A Nevada injured worker whose workers compensation claim is closed can have the claim reopened if his or her condition gets worse. The injured worker can then receive additional:
- medical treatment
- temporary disability benefits
- mileage reimbursement
- vocational rehabilitation
In order to reopen a claim, an injured worker needs to:
- obtain a letter from a doctor stating that the worker’s condition has gotten worse
- send a letter to the insurance company and ask that his or her claim be reopened
The injured worker’s doctor must state:
- that the injured worker’s condition has changed
- that he or she needs treatment
- what kind of treatment is needed
- what the connection is between the original injury and the changed condition
- that the work injury is the primary reason to reopen the case
- the amount of time the injured worker is unable to work
If the injured worker was entitled to permanent partial disability but did not receive it and his or her claim was closed, it can be reopened for permanent partial disability.
If an injured worker loses an appeal of his or her workers comp claim, it cannot be reopened.
Instead of reopening his or her claim, a doctor may determine that an injured worker has a subsequent injury with a new employer.
In this article, our Las Vegas Nevada workers’ compensation attorneys will explain:
- 1. Reopening a Nevada workers’ compensation claim for additional benefits
- 2. What to do to reopen a claim
- 3. What if the Nevada injured worker is retired?
- 4. Time frames for reopening a Nevada workers’ compensation claim
- 5. Reopening claim for permanent partial disability
- 6. Can a claim be reopened after an appeal?
- 7. Aggravation can be a new injury
- 8. Reopening a claim can provide some relief to an injured worker
An injured worker whose claim is closed can have the claim reopened if his or her condition gets worse.
1. Reopening a Nevada workers’ compensation claim for additional benefits
If a worker’s injury gets worse after the claim has been closed, it can be reopened.1
The injured worker can then receive further Nevada workers’ compensation benefits, including medical treatment, temporary disability, mileage reimbursement, and vocational rehabilitation.2
The burden of proof is on the injured worker to show that the claim should be reopened. The injured worker must show it is more likely than not that the claim should be reopened.3
Example: Tim had a shoulder injury at work. He missed work and got temporary disability and then permanent partial disability when his workers compensation case was settled. He went back to work and his claim was closed.
Eighteen months later, Tim experiences shoulder pain again and his injury becomes worse, so he cannot work.
Tim can try to reopen his claim so that he can get further benefits.
2. What to do to reopen a claim
In order to reopen a Nevada workers’ compensation claim, an injured worker needs to:
- obtain a letter from a doctor stating that the worker’s condition has gotten worse
- send a letter to the insurance company and ask that the claim be reopened4
Example: Mia had a neck injury at work. After her claim is closed, she believes her neck condition is getting worse.
Mia goes to the doctor that originally treated her for her work injury. The doctor gives her a letter agreeing with Mia that her condition has gotten worse.
Mia sends the doctor’s letter, along with her own letter, to the insurance company requesting that her claim be reopened. She indicates that she needs the treatment stated which is in the doctor’s letter.
2.1. Information in letter from doctor
The injured worker’s doctor must state:
- that the injured worker’s condition has changed
- that he or she needs treatment
- what kind of treatment is needed
- what the connection is between the original injury and the changed condition
- that the work injury is the primary reason to reopen the case
- the amount of time the injured worker is unable to work5
The doctor will give the letter to the injured worker. It is the injured worker’s responsibility to reopen his or her claim.
Example: Gabriel’s doctor gives him a letter that states:
- the condition of Gabriel’s knee has gotten worse
- Gabriel needs physical therapy for his knee
- his worsening knee condition is the result of the original work injury
- the work injury is the main reason he needs treatment now
- Gabriel is unable to work for the next week
Gabriel can then send this letter to the insurance company and get physical therapy for his knee and temporary disability benefits for the time he will miss from work.
An injured worker who is retired is only entitled to medical treatment.
3. What if the Nevada injured worker is retired?
An injured worker who is retired is only entitled to medical treatment.6 He or she is no longer working or seeking employment, so there is no temporary disability or vocational rehabilitation. However, medical treatment is still available.
Example: Karen injured her back working as a teacher. Her claim was closed, and two years later she retires.
