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Exceptions to Coverage Under Georgia’s Workers’ Compensation Laws
The Georgia Court of Appeals recently handed down a decision in Clarke v. Country Home Bakers, 2008 WL 4603604 (2008), regarding whether a prisoner injured while working in a work release program was eligible for workers’ compensation benefits. The Court affirmed the decision of the lower courts in denying benefits. At issue was whether the…
What is ADR and how does it help?
Recently, the Daily Report sat down with some alternative dispute resolution [ADR] experts to discuss how ADR can reduce the costs of litigation. There are three principal types of ADR that are commonly used. Mediations are commonly used for
Georgia Workers’ Comp Bill Presently Before The House
On February 25, 2009, the House Committee on Industrial Relations offered a substitute to House Bill 330, which directly affects the current Georgia Workers’ Compensation Act (Chapter 9 of Title 34 of the Official Code of Georgia Annotated). The proposed law change:
Death and the Medicare Set-Aside
A colleague recently asked me what happens to the funds placed in an established Medicare Set-Aside when the injured employee/beneficiary dies before the funds are completely exhausted. Since my legal responsibility usually ends once an MSA is established I did not readily know the answer to this question and I had to dig through old…
New York Prepares to Close Second Injury Fund
As of 07/01/07, the self-insured employers and the carriers in New York can no longer file claims for reimbursement with the Special Funds Conservation Committee under Section 15-8. In other words, for claims with dates of accident or dates of disablement of 07/01/07 or later,
Second Injury Fund in North Carolina Still Active
In North Carolina, the Industrial Commission disburses moneys from the Second Injury Fund. In order to qualify for compensation for a second injury, the original and the subsequent injury must be at least twenty percent (20%) of the entire body, and, the additional compensation cannot exceed
Catastrophic Does not Necessarily Mean Forever
In 2005, the Georgia State Legislature amended O.C.G.A 34-9-200.1 to include section (i). Pursuant to section (i), when a claimant has been deemed catastrophic, either by the employer or the State Board, it is possible to request new determination as to the catastrophic or non-catastrophic nature of the employee’s injury. The only requirement is that…
An IME Physician May Request Patient Undergo More Testing
In Georgia, as long as an employee is receiving compensation benefits, then he shall submit himself to examinations ordered by a qualified physician. Independent Medical Examinations (IME) are common in workers’ compensation cases. They give the employer or the Board a chance to determine
Would Kevin Garnett’s knee injury be considered a workers’ compensation claim?
In last night’s match against the Utah Jazz, Kevin Garnett left the game late in the first half after straining his right knee as he attempted to complete a high “alley-oop” pass from Paul Pierce. If Kevin was playing for the Atlanta Hawks, this could be a potential Georgia workers’ compensation claim. First, we would…
The Effect Ongoing Medical Payments Have on Medicare Set-Asides
As a general rule federal law requires parties involved in workers’ compensation claim to consider Medicare’s interests in the event of a settlement. 42 CFR 411.46. However there is one major exception to this rule.
Types of Second-Injury Funds
The two major types of second-injury funds are reimbursement funds and take-over funds. In both of these situations, the employer/insurer can reduce liability when the fund becomes liable.
Thoughts On The SITF
With the Georgia legislature now back in session, it makes me consider the fate of the SITF and its impending sunset. While it does not appear that the legislature will consider any new measures for the SITF in this session, I would certainly wish
Taxes and Medicare Set-Asides
As April 15th draws nearer and my mailbox starts to fill with W-2 and yearly interest statements I am reminded of the old adage, only two things in life are certain; Death and Taxes. Oddly enough my recent dealings with Medicare Set-Asides
Can Catastrophic Designation be Removed?
The answer to the question for claims that arose in July 2005 or later is simple. Yes. O.C.G.A. 34-9-200.1(i) was enacted in 2005 to provide a mechanism by which a the catastrophic status of an individual can be revisited if reasonable grounds exist to challenge the current status. The prerequisite
TPD Rates are not Automatic
O.C.G.A § 34-9-262 provides: “. . . where the disability to work resulting from the injury is partial in character to temporary in quality, the employer shall pay or cause to be paid to the employee a weekly benefit equal to 2/3 of the difference between the average weekly wage before the injury and the…
Drinking and Georgia’s Workers’ Compensation Law Don’t Mix
Occasionally, when the members of Ramos & Law are preparing to defend an employer against a workers’ compensation claim we come across evidence indicating that the injured employee may have been intoxicated when he was injured at work.
Preparing for Mediation
Mediation is an informal means to try to resolve a claim quickly without the need for Court intervention. If both parties approach mediation in good faith, a resolution can often be reached. While informal,
Can I seek Experimental medical treatment for my injury?
Pursuant to O.C.G.A. § 34-9-200(a), an employer must furnish an injured worker such medical treatment which, in the judgment of the Board, is
Employer Must Provide 10 Days Notice Before Suspending Indemnity Benefits
According to O.C.G.A. § 34-9-221(i) “where compensation is being paid with or without an award and an employer or insurer elects to controvert on the grounds of a change in condition or newly discovered evidence, the employer shall, not later than 10 days prior to the due date of the first omitted payment of income…