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  1. #1
    Join Date
    Sep 2010
    Posts
    1

    Default Can Old Claim Be Reopened

    I had an old claim that was settled back in 1992. The company attorney insisted that since I was getting a lump sum settlement that future medical entitlement was non-existent. Company attorney also warned that if any attempt to re-open claim for benifits,that any monies paid would be sued back for by the company. The judge admonished both attorneys ( their's for the tirade and mine for lack of proper representation as the case took so long garnering only monetary compensation.

    After leaving the chambers the attorney sensing that there was some merit to a claim of lack of representation uttered something about the case could be re-opened at a later time for future medical if needed. Over the years my spinal and shoulder injuries have become worse to the point that it is very difficult to work through the pain. I am interested in exploring options available for getting medical and possibly lost future compensation.

    At the time I was covered by federal workers compensation as my place of work was on a dockside facility. Thanks for any help.
    Last edited by Art; 09-07-2010 at 08:29 AM.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Can Old Claim Be Reopened

    If you were paid benefits under the federal comp rules, then Calif WCAB/DWC and labor code statutes have NO bearing on your claim.

    There are no dollars for future lost wages in WC.
    If you closed the claim by C&R/lump sum cash payment, you cannot reopen the claim.
    If you have returned to work with another ER/employer, you would file a new claim for injury. You'd have to assuem the prior ER/carrier would deny reopening anyway....as one, due to the time lapse, and two, new ER, they would claim you had reinjured your prior claimed body part... which would be a new injury and claim with the current ER.

    IMHO... forget about what was... doubt there is any recourse there anyway, and file a first report of injury with your current ER.
    Aggreviation to a prior industrial injury is a compensable claim. There are pre exsisting injuries/issues in WC. You are entitled to medical care, even though a prior PD rating would be subject to apportionment to cause of additional PD/WPI or impairment.
    You are 18 years post (prior) injury/settlement. Unless you have a court ordered Finding w/Award, or Stipulated Award that contains future medical care provisions, there is nothing to fall back on... let alone the issues I described above.

  3. #3
    Join Date
    Oct 2010
    Posts
    1

    Default Re: Can Old Claim Be Reopened

    I was viewing this thread and I also have an old claim, 30 year old one at that. Thank god I save every piece of paper from the injury as well. I did receive a stipulated award for further care and now that I am 50, the body part needs to be replaced because of the injury. I chased records all over the place, did the work of a lawyer and researcher. The state trashes old records and, so it is up to the worker to save his own injured butt. The case is being reconstructed with all my saved records that I maintained. I did try fileing on a reoccured injury, but the L&I examiner just happen to know the Doctor that did my operation. He denied my claim and filed his examin specifying that the original employer was still 100% responsible for the injury and will be for the rest of my life. Sheesh, at the time of operation, my doctor was like 90 years old and I was only age 19. This L&I examiner doctor that knew him was about 80 years old today, so I figure he was probably just starting out as a doctor when he met my original doctor that did the 1st operation. My original MD is dead now and has been for years.
    Well, this thread did make me feel better and as long as the WCAB folks in SF don't have an issue with my records I will be getting some medical care in the future to correct my injury for the last time, I hope.
    Last edited by Bradmph; 10-14-2010 at 10:46 AM.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Can Old Claim Be Reopened

    You are referring to "L&I" here, as well as WCAB... there is no L&I in Calif, only the WCAB has jurisdiction over a WC claim.
    Well, this thread did make me feel better and as long as the WCAB folks in SF don't have an issue I will be getting some medical care in the future to correct my injury for the last time.
    FMC/Future Medical Care awards cover the "natural progression of the injury/illness". That also covers only the accepted body part, or at times, those conditions a Dr can relate to the org injury with substantive medical reasoning/evidence.
    I did receive a stipulated award for further care and now that I am 50, the body part needs to be replaced because of the injury.
    If you have returned to work during the last 30 years... there is always the arguement by the former ER/IC, you have aggreviated the prior injury, or reinjured the same body part, but activities outside your employment, or with the job functions of your new ER. That arguement is used to deny you FMC under the prior award. And, believe it or not, is fully acceptable to a judge at the WCAB. Your prior ER/IC is not liable for what happens when you aggreviate/reinjure with a subsequent ER.

    "Natural progression...etc", basically means parking you butt on the sofa in front of a TV...with a remote.
    Even if you are involved in a MVA/car accident... that too would void the FMC award. Another party is then liable for your injury.

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