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.

In a Georgia workers’ compensation claim, an employee’s personal health information can be used by the employer/insurer to assess the compensability of a claim.   Medical records are of interest to the employer/insurer because these records reveal whether an injured worker has previous injuries to the body part injured in the work accident at issue or pre-existing conditions (such as diabetes or high blood pressure).  It is critical to investigate previous injuries because the employer/insurer may not be liable for payment of medical treatment for an injury which occurred before the accident at issue and/or did not occur in the course and scope of the employee’s employment.  Additionally, if an injured worker is a diabetic or suffers from high blood pressure, these pre-existing conditions can slow down an injured worker’s recuperation or cause complications in healing.

For example, if an injured worker sustains a broken ankle and is also suffering from type 2 diabetes, but is non-compliant with her diabetes treatment plan, he or she may experience delays in her recuperation due to poor circulation or possible nerve damage in the lower extremities.  In the aforementioned example, the repercussion of non-compliance with her diabetes treatment plan can lead to serious complications, which may prevent the employee from returning to work and may sever the employer/insurer’s liability for continued medical treatment for the broken ankle.  The employer/insurer will point to this fact to deny future benefits.  Obviously, this will be a medical question for the administrative law judge.

The medical records are also a tool the employer/insurer can utilize to gather information about injured worker’s conversations with his or her medical providers.  Ordinarily, a patient’s conversation with his or her physician is confidential, however, when an injured worker files a workers’ compensation claim and seeks medical treatment for work-related injuries, the patient-physician conversations are no longer considered confidential.

Pursuant to O.C.G.A § 34-9-207, when an employee files a workers’ compensation claim, the employee waives

“…any privilege or confidentiality concerning any communications related to the claim or history or treatment of injury arising from the incident that the employee has had with any physician… .”

Employees should not be discouraged from filing a claim due to privacy concerns. The release of workers’ compensation information to non-parties is generally prohibited under the workers’ compensation code.  Employees must keep in mind that in order to receive the best medical care, the doctors must have access to his or her medical history to create an effective treatment plan.  The mutual goal of all parties is to return the injured worker back to normal duty if possible.  However, it is important to realize that this may never happen depending on the severity of the injury.  If the goal of “normal duty work status” is not reachable, then the injured worker should still strive to reach maximum medical improvement.

First, it is important to consider the injured workers’ medical status.  If the employee is facing surgery or is not close to maximum medical improvement (MMI), then the case should not settle.  The rationale behind this rests in the fact that potential medical expenses may exceed the settlement proceeds.  In other words, there is no point in settling a a case for $25,000 when the potential medical expenses may cost $40,000. It is more sound to settle the case after the injured employee’s medical condition has improved or has stablized.  Therefore, the injured worker must carefully consider the value of his or her future medical expenses as it relates to the industrial accident.

Assuming the employee’s medical status is plateaued, the next consideration is whether the claimant is physically able to return to work in some capacity.  The ability to return to work does not necessarily mean returning to “regular” or “normal” duty work.  Whether the injured worker can return to work for any employer influences the overall value of the case.  If the claimant cannot return to work in any capacity or is totally disabled, the value of the claim generally increases.

Moreover, if the injury is severe, the injured worker’s permanent impairment may be significant.  Georgia law provides another formula for compensating the employee for the permanent loss of use as it relates to the occupational injury.  The formula considers the claimant’s weekly compensation rate, the affected body party, and the level of impairment.  This rating is very specific and incorporates the American Medical Association’s Guides to Impairment (5th Edition).

As you can see, there are many factors to consider how much a workers’ compensation claim may be “worth.” However, the actual value of the case depends on what the insurance company will pay and how much or little the injured worker will take.  No two claims are the same and it is important to consult a workers’ compensation expert like the attorneys at the Ramos Law Firm to navigate the complex work comp law.

Additionally, the injured worker has one (1) year from the date of injury or last remedial medical treatment to file his or her notice of claim with the State Board. O.C.G.A. §34-9-81. Notice must be provided with the WC-14 filing. In other words, simply telling your supervisor is not enough. You must file the Board Form to toll the statute of limitations. However, if the injured employee is receiving income benefits but was suspended and undergoes a change in condition for the worse, the worker can file a request for recommencement within two (2) years from the date of last payment of income benefits. O.C.G.A. § 34-9-104.

Likewise, claims for permanent partial disability benefits must be filed within four (4) years from date of last payment of income benefits.