There are a number of circumstances in which they Kentucky workers compensation claim needs to be reopened. The two most common are (1) where the problems caused by the work injury worsen and the injured worker becomes entitled to a greater amount of permanent partial disability (often referred to as PPD benefits); and/or, (2) further medical treatment is necessary to deal with the problems caused by the work injury.
There are two basic limits and requirements to reopening a Kentucky workers compensation claim. The first is a time limit. A Kentucky workers compensation claim cannot be reopened when more than four years have passed since the last order granting or denying benefits was entered. The second is the requirement of proof or evidence of a greater impairment rating and/or the need for additional medical treatment.
A case, Toyota Motor Manufacturing v. Prichard, provides a helpful discussion and illustration for when reopening a Kentucky workers compensation claim is necessary. The worker sustained a neck injury working on the assembly line at Toyota on March 16, 2005. She filed a Kentucky workers compensation claim on March 14, 2007, and later that year, on November 13, 2007, she was awarded permanent partial disability (PPD) benefits based on a permanent impairment rating of 8%. She tried to return to work but encountered continuing and escalating problems. In August 2008, she had cervical fusion surgery.
Prichard in April 2009 filed to reopen her 2007 award because her injury and the resulting impairment and worsened. More than two years later, in September 2011, an ALJ ruled that her permanent impairment rating had increased from 8% to 28%, a decision that in turn increase the amount of PPD benefits to which she was entitled.
Despite the surgery, Prichard's condition continued to deteriorate and her doctor concluded in April 2014 that she was no longer able to perform even sedentary work. A few months later, on August 12, 2014, Prichard sought to reopen the 2011 award. Notwithstanding testimony from Toyotas medical expert that her condition had not changed since 2009, Prichard was deemed totally disabled by the ALJ in an opinion issued May 20, 2015, because of further deterioration of her work-related cervical condition injury.
Toyota appealed and argued, among other things, that Prichard had only four years after the original and the initial Kentucky workers compensation award in 2007. The Kentucky Supreme Court had already rejected this type of argument in a 2008 case and did so again. The court 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 to reopen is calculated from the later date, rather than from the original award. Since Prichard sought in 2014 to reopen the 2011 award, she was within the four-year limitation period.
Lexington, Kentucky workers compensation lawyer Robert Abell represents individuals and employees in Kentucky workers compensation cases; contact him at 859-254-7076.