When you have experienced a work-related illness or injury and were deemed to be qualified for workers’ compensation benefits, you may question whether you can reopen your workers’ comp case in Massachusetts once your benefits have lapsed or your case was closed.
In Massachusetts, all employers are required by law to carry workers’ compensation insurance covering their employees. This law is applicable despite the number of hours worked in any given week. The requirement for domestic service employees is not the same. They must work 16 hours per week in order to require coverage.
Reasons to Reopen a Workers’ Comp Case in Massachusetts:
There can be numerous reasons due to which you may want to reopen your case. This does not depend on whether your case was denied or settled. The main cause would be that your condition has worsened. Other reasons due to which you want to reopen the case may be due to the following reasons:
- A factual or legal mistake was made.
- Fraud was committed by the insurance company.
- You have new developments regarding your medical condition.
- Your capability to earn has significantly diminished.
The procedure is generally similar to any dispute over workers’ comp claims, once the application is received. Typically, your case will be scheduled for a court hearing before a workers’ compensation judge. You will need to prove what benefits you should receive and why your case should be reopened. The judge will then give the final decision on whether you should receive additional benefits or your case should be reopened.
Stipulation and Award:
You may be able to reopen your closed workers’ comp case in Massachusetts if your case was resolved under a stipulation and award. Some of the reasons you might want to reopen the case may include an issue in the paperwork, your disability worsening, or if there was a legal discrepancy witnessed that resulted in your case being closed.
You will be granted five years from the date at which you were injured, to pursue the reopening of your case. You will have to discuss the case with your attorneys and they will guide you regarding your further course of action under Massachusetts workers’ comp laws.
The Compromise and Release:
You will not have the option of reopening your case for any reason other than fraud, in case your case was closed under a compromise and release settlement. This is due to the fact that these types of settlements contain clauses that explicitly discharge the employer and the insurer from any past, current, or future claims that might arise from the same occupational conditions you faced.
These cases often involve a lump sum settlement offer. If you receive such an offer, it is essential that you thoroughly review such provisions with your lawyer, so that they may advise you according to the situation.
How Settlements May Affect Your Right to Reopen a Workers’ Compensation Claim:
Typically, if a workers’ compensation judge issued an order after a hearing, you may be able to reopen your case for a qualifying reason. The situation can be very different if the case has been settled and the compensation has been provided in full.
If the contract explicitly allowed additional benefits and provided for installment payments, you might be able to reopen your case.
Insurance companies, however, often insist on a lump sum settlement. This means that you will have to waive your rights to receive any future claims arising out of the injury, once you have opted for a final settlement. In some circumstances, you may request additional reimbursement of medical costs, even after you have signed a waiver.
Seeking Legal Help in Your Workers’ Comp Case in Massachusetts:
It can be very cumbersome to reopen a closed workers’ compensation case. Judges are unwilling to open old claims unless there is solid evidence that the award or settlement was unjust. Convincing a judge regarding recent developments in your medical condition can be very complex, and depends on factors such as how much time has passed.
About Robert C. Shea:
An experienced workers’ compensation attorney can assist you with your workers’ comp case in Massachusetts by demonstrating to you the legal framework of such cases. Our competent lawyers can facilitate you in gathering quality evidence for your case and effectively persuading the judge in your favor. They may also help you with reopening the claim when your past wounds worsen and lead to serious risks regarding your medical condition.