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 is that the claimant must have been deemed catastrophic at some prior time.

For claims arising prior to 2005, the answer is not so simple. Many of the Administrative Law Judges at the State Board of Workers’ Compensation believe that an Employer/Insurer may seek removal of catastrophic designation by applying the change of condition statute O.C.G.A. 34-9-104. Appellate decisions have been issued indicating the belief that catastrophic designation is a “status” under the statute which is subject to change. The contrary position is that O.C.G.A 34-9-104 is silent in terms of the actual words “catastrophic designation.” Additionally, if 34-9-104 is applicable in removing catastrophic designation, then why did the legislature feel compelled to enact 34-9-200.1(i)?

To date, there is no published caselaw from the Appellate Courts to make a determination on this issue. As a result, this issue is certainly ripe for a decision in the near future. Whichever way the Appellate Courts rule will certainly have a great impact on these types of cases.