Insurance Carriers have to keep a Kentucky workers compensation claim open at least five years. There is a specific regulation of the Kentucky Department of Workers’ Claims which requires claims to be open at least five years. Here is the pertinent part of the regulation:
803 KAR 25:240. Workers’ compensation unfair claims settlement practices.
Section 2. File and Record Documentation.
(6) A claim file shall be maintained for a period not less than five (5) years following the creation of the material or the completion of the purpose for which it was created, whichever shall occur last.
So, if a carrier tells you that your Kentucky Workers’ compensation claim is closed, you can tell them they are violating the law, and cite that regulation.
If the carrier still argues the claim is closed, call the Department of Workers’ Claims, 502-564-5550, and ask to speak to a Claims Specialist. Tell the Claims Specialist the problem you are having with the carrier and give them your carrier’s claim number and the name of the adjuster. The Claims Specialist will probably threaten them with a fine, and they will then admit the claim is open.
Now, just because your claim is still open does not mean the adjuster will bend over backwards to make you happy. The carrier still gets to argue if medical treatment or other benefits are work related and reasonable, but you are now able to get your foot in the door and see if you can get that treatment. In addition, you have statute of limitations that require the injured employee to file or settle a formal claim within certain time limits, which is usually two years from the date of the injury or last payment of temporary total disability benefits, whichever is later, for traumatic injuries. If a formal claim is not filed or settled within that time, the carrier is probably off the hook for any payments for a traumatic injury.