Karen’s back injury has gotten worse and she has a letter from a doctor stating this.
Since Karen has retired from the workforce, she can only get medical treatment if her claim is reopened.
4. Time frames for reopening a Nevada workers’ compensation claim
The ability of an injured worker to reopen a claim depends on what occurred on his or her case before the request to reopen.
There is no limit to the number of times an injured worker can request a claim be reopened. However, if a request to reopen is denied, an injured worker must wait one year before making another request.7
If an injured worker does not miss any time from work and receives no permanent partial disability benefits, he or she must request reopening his or her claim within one year of the date of closure.8
An injured worker probably cannot reopen a claim if it was closed because his or her medical treatment was less than $800 in the first twelve months.9 This indicates the injury was likely not a catastrophic injury.
Example: Leo’s ankle injury requires medical treatment, but he does not miss any work and does not get any permanent partial disability at the end of his claim. His claim was closed on March 30, 2017.
Leo’s ankle has gotten worse and he would like to reopen his claim. He tries to do this in April 2018. However, since Leo had no lost time from work and was not awarded any permanent disability benefits, he would have had to request reopening his claim by March 30, 2018.
Leo cannot reopen his claim.
5. Reopening claim for permanent partial disability
If the injured worker was entitled to Nevada permanent partial disability but did not receive it and his or her claim was closed, the claim can be reopened for that permanent partial disability.10
The injured worker must show that he or she had a permanent partial disability at the time the claim was originally closed, not at the time he or she is reopening the claim.
Example: Isaac injures his back at work. He thinks he should have gotten permanent partial disability benefits, but his insurance company does not agree and closes the claim. At the time Isaac does not understand all the benefits he is entitled to.
A year later, Isaac believes he should have gotten permanent partial disability and requests his claim be reopened.
An injured worker who loses an appeal cannot reopen a claim.
6. Can a claim be reopened after an appeal?
An injured worker who loses an appeal cannot reopen a claim.11
Example: Monica appeals her claim after she is not given permanent disability. She loses her appeal.
Monica cannot later reopen her claim even if her condition gets worse.
7. Aggravation can be a new injury
A worker may injure himself or herself while employed with one company and then have a subsequent injury while working for a new employer.12 13
There must be a medical determination as to whether the injured worker’s current condition is the result of the original injury or a new injury.
Example: Miguel is a paramedic and injures his back. He receives benefits and the claim is closed.
He is later working for another employer and injures his back lifting a gurney. Miguel tries to reopen his claim.
Miguel’s request to reopen his claim is denied, but he is found to have a new back claim with his new employer.
He can open a new claim and receive worker’s compensation benefits from the insurance company for his new employer.
8. Reopening a claim can provide some relief to an injured worker
If a Nevada injured worker’s condition gets worse after a claim is closed, he or she should consider attempting to reopen the claim.
An injured worker should not delay in going to his or her doctor to get needed medical treatment and temporary disability benefits.
Call us for help…
If you or someone you care about is a police officer injured in the line of work, our legal team can help to file a Nevada workers’ compensation claim. (For cases in California, please see our page on workers’ compensation claims by police officers in California.)
For a free consultation to discuss your case simply fill out the form below or call us.
Legal References:
- Nev. Rev. Stat. § 616C.390
- Jerry’s Nugget v. Keith (1995) 111 Nev. 49, 888 P.2d 921.
- State Indus. Ins. Sys. v. Hicks, 100 Nev. 567, 688 P.2d 324, 1984 Nev. LEXIS 426
- Nev. Rev. Stat. § 616C.390
- Nev. Rev. Stat. § 616C.390
- Nev. Rev. Stat. § 616C.390(6)
- Nev. Rev. Stat. § 616C.390(1)
- Nev. Rev. Stat. § 616C.390(5)
- Nev. Rev. Stat. § 616C.235
- Nev. Rev. Stat. § 616C.392
- Nev. Rev. Stat. § 616C.390(9)
- Warpinski v. State Indus. Ins. Sys., 103 Nev. 567, 747 P.2d 227, 1987 Nev. LEXIS 1871
- Nev. Rev. Stat. § 616C.545