My claim is closed, but I still need medical treatment for my accepted medical condition. Can my claim be reopened?
Yes. You may be eligible for medical treatment or your claim may be reopened if your attending physician recommends further medical treatment.
- Aggravation: An aggravation is a request to reopen your claim for an actual worsening of your accepted medical conditions. You must fill out Form 827 at your doctor’s office and check the box on the form that says “Report of aggravation of original injury.” Your doctor will send this form to the insurer along with medical reports describing your worsened condition and need for medical treatment.
- Palliative care: Palliative care is medical services provided to temporarily reduce or moderate the intensity of an otherwise stable condition to enable you to continue working. Your claim does not need to be reopened to receive palliative care, but your attending physician does need to submit a Form 827 to the insurer requesting approval.
Is there a time limit to file a claim for “aggravation”?
Yes. Your right to reopen your claim, or your “aggravation” rights, ends five years after your claim was originally closed (for a disabling claim) or five years after your date of injury (for a nondisabling claim).
Can my claim still be reopened after my aggravation rights end?
Yes. You must submit a written request for own-motion benefits to the insurer indicating that your condition has worsened, resulting in an inability to work and requiring hospitalization or inpatient or outpatient surgery, or other curative treatment prescribed in lieu of hospitalization that is necessary to enable you to return to work.
If your reopening request is for a new medical condition or an omitted medical condition related to your original claim, you must clearly request formal written acceptance of that condition and inform the carrier of your request for own-motion benefits. Your request must clearly specify the conditions for which you are seeking acceptance.
More information about own-motion benefits.