Workers’ Compensation Blog

The South Carolina appellate courts have been faced with several questions on workers’ compensation in recent months, producing opinions that will affect practice points and claims handling in defending workers compensation claims. This series discusses the rulings and how employers and carriers should be mindful of this precedent going forward.

In Simmons et al. v. Solo Cup Operating Corporation, the Georgia Court of Appeals recently issued an opinion in a case involving a wrongful death claim that highlights critical questions about employer responsibilities and safety protocols.

Introduction The South Carolina appellate courts have been faced with several questions on workers’ compensation in recent months, producing opinions that will affect practice points and claims handling in defending workers compensation claims. In this series, I’ll discuss the rulings and how Employers and Carriers should be mindful of this precedent going forward. The Case

Introduction The South Carolina appellate courts have been faced with several questions on workers’ compensation in recent months, producing opinions that will affect practice points and claims handling in defending workers compensation claims. In this series, I’ll discuss the rulings and how Employers and Carriers should be mindful of this precedent going forward. The Case

The State Board of Workers’ Compensation in Georgia has recently posted several proposed rule changes, which it expects to take effect starting July 1, 2024…

CMS has clarified its plans to amend Section 111 relating to workers’ compensation settlements, announcing its plan to change its TPOC under Section 11 and increase the CMP to be imposed on reporting entities.

Workers’ compensation is, at its core, one of the more state-specific areas of the law. Each state legislates its own statutes and regulations and operates its own administrative body, often very differently…

If a workers’ compensation claim was a one-act play (and oftentimes it seems it is), the panel of physicians would be the main character. For employers and insurers, the goal is to make sure the panel is the hero of the show rather than the anti-hero.

The purpose of the Georgia Workers Compensation Act is to provide immediate medical care and wage replacement or income benefits for injured workers. But once these “red flags” are present the question arises: What can I do to stop this type of action and deter others from attempting the gain unwarranted workers compensation benefits?

The Georgia Court of Appeals recently handed down a claimant-friendly decision (Lilienthal v. JLK, Inc.) regarding how and where the required Panel of Physicians is to be posted. Under OCGA 34-9-200(a), an employer is required to furnish an injured worker with reasonably required medical treatment. OCGA 34-9-201(b)(1) satisfies that requirement by allowing the employer to

Written by: Daniel Richardson, Esq. The longer an employee stays out of work, the less likely they are to ever return. And workers compensation claims become increasingly expensive when employees do not return. To manage this exposure, it is important to have a good return-to-work program and to communicate clearly regarding your expectation that you

Written by: Dan Addison, Esq. South Carolina recently had a sea change shift in settlements involving workers’ compensation claims, as well as the procedural nature of Mediations of any workers comp case. In a recent decision from the South Carolina Court of Appeals issued on August 3, 2022 — in which I represented the defendants

Written by: Rayford H. Taylor, Esq. In Florida, a failure by an employer/carrier to promptly grant an employee’s change of physician deprives the employer/carrier of the right to select the doctor, as once again, Florida courts have been called upon to address the “one-time change” provision of F.S. 440.13(2)(f) in the case of Andrews v.

Written by: Daniel Richardson, Esq. As employers seek to provide a safe workplace, it is imperative that no retaliatory action be taken against employees who choose to exercise their rights under the Occupational Safety and Health (OSH) Act or other statutes designed to protect employees. Doing so can be quite costly. Section 11(c)(1) of the

Written by: Laura Gregory, Esq. Recently, the North Carolina Court of Appeals issued a holding that declined to extend the Seagraves test, which is used by courts to determine whether an employee constructively refused suitable employment when they have been terminated for cause unrelated to their work injury. This holding significantly limits an employer’s ability

Written by: Carolina Martin, Esq. Under Tennessee Workers’ Compensation law, an employee is entitled to lifetime medical treatment made reasonable and necessary by their compensable workplace injuries. This can be a daunting prospect for employers, especially in cases where the injured worker is young and the contemplated period of entitlement to these benefits spans several

