What to Do After Your Claim Is Reopened

By Jason Weinstock on June 1, 2011

If you manage to jump through the hoops to finally get your claim reopened for more treatment, what’s next?  (If you are still having trouble reopening your claim, please click here for help in reopening your claim.)

1. Send the insurer the bill for the doctor’s exam and report that was used to reopen your claim.  As with all communications to the insurer, make sure that you keep a copy of the bill and the letter you send requesting reimbursement.

2. Request treatment with a doctor on the insurer’s provider list.   If the doctor you used to reopen your claim is not on the insurer’s provider list, then you will need to select one who is on the provider list to treat you.

3. Benefits are paid retroactively to the date the claim is reopened.  If you are unable to work, you must ask your doctor for an off- work slip in order to obtain compensation benefits.  The insurer will not pay you for any time you were unable to work before you requested reopening of your claim.

4. If you were receiving a PPD installment check, those installments will stop if you are entitled to receive TTD checks now that your claim is reopened.  The law does not allow you to receive a TTD check and PPD simultaneously.  If you received a lump sum PPD check, a small amount of money will be deducted from your current TTD check as an offset.

5. You may be entitled to another rating evaluation when you are done with treatment again.   If your treating doctor states that you have a ratable impairment when you conclude treatment after your claim has been reopened, you may be rated again.  If you have a percentage of impairment that is greater than what you have already received, you will be awarded the difference.