Ramos Law Firm Workers' Comp Blog » Workers’ Compensation Act http://www.ramoslawblog.com Georgia Workers' Compensation, Medicare Set-Asides and Injury Trust Funds Thu, 15 Jul 2010 03:07:34 +0000 en hourly 1 http://wordpress.org/?v=3.0 Change of Condition For The Worse http://www.ramoslawblog.com/2010/07/14/change-of-condition-for-the-worse/ http://www.ramoslawblog.com/2010/07/14/change-of-condition-for-the-worse/#comments Thu, 15 Jul 2010 02:27:36 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=1189 Generally, a “change in condition for the worse” is defined as a change in the injured employee’s wage earning capacity, physical condition, or status after the original “condition” was established under the law.  (O.C.G.A. § 34-9-104)  The original condition is usually the establishment of the worker’s weekly benefits or medical status.

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.

Related posts

]]> http://www.ramoslawblog.com/2010/07/14/change-of-condition-for-the-worse/feed/ 0 What if I am terminated because of my injury? http://www.ramoslawblog.com/2010/01/25/1118/ http://www.ramoslawblog.com/2010/01/25/1118/#comments Mon, 25 Jan 2010 12:08:10 +0000 admin http://www.ramoslawblog.com/?p=1118 Many injured workers are terminated because of their work injuries. If this occurs, the law provides relief under the Workers’ Compensation Act.  In these cases the employee may be entitled to TTD benefits to help replace his income while he continues his job search.  There are certain deadlines to be followed and it may require the filing a WC-14 Request for Hearing.  As such, the guidance of an experienced workers’ compensation attorney is advised.

According to the Georgia Department of Labor, it is indicated that the state’s unemployment rate now matches its record high.  The new figures support that the unemployment rate is 10.3 percent.  The jobless rate also increased .2 of a percent point.  Additionally, Department of Labor Commissioner Michael Thurmond stated that the Georgia workforce shrunk by 121,527.

If you have been injured on the job and were terminated because of it, please contact the Ramos Law Firm.

Related posts

]]> http://www.ramoslawblog.com/2010/01/25/1118/feed/ 0 Understanding Your Georgia Workers’ Compensation Claim http://www.ramoslawblog.com/2009/09/02/understanding-your-georgia-workers%e2%80%99-compensation-claim/ http://www.ramoslawblog.com/2009/09/02/understanding-your-georgia-workers%e2%80%99-compensation-claim/#comments Wed, 02 Sep 2009 15:42:11 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=1032 When an employee files a workers’ compensation claim in Georgia, the process may become confusing, frustrating, and costly.  Generally, the injured worker wants immediate medical care and income benefits because he or she got hurt on the job.  The insurance company, on the other hand, wants to delay and investigate the matter to save as much money as possible.  These opposing forces often cause a lot of heartache and anger.

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.

Related posts

]]> http://www.ramoslawblog.com/2009/09/02/understanding-your-georgia-workers%e2%80%99-compensation-claim/feed/ 0 Recent Court of Appeals Decision on Workers’ Compensation http://www.ramoslawblog.com/2009/08/06/recent-court-of-appeals-decision-on-workers%e2%80%99-compensation/ http://www.ramoslawblog.com/2009/08/06/recent-court-of-appeals-decision-on-workers%e2%80%99-compensation/#comments Thu, 06 Aug 2009 17:34:56 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=967 The Georgia Court of Appeals recently reversed a decision rendered by the Superior Court of Lowndes County on the issue of appellate jurisdiction.  The case at bar was Strickland v. Crossmark, Georgia Court of Appeals, A09A0491 (06/26/09).

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.

Reblog this post [with Zemanta]

Related posts

]]> http://www.ramoslawblog.com/2009/08/06/recent-court-of-appeals-decision-on-workers%e2%80%99-compensation/feed/ 0 Georgia Workers’ Compensation Changes in 2009 http://www.ramoslawblog.com/2009/07/14/938/ http://www.ramoslawblog.com/2009/07/14/938/#comments Tue, 14 Jul 2009 10:36:41 +0000 admin http://www.ramoslawblog.com/?p=938 Earlier this year we wrote about the proposed changes to the Georgia Workers’ Compensation Act.  These changes have now taken effect.

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.

