Can I Reopen My Kentucky Workers Compensation Claim If My Medical Condition Has Worsened?

The answer is yes. However and as with other legal claims, there is a time limit and other requirements. There is a four-year limitation period to reopen a Kentucky workers compensation claim.

A case, Toyota Motor Manufacturing v. Prichard, recently decided by the Kentucky Supreme Court provides a good illustration of how and when a Kentucky workers compensation claim may be reopened because of a deteriorating and worsening medical condition.

The worker, Prichard, suffered a neck injury while working on the assembly line at Toyota on March 16, 2005. She was diagnosed with a cervical strain and degenerative disc disease in her neck area. She filed a Kentucky workers compensation claim on March 14, 2007, and on November 13, 2007, and ALJ found she had a permanent impairment rating of 8% and awarded her permanent partial disability (often referred to as "PPD benefits) benefits corresponding to that impairment rating. Prichard tried to return to work, but her condition worsened and she had cervical fusion surgery performed in August 2008.

Prichard moved in April 2009, well within the four-year limitation period, to reopen her original 2007 award, because her injuring and resulting impairment had worsened. An ALJ ruled in September 2011 that her impairment rating had increased from 8% to 28%, a ruling that entitled her to a corresponding increase in PPD benefits.

Prichard's medical condition continued to deteriorate. In April 2014, her doctor concluded that she was unable to perform even sedentary work, something she had previously been thought able to perform. On August 12, 2014, Prichard moved to reopen the 2011 award. This time the ALJ in an opinion and Ward issued May 20, 2015, concluded that as a result of the further deterioration of Prichard's work-related cervical condition, she was totally disabled.

Toyota appealed and argued that Prichard's right to reopen her Kentucky workers compensation claim was cut off four years after the initial 2007 award. The Kentucky Supreme Court rejected that ruling and reiterated  the rule as follows: when an order granting or denying workers compensation benefits has been entered subsequent to the date of the original award, the four-year limitation period for reopening the claim is calculated from the later date, rather than from the original award.

There is no limit on the number of times that a Kentucky workers compensation claim may be reopened, but each reopening must occur  within the four-year limitation period of the date that the last order either granting or denying benefits was entered. Obviously, problems of proof – tying the worsening condition to the initial work injury – arise as more and more time passes from the date of the injury.