Opinion ID: 1451210
Heading Depth: 1
Heading Rank: 2

Heading: Motions to Reopen

Text: Although the principle of finality of judgments applies to Workers' Compensation awards the same as court judgments, KRS 342.125 permits an award of compensation to be reopened prospectively in some cases due to certain post-award changes. Beale v. Faultless Hardware, 837 S.W.2d 893, 896 (Ky.1992). The procedural device for doing so is a motion to reopen. Hodges v. Sager Corp., 182 S.W.3d 497, 499 (Ky.2005). A motion to reopen is, in some respects, similar to a motion to re-docket, where the grounds for re-docketing are tested prior to the matter proceeding further. Cf., Evans Elkhorn Coal Co. v. Ousley, 388 S.W.2d 130, 131 (Ky.1965) and Stambaugh v. Cedar Creek Mining Co., 488 S.W.2d 681, 682 (Ky. 1972). As we explained in Stambaugh : The party who seeks to change the Workmen's Compensation Board's decision... on an application to reopen should be required to make a reasonable prima facie preliminary showing of the existence of a substantial possibility of the presence of one or more of the prescribed conditions that warrant a change in the Board's decision before his adversary is put to the additional expense of relitigation. The Board should formulate reasonable standards for the form and content of such a preliminary showing. [3] Id. at 682. Stambaugh , left [it] to the fact-finder's `reasonable discretion' to determine whether the showing in a particular case was sufficient to warrant the taking of evidence. Hodges, 182 S.W.3d at 500 ( quoting Stambaugh, 488 S.W.2d at 682). However, where the premise for a motion to reopen is a post-award change of disability [or medical condition], the change must exist when the motion is filed and the motion must be supported by the prima facie showing that KRS 342.125( l )(d) specifies. Id. (emphasis added). Although, Hodges , dealt with the type of prima facie showing that KRS 342.125( l )(d) requires in order to grant a motion to reopen, it very pointedly established when the prima facie showing must be made. Id. at 498. In Hodges , the claimant filed her motion to reopen on December 12, 2000. On January 18, 2001, the ALJ placed the matter in abeyance. On January 19, 2001, the employer filed its response to the motion. On January 26, 2001, the ALJ amended the previous order, granted the motion to reopen, and placed the reopened claim in abeyance. In the subsequent proceeding on the merit s, the employer continued to assert that the claimant's motion failed the necessary prima facie showing. In upholding the employer's argument, this Court stated: The record before the ALJ on January 26, 2001, included medical evidence that addressed the claimant's condition in May, 1999, when Dr. Davies began treating her. That evidence did not permit her impairment in 1987 to he compared with her impairment in December, 2000, when she filed her motion to reopen. Under the circumstances, it was an abuse of discretion to grant the motion. Id. (emphasis added). A claimant's burden at reopening is to prove that she sustained a post-settlement worsening of impairment from the injury; to prove that the change is permanent; and to prove that it caused her to be totally and permanently disabled. Colwell v. Dresser Instrument Div., 217 S.W.3d 213, 217, 218 (Ky.2006). Income benefits are awarded based upon the amount of occupational disability which exists at the time the worker reaches maximum medical improvement following an injury, Brooks v. University of Louisville Hosp., 33 S.W.3d 526, 530 (Ky.2000), and an [i]mpairment is considered to be permanent `when it has reached maximum medical improvement (MMI), meaning it is well stabilized and unlikely to change substantially in the next year with or without medical treatment.' Colwell, 217 S.W.3d at 217. Thus, given the fact that Hall was still receiving TTD benefits and had not reached MMI by the time the four year limitation allegedly ran, she could not have made the prima facie showing as is required upon the filing of a motion to reopen prior to its alleged expiration date. The unsupported suggestion by the Court of Appeals that Hall could have avoided the four year limitation of KRS 342.125(3) by pre-filing and then abating the motion to reopen until she reached MMI (even if MMI was post-expiration of four years from the original award date) is simply not correct under the existing statutory scheme. See Kendrick v. Toyota, 145 S.W.3d 422, 425 (Ky.App.2004). In Kendrick , the Court of Appeals stated: Addressing the claimant's argument that the abeyance provisions contained in KRS 342.265(5) and the statute of limitations contained in KRS 342.185(1) should be applied so as to extend the statute of limitations on reopening, the court determined those statutes were directed solely to the application for resolution of a claim and the filing of an