What is the difference between Reopening and Reconsideration?

The Maryland Workers’ Compensation Act (“the Act”) provides three methods for challenging an individual award.  Immediately after the Workers’ Compensation Commission (“WCC”) issues its decision, an injured worker may request a rehearing before the Commission or appeal the case to circuit court.  Additionally, injured workers may petition the Commission to reopen a case due to a subsequent “worsening of condition.”  It is important to note that all three avenues of review carry strict timing requirements that must be met for a case to proceed.

For example, a request for a rehearing must be made within 15 days of the Commission’s Order, an appeal must be filed within 30 days of the later of either the Commission’s Order or its ruling on a request for rehearing, and a petition to reopen must be made within five years from the date of “the last compensation payment.”

The following will discuss in-detail the procedures involved in seeking rehearings and reopenings.  For more information on appellate review, click here.

Rehearings

The Act is located in Title 9 of the Labor and Employment (“L&E”) Article of the Maryland Code.  Therein, L&E § 9-726 governs motions for rehearings (also referred to as a request for “reconsideration”).  In order to properly request a rehearing, a motion must be filed in writing within 15 days of the WCC’s decision.  L&E § 9-726(a).   The motion must state the grounds on which reconsideration is sought, and the WCC may only grant the motion due to an error of law or newly discovered evidence.  L&E § 9-726(d)(3).  The WCC can also deny the motion without a hearing.  L&E § 9-726(d)(2).

Reopenings

While a Claimant may only seek a rehearing under L&E § 9-726 on two limited grounds, the ability to seek a reopening of his or her case is much broader.  Rather than being limited to assertions of legal error or newly discovered evidence, injured workers may reopen their comp claims simply because of a “worsening of condition.”  Moreover, reopenings are possible for all four types of disability benefits; even if the initial claim was only for temporary disability, an injured worker may thereafter reopen the case to seek a permanent award.

Reopenings are covered by L&E § 9-736.  Again, injured workers may request to reopen their comp claim due to a subsequent worsening of condition.  However, the employer/insurer, as well as the Commission itself, also possess the ability to seek a reopening.  L&E § 9-736(a).  For example, if an employee is receiving permanent total disability (“PTD”) and the employer gets word that the employee has subsequently found work elsewhere, a request may be made for a readjustment of the employee’s PTD benefits.

For an injured worker to reopen his or her case due to a worsening condition, “issues” must be filed with the Commission in writing.  Although the pertinent medical documentation need not be submitted at the time of filing, a petition to reopen must be supported by a sufficient factual basis—i.e. generalized allegations of a worsening in condition may be denied summarily.

Under L&E § 9-736(b)(3), the WCC may not reopen a case to “modify an award unless the modification is applied for within 5 years . . . [of] the last compensation payment.”  In applying this statute throughout the years, Maryland courts have been tasked with defining terms such as “compensation” and “payment.”  With respect to what constitutes “compensation” under L&E § 9-736(b)(3)(iii), the courts have held that the term encompasses disability benefits and attorneys fees, but not medical bills.  See Chanticleer Skyline Room, Inc. v. Greer, 19 Md. App. 100 (1973), aff’d, 271 Md. 693 (1974) (attorneys fees); Holy Cross Hosp. v. Nichols, 290 Md. 149 (1981) (medical bills).  Accordingly, to properly reopen a case under Maryland law, a Claimant must file Issues that seek additional disability compensation, rather than simply requesting further medical care.  McLaughlin v. gill Simpson Elec., 206 Md. App. 242 (2012).  Lastly, any “compensation” must have been paid pursuant to an Order of the WCC, as opposed to voluntary payments by the employer.  See Mona Elec. Co. v. Shelton, 377 Md. 320 (2003).

The term “payment” was defined by the Court of Appeals of Maryland in the case of Stachowski v. Sysco Food Service of Baltimore, Inc., 402 Md. 506 (2007).  Specifically, the issue before the Court was whether “payment” referred to the date on which the last compensation payment was mailed to the Claimant, or alternatively, the date on which the payment was received by the Claimant.  This mattered because the date that the Claimant had requested a reopening was more than 5 years after the date his last compensation payment was mailed, but within 5 years of the date the payment was received.

The Court of Appeals opined that the term “payment” was ambiguous and thus had to invoke classic principles of statutory construction to resolve the issue.  The Court held that payment occurred upon the date of receipt, rather than on the date of mailing.   This decision reversed the earlier rulings of the WCC, circuit court and Court of Special Appeals, which had all concluded that payment was complete upon mailing.  The reversal was supported by both the dictionary definition of payment, in addition to the term’s usage elsewhere in Maryland law.  See Stachowski, 402 Md. at 526.

Furthermore, a modification of an award pursuant to a reopening may have prospective effect only.  This is because a modification pursuant to a reopening is based on a change of circumstance, and not upon any legal error in the original award itself.  See W.R. Grace & Co., et al. v. Swedo, et al., 439 Md. 441, 458 (2014) (citing Del Marr v. Montgomery County, 397 Md. 308 (2007)).  Therefore, when crediting an employer upon reopening for payments previously made, the proper calculation would be based on the amount of weeks of payments and not on the total dollar amount.  Del Marr, 397 Md. at 320.  To credit the employer in terms of total dollars paid could have the effect of retroactively modifying the initial award.

Relevant to any disability calculation is the employee’s average weekly wage (“AWW”); this remains true in the context of reopenings.  Moreover, while the purpose of a reopening is to account for a material change in circumstance, the calculation of a Claimant’s AWW is always based on the date of injury.  See Jung v. Southland Corp., 114 Md. App. 541 (1997).