How to Reopen a Workers’ Compensation Claim: Key Steps and Eligibility
Workers’ compensation offers vital support after a workplace accident, covering medical costs and providing income when you’re unable to work due to your injury. Eventually, once your medical treatment is finished, the workers’ compensation claim is closed.
In many situations, this marks the end of the matter, allowing you to move forward. But what if your injury worsens after the claim has been closed? In Nevada, it’s possible to reopen a workers’ compensation claim, though only under specific conditions.
When You Might Need to Reopen a Workers’ Compensation Claim
There are several situations that may lead someone to seek reopening their workers’ compensation claim. A personal injury lawyer can review your case to determine whether you qualify. Common reasons for reopening a claim include:
Your medical condition has worsened again.
You now require medical treatment that was not needed when the claim was first filed.
The injury has gotten worse, making it difficult or impossible for you to work.
Your doctor recommends additional treatment directly related to your original injury.
When It’s Possible to Reopen a Workers’ Compensation Case
To reopen a workers’ compensation claim for additional treatment related to your workplace injury, the original condition must have worsened. This worsening may require further medical care, such as surgery or rehabilitation, and could even prevent you from returning to work.
In these situations, you may qualify to reopen your claim. However, timing is crucial, and your personal injury lawyer can help you review the details. For example, if your injury didn’t result in disability or missed work, you have one year from the date your case was closed to reopen it. If your condition did cause disability or time off work, there is no time limit for reopening your claim.
When Reopening a Workers’ Compensation Claim Isn’t Allowed
Although reopening a workers’ compensation claim is possible in many cases, there are specific situations where it’s not permitted. You won’t be able to reopen your claim if:
The one-year deadline has passed.
The claim amount was $800 or below in Nevada.
There has been no change in your condition.
Your condition resulted from a new injury.
Steps to Reopen a Workers’ Compensation Claim in Nevada
If you choose to reopen your claim for further treatment, there are several key steps to follow. First, you’ll need a medical report confirming that your condition has worsened, that additional treatment is necessary, and that the worsening is directly related to your original work injury.
After obtaining the medical report, submit a written request to your employer’s workers’ compensation insurance company and include the report with your request.
Next, wait for a response from the insurer, who has 30 days to reply. Their response may approve the reopening, ask for additional information, or deny your request.
Proof You Might Need When Reopening Your Claim
To begin the process of reopening your claim, you’ll need to provide a medical report along with objective evidence, such as new diagnostic tests. The insurance company may respond by asking for additional details and, in some cases, may request an Independent Medical Examination (IME).
An Independent Medical Examination is conducted by a healthcare provider to verify the findings in your original medical report, confirming that your condition has worsened and that further treatment is necessary. The insurer might also ask for your medical history.
If you plan to reopen a claim, having all this documentation prepared in advance can help ensure the process moves efficiently and without delays.
Workers’ Compensation Reopening Denied? Here’s What to Do Next
If your request to reopen a workers’ compensation claim has been denied, you may still have options. Ask your personal injury lawyer to review the denial letter and determine the reason for rejection. In many cases, denials occur due to insufficient evidence that your condition has worsened, a lack of proof linking the worsening to your original injury, a medical report that fails to meet legal standards, or missing the reopening deadline.
To appeal the decision, complete a Request for Hearing form and submit it to the Nevada Department of Administration, Hearings Division. Your denial notice will list the local Hearing Office where you must file. You have 70 days to submit the appeal.
Next, gather stronger medical evidence and consider obtaining a second opinion from another approved provider. Attend the hearing with your lawyer to present your case. If your appeal is denied again, you have 30 days to file another appeal. If necessary, you can then bring the case before the Nevada District Court.
Filing a Request to Reopen Your Workers’ Compensation Claim
If you require additional treatment following a workplace injury, it’s important to understand your rights under Nevada’s workers’ compensation system. Reopening a claim can provide access to further medical care and benefits if your condition has worsened. Seeking guidance from a qualified personal injury lawyer experienced in workers’ compensation matters can help ensure your request is properly prepared and supported with the necessary documentation.
