After a work injury, you successfully navigated the workers’ compensation system to obtain medical care and wage replacement benefits. You secured a settlement that you anticipated would meet your needs and the needs of your family. Now, your condition has worsened, and you feel you need additional compensation to receive the proper care and remain financially stable. Can you reopen an old workers' compensation claim and get additional benefits? The answer is both yes and no. The unique details of your claim and settlement will dictate the options available to you.
Revisiting a Settled Iowa Workers’ Compensation Claim
It can be possible to re-open an old claim to apply for additional benefits. In Iowa, this is known as a review-reopening claim. However, specific conditions must be met in order to do so successfully. A review-reopening claim is not intended to simply review the original claim. The injured worker must have experienced some type of change or worsening of the injury. To pursue a review-reopening claim, the worker must have experienced:
Worsening of the medical condition
Decrease in wage-earning capacity
Newly discovered medical evidence (such as a new related diagnosis or unforeseen complication)
A legal or factual mistake
Fraud by the insurance company
The burden of proving that one of these elements exists does fall on the injured worker, and specific criteria must be met depending on the type of injury. The following is a brief overview:
Scheduled loss – Injured worker must show that the functional disability has increased.
Unscheduled loss – Injured worker must demonstrate that either the functional disability has increased or his earning potential has decreased.
Certain Types of Settlements Cannot Be Reopened
If you want to take a second look at an old claim simply because you are dissatisfied with your benefits, it is typically not possible. Injured workers must meet the stated criteria to revisit an old claim. Additionally, there are times when even workers who are eligible under those guidelines may be prohibited from a claim review. There are a number of different types of settlements in Iowa, and the type of settlement that was originally accepted will dictate eligibility for a review-reopening claim. Some claims are settled in a manner that is considered “full and final,” which means that the injured worker is barred from a review of the claim once the agreement is reached. In other situations, an employee may be able to obtain payment for medical costs only, while there are still other times that full compensation is available. The terms of the original settlement should be discussed with an experienced lawyer who can help you understand your rights and help you explore ways to be successful if a review-reopening claim is possible.
Pursuing a Review-Reopening Claim in Iowa
Employers and insurance companies are usually reluctant to review an old claim once it has been settled. They are interested in saving as much of their money as possible, and they will try to avoid further payments if at all possible. Typically, a review-reopening claim requires paperwork to be filed with supporting documents. It will be considered by the state commission, and a hearing may be necessary to examine your case further. It is important to note that a review-reopening claim must be filed within three years of the final payment of weekly benefits for the original case.
Filing a Second, New Claim Can Be Possible
Even if a review-reopening claim is not an option in your case, it may still be possible to obtain further compensation. An injury can be classified as a new injury, and a new workers’ compensation claim can be opened. This is typically possible if:
The injury is aggravated in a new employer’s work environment.
The injury is unrelated to a previous claim.
Workers’ compensation law can be complex, and it can be difficult to know if your injury meets the conditions appropriate for a review-reopening claim, a new claim, or no claim at all. At Pothitakis Law Firm, our experienced workers' compensation lawyers have helped injured Iowa workers just like you fully understand their legal options and obtain the maximum compensation possible. Call our office or take a moment to fill out the contact form on this page to get in touch with our lawyer and schedule a free, no-obligation consultation.
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