If you have a formally established workers’ compensation claim, you might have some questions about your case’s status. Once you have received a written decision from the Workers’ Compensation Board confirming your injuries, you will start to earn your benefits. However, this doesn’t mean your case is closed. Depending on your situation, it’s possible your case remains open for life.
How Long Does a Workers’ Compensation Case Stay Open?
Unless you opt to settle your claim on a full and final basis, your workers’ compensation case remains open. When your case is open, you are entitled to “casually related medical treatment” for as long as necessary, which could last the course of your entire life. Causally related medical treatment means your doctor has specifically stated the treatment you need is related to your work injury.
When Does a Workers’ Compensation Case Close?
There is only one way to formally close a workers’ compensation claim. To close a case, the injured workers and the insurance carrier must enter into an agreement pursuant to Workers’ Compensation Law, Section 32. Section 32 allows you to negotiate with the insurance carrier to effectively settle your workers’ compensation case, typically for a single lump sum. If the Workers’ Compensation Board approves the agreement, your case will be considered closed, which means that you will not receive any additional compensation beyond the agreed-upon sum, even if you require medical treatment or care related to your workplace injury in the future.
What If My Case Is Open But Payments Are Denied?
Circumstances may arise where an injured worker needs treatment related to their injury, even if they have gone several months or even years without needing any medical care. In these situations, insurance companies often object to treatment or claims for lost time. They argue that the injured worker must have sustained a new injury in a different accident rather than require care for injuries they obtained in their workers’ compensation claim. So, even though a claim is technically open, some insurance carriers may dispute medical bills and lost wage payments. If this happens, the injured worker is generally advised to obtain legal counsel, as a hearing will be required.
Don’t Miss Out on Benefits You’ve Earned
If you’ve been told your workers’ compensation case is closed or have been approached with a settlement offer to close your case, get in touch with legal counsel you trust. The attorneys at Lewis & Lewis can help you understand your workers’ compensation case status, review settlement offers, and get the benefits you’re entitled to.
