Closing your workers’ compensation claim may have been the end of this phase of your life. The whole ordeal is now behind you and you can move forward. Except the pain came back. Now what? The good news is that closing your claim does not always close the door for good. In some situations, you may be able to reopen an L&I claim and receive additional benefits or medical treatment.

Key Takeaways

• Washington allows injured workers to reopen a closed L&I claim.
• Increased pain alone is usually not enough.
• Time limits vary depending on the benefits you are seeking.
• Strong medical documentation showing your condition got worse is critical.

Can You Reopen an L&I Claim in Washington?

Yes, Washington workers can request to reopen their L&I claim. However, there are restrictions. The original approved condition must have objectively worsened. Reopening applies only to deterioration that occurs after closure and not a condition caused by a new incident, accident, or illness.

Washington L&I Claim Reopening Requirements

Not every increase in pain qualifies you to reopen an L&I claim. Your medical provider must present evidence that your accepted work injury or occupational disease has objectively worsened since your claim closed. Your doctor must be able to document changes that support reopening, rather than relying only on your description of your symptoms.

Objective worsening may include:

• Reduced range of motion
• New physical limitations
• Imaging or diagnostic tests showing a decline
• The need for additional medical treatment, surgery, or therapy

The condition must also be tied to the work injury or occupational disease that L&I previously accepted. If your symptoms are the result of a new accident or a separate injury, reopening your original claim generally is not the appropriate solution. Instead, you may need to file a new workers' compensation claim.

Are There Time Limits to Reopen an L&I Claim?

Depending on the type of benefits you are seeking, there is a time limit for reopening your L&I case. If you are requesting to reopen the case for medical treatment only, then you can file at any time. If you are reopening the claim for medical treatment and financial benefits, then the deadline is seven years from the date the case was first closed. There is an exception for eye injuries, extending the deadline to ten years.

If your claim has been closed for over seven years, filing to reopen the case becomes more challenging. Recovery options are more limited, and additional financial benefits may no longer be available.

How to Reopen a Workers' Comp Claim

The first step to reopening a workers’ compensation claim is to speak with an attorney. A lawyer can explain the process to request a reopening. They can also explain the type of medical documentation required. Their guidance can help prepare a thorough application. They can ensure that the filing is accurate and consistent with the original compensation claim. Being vague or inconsistent can delay your application. Include supporting medical documentation.

Discuss with your doctor the information that is required for your application. The information needs to show a measurable medical change, not just an increase in pain alone.

Avoid using outdated or incomplete documentation that can trigger delays or a closer review. The supporting documentation needs to clearly connect the worsening condition to the original condition. It also needs to accurately document the changes that caused the condition to be worse.

Reopening Claim Benefits

The benefits available will vary based on the circumstances of their injuries and their closed claim. Some common potential benefits that can be gained from reopening a case include:

• Additional medical treatment
  • Physical therapy
  • Surgery
  • Medication
• Wage replacement (if eligible)
• Permanent Partial Disability
• Total Permanent Disability

It is important to understand that receiving approval to reopen an L&I case does not automatically mean the worker will receive additional benefits.

What Happens if L&I Denies Your Request?

If L&I denies your request to reopen your case, then the case remains closed. There will be no opportunity to receive additional benefits. A denial does not mean that your condition has not gotten worse. It means that the submitted request did not include enough evidence to show that the medical and legal standards were met.

Working with an experienced L&I attorney can provide valuable legal guidance. Their knowledge can help you avoid common mistakes that lead to denial. One common reason is a lack of supporting evidence to effectively show the condition has worsened. Another is a failure to connect the worsening condition to the original incident and the accepted condition.

Speak With a Washington Workers' Compensation Attorney

A closed claim is not always the end of your workers' compensation case. If your work-related injury or occupational disease has gotten worse, reopening your L&I claim may allow you to receive additional medical treatment or other benefits.

If your condition has changed since your claim was closed, the attorneys at Robinson & Kole can evaluate your situation and explain your options.Contact us today to schedule a consultation and find out whether reopening your L&I claim is the right next step.