Related posts

]]> http://www.ramoslawblog.com/2009/07/14/938/feed/ 0 Payment of Weekly Benefits by Electronic Transfer http://www.ramoslawblog.com/2009/07/07/payment-of-weekly-benefits-by-electronic-transfer/ http://www.ramoslawblog.com/2009/07/07/payment-of-weekly-benefits-by-electronic-transfer/#comments Tue, 07 Jul 2009 18:23:23 +0000 Adriana Sola Capifali http://www.ramoslawblog.com/?p=464 A claimant may receive weekly income benefits, when an insurer voluntarily commences payment of benefits or when the Board orders payment benefits. Due to the financial pressures many claimants experience when they are unable to work or have suffered a loss in earning capacity due to their work-related injury, claimants often inquire as to how their weekly income benefits are paid.

O.C.G.A. § 34-9-221(a) states that income benefits shall be paid in the following forms: cash, check or electronic transfer of funds.  The standard practice is that the insurer will pay weekly income benefits in the form of a check.   In the past, for payment to be made in the form of an electronic transfer, the Georgia Workers’ Compensation Act required the filing of an application for an exception with the State Board.  However, recently the Georgia Workers’ Compensation Act was amended to allow for electronic transfer of weekly income benefits if both the insurer and claimant are in agreement. O.C.G.A. § 34-9-221(b).

Although the Georgia Workers’ Compensation Act has made a provision for electronic transfer of income benefits, this payment method is rarely used due to technological challenges faced by insurers.  Transitioning from mailing paper checks to electronically transferring funds into claimants’ bank accounts requires insurers update their technology which is expensive and often a slow process.  However, with the mainstream movement to go green and promote a paperless work place, more and more insurers may begin to offer the option to electronically transfer of funds to claimants.

Related posts

]]> http://www.ramoslawblog.com/2009/07/07/payment-of-weekly-benefits-by-electronic-transfer/feed/ 0 Reporting the workers’ compensation injury http://www.ramoslawblog.com/2009/07/06/reporting-the-workers-compensation-injury/ http://www.ramoslawblog.com/2009/07/06/reporting-the-workers-compensation-injury/#comments Mon, 06 Jul 2009 11:40:22 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=877 Being injured on the job can be embarrassing and some workers fail to report their injuries until the condition is much worse.  While this is understandable, the workers’ compensation law provides that the injured worker must report their accident to his or her supervisor as soon as possible and within 30 days after the accident.  There is no magic form in reporting the injury.  A simple phone call or conversation will suffice. In a recent case, the worker fell and injured his knee in front of his supervisor.  The supervisor helped the worker to a chair and called the ambulance.  While the injured worker did not actually make an official report, the supervisor had actual knowledge of the industrial accident.  As a result the employer was prevented from claiming it did not have notice.

From a practical standpoint, it is always good to report all injuries immediately.  By doing this, the employer has an opportunity to investigate and the employee’s credibility should remain intact.  In another case, an employee was lifting crates of cola and stacking them at a convenient store.  The employee felt some pain in his back but thought it would go away.  The next morning the worker required immediate medical attention as his back “froze up.”  The employee called into work “sick” and saw his own doctor.  The physician diagnosed him with a back strain, and the employee relayed the information to the supervisor.  The employee’s reporting the injury to his supervisor should be enough.  It would be better if the employee provided some background as to “how” the back pain started.  In turn, the supervisor should investigate the facts surrounding the injury. Additionally, the employee should request for a “panel of physicians” or list of doctors he can treat without cost to the employee.  The worker has the right to choose any of those doctors.

If you have any questions about reporting your injuries, please contact the attorneys at the Ramos Law Firm.

Reblog this post [with Zemanta]

Related posts

]]> http://www.ramoslawblog.com/2009/07/06/reporting-the-workers-compensation-injury/feed/ 0 State Employees are eligible for workers’ compensation benefits http://www.ramoslawblog.com/2009/06/30/state-employees-are-eligible-for-workers-compensation-benefits/ http://www.ramoslawblog.com/2009/06/30/state-employees-are-eligible-for-workers-compensation-benefits/#comments Tue, 30 Jun 2009 11:13:50 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=880 It is not surprising that the largest employer of Georgia workers is the State of Georgia itself.  The State of Georgia has dozens of agencies from the State Accounting Office to the Department of Transportation.  Under the workers’ compensation code, state workers are included as eligible employees for benefits should they be injured on the job.