Written By: Daniel Richardson On October 27, 2021, OSHA published in the Federal Register an Advance Notice of Proposed Rulemaking (ANPRM) on the issue of Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings. According to this Notice, heat is the leading cause of death among all weather-related phenomena. “Excessive heat exacerbates existing

Written by: Margaret “Meg” H. Donahue, Esq. On March 23, 2022 The SC Workers’ Compensation Commission issued this advisory notice clarifying information to be included on the Form 19 at the close of a claim. The Commission has determined that expenses that are not specifically medical care and treatment are being included on Line 6,

Written by: Rayford H. Taylor, Esq. The Employee, in the case of Noa v. City of Aventura and Florida League of Cities, appealed an Order of the judge of compensation claims (JCC) denying an increase in her average weekly wage (AWW).  The Employee contended she was entitled to include a pro rata share of her

Written by: Rayford Taylor, Esq.  The Hampton case established the mere fact an attorney fee amount has not been established does not prohibit the Statute of Limitations from operating to defeat payment of additional benefits.  The Tejeda case reaffirmed that a claimant who voluntarily changed their authorized physician cannot return to the prior physician for

Written by: Peter Skaily, Esq. One of the most important aspects of any workers’ compensation claim is control of medical treatment. The employer/insurer will want the claimant to treat with a provider from the panel of physicians. On the other hand, the claimant will want to treat with an off-panel, claimant-friendly physician. A common way

Written by: Meredith Knight, Esq. Famously, the Medicare Secondary Payer Act has not changed significantly in decades.  It is clearly understood that the MSPA prohibits Medicare from making payments that are the responsibility of a primary payer.  Such primary payers include workers’ compensation plans.  Workers’ compensation employers/insurers have a duty to consider Medicare’s interests as

Written by: Daniel Richardson, Esq. When a claimant files a hearing request, the first thing to check is whether there is an applicable statute of limitations defense. The Georgia Court of Appeals recently addressed a statute of limitations defense raised in a claim for a catastrophic designation in Sunbelt Plastic Extrusions, Inc. v. Paguia, 2021

Written by: Rayford H. Taylor, Esq. The Court of Appeal was asked to again  interpret Section 440.093(3) Fla. Stat. concerning entitlement to temporary indemnity benefits based upon a mental injury arising out of a workers’ compensation accident in the case of Le’Tavia Jones v. State of Florida, Dept. of Corrections, and Div. of Risk Management, 1D20-1741

Written by: Margaret H. Donahue, Esq. On July 27, 2021, the South Carolina Workers’ Compensation Commission issued the attached advisory notice detailing new procedures for email submission of Forms 15,17,19, and 20 by Carriers.  As with prior versions of electronic submission, the Commission is requiring specific format to be followed and will assume no responsibility

Written by: Rayford H. Taylor, Esq. The First District Court of Appeal in the case of Patrick Sean Jones v. Grace Health Care, ______ So.2d ______, (1D19-1684, June 30, 2021) was presented with the question of whether an employer/carrier should be required to pay for an evaluation for a referral for medical marijuana.  The case

Written by: Rayford H. Taylor, Esq. The First District Court of Appeal in the recent case of N. Hannoush Jewelers, Inc. v. Bly, 1D20-2432, (Fla. 1st DCA June 30, 2021) addressed the effect of an employee’s receipt of unemployment compensation benefits (UC) on any award of temporary partial disability (TPD) benefits.  The injured worker sought

Written by: Rayford H. Taylor, Esq. An employer/carrier must aggressively pursue obtaining an appointment with the newly authorized physician or risk having the injured worker select the alternate physician.  While we do not know what period of time is acceptable, we know that taking longer than 50 days from the request for a physician to

Written by: Rayford H. Taylor, Esq. Circuit court judges in Florida have the authority to require provision of benefits ordered by a jcc but which are found to be willfully withheld.  Trial courts can use a Rule Nisi proceeding to not only order the provision of the benefit being denied, but also impose a monetary

