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Kentucky high court clarifies prerequisites for reopening claim

Ky supreme court

The Kentucky Supreme Court unanimously ruled that a claimant does not need a permanent injury to reopen a claim.

Maria Jimenez worked for Lakshmi Narayan Hospitality Group at a Holiday Inn in Louisville. She suffered injuries in August 2014 when she slipped and fell while cleaning a bathroom.

An administrative law judge awarded Ms. Jimenez temporary total disability benefits from August 2014 through April 2015. The ALJ also determined that Ms. Jimenez did not sustain a permanent injury and was not entitled to future medical benefits.

In July 2019, Ms. Jimenez filed a motion to reopen due to a change in disability after being diagnosed with cervical disc disease and depression. She also sought an award of permanent partial disability benefits.

The ALJ granted the motion, and the reopened claim was assigned to a different ALJ, who found that Ms. Jimenez established a worsening of her condition and awarded permanent partial disability benefits and reasonable medical expenses.

The Workers’ Compensation Board reversed because the original ALJ had found she did not sustain a permanent injury.

The Court of Appeals then reversed, ruling that Ms. Jimenez's claim was not barred and that the board had misconstrued state law on reopening claims.

The Kentucky Supreme Court in a Sept. 22 decision clarified that state law allows the reopening and review of any award or order when there is fraud, newly discovered evidence, a mistake or a change of disability. The court said Ms. Jimenez's efforts to reopen her workers compensation claim due to a change in her disability are covered by the statute

WorkCompCentral is a sister publication of Business Insurance. More stories here.