In certain situations, your workers’ comp case can be reopened. This is true, for example, even if you have settled your case (in limited circumstances) or a hearing officer has denied your petition for an award. Determining whether or when you can reopen your case, however, is not always a straightforward analysis.
Injured Florida workers whose workers’ comp cases have been closed and who have later received an updated diagnosis or new information about work-related injuries should promptly contact an experienced Florida workers’ compensation lawyer, including any of the workers’ comp attorneys at the Berlin Law Firm, for an assessment of whether their workers’ comp cases can be reopened.
Trusted Counsel from Founding Partner, Stephen Berlin
“The thing to remember is that a case is not closed until approved by a judge. This is especially true if you are not yet represented by an attorney. Any agreement made between an injured worker and the carrier directly is not a final agreement until approved by a judge.”
Under what circumstances should an injured worker seek to reopen a workers’ comp case?
If your petition for a workers’ comp award was denied or you have discovered new evidence that was not considered in evaluating your petition, your case may be ripe for reopening. Consider, for example:
- You are unrepresented and the Judge has not yet approved your settlement: This is by far the most common time when a settlement agreement can be reopened. If you are not represented and have negotiated settlement with the insurance company, IT MUST BE APPROVED BY THE JUDGE BEFORE BINDING. If it has not yet been approved at a hearing, we can reopen your claim.
- Changed circumstances: Your work-related injury is taking longer to heal than your doctor originally estimated, and you need additional medical treatment and will be away from work longer for a complete recovery.
- Inaccurate settlements/errors and mistakes: You discover an error in your award or you determine that the review panel made a mistake in its initial analysis, or you discover new information.
- New evidence has come to light: You discover new information regarding your accident, your employer, or other relevant information.
- Your claim was denied: You receive credible information that your employer or the workers’ comp insurance company fraudulently denied your claim.
- Worsening conditions: Your post-injury medical condition has deteriorated, and your wage-earning prospects have declined as a result.
You should never assume that a closed workers’ comp case is the final and ultimate conclusion of your petition. You may still be able to recover the full amount of benefits that you deserve. Do not hesitate to contact our workers’ compensation attorneys if these or any other similar situations apply to your case.
How to Reopen a Workers’ Comp Case
To reopen a workers’ compensation claim in Florida, follow these steps or contact a Florida Workers Compensation Lawyer to evaluate your case and assist you with this process:
Determine Eligibility
Ensure that your work injury case qualifies for reopening.
You may reopen a claim if:
- Your claim has not been settled
- It is not more than 2 years from the date of your accident
- You have seen an authorized workers compensation physician within the last 12 months
- Your condition has worsened
- You need additional medical treatment
- Your claim was inappropriately denied
- Your claim was never reported by your employer to its insurance company
However, if you signed a full and final settlement release, reopening may not be possible. Discuss your claim with our highly experienced lawyers today.
Check the Statute of Limitations
Florida law generally allows you to reopen a workers’ comp case within two years from the date of your last benefit payment or authorized medical treatment.
Gather Medical Evidence
Obtain updated medical records, doctors’ reports, and other supporting documentation showing that your condition has worsened or requires further treatment.
File a Petition for Benefits (PFB)
Submit a Petition for Benefits with the Florida Division of Workers’ Compensation outlining the reason for reopening and the benefits you are seeking (medical treatment, disability payments, etc.).
Negotiate with the Insurance Company
If your employer’s insurance carrier disputes your request, you may need to negotiate or attend mediation to resolve the issue.
Attend a Hearing (if necessary)
If the insurance company denies your petition, you can request a hearing before a Judge of Compensation Claims (JCC), where you must present evidence to support your case.
Seek Legal Assistance
A workers’ compensation attorney can help you navigate the process, strengthen your case, and improve your chances of success. Contact our firm today for a free consultation. We are here to help you.
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How is reopening a case different than an appeal?
Before your workers’ comp lawyer files a petition to reopen your case, he or she will review the record of your dispute to verify that the facts and evidence about your work-related injury were evaluated fairly and accurately and that the review panel followed all required legal protocols. If evidence was overlooked or the panel made a legal error, your lawyer will have grounds for an appeal.
There will be grounds to reopen the case when new information about your injury comes to light, particularly when that information was not available to you during the review of your original petition. Your lawyer will determine the appropriate alternative that gives you a better opportunity to increase your worker’s comp award.
What Are Section 20 Settlements?
In Florida workers’ compensation cases, a Section 20 settlement is a lump-sum settlement that resolves all claims, meaning the injured worker waives their right to any future benefits, including medical treatment and wage loss compensation. A Section 20 settlement in Florida is generally final and cannot be reopened. Once approved by a Judge of Compensation Claims, the settlement is legally binding and cannot be reopened except in very limited circumstances.
The only possible way to challenge a Section 20 settlement is to prove fraud, coercion, duress, or a mutual mistake of fact at the time of the agreement. However, proving these claims is extremely difficult, as Florida law strongly favors finality in workers’ compensation settlements.
If you believe you were misled or forced into accepting an unfair settlement, consult a workers’ compensation attorney to determine if any legal options are available to challenge the settlement.
Can My Employer Reopen My Case?
In Florida, an employer or their workers’ compensation insurance carrier generally cannot reopen a settled case if a full and final settlement has been reached and approved by a Judge of Compensation Claims. Once a Section 20 settlement is finalized, the employer waives their right to challenge it in most cases.
However, if the case was not fully settled, such as when medical benefits remain open, the employer may request a review to argue that the worker’s condition has improved and that ongoing benefits should be reduced or terminated. The employer may also contest a claim if there is evidence of fraud, such as the claimant exaggerating their injury or working while receiving benefits.
In such cases, the employer can request an Independent Medical Examination or present evidence to challenge continued payments.
How Long Does the Process of Reopening a Workers’ Comp Case Take?
The process of reopening a workers’ compensation case in Florida can take several weeks to several months, depending on the circumstances of the case. If you are reopening the claim due to a worsening medical condition, the timeline may depend on how quickly you can obtain updated medical evaluations and submit a Petition for Benefits to the Florida Division of Workers’ Compensation.
The insurance company typically has 14 days to respond. However, if they deny the request, the case may proceed to mediation or a hearing before a Judge of Compensation Claims, which can take several months to resolve.
If you are challenging a settlement agreement on the grounds of fraud, coercion, or duress, the process may take longer, as you must file a Motion to Vacate the Settlement and present strong evidence.
What is the time limit to reopen a workers’ comp case?
All workers’ compensation claims in Florida are subject to strict filing deadlines. Your initial claim must be filed within two years after you first suffered a work-related injury. Then, your petition to reopen your case must be filed within one year after you last received a payment under your initial claim or within a year after you last received an authorized medical treatment for your injury.
Contact a knowledgeable workers’ compensation lawyer as soon as you can to avoid missing these critical deadlines.
Get the full compensation you deserve. Call Berlin Law Firm.
The workers’ compensation lawyers at the Berlin Law Firm will analyze your case and any new evidence and information about your injury and original claim to determine whether and when it can be reopened. We offer complimentary, no-obligation consultations to all injured Florida workers.
Please call us at your earliest opportunity for your complimentary and confidential workers’ comp case review.
Related Topics
- Pre-existing Conditions and Workers’ Compensation
- Repetitive Use Injuries and Work Injury Claims
- Why Choose Berlin Law Firm
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