Generally, a “change in condition” occurs when the injured worker demonstrates a change in the wage-earning capacity, physical condition, or employee status after original injury (established by award or otherwise).  O.C.G.A. § 34-9-104 (a); Atlanta Hilton & Towers v. Gaither, 210 Ga. App. 343, 436 S.E.2d 71 (1993). See also Aldrich v. City of Lumber City, 273 Ga. 461, 542 S.E.2d 102 (2001). See ABB Risk Management Service/Georgia Kaolin v. Lord, 254 Ga. App. 88, 561 S.E.2d 225 (2002).  An injured worker must be careful in these situations as a few statutes of limitations may be triggered for restarting income benefits, or even formally accepting the claim.  See, O.C.G.A. §34-9-104 and 82.

In some cases, an injured employee who sustains a job-related injury may continue to work until her condition forces her to cease work because of gradual worsening of her physical condition.  The Georgia law will generally consider the date she stopped working as a “fictional new date of accident.”  Central State Hospital v. James, 147 Ga. App. 308 (1978).  These fictional new date of accident cases do not involve a new “traumatic” injury.  This scenario is analogous to the “straw that broke the camel’s back” story.

If you have been injured on the job and have recently stopped working, you may be entitled to workers’ compensation benefits.  For a free consultation, please contact the Ramos Law Firm.

Board Rule 200(a)(1) further explains that the: “Employer/Insurer have a duty to provide all reasonable and necessary medical treatment in a timely manner and to give appropriate assistance in contacting medical providers when necessary.”  Similarly, the Employer and Insurance company must approve and authorize this treatment without significant delay.

In our experience, many injured workers fall victim to delays and denials of medical treatment as they are not properly trained on what to ask for or what to do.  Medical treatment is crucial to properly heal from the work accident.  If you have suffered a work related accident and you are unable to get medical care, we recommend you call us at 404-355-3431 to assist you.

Georgia’s Workers’ Compensation Act provides compensation in relation to the physician’s impairment assessment.  This table is found in O.C.G.A. §34-9-263 or on our website.  In certain circumstances, doctors may disagree as to the ratings and they can differ.  Also, you may have the option of seeking a second opinion.  If you have any questions about the PPD rating, please contact me at 404-355-3431.

Nationally, approximately $183 billion dollars were spent on workers’ compensations claim in 2008 according to the National Safety Council.  These costs included payment for medical bills as well as lost work days.  In fact, it is estimated that 3.2 million claims were made in 2008.

As you can see, workers’ compensation is big business.  In fact, many insurance companies have teams of lawyers and “adjusters” on their payroll just in case someone files a claim.  These insurance companies have sophisticated systems designed to make it difficult for injured workers to receive benefits.  If you have been injured at work, it is important to realize that the insurance company will not have your best in interest in mind.  In fact, they have every reason to deny your case just to save a few dollars for their company stockholders.

Remember, they are in the business of denying your claim and benefits.  If you have a work injury, don’t try to handle your claim alone.  If you would like a free consultation about workers’ compensation, please contact Bryan Ramos at the Ramos Law Firm in Atlanta, Georgia, 404-355-3431.

Unfortunately, there is no Georgia rule or law mandating the insurance company to provide for direct deposit funding of workers’ compensation checks. However, we understand that some insurance companies do provide this option. At this point it is solely dependent upon the workers’ compensation carrier.

If you have any questions about your entitlement to income benefits because of your work injury, please contact the Ramos Law Firm at 404-355-3431.

The injured employee has the burden of demonstrating that change has occurred.  To do this, the injured worker must demonstrate that (1) her condition has changed for the worse; (2) that because of this change, she is unable to continue to work; (3) that because of this inability to work, she has either a total or partial loss of income; and (4) that the inability to work was caused by the original work injury.

A typical “change in condition” situation occurs when the employee hurt-at-work has an accepted and valid occupational injury.  She is provided weekly income benefits (temporary total disability) for a period of time, as well as medical treatment.  At some point in time, she was able to return to work for the employer.  However, after a few months, the injured employee’s physical condition worsened causing her to miss time from her work.

As you can see, the original condition was established when her claim was accepted under workers’ compensation and she was provided income and medical benefits.  After her return to work, her condition changed for the worse.  Because of this change the injured worker became unable to work which caused some loss of income.  For our purposes, we must presume that the claimant’s recent inability to work was caused by the original work accident.  Consequently, the injured employee may be entitled to a recommencement of workers’ compensation income benefits provided that a proper filing was made with the State Board.

For information, please contact Bryan Ramos at 404-355-3431 or email.

After the workers’ compensation claim is filed, everyone begins speaking a different language.  The insurance company and their lawyers use acronyms such as TTD, PPD, or MMI.   The doctors will often throw terms around like MRI, CT, PT, or FCE.  The judge may even mandate you to treat with something called an “orthopod”. Being on “workers’ compensation” is not easy and the injured employee did not ask to be hurt.