Not unlike any other injured worker, the state employee who is injured on the job, either by a traumatic accident such as a prison guard being attacked by an inmate or by a repetitive or cumulative motion injury such as carpal tunnel syndrome that a clerical assistant or worker at the State Personnel Office may incur, may be entitled to weekly benefits and medical treatment.  The threshold questions are (1) whether the worker was in fact an employee of the State, and (2) whether the accident arose out of and in the course of employment. The answers to both questions must be “yes.”
As another general example, should an officer with the Georgia State Patrol be injured as a result of a car accident when chasing a criminal or shot in the line of duty, the officer would be entitled to workers’ compensation benefits.  Specifically, he or she would be entitled to weekly income benefits should he or she miss time from work as well as medical treatment relating to the injuries sustained in the accident.  Furthermore, in the event the injured officer may need mental health counseling for depression or post-traumatic stress, the psychiatric or psychological sessions would also be covered, provided that the officer also had physical injuries.
The state workers or employees can receive up to 400 weeks of income benefits under the law in certain circumstances.  Also, the state worker would be eligible for life-time medical treatment for the injuries he or she sustained while on the job.  However, the authorized treating physician must document the continued treatment was causally related to the workers’ compensation injury.  Lastly, the state employee may be entitled to compensation for any permanent loss of use or impairment.  The value of the permanent impairment depends on the severity of the injury, the physician’s evaluation of the loss of use, and the state worker’s compensation rate as determined by the workers’ compensation law.
If you have any questions about state workers’ rights under the Workers’ Compensation Act in Georgia, contact Bryan Ramos at the Ramos Law Firm.
Reblog this post [with Zemanta]

Related posts

]]> http://www.ramoslawblog.com/2009/06/30/state-employees-are-eligible-for-workers-compensation-benefits/feed/ 0 What is the value of my workers’ compensation case? http://www.ramoslawblog.com/2009/06/23/what-is-the-value-of-my-workers-compensation-case/ http://www.ramoslawblog.com/2009/06/23/what-is-the-value-of-my-workers-compensation-case/#comments Tue, 23 Jun 2009 14:55:25 +0000 Bryan Ramos http://www.ramoslawblog.com/?p=852 A common question that the Atlanta attorneys of the Ramos Law Firm are asked is “how much is my case worth?”  While there is no amount of money that could fully compensate an injured worker for the pain and heartache she experiences, the Georgia Workers’ Compensation Act provides a framework to consider.

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.

Reblog this post [with Zemanta]

Related posts

]]> http://www.ramoslawblog.com/2009/06/23/what-is-the-value-of-my-workers-compensation-case/feed/ 0 Can I receive disability benefits and workers compensation benefits at the same time? http://www.ramoslawblog.com/2009/06/01/can-i-receive-disability-benefits-and-workers-compensation-benefits-at-the-same-time/ http://www.ramoslawblog.com/2009/06/01/can-i-receive-disability-benefits-and-workers-compensation-benefits-at-the-same-time/#comments Mon, 01 Jun 2009 18:00:48 +0000 Julia Lindsey http://www.ramoslawblog.com/?p=796 No, pursuant to Board Rule 200 (c), “an injured employee who receives regular wages during disability shall not be entitled to weekly benefits for the same period.”

Assuming that an employee has a wage-continuation plan or sick leave policy, the employer should offer the employee the choice to receive either the sick leave OR the workers’ compensation benefits after the employee is injured.  In most cases, the wage-continuation plan/sick leave will be equal to the employee’s salary which is usually more than temporary total disability benefits (TTD).   Therefore, most employees will elect to receive the wage-continuation benefits over the workers’ compensation benefits (TTD).

It is important for the employee to understand that when the employer offers the employee both types of benefits, the employee must select one in lieu of the other.  In other words, they cannot select one now and use the other later.  If the employee elects to receive benefits under the wage-continuation plan, the employee will not receive the workers’ compensation benefits and the employer can request a credit for the workers’ compensation benefits.  Under the law, employees are offered 400 weeks of workers compensation benefits.  When an employee chooses his wage-continuation plan, the employer can obtain a credit pursuant to O.C.G.A. § 34-9-243 which starts the clock ticking for the 400 weeks of workers’ compensation benefits.

Related posts

]]> http://www.ramoslawblog.com/2009/06/01/can-i-receive-disability-benefits-and-workers-compensation-benefits-at-the-same-time/feed/ 0