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Injuries can affect individuals in different ways. Sometimes, damages have certain short-term effects that change or worsen as time passes. If you have already settled your workers’ compensation case and are experiencing deteriorating symptoms, there are a few ways you can address your current situation.
If your original settlement is considered a Compromise and Release (C&R) settlement, you may not have the opportunity to reopen the case. The agreement covers all retroactive, present, and future costs associated with the injury in the form of a lump sum payment. As soon as you accept and sign the settlement agreement, you waive your right to reopen the claim.
An injured worker may only reopen this type of settlement in cases of fraud. Employers and insurers are responsible for representing the terms of a settlement in good faith.
A stipulation and award settlement allows a claimant to accept benefits based on existing disability and medical recommendation. The payout associated with this type of settlement is typically lower than a C&R settlement, but a claimant can reopen and change the terms of the settlement based on new symptoms associated with an old injury. There is a five year statute of limitations (from the date of injury) on reopening an old workers’ compensation case in the state of California.
Depending on the type of symptoms you experience, you may open a new case for specific or cumulative trauma. If another workplace incident or exposure aggravated your symptoms, filing a new workers’ compensation claim may make more sense than trying to reopen or change your existing settlement. Specific trauma injuries typically cover one instance and one set of symptoms. For instance, this might include suffering from broken bones after falling from scaffolding or recovering from a car accident.
Cumulative trauma cases typically involve some type of repetitive injury or a progressive illness, but they may also include specific trauma cases that lead to chronic pain or a new repetitive injury. Since cumulative trauma occurs over time, the experience of the injury or illness often manifests differently. These cases are highly complex and generally treated as new claims.
Determining workers’ compensation benefits in the light of worsening conditions can be complicated. For instance, you and your physician will need to determine if the new symptoms are a result of the previous injury or if they qualify as a new injury that happens to affect the same area of the body. Work closely with your treating physician and your attorney to determine the best approach for reopening a case or filing a new workers’ compensation claim.
After an initial settlement, you may run into roadblocks with aggravated symptoms. Your benefits may not cover the costs of additional medical treatment, and you may have to use private health insurance to obtain the medical care you need until you sort out the paperwork for additional workers’ comp benefits.
Finding an experienced workers’ compensation attorney can help you get the treatment and support you need. Your attorney can help you find qualified medical care, expedite the workers’ compensation process, and determine the type of medical care your benefits will cover.
When you reopen or pursue a new claim, a workers’ compensation insurer may try to delay or deny your new request. The attorneys at DiMarco Araujo Montevideo are prepared to help you fight for your right to fair benefits after you experience worsening symptoms. Reach out to our office today for a free case evaluation.