Closed. Final and binding. Or is it?!?
Claim closure is always our goal, but did you know that claims can be reopened? It’s true that a claim can be reopened within 7 years of the date the claim was first closed (10 years for eye injuries) in Washington state.
Long after you’ve filed the claim away and forgotten about it, you could get a letter explaining that it’s back in action due to it reopening.
Will reopened claims impact my rates?
The answer is it depends on the original date of injury of the claim. While this may sound scary, sometimes a claim reopening can advantageous for the employer versus a new claim being filed.
That’s because claims only impact your workers’ comp rates (and retro refunds) for three years, even if the claim is reopened and costs are increasing.
Here’s an example to illustrate a possible scenario:
- Date of Injury: May 12, 2014
- Claim closed: March 28, 2015
- Impact to Rates: 2016, 2017, 2018 calendar years
- Claim reopens September 9, 2019
This claim is reopening after the experience period, so there won’t be any impact to your rates, no matter what happens with the reopened claim.
If your injured employee instead has a new claim for a new injury, that could financially impact you for three future years — on top of the financial impact you’ve already sustained from the original claim.
Why are workers’ comp claims reopened?
A Washington state workers’ comp claim can only be reopened if the condition on the original claim has worsened. This must be supported by objective medical findings from the medical provider.
If there is a new condition or a new injury, then a new claim would need to be filed. A claim cannot be reopened in order to add new conditions, even if they are related to the original injury.
Claims can potentially be reopened after the usual 7-10-year period, but this would require approval from the director of L&I. These cases are unusual and, in any case, won’t impact the employer because so much time will have passed since the original injury.
What if we’re notified of claim reopening?
Let us know if you receive any notification of a reopened claim. If it’s still within the experience period, we’ll manage the claim with you just as we did originally, with the same goals in mind. We may also be able to protest the reopening if there’s a reason to question its validity or additional information is needed. Either way, we will partner with you throughout the process.
