April 23, 2018
Even with the best medical care, it’s hard to predict exactly how a patient’s body responds to severe injuries. Some symptoms may take weeks to appear while others appear right away and heal after a short amount of time.
Given all the strange work-related injuries doctors see each year in Indiana (on top of the difficulty of predicting future health), it’s not uncommon for some patients’ conditions to take unexpected turns late into treatment. This can cause all sorts of minor inconveniences and major problems depending on the type of injury and how it affects the person’s daily life.
On the financial side of things, however, what happens when you suddenly are told you need surgery to correct a problem you thought had gone away? If you had been on the road to recovery, chances are you may have settled the workers’ compensation claim associated with the injury. Now the injury has caused more expenses, but you’re stuck paying for them out of pocket! Or are you?
Reopening a Workers’ Compensation Claim
In Indiana, as in most states, the language of the claim determines whether you can reopen it under certain conditions. However, if you’ve closed your claim under a “full and final release” clause, you likely won’t be able to get any more money to pay for other treatments associated with that injury. And if your condition hasn’t been worsened by any other work-related injury, you may have to pay out of pocket for treatment.
Full and final clauses are tactics insurance companies employ to save money by refusing payment to injured workers. If you’re negotiating your own workers’ compensation settlement, you should consider eliminating any such clause if possible. As always, it helps to have experienced legal counsel to support you and argue your position in strong legal language, but being aware of clauses like these can help, too.
Indiana’s Conditions for Reopening a Claim
According to our state’s Workers’ Compensation Board, cases not settled as full and final may be opened for any number of valid reasons, including the following:
- The employee’s permanent partial injury (PPI) becomes a temporary total disability (TTD).
- The employer reduces the workload assigned to the employee, so as to allow him or her to function fully on the job while injured.
- The employee’s condition worsens and incurs additional costs after initial settlement.
- Symptoms of the employee’s injury only become apparent after initial settlement.
Though this isn’t an exhaustive list, it provides a glimpse into the many reasons for reopening a workers’ compensation claim after it’s been settled initially, as long as it wasn’t full and final.
Time Restrictions on Filing Indiana’s Readjustment Claim
Like in many legal cases, reopening a workers’ compensation claim is subject to a statute of limitations. That means there is a time limit on your ability to reopen the claim. For PPIs that have worsened, permanent disabilities that incur additional unexpected costs, or any additional medical treatment for the injury, the time limit is two years past the date on which you were last paid from workers’ compensation.
The language of your particular claim may adjust these time limits, so be sure to read your settlement carefully if you haven’t hired an attorney to read and discuss it on your behalf.
The Importance of Experienced Workers’ Compensation Attorneys
Even if you feel fully recovered and have a doctor’s stamp of approval, you may not be able to guarantee you’ve fully recovered from your work-related injury. That’s why it’s crucial to take workers’ compensation claims seriously. Settling a claim prematurely can result in less compensation than you may recover if you hired an attorney to advocate for your best interests and keep every possible avenue open.
Hensley Legal Group is committed to helping fellow Hoosiers earn as much as they deserve from insurance companies after they’ve been injured at work. If you’ve seen yourself in any of the situations mentioned above, feel free to give us a call or contact us online. Your conversation is free; you won’t owe us anything by asking a few questions. We’ll do our best to help you navigate this tricky time.