An injured worker should not go at it alone.  The insurance companies have complex programs and systems designed to maximize the law to their benefit.  Also, many insurance companies hire skilled lawyers who devote their entire lives to protecting these corporations.  It is the classic “David v. Goliath” situation.

Who is protecting the injured worker?  At the Ramos Law Firm, our attorneys can level the playing field for you.  Our lawyers use their knowledge of the insurance defense practice to help workers hurt on the job. We have extensive trial experience, and we are ready to put it to work for you.  For a free consultation, please contact us.

In this case, the claimant was an employee at Wal-Mart who was tasked with stocking shelves in a store located in Valdosta, Georgia.  In order to perform this job, she was using a ladder.  The claimant, who had pre-existing back problems, missed a step on the ladder and experienced lower back pain.  This injury allegedly occurred between 11:00 and 11:30 in the morning.  However, the Employer presented evidence that the claimant had not signed in until noon that day.   Moreover, the Employer presented other contradictory evidence to the claimant’s case.  The presiding administrative law judge denied the claimant’s claim for benefits, as well as her claim for attorney’s fees.

Initially, Employer/Insurer voluntarily commenced benefits, but later controverted the claim.  The claimant contested the controvert on the grounds that the Employer/Insurer failed to pay her all compensation due at the time of filing, in violation of O.C.G.A. § 34-9-221.

The claimant successfully appealed the ruling and the Appellate Division vacated the decision and remanded the matter for additional proceedings on the procedural issues surrounding the controvert.  The Employer/Insurer filed an appeal to the Superior Court, who reversed and remanded the case back to the Appellate Division to review only the issues raised before the trial administrative law judge.  As a result, the claimant requested assistance from the Court of Appeals to review the Superior Court’s order and sought a reinstatement of the Appellate Division’s decision.  The claimant argued that the Superior Court did not have jurisdiction and prematurely decided the matter on the merits.

The Court of Appeals agreed with the claimant on the procedural issue as the State Board’s decision was not a “final award” as mandated by law.  The Court held that the decision of the Appellate Division remanding the case to the trial division was “pending.”  Hence, the Superior Court should have declined to review the Employer/Insurer’s appeal as “such an interlocutory appeal is unauthorized under the Workers’ Compensation Act.”

For a copy of this case or for more information, please feel free to contact the Ramos Law Firm.

Mr. Tommy J. Wilson worked as a truck driver for the Kroger Company when he injured his back in 1994.  He underwent spinal surgery and remained out of work for nearly two years.  He was able to return to wok in a light duty capacity for the next 14 months.  Unfortunately, Mr. Wilson required another surgery in 1998 but was able to return to work in a sedentary “dispatcher” position.  During this time, Mr. Wilson was paid temporary total and partial disability benefits accordingly.

In September 2001, Mr. Wilson reached the statutory caps for indemnity benefits.  While he was able to continue to work until May 2004, he apparently did so without any workers’ compensation income supplements.

In August 2003, Mr. Wilson filed a WC-14 requesting an evidentiary hearing on the issues of temporary total or partial disability from September 2001 forward.  The hearing did not take place as he later withdrew his request.

In April 2006, Mr. Wilson filed an Employee’s Request for Catastrophic Designation with the Board.  However, the administrative law judge (ALJ) issued an order finding that Mr. Wilson’s claim was time-barred under the change of condition limitations found in O.C.G.A. § 34-9-104.  Upon appeal the Appellate Division reversed the ALJ’s decision and the Superior Court of Clayton County affirmed appellate decision.

The Court of Appeals granted discretionary review and first examined what limitation period applies to catastrophic designation cases.  The Court determined that requests for catastrophic designation constitutes a change in status or condition contemplated in O.C.G.A. § 34-9-104. Consequently, the two year statute of limitations applies from the last date of income benefits.

As that statute of limitations applies, the next question the Court addressed was whether Mr. Wilson’s filing was sufficient.  The Court found it was not.  The Court noted that the 2003 filing did not include a request for catastrophic designation.  Moreover, Mr. Wilson was working at the time and the Employer could not have adequate notice that the 2003 request was for life-time benefits.  Furthermore, the State Board Rules require that the employee file an official “Employee’s Request for Catastrophic Designation.” Mr. Wilson did not file this request in 2006.

Therefore, the claim for catastrophic designation was invalid as a matter of law.

These issues raise many questions as to the form, process and due process rights of the parties involved in a workers’ compensation claim.  For information regarding this case or about your workers’ compensation issues, please contact Bryan Ramos.

Following are some of the changes:

Allowing the ICMS email system to serve as the “notice” and “service” vehicle for ALJ Awards.  The bill also contemplates the “issuance” of awards  via email will be recognized as notice and service to the parties for appellate matters.

The medical release language has been broadened and it’s possible that an employee’s psych recods may be produced.  Click here to see a full copy of original post outlining some of the changes with examples.