Form WC37 "Petition to Reopen" - Colorado

What Is Form WC37?

This is a legal form that was released by the Colorado Department of Labor and Employment - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2006;
  • The latest edition provided by the Colorado Department of Labor and Employment;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form WC37 by clicking the link below or browse more documents and templates provided by the Colorado Department of Labor and Employment.

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Download Form WC37 "Petition to Reopen" - Colorado

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Instructions for Completing the
Go to Form
Petition to Reopen
Please read all pages
This form is “fillable.” That means you can type the information onto
the form from your computer and print the form. You will not be able
to save the form onto your computer’s hard drive.
When you open the form, click in the “Claimant” box (field), complete
the information, and use the tab key to navigate to the next field. Do
not use the Enter key; pressing the Enter key will only page down.
Each field has been limited. This means that you cannot continue to
type information into a field if it doesn’t fit into the space provided.
Use numbers only to fill in the fields for Social Security # and phone
numbers. Do not use dashes or parentheses; when you tab out of the
field, it will fill in automatically. To fill in a
check
box, click inside the
box with your mouse.
The “Certificate of Mailing” fields are
surrounded by a
gray
border. Type the information in the first field and
tab to the next to enter more information.
To clear or delete all the information you have typed onto the form,
click on the red
“Clear Entire
Form” button. To change the information
in one field, use the backspace or delete key.
1
Instructions for Completing the
Go to Form
Petition to Reopen
Please read all pages
This form is “fillable.” That means you can type the information onto
the form from your computer and print the form. You will not be able
to save the form onto your computer’s hard drive.
When you open the form, click in the “Claimant” box (field), complete
the information, and use the tab key to navigate to the next field. Do
not use the Enter key; pressing the Enter key will only page down.
Each field has been limited. This means that you cannot continue to
type information into a field if it doesn’t fit into the space provided.
Use numbers only to fill in the fields for Social Security # and phone
numbers. Do not use dashes or parentheses; when you tab out of the
field, it will fill in automatically. To fill in a
check
box, click inside the
box with your mouse.
The “Certificate of Mailing” fields are
surrounded by a
gray
border. Type the information in the first field and
tab to the next to enter more information.
To clear or delete all the information you have typed onto the form,
click on the red
“Clear Entire
Form” button. To change the information
in one field, use the backspace or delete key.
1
“Clear Entire
Form” button
Clears all information at once
“Check
Box”
Click in box
2
“Gray Border”
Enter information and tab to next field
3
Clear Entire Form
Back to Instructions
PETITION TO REOPEN
Claimant
WC#
Claimant’s Address
Carrier Claim #
Social Security #
Claimant’s Phone #
Date of Injury
Employer
Insurance Carrier
This matter should be reopened because:
Change in medical condition - Attach documentation
Error - Attach documentation
Mistake - Attach documentation
Fraud - Attach documentation
Overpayment - Attach calculations
Terminate Permanent Total Benefits - Attach statement
Requester:
(Please check one)
Claimant
Employer
Insurance Carrier
Signature of Requester _________________________________________ Date Signed ________________________
CERTIFICATE OF MAILING
Copies of this document were placed in the U.S. mail or delivered to the following parties
this _________ day of _______________________________, ____________.
List names and addresses of all persons copied:
Name
Address
Claimant:
Claimant’s Attorney:
Employer:
Carrier:
Carrier’s Attorney:
By: ___________________________________________________________________
(Signature)
This petition must be provided to the other party and to all attorneys of record. The petition must state the basis for
the reopening, and supporting documentation must accompany the request. Once a petition has been filed, the requester
may apply for a hearing before an Administrative Law Judge. To request a hearing, contact the Office of Administrative
Courts at 303.866.2000 and request an APPLICATION FOR HEARING form.
WC37 Rev 01/06
PETITION TO REOPEN
INSTRUCTIONS
Please read the following instructions carefully. This form must be complete so that the opposing party* has the information
to consider your request. Please type or neatly print, and then sign the form. You may want to use the last Final Admission
of Liability filed on this claim or, if applicable, the final order to help you fill out this form. Fill in all the blank lines.
Claimant:
Name of injured worker
Claimant’s Address:
List the current address for the claimant
Claimant’s Phone #:
List the current phone number for the claimant
Employer:
Name of employer that the injured worker was working for on the date of injury
WC#:
Workers’ Compensation Number - refer to the carrier’s last admission
Carrier Claim #:
Insurance carrier’s claim file number - refer to the carrier’s last admission
Social Security #:
Social Security Number - make sure number is correct for the injured worker
Date of Injury:
Date this injury occurred
Insurance Carrier:
Name of the insurance company or self-insured employer
Check the reason or reasons for reopening the claim. If the request to reopen is based on a change in medical condition,
some type of documentation reflecting the change in condition must be attached. If a medical report is submitted, it may
include information on the following: the physical condition of the claimant at the time the petition is filed, how the
condition has worsened or improved, and a statement relating the disability to the work-related accident or exposure.
Documentation for any other reason checked must also be attached.
Check the box to indicate whether the person completing the Petition to Reopen (Requester) is the Claimant, Employer, or
Insurance Carrier. The requester must sign and date the form.
A copy of the completed form and accompanying documentation must be sent to the opposing party* and to all attorneys of
record. Fill in and sign the mailing certificate at bottom of the form. List the names and addresses of all the parties to whom
you are mailing copies. Make sure to keep a copy for yourself.
If the opposing party* does not voluntarily reopen the claim or does not provide a response, you may wish to set the matter
for a pre-hearing conference by calling 303.318.8736. If issues cannot be resolved between both parties, you may request
a hearing before an administrative law judge. To request a hearing, contact the Office of Administrative Courts
at 303.866.2000 and ask to have Application for Hearing forms sent to you. If you do not take any action, the status of
the claim remains unchanged. If either party agrees to reopen the claim, the insurer must notify the Division in writing
or by admission.
*Note to Claimants: The opposing party in your claim is the insurance company or the self-insured employer. The address
for the opposing party is on the admission of liability.
REOPENING PERMANENT TOTAL DISABILITY BENEFITS:
Section 8-43-303(3) of the Colorado Revised Statutes provides:
In cases where a claimant is determined to be permanently totally disabled, any such case may be reopened at any time to determine
if the claimant has returned to employment. If the claimant has returned to employment and is earning in excess of four thousand
dollars per year or has participated in activities which indicate that the claimant has the ability to return to employment, such
claimant's permanent total disability award shall cease and the claimant shall not be entitled to further permanent total disability
benefits as a result of the injury or occupational disease which led to the original permanent total disability award. Any subsequent
permanent partial disability benefits awarded for the same injury or occupational disease shall be decreased by the amount of
permanent total disability benefits previously received by the employee.
In the absence of an agreement with the claimant to voluntarily reopen and terminate permanent total disability benefits
followed by an admission terminating the same, the insurer or self-insured employer must request a hearing before an
administrative law judge should it seek to terminate these benefits.
IF YOU HAVE ANY QUESTIONS OR NEED HELP IN COMPLETING THIS FORM, CONTACT THE
DIVISION OF WORKERS’ COMPENSATION, CUSTOMER SERVICE UNIT
633 17TH STREET, SUITE 400, DENVER, CO 80202-3626
303. 318.8700 OR TOLL FREE AT 888.390.7936
WC37 Rev 01/06
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