Q: I have 2 work comp claims. One from 2012, and one from 2015. They were always treated as 2 separate claims..
I am treated by different doctors as they are different injuries. I am seen every 2 to 4 months from both doctors. The insurance carrier, without notice, closed one claim and combined it with the other. My Dr was not paid, that is how I found out. The carrier told him the claim was closed and to use a different claim number, the claim number from my other injury.. Can the carrier do that? I was never notified. I asked the carrier, she said one of the claims closed, and to use the one, open claim for everything. She would not give me a reason why. (the newer claim was closed)
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A: The short answer is that an insurance carrier does not have the ability to decide whether a subsequent injury is a "new injury" or a "recurrence" of a previous injury. The insurance carrier can certainly issue papers, trying to shape the case one way or the other, but, ultimately, that would be an issue for a workers' compensation judge to decide. There may be a reason why your case would be better served one way or the other, so it is critical that you consult with an attorney who is certified as a specialist in PA workers' compensation law, so you can get legal advice based on the specific facts of your case. Good luck!
A:
Open or closed are often times just the classifications used by the insurance carrier for their own internal file management. The important question is whether or not the 2015 injury was ever legally accepted using the proper Bureau forms. You only have 3 years to file a Claim Petition if the injury has not been properly accepted. Once the 3 years passes, even if the carrier has paid medical bills, you may be barred from pursuing this injury further.
In addition, if you are losing time from work due to the injury or if you lose time from work in the future, the 2015 injury date may have a higher compensation rate. This is another good reason to make sure the 2015 date of injury was properly accepted.
If you do not have an attorney, I would strongly suggest you contact an attorney to confirm the legal status of the 2015 date of injury.
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