It is not an uncommon scenario: A worker sustains an injury, files and settles a workers’ compensation claim and, as time goes by, instead of getting better, the injury grows worse. Because the claim is closed, however, does that mean the worker must pay out of pocket for continuing care, or try to get by with little to no income? Not necessarily. If your condition worsens over time, you may be able to reopen your Florida workers’ compensation claim.
According to FindLaw, a change in condition is the most common reason workers petition to reopen their claims. If you hope to reopen your claim for this reason, your worsened condition must be either physical or mental — purely economic reasons are not enough to warrant additional compensation. Furthermore, your worsened condition must not be the result of a non-work-related activity or other intervening cause.
When deciding whether or not to reopen a case, the administrative judge has ultimate discretion. Unfortunately, it is not enough to provide a medical report that states that your condition has grown worse with time to receive additional compensation. Rather, you have the burden to convince the judge that you deserve additional benefits.
An administrative judge does not have to reopen a workers’ comp claim unless there exists evidence that compels him or her to do so. Whether or not a physician’s report is “compelling” is up to the judge. For a judge to consider a doctor’s report compelling, it should ideally come from one whom you routinely see or who thoroughly understands your condition.
In addition to your medical records, a judge may give consideration to your own testimony. Your testimony should detail how the worsened condition has negatively impacted your finances, ability to work and overall quality of life.