Reopening a Closed Workers Compensation Case
Sept. 23, 2021
In Fiscal Year 2020, ending September 30, 2020, there were 45,281 total occupational injuries and illnesses reported to the Kansas Division of Workers Compensation. The overwhelming majority of claims – 96.4 percent – were for traumatic injuries. There were also 1,107 cases of repetitive trauma (2.2 percent) and 607 occupational disease claims (1.3 percent). Only 8,851 of the cases were compensated for lost time at work.
The incident rate for workplace injuries/illnesses has fallen steadily since the enactment of the revised Kansas Workers Compensation Act (KWCA) in 2011. In the year of enactment, 4.51 of every 100 full-time employees would suffer an incident. In 2020, the rate stood at 3.30.
State officials will claim the falling incident rate is due to improved workplace safety, but the KWCA has made it difficult for workers to even file claims, let alone recover compensation for injuries and lost work time.
Plus, the adoption of the 6th edition of the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” has made it more difficult for physicians to assign disability status to those injured at work.
Some workers who’ve already filed a claim and closed it after recovery may, at a later time, see medical issues reappear and wonder if they can reopen their case. The answer is generally “no” but also “maybe,” depending on various factors.
Whatever workers compensation issues you face in Kansas, contact Wichita-based Slape & Howard. Our attorneys have experience in every aspect of workers' compensation in Kansas. We have been advocating for reforms to make the system more employee-friendly as it was before the enactment of the revised KWCA.
Reopening a Workers Compensation Claim
Reopening a workers' compensation claim is at best an “iffy” proposition.
Generally, if you received a settlement from your workers' compensation insurance company, you were no doubt asked to settle the fully and finally, which means you agree that the settlement closes out any future claims. In other words, a full and final settlement is just that – a final agreement with no future options. This type of settlement usually involves a lump sum payment and is the most common type of settlement that insurance companies will offer.
Another type of settlement – called a running award – keeps two very important rights alive. The first is the right to future medical. This will keep your medical rights open, kind of. Kansas law provides that after two years from the date the insurance companies last paid for medical benefits, they can petition to close all medical benefits in your case. You will then have to show that future medical benefits are still necessary to cure and/or relieve the effects of your injury.
The second right that you retain on a running award is the right to review and modification. This means that you can petition the court to review your case and modify the award that was given. This will generally account for things like the condition getting worse, wage loss, or any real change of circumstance since the initial award. It is important to ask an attorney about this option as soon as you know that the conditions have changed. The law will usually only look back a maximum of six months from when you file the paperwork to review and modify your case.
If these rights are left open, you maintain your right to be able to file an appeal through the workers' compensation system. In egregious cases, you might be able to pursue your claim in a court of law, if you can show that the agreement you signed was based on fraud, deception, or inherent mistakes. However, in Kansas, you must attest before an administrative law judge that you understand the settlement, you understand the medical, and you believe it is in your best interests to settle the case on the terms that are proposed. If you worry about any of this, call an attorney.
Managing the Claims Process
What this shows is that you need to be cautious when settling a workers' compensation claim. Insurance companies are forever dedicated to the bottom line of profitability. They will generally do everything in their power to lowball or deny any claim you have, whether it’s for an auto accident, property damage, or workers' compensation.
When you’re injured at work, you need to involve experienced and knowledgeable workers' compensation attorneys from the very start. They can guide you through the process and review any insurance company demands, and then work with you toward a settlement that covers you even if symptoms reappear or worsen down the road.
In other words, don’t sign off on anything without getting an attorney’s assessment of what you’re signing and what it means for future claims should condition change in your recovery.
Getting the Experienced Legal Help You Need
Wichita-based Slape & Howard has been working with advocacy groups and other pro-employee attorneys to reform the workers' compensation system in Kansas. Starting with the KWCA revision in 2011, the claims process has become more and more insurer-friendly, piling on new deadlines and qualification hurdles for injured workers. The adoption of the 6th AMA edition furthered this process by restricting physicians in their assessment of disability.
Let us handle the insurance companies while you recover. We’ll work to obtain a settlement that covers as many eventualities as possible.
We proudly serve injured workers throughout Kansas as they seek proper care and treatment through the workers' compensation system.