Written by Daniel Richardson, Esq. Last year the Georgia Supreme Court addressed the collision of two separate lines of precedent that the Court of Appeals had been trying to hold together with confusing results. This involved (1) the Scheduled Break Exception and (2) the Ingress and Egress Rule. In 1935, the Supreme Court first enunciated

Written by: Rayford H. Taylor, Esq. The case of Stalwart Films, LLC v. Bernecker, 855 S.E.2d 120 (2021) involved a wrongful death action brought by a stunt performer’s family against the film production company and television show producer alleging negligence arising from his fatal fall during the filming of a television show.  The State Court

Written by: Rayford H. Taylor, Esq. The case of Stalwart Films, LLC v. Bernecker, 855 S.E.2d 120 (2021) involved a wrongful death action brought by a stunt performer’s family against the film production company and television show producer alleging negligence arising from his fatal fall during the filming of a television show.  The State Court

Written by: William T. Goran, Esq. For over 75 years now worker’s compensation practitioners have grappled with issues concerning compensability of slip and fall accidents that occurred at work and the evidence is unclear as to why the slip and fall occurred, raising questions regarding whether the accident and injury “arises out of” the employment

Written by: Rayford Taylor, Esq. The First District Court of Appeal recently issued an opinion in the case of Dennis F. Scott v. James A. Jones Construction Co. v. Central Florida Siding Pros, LLC, et al., Case No. 1D20-689 (Fla. 1st DCA March 16, 2021).  While the instant case did not create any new law,

Written by: Rayford H. Taylor Esq. The Florida Legislature began its annual session on March 2, 2021 and will conclude on April 30, 2021, absent any extensions.  There have been three bills introduced thus far which seeks to amend Chapter 440 Fla. Stat., which is Florida’s Workers’ Compensation Statute. Senate Bill 1458 and House Bill

Written by: Margaret “Meg” H. Donahue, Esq. At the one-year anniversary of COVID-19 in America, you’d probably think all the questions had been asked.  But only recently, one came up that I was surprised hadn’t surfaced sooner.  The question was, if a worker is on light duty for a work injury and receiving temporary partial

Written by: Ann Baird Bishop, Esq. In a case decided October 29, 2020, the Court of Appeals held, among other things, that while the doctrine of res judicata applies in workers’ compensation cases, it does not preclude litigating a request for certain medical treatment a second time.  In Trejo-Valdez v. Associated Agents et al. (A20A1499,

Written by: Rayford H. Taylor, Esq. Georgia employers are generally aware they must purchase and maintain workers’ compensation insurance to operate within the state. Those employers obtain coverage for themselves and their employees, but often do not pay attention to the types of coverages included in a workers’ compensation and employer’s liability insurance policy. This

Written by: Rayford H. Taylor, Esq. The First District Court of Appeal (1st DCA) issued an opinion in the case of Julio Sanchez v. Yellow Transportation/Gallagher Bassett, which held the Claimant did not have to establish the workplace accident was the major contributing cause (MCC) for requested treatment.  The Judge of Compensation Claims (JCC) denied

Written by: Ann Baird Bishop, Esq. For almost 20 years, the Workers’ Compensation Act has provided for unilateral conversion from temporary total disability benefits to temporary partial disability benefits in non-catastrophic claims where the claimant is released to light duty for 52 consecutive weeks or 78 aggregate weeks, provided the employer files a correct form

On June 16, 2020, the Supreme Court of Georgia reversed the Court of Appeals and overruled the Supreme Court’s prior decision that developed the “lunch break exception…”

Written by: Rayford H. Taylor, Esq. The First District Court of Appeal (First District) in City of Bartow v. Flores, 1D18-1927 (May 29, 2020) has certified a question of great public importance to the Florida Supreme Court on the issue of when a workers’ compensation carrier has “provided” an alternate physician pursuant to F.S. 440.13(2)(f). 

