility of paying medical expenses or compensation when a claimant’s condition worsens.
Hire an Attorney To Reopen a Workers’ Comp Case
It may be challenging to reopen closed workers’ compensation cases. Insurance firms often deny such requests, and the judges hesitate to reopen claims unless solid evidence shows the award or settlement was unfair. Depending on the time elapsed, you may struggle to convince a judge that your worsening state is due to the original work injury and not other factors.
An attorney at Elrod Pope Law Firm can help you. Once you contact us, our team will get the necessary facts, evaluate your case, recommend the appropriate legal actions, represent you, and advise you throughout the process. Contact us today to discuss your case.
Reopening a Workers’ Comp Case FAQs
Is it important to have legal representation while seeking to reopen a workers’ compensation case?
Yes. An attorney has the experience and the legal knowledge to handle the reopening of an old workers’ compensation case.
Do my options of settling a workers’ compensation case affect future related actions?
You may settle a workers’ compensation case through a full and final clincher agreement (no more compensation), indemnity-only clincher agreement (only medical claims), and Form 16A (room for more compensation and medical claims).
Is fraud a potential reason to request reopening my workers’ compensation case?
Yes. You could request to reopen an old workers’ compensation case if the employer or their representatives committed fraud before the original workers’ comp agreement.