Settled, and it got worse? Reopening a workers’ comp case

What reopening means

The Appeals Board keeps its hand on an award for five years from the injury.

Every California workers’ compensation settlement is approved by a judge of the Workers’ Compensation Appeals BoardWCAB Workers’ Compensation Appeals Board. The court system that decides these cases. 23 district offices statewide., and the Board does not simply let go of the case afterward. The law gives it continuing jurisdiction: in its own words, the Board “may rescind, alter, or amend any order, decision, or award, good cause appearing therefor.” That power “includes the right to review, grant or regrant, diminish, increase, or terminate, within the limits prescribed by this division, any compensation awarded, upon the grounds that the disability of the person in whose favor the award was made has either recurred, increased, diminished, or terminated.”

The five years. A separate statute sets the outer edge. It says that nothing bars an injured worker from bringing proceedings “for the collection of compensation within five years after the date of the injury upon the ground that the original injury has caused new and further disability,” and that the Board’s jurisdiction in these cases “shall be a continuing jurisdiction within this period.” Another provides that no award may be rescinded, altered or amended after five years from the date of the injury, except on a petition filed within those five years.

Two doors, one window. In practice there are two ways back in. A petition for new and further disability says the injury has caused more disability than the award covers. A petition to reopen asks the Board to rescind, alter or amend the award for good cause. Both are bounded by the same five years from the date of injury.

The same claim, not a new one. Reopening returns to the original case: the same date of injury, the same employer, the same carrier and the same file.

A changed condition, not a better deal. Reopening exists for a body that changed. It does not exist to revisit a settlement because the number now looks low, or because a different doctor would have rated the same condition higher.

Can I reopen my case? Already settled? What is still available

Count from the injury, not the settlement

The most commonly miscounted deadline in California workers’ comp.

The five years run from the date of injury. Not from the date you settled, not from the date of the award, not from your last payment, and not from the day you noticed you were getting worse. Because most cases take years to settle, the time left after a settlement is usually much shorter than five years. Count five years from the day you were hurt, not from the day you signed.

What that does to the arithmetic. Illustratively, in whole years: a worker injured in 2021 who settled in 2025 has until 2026, one year rather than five. A worker injured in 2019 who settled in 2024 has already run out on the day of signing. The same settlement can leave years of protection or none at all, depending on how long the case took.

There is no extension for a late discovery. A worsening found after the five years, however real, does not restart the count, and nothing in the statute adds time for not knowing.

Which date is the date of injury. For a specific injurySpecific injury One identifiable event on one date., it is the day it happened: the fall, the lift, the crash. For a cumulative traumaCT — Cumulative trauma Injury from repeated exposure over time. The largest injury category in California and the least claimed., an injury that built up over months or years of work, there is no single day, so the law supplies one: the date you first suffered disability from it and knew, or reasonably should have known, that the work caused it. That date can fall well after your last day of exposure, which means the five years for a cumulative trauma can end later than people expect.

Where to find it. The date of injury is on the claim form, on the application that opened the case, and on the award or the settlement itself. If there is more than one injury, each has its own date and its own five years.

The deadline calculator Cumulative trauma, and its date of injury

Which settlement you signed

The title on the first page decides most of this.

There are exactly two ways a California workers’ comp case settles, and the choice between them is largely irreversible. It also decides, more than anything else, whether reopening is possible at all.

Stipulations with Request for Award. You and the insurer agree on the permanent disabilityPD Permanent Disability. Compensation for lasting impairment. A different and much lower weekly rate — 2026 maximum $290/week. percentage, and it is paid to you every two weeks. Your right to future medical care for the injury stays open, and you keep the right to reopen within five years of the date of injury if your condition worsens.

Compromise and Release. You take a lump sum. Future medical care for the injury is bought out and becomes your responsibility, permanently, and the case generally does not reopen. That is the trade a Compromise and Release makes: money now, in exchange for closing the claim.

A judge approved it, and that cuts both ways. No settlement is valid until a workers’ compensation judgeWCJ Workers’ Compensation Judge. Decides your case. There is no jury. approves it, and the judge must find it adequate, not merely signed. In Gaines v. ABM Aviation, an en banc decision of the Appeals Board in June 2026, the Board confirmed that a judge must independently assess a settlement’s validity and adequacy. That protection works at approval. It is not a way to undo a settlement later because it turned out to be the wrong choice.

Read the document, not your memory of it. The title is on the first page of the settlement, and on the award that approved it. If you cannot find your copy, the Appeals Board’s district office, or its electronic case file, EAMSEAMS Electronic Adjudication Management System. The Board’s case file system., has it.

A workers’ comp settlement offer, read line by line Settlements: Compromise and Release, and Stipulations

What counts as getting worse

A demonstrable change, not the same pain on a different day.

