The recent law also provides that no C-250′s may be filed after 07/01/10, for claims with dates of accident or dates of disablement prior to 07/01/07, for the purpose of seeking 15-8 relief. Regardless of the filing dates of the C-250′s, again for claims prior to 07/01/07, all written submission of evidence in support of a 15-8 claim must be filed prior to 07/01/10 for consideration by the Special Funds Conservation Committee.

The Statute also requires that all requests for reimbursement for cases with established 15-8 or 14-6 findings be submitted to the Special Funds Conservation Committee within one year from the date of the expenditure or one year from the effective date of this legislation, 03/13/07, whichever is later. The reimbursement request would be deemed waived if the employers or the carriers do not comply with this provision.

The Fund may also pay compensation and medical expenses in cases of permanent and total disability resulting from an injury to the brain or spinal cord. In the claims that pertain to total and permanent disability due to paralysis or loss of mental capacity, the Fund may cover expenses related to medical, nursing, hospital, institutional, equipment, and other treatment expenses reasonable and necessary during the life of the injured employee.

States, such as Georgia and New York, which have reimbursement funds which actually reimburse the carrier for indemnity and medical benefits made to a claimant. The employer/insurer remains the primary claims handler and must request periodic reimbursements from the fund for payments made on the claim.  These funds will also take an active role in any settlement discussions.

States which have take-over funds will pay the claimant directly once the liability has been determined. In New Jersey, for example, once the fund’s liability has been established, it can pay the claimant’s permanent and total benefits for the life of the claims.  The employer remains liable for the medical expenses.

There are many active second-injury funds in the U.S.  Since many of them have different rules and regulations, strict attention must be paid to the statutory requirements for each state.

The Subsequent Injury Trust Fund (SITF) was created to keep Georgians at work. It provides a means by which employers can feel safe in taking a risk on hiring someone who has previously suffered a work-related injury.  Any injury or furtherance of the previous injury would not affect the employers’ workers compensation insurance.

Without the SITF, there are two major problems that will arise.  First, employers will not want to hire people who have been previously injured on the job.  This is due to a reluctance to possibly take on the medical expenses of the worker.  Second, once workers understand that they cannot be hired with pre-existing injuries, they will begin to lie about their pre-existing injuries in order to be hired.  This will cause a great deal of litigation over pre-existing injuries.

Particularly considering today’s economy, I think it’s a brutal blow to Georgia’s workforce for the SITF to be shutting its doors.  I would urge everyone to consider the ramifications of the SITF sunset and take action to contact legislatures and express how important a program like the SITF is to Georgia’s future.

For some medical conditions, the Fund has defined them as presumptive conditions. In other words, the employer/insured need not provide documentation to prove that these medical conditions are permanent and a hindrance to employment. Pursuant to Section 34-9-361 of the Official Code of Georgia, the presumptive medical conditions are defined as permanent and a hindrance to employment.

The 23 presumptive medical conditions in O.C.G.A. § 34-9-361 are:

1. Epilepsy

2. Diabetes

3. Arthritis which is an obstacle or hindrance to employment or reemployment

4. Amputated foot, leg, arm or hand

5. Loss of sight of one or both eyes or a partial loss of uncorrected vision of more than 75 percent bilaterally

6. Residual disability from poliomyelitis

7. Cerebral palsy

8. Multiple sclerosis

9. Parkinson’s disease

10. Cardiovascular disorders

11. Tuberculosis

12. Mental retardation, provided the employee’s intelligence quotient (IQ) is such that he or she falls within the lowest two percent of the general population; provided, however, that it shall not be necessary for the employer to know the employee’s actual IQ or actual relative ranking in relation to the IQ of the general population.

13. Psychoneurotic disability following confinement for treatment in a recognized medical or mental institution for a period in excess of six months.

14. Hemophilia

15. Sickle cell anemia

16. Chronic osteomyelitis

17. Ankylosis of major weight bearing joints

18. Hyperinsulism

19. Muscular dystrophy

20. Total occupational loss of hearing as defined in Code Section 34-9-264

21. Compressed air sequelae

22. Ruptured intervertebral disc

23. Any permanent condition which, prior to the occurrence of the subsequent injury, constitutes a 20 percent impairment of a foot, leg, hand, or arm, or the body as a whole

In order for an employer/insured to be eligible for reimbursement from the Fund, the employee’s subsequent injury must be directly caused by the prior impairment, or combine with a prior impairment to create greater employer liability for lost time benefits and medical expenses. In addition, the employee must have a preexisting impairment that the employer considered to be permanent and likely to be a hindrance to employment, and the employer must have knowledge of the prior impairment before the subsequent injury occurs. The law also contains a list of conditions which are presumed to be permanent and likely to be a hindrance to employment provided the employer can demonstrate knowledge prior to the subsequent injury.

While many states are closing their Funds similar to the Subsequent Injury Trust Fund, there are still a handful of them out there that are going strong.

 At the Ramos Law Firm our legal team has over 30 years of combined experience. The Firm was founded in April of 2005 and has been helping injured workers fight for the benefits they deserve since they opened.

Bryan Camacho Ramos is the founder and principal of the firm. He has handled thousands of cases over his career. He has significant trial experience ranging from the simple hand strain to complex catastrophic cases involving complicated medical issues and housing considerations. Mr. Ramos has utilized alternative dispute resolution methods and conferences to reach the best result for his clients. Additionally, many clients have provided testimonials attesting to their positive experiences with the Ramos Law Firm. Mr. Ramos devotes many hours every month to community service events and charities. Additionally, Mr. Ramos is active within the Asian and Hispanic communities.

Mr. Ramos has published dozens of articles on numerous topics involving workers’ compensation in both national and local law journals. He regularly conducts client seminar and lectures.  Additionally, he mentors young attorneys who have recently passed the Bar and are just beginning their practice of law.

Gail Bailey is the Senior Paralegal and Legal Administrator for the firm. She has been with the firm since August of 2005 and has worked in Atlanta law firms since 1997. Mrs. Bailey has conducted a number of seminars/webinars through NBI, Inc. for paralegals in both the Atlanta area and on a national level.

Melissa Krick joined the firm in August of 2009 as the firm’s receptionist and has since moved into the position of Legal Assistant/Paralegal. While having only been with the firm a couple of years, she has been in the legal industry for over nine years. Ms. Krick interacts with clients on a day to day basis and is often the first point of contact.

Bookmark It

Hide Sites