In workers compensation cases, things (like an injured worker’s functional capacity) change over time, but thankfully the law gives the Labor Commission continuing jurisdiction to make changes as needed. Utah Code 34A-2-420 states the Labor Commission “may from time to time modify or change a former finding or order of the commission.” However, other sections of the Workers Compensation Act (WCA) require the injured worker to prove his/her claim for indemnity (disability payments to the injured worker) within 12 years, so there is a limit to this “continuing jurisdiction.” There is no such 12-year limit for a claim for medical treatment (e.g., payment of medical bills)–the 12-year limit only applies to claims for disability payments (e.g., for lost wages and permanent impairment). Note: If the injured worker got hurt before 1999, then the 12-year rule does not apply.
What does this mean? If you got hurt less than 12 years ago; and if the workers comp insurance company paid some benefits and closed your case; and if your condition has worsened, then the Labor Commission still has jurisdiction to order the carrier to pay further benefits.
On the contrary, if you got hurt after 1999 but more than 12 years ago, your claim for further indemnity will likely fail, though you can still claim medical benefits (i.e., surgery) if you can prove that the needed surgery is reasonable and necessary and due to your industrial accident.
The rationale for this 12-year rule was explained in a 2017 Utah Supreme Court case called Waite v. Labor Commission. The idea is that evidence grows stale and insurance companies would need to charge higher premiums if they were required to defend and potentially pay benefits on old cases. Of course, the counter-argument is that these cases are rare (they will not “break the bank” for insurance companies) and injuries sometimes grow worse over a long period of time. But, the Utah Supreme said balancing these arguments is an issue for the legislature and the legislature in 1999 voted for the 12-year rule.
This blog if for general information purposes and is not tailored legal advice. If you have questions about how the 12-year rule might apply to your situation, contact Tim Daniels Law Services at (435) 592-1235.