You settled your workers’ compensation case, or an arbitrator issued an award, and you tried to move on. Months later, the pain returns, the surgery you hoped you would never need is now on the table, and the disability you were compensated for has clearly gotten worse. A natural question follows: can you go back and ask for more? Under Illinois law, the answer is sometimes yes — but it depends heavily on how your case ended and how much time has passed. This is governed by Section 19(h) of the Illinois Workers’ Compensation Act, and understanding how it works can protect benefits you may not realize you still have a right to claim.
What Section 19(h) Actually Does
Section 19(h) gives the Illinois Workers’ Compensation Commission the power to review a prior disability award when an injured worker’s condition has changed. On review, the Commission can re-establish, increase, decrease, or end compensation. The provision exists because injuries are not static. A back condition rated at a certain percentage of disability at the time of a hearing can deteriorate over the following years, and the law recognizes that the original award may no longer reflect reality.
Illinois courts have long described the Workers’ Compensation Act as a humane, remedial law meant to be interpreted in favor of the injured worker. In one leading case, the Appellate Court emphasized that Section 19(h) is “particularly remedial in nature” because it specifically addresses changes in circumstances after an award is entered, and that additional review should be encouraged to carry out the purpose of the Act. In practical terms, that means the door to reopening a case is intended to be genuinely available — not a technicality designed to keep you out.
The Critical Distinction: Awards Versus Lump-Sum Settlements
Before anything else, you need to know how your case was resolved, because this single fact often decides whether Section 19(h) is even available to you.
If your case went to a hearing and an arbitrator or the Commission issued an award of permanent disability, that award can generally be reviewed under Section 19(h) if your condition later worsens. But if you resolved your case through a lump-sum settlement contract approved by the Commission, the situation is very different. The Act provides that when compensation is ordered paid in a lump sum, no review under Section 19(h) may be had. In other words, most lump-sum settlement contracts close the case permanently, and when you sign a typical Illinois workers’ compensation settlement you are usually giving up the right to come back later and ask for more, even if your injury deteriorates.
That said, the specific language of your settlement controls. Some settlement contracts expressly leave medical rights open, and a settlement paid in installments rather than as a single lump sum can present a different analysis. What you are able to do later depends on exactly how your settlement was written and structured, which is one more reason to read it carefully before signing.
This is one of the most important reasons to understand the terms of a settlement before you sign it. A lump-sum settlement provides finality and a guaranteed sum of money, but that finality cuts both ways. If there is a real chance your condition will worsen or that you will need future surgery, the decision to settle — and how to structure that settlement, including whether to leave medical rights open — deserves careful thought with an attorney who represents injured workers, not the insurance company.
The 30-Month Deadline
For cases resolved by award, Section 19(h) imposes a strict time limit. A petition to review the award generally must be filed within 30 months after the Commission’s decision or award becomes operative. There is an important exception: for wage differential awards under Section 8(d)(1) of the Act, the review period is 60 months rather than 30. Illinois courts treat these deadlines as jurisdictional and unforgiving, and they are generally not extended simply because a party has asked a court to review the underlying decision. Miss the window, and the right to seek an increase is typically lost no matter how much your condition has declined. Because the exact trigger date can turn on appeals and the procedural history of your case, calculating it carefully and early is essential.
You are also not necessarily limited to a single 19(h) petition. Where an earlier 19(h) proceeding results in a new or modified award, a fresh review period may run from that decision, allowing a later petition if your condition continues to change. But this is not automatic — simply having filed or lost an earlier petition does not, by itself, restart the clock. These timing rules are technical and the consequences of missing a deadline are permanent, which is exactly why this is an area where prompt legal advice matters.
What You Have to Prove: A “Material” Change
Filing on time is only the beginning. To increase an award under Section 19(h), you must show that your condition has changed materially since the original decision. A small fluctuation in symptoms, or simply continuing to have the same level of pain you had before, is not enough. The Commission compares the medical evidence from the original proceeding to your current condition and asks whether there has been a real, substantial worsening of the disability.
For example, if a worker was awarded benefits for a percentage loss of use of an arm, and later medical evidence shows decreased range of motion, muscle atrophy, the need for additional surgery, or a documented decline in function tied to the original injury, that can support a material change. By contrast, courts have denied increases where the evidence showed only marginal differences, or where a worker’s condition had actually improved in some respects. The change also has to be connected to the original work injury — not to a new accident or an unrelated condition that developed in the meantime.
Because the standard turns on comparing past and present medical evidence, strong, well-documented medical support is essential. Treating physicians’ records, objective testing, and clear causation opinions linking the worsening to the original injury are what make or break these petitions.
Section 8(a): Reopening for Additional Medical Treatment
Section 19(h) is frequently paired with a petition under Section 8(a) of the Act, which addresses medical expenses. Even where the question is not about increasing a disability percentage, an injured worker whose case was resolved by award — and, in some cases, a worker whose settlement expressly left medical rights open — may seek payment for additional reasonable and necessary medical treatment that becomes necessary later, such as a recommended surgery or ongoing care to relieve the effects of the original injury. The Commission has authority to order an employer to pay for that continued treatment when it is reasonably required to cure or relieve the effects of the work accident.
It is important to understand that the right to ongoing medical care and the right to increase a disability award are two different things. A settlement that leaves your medical open may allow you to pursue future causally related treatment under Section 8(a) even though it does not let you reopen and increase your permanency under Section 19(h). The reverse is also true: you may have a strong claim for a needed procedure without having a viable claim to increase your disability percentage.
This matters because the most pressing problem for many injured workers whose condition declines is not a number on a disability rating — it is getting a needed procedure authorized and paid for. Where it is available, a combined 19(h) and 8(a) petition can address both the disability and the medical bills at the same time.
Remember: Review Can Cut Both Ways
It is worth understanding that Section 19(h) is not a one-way street. Just as an injured worker can petition to increase an award when a condition worsens, an employer can petition to decrease or end compensation if it believes the worker’s condition has improved. This is another reason to approach any review proceeding with experienced counsel. The same hearing that could increase your benefits is one in which the insurance company will be looking for evidence to limit them.
What Injured Workers Should Take Away
If your work injury has gotten worse after your case ended, do not assume the matter is closed. First, find out whether your case was resolved by an award or by a lump-sum settlement, because that determines whether reopening is even possible. Second, pay attention to the calendar — the deadline is unforgiving. Third, gather your medical records and talk to your treating doctor about whether your current condition represents a genuine, documented worsening connected to the original injury. And if you are still deciding how to resolve your case, understand that signing a lump-sum settlement generally ends your ability to seek more later, which makes the structure of that settlement one of the most consequential decisions in your claim.
These are exactly the kinds of judgments that benefit from guidance early, while your options are still open. You can learn more about how our Illinois workers’ compensation attorneys protect injured workers throughout the claims process, or read about the services our Wheaton workers’ compensation office provides.
If you have been injured at work and your condition has worsened, or you are weighing a settlement and want to understand what you may be giving up, the attorneys at The Law Offices of Millon & Peskin, Ltd. are here to help. We represent injured workers throughout the Chicagoland area, including DuPage, Cook, Will, Kane, and Lake counties. Contact us today at 630-449-3884 for a free consultation to discuss your case.