Written by: Rayford Taylor, Esq.  It has been suggested that if an employee cannot obtain workers’ compensation benefits because of COVID-19, that employee might sue the employer under the employer’s liability portion of a workers’ compensation policy. For purposes of this discussion, workers’ compensation policies essentially consist of two parts.  Part One, known as Workers’

Written by: Denise L. Dawson, Esq. Florida has taken steps to move forward into an enlightened age of technology but may be setting itself up for increased fraud from unscrupulous actors. As recently as last month, the State’s Chief Financial Officer, Jimmy Patronis, issued a statement on April 7, 2020 urging health insurers to take

Written by: Daniel Richardson, Esq. and Peter Skaliy, Esq. Before COVID-19, many companies were experimenting with remote work. It has now become a widespread reality. This creates unique worker’s compensation risks, even as it may decrease the likelihood of some of the more serious or even catastrophic claims. An employee’s home environment is less subject

Written by: Rayford H. Taylor, Esq. Florida’s Chief Financial Officer, Jimmy Patronis, has issued Directive 2020-05 to provide workers’ compensation coverage to “frontline state employees” who contract COVID-19.  Florida’s Risk Management Department provides workers’ compensation coverage to state employees.  The Risk Management Department will now have to provide workers’ compensation coverage to such workers who

Written by: Peter Skaily, Esq. There has been extensive literature published in the past few weeks across the United States explaining the reasons that COVID-19 is (for most, if not all, states) not a covered “accident” and “injury” under the given state’s workers’ compensation laws. However, on April 7, 2020, the Minnesota Legislature removed all

Written by: Ann Bishop, Esq. Effective March 17, 2020, all Social Security Administration field offices were closed to the public in an effort to slow the growing rate of COVID-19 sufferers.  In response to the field office closure, the Social Security Administration is not providing information about Social Security Disability Insurance status to third parties. 

Written by: Meredith Knight, Esq. Last week, we posted our conclusions regarding the compensability, or really, lack thereof, regarding COVID-19 in the workplace as specifically pertaining to the Georgia Workers’ Compensation Act. What follows are three common scenarios employers currently experience that raise further questions about COVID-19 in the workplace. First, please review our initial

Written by: Meredith Knight, Esq. Over the past week, multiple questions have arisen regarding whether contracting COVID-19 is a compensable workers’ compensation event.  The answer will almost always be no.  In a few very fact-intensive cases, the answer may be yes. This article discusses the compensability of viruses in Georgia, as well as the unique

Written by: Peter Skaliy, Esq. In Smith v. Camarena, 835 S.E.2d 712 (Ga. Ct. App. 2019), Fabiola Zavaleta-Ramirez was an employee of a grocery store located in a shopping center with other stores, which shared a communal parking lot. Like the customers, Zavaleta-Ramirez parked her car in the communal parking lot, which was maintained by

Written by: Ann Baird Bishop, Esq. Effective July 1, 2017, the State Board of Workers’ Compensation enacted Rule 205(c) in an effort to address complaints regarding claimants’ difficulties in receiving prompt medical attention.  The WC-PMT procedure was enacted to allow injured workers or their lawyers to request that employers/insurers show cause why medical treatment and

Written by: Daniel Richardson, Esq. Jay Kil was a restaurant manager of Legend Café. He oversaw the restaurant, operated the cash register, ensured orders were correct, and oversaw cleanliness. He lived with restaurant owner Willmore Lim, and after each workday, they would spend around an hour at home reviewing the day’s sales, receipts, accounts, and

Written by: Dale Slemons, Esq. A rapidly growing trend in today’s fast paced, technological era is telecommuting for more and more workers.   More employers are permitting their employees to work at home as a benefit to the worker and a cost saving measure for employers.  In today’s society, where more and more companies are becoming

Written by: James G. Smith, Esq. In a decision published on June 24, 2019, the Claimant in question was a custodian for Ware County Board of Education for 10 years. He sustained a compensable right shoulder injury and was thereafter paid TTD benefits at the rate of $207.61 per week (per the BOE’s calculations). The

By: Ann Bishop, Esq. Here is a copy of Senate Bill 135 which passed and was signed into law by Governor Kemp and which went into effect on Monday, July 1, 2019.  The amendments made some changes to the office of Director Emeritus of the State Board of Workers’ Compensation and to the position of