application for adjustment of claim respectively. The court stated that based upon the plain language of the statutes, they were applicable to initial claims and not motions to reopen. Id. (citations omitted) (emphasis added). There is simply no statutory authority for an ALJ to place a motion to reopen in abeyance once the motion is challenged by an opposing party. Moreover, the suggestion by the dissent, that since Appellant had asked for all proper relief in her motion for TTD benefits her KRS 342.125(3) statute of limitations within which to file a motion to reopen was extended from July 22, 2001 to June 7, 2002  is belied by the dissent's ultimate premise  that KRS 342.125(3) cannot be extended by subsequent orders granting benefits. This notwithstanding, that MMI is a prerequisite for the evaluation of permanent impairment and a permanent impairment rating is [a] prerequisite to a finding of permanent total disability. Colwell, 217 S.W.3d at 217. An [i]mpairment is considered to be permanent `when it has reached maximum medical improvement (MMI), meaning it is well stabilized and unlikely to change.' Id. Once an impairment has reached MMI a permanent impairment rating may be performed. Linda Cocchiarella & Gunnar B.J. Anderson, Guides to the Evaluation of Permanent Impairment 19 (5th ed.2000). Thus, as a practical matter it takes many months to put together experts and expert reports making the appropriate medical/legal comparison between the prior permanent partial disability and a permanent total disability, as well as the other documentation required by 803 KAR 25:10 § 4(6)(a). And this can only begin after the attainment of MMI. Here, MMI occurred eleven (11) months after the alleged expiration of the limitations. Generally, the standard for reopening that existed as of the date of the injury controls the rights and obligations of the parties. Woodland Hill Min., Inc. v. McCoy, 105 S.W.3d 446, 448 (Ky.2003); KRS 342.125(6). However, the four year statute of limitation added to KRS 342.125 after Hall's injury is an exception to the rule. Meade v. Reedy Coal Co., 13 S.W.3d 619, 622 (Ky.2000) (the four-year limitation contained in KRS 342.125(3) govern[s] the reopening of claims in which an award is entered on or after December 12, 1996.). Thus, the evidentiary standards for reopening are controlled by the statute on the date of injury (1995), but, the limitation period is governed by the latter amendment. Id. In 1995, when Appellant was injured, KRS 342.125(1) provided an award or order could be reopened at any time upon the requisite showing. As aforenoted however, KRS 342.125(3) was amended effective December 12, 1996, to provide, in pertinent part, that: (1) Upon motion by any party or upon an ... administrative law judge's own motion, an ... administrative law judge may reopen and review any award or order on any of the following grounds: . . . . (d) Change of disability as shown by objective medical evidence of worsening or improvement of impairment due to a condition caused by the injury since the date of the award or order. . . . . (3) Except for reopening solely for determination of the compensability of medical expenses, fraud, or conforming the award as set forth in KRS 342.730(1)(c)2., or for reducing a permanent total disability award when an employee returns to work, no claim shall be reopened more than four (4) years following the date of the original award or order granting or denying benefits, or within two (2) years of such award or order, and no party may file a motion to reopen within two (2) years of any previous motion to reopen by the same party. [4] . . . . (8) The time limitation prescribed in this section shall apply to all claims irrespective of when they were incurred, or when the award was entered, or the settlement approved. However, claims decided prior the effective date of this act, may be reopened within four (4) years of the award or order or within four (4) years of the effective date of this act, whichever is later, provided that the exceptions to reopening established in subsections (1) and (3) of this section shall apply to these claims as well. KRS 342.125 (Dec. 12, 1996). (emphasis added). In this instance, the ALJ found the settlement as originally approved to be consistent with an award pursuant to KRS 342.730( l )(d) and, thus, held Appellant to a standard of proof showing a change in medical condition, KRS 342.730(1)(d), as well as the additional standard of showing a change in occupational disability, as was then required by KRS 342.125(1) (1995). Reviewing the evidence, the ALJ found that Appellant proved both standards, finding: Allene Hall, as a result of the injury of April 9, 1995, is now totally occupationally disabled. There has been a change in medical condition and a change of occupational disability as a result of the injury of April 9, 1995.