The statute’s phrase is new and further disability, and the courts have defined it. In Applied Materials v. WCAB, decided by the Court of Appeal in 2021, the court wrote that “’New and further disability’ means disability resulting from some demonstrable change in the employee’s condition.” It named the kinds of change that qualify: a gradual increase in disability, a return of temporary disabilityTD / TTD / TPD Temporary Disability, Total or Partial. Wage replacement while recovering. Two-thirds of average weekly earnings; 2026 maximum $1,764.11/week., a new need for medical treatment, or a temporary disability that became permanent.

What tends to show it. A demonstrable change is one the medical record can point to:

• A new objective finding. Imaging, a test or a new diagnosis that was not there at the time of the award.
• Surgery. An operation nobody contemplated when the case settled, or one that failed.
• Documented progression. A degenerative or progressive condition that measurably advanced.
• A compensable consequenceCompensable consequence A new problem caused by the original injury or its treatment. Overusing the other side, the joint above or below, a surgical complication.. A problem the original injury caused later: the other shoulder from doing everything one-handed, the hip or back from a changed walk, a complication of the treatment itself.
• A new period of temporary disability. Time off work again because of the same injury.

What does not. The same condition, unchanged, evaluated more favorably by a different doctor is not new and further disability. Neither is pain that is no worse than it was, or regret about the settlement. The question is always what changed in your body, and when.

A consequence has to be raised, or it counts for nothing. A new problem caused by the original injury is part of the claim, but nobody adds it on their own. Tell the treating doctor at the next visit and make sure it goes in the note; report it to the claims administratorClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer. in writing, dated and specific. A body part that never reaches a medical report is never rated.

Now my other side hurts

The change has to happen inside the five years

Filing early does not stretch the window.

Two timing rules defeat more petitions than any medical question.

The petition must be filed within five years of the date of injury. That is the statute’s own limit.

The worsening itself must happen within the five years. Applied Materials put it directly: to recover more, the worker “must not only file a timely petition to reopen but must also have suffered a ‘new and further disability’ within that five-year period,” unless there is otherwise good cause to reopen the award. And a petition filed early to hold the door open does not work: a worker “cannot confer jurisdiction on the WCAB by filing a petition to reopen before the five-year period has expired for anticipated new and further disability that may occur after the five-year limitation period has run.” You carry the burden of showing that the change happened in time.

A petition filed in time can be decided later. The five years limit the filing, not the decision. In Sarabi v. WCAB, decided by the Court of Appeal in 2007, the court explained that if a petition to reopen is filed within the five-year period, the Board has jurisdiction to decide it beyond that period. A case that is filed in year four and heard in year six is not lost to the calendar.

What that means in practice. Three things have to line up: a change in your condition, a date for that change inside the five years, and a petition on file before the five years end. The medical record is usually what proves the second. A report that says you are worse, without saying since when, leaves the most important question open.

How a petition works

Plead the change, date it, and prove it with medicine.

A petition is a written request filed with the Appeals Board in the original case. It is not a form you send to the insurer, and the insurer does not decide it.

What it says. A petition to reopen for new and further disability pleads the specific, demonstrable change in your condition and when it occurred, and it is supported by medical evidence. A general statement that you are worse is not enough. The change and its timing are what the Board decides.

The medical evidence. The evidence is a physician’s report. Under EscobedoEscobedo The en banc decision requiring an apportionment opinion to explain how and why. A percentage without reasoning is not substantial evidence. v. Marshalls, an en banc decision of the Appeals Board in 2005, a medical opinion the Board can rely on has to be framed in reasonable medical probability, not speculation, and has to rest on an adequate history and examination, with its reasoning set out. A report written to that standard, that names the change and dates it, is what a petition stands on.

What can follow. If the Board finds new and further disability, the award can be increased: more permanent disability where the rating rose, and temporary disability again where you could not work. The record is built as it was the first time, through the treating doctor and, in a dispute, a medical-legal evaluator.

Hurt again, or the old injury worse? If something happened at work again, the honest answer to which it is may be both. A new event is a new injury with its own date of injury and its own claim; work since the first injury can also add up to a new cumulative trauma; and the old injury may simply have worsened on its own. These are usually not either-or choices. Filing a new claim form and, inside the five years on a Stipulated award, a petition to reopen keeps both doors open while the medical evidence sorts out which it is. Choosing wrong on your own is how people lose one without gaining the other.

I got hurt again at the same job Sent to a QME? From the panel to the report

The risk that comes with a petition

The power to increase an award is the same power that can reduce one.

The law that lets the Board increase an award does not run in one direction. Its words, quoted above, are to “diminish, increase, or terminate” compensation, on the ground that disability “recurred, increased, diminished, or terminated.” A petition to reopen for more permanent disability opens the award to a petition from the other side to reduce it, and the defendant has 30 days from your petition to file a counter-petition of its own.

Why that matters. If your condition has improved in some respect while it worsened in another, or if the insurer’s evaluator would now rate you lower, reopening the award puts all of it back on the table. That is not a reason not to file. It is a reason to file with the medical evidence already developed, not to file first and look for the evidence afterward.

