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Can you reopen your workers’ comp claim in Pennsylvania?

If you sustained an injury at your Pennsylvania job, and if you now receive workers’ compensation benefits, your employer may lead you to believe that the benefits you receive are all that you can get. That is not true. In certain circumstances, you can reopen your workers’ comp claim and request more benefits.

According to FindLaw, you may reopen your workers’ compensation case under limited circumstances. Such circumstances include a worsened medical condition, a mistake or an error that a medical professional made in your diagnosis or treatment, overpayment of benefits, fraud or mutual mistake of material fact.

Worsening condition is the most common reason that injured parties reopen their workers’ comp cases. For your case to qualify for reevaluation on the grounds of worsened condition, you must not only have a physician’s report stating that your condition has gotten worse, but also, you must have substantial evidence that the original compensable injury caused the worsening condition. You must also prove that your worsening condition makes you eligible for additional workers’ comp benefits. Your condition must be purely physical or mental in nature. A worsening economic situation is not grounds for additional workers’ comp benefits.

It is important to keep in mind that just as you have the right to reopen your workers’ compensation case, so too does the insurer have a right to reevaluate your benefits. If the insurer believes that you were overpaid or that you made your claim under fraudulent circumstances, it may request a repayment of benefits.

The information in this post is for purely informational purposes. You should not perceive it as legal advice.