Dwc District Office California Form Pack


Information & Assistance Unit guide 11
How to file a petition to reopen
If your disability has gotten worse after a workers’ compensation judge has issued an
award, this form can be used to reopen your case.
You should get a medical report from your doctor saying your condition has
worsened, and collect any other facts that support your case.
Complete the form, following the attached sample. Be sure to sign and date the form.
You have five years from the date of injury to file this petition.
If the insurance company won’t voluntarily reopen your case and you are ready for a
hearing, fill out a declaration of readiness to proceed (see I&A guide 5) and submit it
with your petition.
Send the original to your local WCAB office and copies to all the parties.
Submit the following documents with your form filing in the order shown:
Document Cover Sheet
Document Separator Sheet
(for Petition for Reopen)
Petition for Reopen
Document Separator Sheet
(for Proof of Service By Mail)
Proof of Service By Mail
Keep copies of your filings for your records.
All documents filed with the WCAB must include a document cover sheet and
document separator sheet.
Please see I&A guides 17 and 18 to learn how to
complete these forms.
In addition all forms must be typed or handwritten in block
letters to insure legibility. Additional form instructions can be found on the EAMS
OCR handbook at
If you need help, call an
Information and Assistance (I&A)
office, or attend a
workshop for injured
workers. The local I&A phone numbers are attached to this
guide. You can get information on a local workshop from the I&A office or on the Web
I&A 11
Rev. 11/14


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