Re-Opening A Workers Compensation Claim
Under the law in Nevada, there are certain requirements in re-opening a claim that you should be aware of. If you’ve previously filed a claim, you may be entitled to reopen your worker’s compensation claim so long as you have received benefits for permanent partial disability (PPD) and you were off work due to the injury. To re-open your claim, you your request must be made in writing and one year after your original claim was closed. Along with your application, you must include a certificate by your chiropractor, or your physician, explaining that there has been a change in circumstances regarding your work injury that was documented in the original claim that necessitates an increase or rearrangement in worker’s compensation for the duration of your life. If this can be shown, your employer’s insurer must re-open your claim.
After for re-opening is received by the insurer, they determine whether you have shown good reason to reopen your claim. So long as you have attached the necessary documents from your doctor and the insurer decides the application is for good cause, your claim will be re-opened and they will conduct a medical investigation. If you fail to attach a request from your health care provider, your application will be denied. Your employer’s insurer can only re-open your claim if (1) it is obvious that the reason for the change in circumstance is due to the original injury in your original claim and (2) medical evidence supports your application.
Pursuant to NRS 616C.392, the law specifically states:
- The claim was closed and the claimant was not scheduled for an evaluation of the injury in accordance with NRS 616C.490;
- The claimant demonstrates by a preponderance of the evidence that, at the time that the case was closed, the claimant was, because of the injury, qualified to be scheduled for an evaluation for a permanent partial disability; and
- The insurer has violated a provision of NRS 616D.120 with regard to the claim.
If your application for re-opening is granted, there are certain benefits you will not be entitled to you either retired prior to your claim being re-opened or if you left your place of work voluntarily for any reason other than the underlying injury in your original claim. These benefits include those involving a temporary total disability or rehabilitation services. If your application is denied, you must wait until one year after the decision before applying to re-open again, unless you appeal that original decision.
There are some circumstances in which your application to re-open a claim for PPD is absolutely required. This would include (1) a violation on the part of the insurer, (2) your claim was closed and you were not scheduled for an injury evaluation, and (3) you can prove that at the time your claim was closed, you qualified to be scheduled for a PPD evaluation. Securing experienced legal counsel can assure that your rights are protected in any worker’s compensation claim.