The honest odds. A petition with a dated, documented change and a supportive report stands on solid ground. A petition built on pain that has not measurably changed, or on a change that came after the five years, usually fails, and can cost more than it gains.

After a Compromise and Release

Narrow, but not always nothing.

A Compromise and Release is built to close the claim, and it does. Reopening for new and further disability is practically foreclosed. Future medical care for the injury was bought out, and it does not come back because the injury got worse.

The narrow door. The route back into a Compromise and Release is a petition to set the settlement aside for good cause. It is narrow, it is decided by the Appeals Board, and it must be filed within five years of the date of injury. Changing your mind is not good cause; neither is a worsening the settlement was meant to cover. Practically, plan as if a signed and approved Compromise and Release is final.

What a Compromise and Release does not end. Several things survive it, and they are taken up in the next section: a claim against the Subsequent Injuries Benefits Trust Fund, problems with a Medicare Set-Aside, amounts the settlement ordered that were never paid, and the way the settlement interacts with Social Security Disability.

A new injury is a new claim. A Compromise and Release settles the injury it names. A new injury at work, with its own date of injury, is a new claim, whatever the old one settled. So is a new cumulative trauma from work done after the first injury, the route most often missed by workers who assume a settled case ends everything.

And a claim outside workers’ comp. If someone other than your employer caused the injury, a negligent driver, a defective machine, a subcontractor, a third-party claim may exist entirely outside the comp file.

What a settlement does not close

Some claims run on their own clocks.

Several things that matter after a case closes are not governed by the five years at all.

Future medical care under a Stipulated award. If your award left future medical care open, it stays open. The five-year limit on reopening for new disability does not close medical care. Asking for treatment is not reopening the case: your doctor requests it, and if it is denied, the dispute goes through utilization review and independent medical review, as it would have before the award.

The Subsequent Injuries Benefits Trust Fund. If you had a disability before the work injury, from any cause, and the combination is severe, the fund may owe you benefits your employer never did, frequently a life pension. A claim against the fund survives a Compromise and Release. Since July 2026, it has its own deadline: five years from the subsequent injury, or six months from the resolution of permanent disability, whichever is later. The screening question is simple: did any doctor in your case apportion part of your disability to a pre-existing condition?

An award that is not being paid. A late temporary or permanent disability payment is increased by 10% automatically, without anyone asking. Awards bear interest from the date of the award. Compensation unreasonably delayed or refused is increased by up to 25% or $10,000, whichever is less, though that requires showing the delay was unreasonable. And an award can be converted into a superior court judgment, which brings the civil courts’ collection tools to bear.

A Medicare Set-Aside. If the settlement set money aside for future care, that money is restricted to injury-related treatment Medicare would otherwise cover, and it must be accounted for. If it is exhausted, nearly exhausted, or you are unsure it was administered correctly, have it looked at before you need the treatment, not after.

Social Security Disability and retirement. Disability benefits from Social Security can be offset by workers’ compensation, and how a settlement was worded affects the size of that offset, even years later. For public employees, industrial disability retirement is a separate proceeding, with its own standards and its own medical evidence.

• The settlement’s first page — Stipulations with Request for Award, or Compromise and Release, and the date the judge approved it.
• The date of injury, plus five years — For each injury in the case; for a cumulative trauma, the date the law sets, not your last day of work.
• Medical records since the award — Anything new: imaging, a diagnosis, a surgery, time off work, a new body part, each with its date.
• Any apportionment finding — A doctor who apportioned part of your disability to a pre-existing condition is the screen for the Subsequent Injuries Benefits Trust Fund.
• The payment ledger — Every payment the award ordered, against the date it was due.
• The set-aside balance — If there is one, what is left and how it has been spent and reported.

• After SB 171: the Subsequent Injuries Benefits Trust Fund
• The 10% the law adds to a late check
• Treatment denied? Utilization review and IMR

When you do not need a lawyer for this

Sometimes the answer is that nothing is left to do, and that is worth knowing too.

Not every settled case has something left in it. If your Stipulated award left future medical care open and your treatment is being approved, you are using the award as it was meant to work, and nothing needs reopening. If the five years have passed, nothing has gone unpaid, there is no set-aside and no earlier disability, a consultation may tell you only what you already suspect. The state’s Information and Assistance officers answer questions about a claim at no cost, including what your settlement says and how to count the date.

A consultation is worth having when your condition has changed and the five years have not yet run, when a doctor has apportioned your disability to something earlier, when payments the award ordered are late or missing, or when you were hurt again and cannot tell whether it is the old injury or a new one. A petition carries the risk of a counter-petition, and that is a reason to have the evidence and the dates checked first. A consultation with this office costs nothing, and if there is nothing worth doing, we will tell you that.

When you don’t need a lawyer, and what changes the answer