Worsening of Condition in Maryland Workers Compensation Cases
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If you have been involved in a Maryland Workers Compensation case you may have heard the term worsening or reopening. While an injury on the job ordinarily requires the assistance of a Maryland work injury lawyer, the need for representation is increased substantially if the injured worker wants to reopen for worsening. In regards to the term worsening and reopening there are two scenarios which will ordinarily arise.
The first scenario in which the injured worker may hear or use the phrase “reopen for worsening” is when verbalizing their physical issues. At times physical therapy or injections will worsen the injured workers physical problems to the point where they will need increased or more aggressive treatment. Premature or overly aggressive therapy may lead to physical complaints that require surgery or increased medication use. The injured worker may go through a course of treatment and show improvement or apparent resolution of symptoms. Once the treatment stops the pain may return and may return worse.
When symptoms worsen it is important to be seen by a doctor immediately. Reopening is important at this time especially in the case where the treatment had previously concluded. For example: Physical therapy improved the injured Maryland worker to the point where they could return to their job and discontinue the therapy. About a month or so later the pain and complaints come back with a vengeance. It is this scenario that should lead the injured worker to the doctor immediately. Not only is prompt treatment important for the injured workers’ health but the injured worker will be met with reluctance from the workers compensation adjuster if they wait to seek out treatment. A gap in treatment is indicative there is no true injury so the adjuster will be very unlikely to reopen the file and often simply tell the injured worker their case is closed. Hint: Your case is not closed!
The second scenario in which the injured worker will hear the reopening for worsening used is in regards to Maryland workers compensation procedural law. An injured worker goes through treatment and is discharged from the doctor as at maximum medical improvement (MMI). The injured worker will then be entitled to recover compensation if they have any remaining issues. That compensation is referred to as permanency. Under the work injury laws of Maryland a person may apply for a modification of the previous award and reopen their case for “worsening of condition.” This entails more treatment and possibly recovery of more compensation at a new permanency hearing.
The reopening of the case can take place if the injured workers’ condition is worse than it was at the time of the permanency hearing. The worsening can be in the form of increased pain, different complaints, increased restrictions and so on. There are some practical restrictions to an injured worker when they seek to reopen their workers compensation case:
Consider the prior permanency awarded to the injured worker
When the injured receives his or her permanency award there will be a percentage impairment issued on the award. The lower the number the less likely the injured worker will be able to reopen his case for treatment. The higher the number, the more likely the injured worker will be able to reopen their case. For instances an injured Maryland worker who was awarded a 2% impairment to the injured body part is unlikely to successfully reopen their workers compensation case. On the other hand, an award of 10% or more may lead to a successful reopening. Re-openings are not something that should be handled without a Maryland workers compensation attorney as they are even more complicated than the first period of the case and often met with more resilience from the workers comp insurer.
How long has it been since the injured worker was last seen?
The timing of a reopening is a factor that must be considered by the injured Maryland worker. If it has been only two or so months since the first permanency hearing then some reluctance should be exercised upon reopening. On multiple occasions Workers Compensation Commissioners have commented about reopening in such close proximity to the first permanency award. The theory is that quick re-openings reflect that the employee was not “permanent” the first time around and now continues to seek compensation arbitrarily. Premature modifications can not only damage the claim but often lead to the claim being barred for ever and the injured worker missing out on valuable and needed treatment.
In the alternative, a reopening that takes place years later may also have the same affect as the premature modification. A serious condition will require follow up treatment regularly. In Maryland if the injured worker does not reopen for an extended duration then the reopening may seem like a measure only motivated by the compensation and not for medical necessity.
It is best for Maryland injured employees to consult a qualified and experienced workers compensation attorney so that they can be properly advised regarding the reopening/ modification of their prior permanency award.
Has the injured worker been involved in other accidents?
Accidents arising after the first permanency award may prove fatal to the original claim however this is not always the case. Obviously the body part that was injured in the subsequent accident must have been the body part that was involved in the workers compensation case. Also, the subsequent accident must be looked at to determine the severity of the injury, and the treatment provided. If the injured worker was able to get back to their base line pain level then they be successful in later reopening their workers compensation case for continuing treatment and further permanency.