Written by: Rayford Taylor, Esq. Teresita DeJesus Abreu v. Riverland Elementary School and Broward County School Board, So.3d (Fla. 1st DCA June 18, 2019). In 2015, the Claimant injured her shoulder while at work.  The Employer/Carrier accepted compensability of the accident and authorized treatment.  The treating doctor performed an arthroscopic shoulder surgery to address a partial

Written by: Denise Dawson, Esq. There are two versions of a comprehensive workers’ compensation bill working their way through the legislature in Tallahassee, FL. The House version of the bill, House Bill 1399, has seen some movement in recent weeks, however, the Senate version, Senate Bill 1636, seems to have lost momentum and a decision

By: Meredith Knight, Esq. At this point, we all know social media is an excellent tool to use when researching the activities of claimants, and a number of our recent posts have encouraged the use of electronic and social media to advance our defense of workers’ compensation claims. This post similarly encourages us to take

By: Rayford Taylor, Esq. On February 26, 2019, The Georgia Court of Appeals in Daniel v. Bremen-Bowdon Investment Co. ruled that an employee injured while on a regularly scheduled lunch break is not entitled to workers’ compensation benefits under the ingress and egress rule. At the time of the incident, Ms. Daniel was employed as

Written by: Daniel Richardson, Esq. Rochelle Frett worked as a claims associate for State Farm. Each workday she had a mandatory unpaid 45-minute lunch break. During her lunch break she was free to do as she pleased, including leaving the office for lunch. She was not expected or asked to do any work on her lunch

y: James G. Smith, Esq. Effective January 1, 2019, the Georgia State Board of Workers’ Compensation will begin actively enforcing the requirement to timely file a Form WC-1 in all claims, including those deemed “medical only.”  Although Board Rules already require that a WC-1 must be filed and provided to the employee within 21 days of

Written by: Rayford Taylor, Esq. LINGO V. EARLY COUNTY GIN, INC. GEORGIA COURT OF APPEALS EMPLOYER WAS NOT ENTITLED TO STATUTORY PRESUMPTION CONCERNING DRUG USE Analysis An employer which seeks to use the statutory presumption that a workplace accident was caused by drug use must strictly comply with the statutory requirements. If not done properly, the

Written by: Byron Lindberg Several revisions to the Claims Handling Standards (0800-2-14) went into effect, on August 2, 2018, with new rules ranging from a requirement that adjusting entities designate a liaison between the entity and the Bureau of Workers’ Compensation to new regulations governing contact/interaction with injured employees. Some of the revisions to be especially

Written by: Rayford Taylor, Esq. Analysis Plaintiffs seeking damages from employers or co-employees allegedly arising from the negligence in a workplace accident must properly plead and prove facts which support intentional or grossly negligent conduct to defeat workers’ compensation immunity. Facts Mr. and Mrs. Ramsay, as personal representatives of their son’s estate, sued the employer and

Written by: Daniel Richardson, Esq. One of the most important avenues to control the medical costs and overall exposure of your worker’s compensation claims is to utilize the control given to Employers by O.C.G.A. § 34-9-201, which requires that the Employer maintain a valid Panel of Physicians. The statute requires that you list at least six

By: Denise Dawson, Esq. Firefighters, police officers and other first responders who suffer from post-traumatic stress disorder (PTSD) will qualify for a full array of workers’ compensation insurance benefits effective Oct. 1, 2018, under a bill that Gov. Rick Scott signed into law, at the Tampa Firefighters Museum on March 27, 2018. Three Central Florida first

By: Dale Slemons, Esq. Georgia’s House Bill 249 , which was signed into law by Governor Deal last year, has put new teeth into Georgia’s Prescription Drug Monitoring Program (PDMP). Specifically, the law shifts control of Georgia’s PDMP from the Georgia Drugs and Narcotics Agency to the Georgia Department of Public Health. The law further requires

By: Dale Slemons, Esq. As you know, one of the most important avenues to control the medical costs and overall exposure of your workers’ compensation claims is to utilize the control given to Employers by O.C.G.A. 34-9-201, which requires that the Employer maintain a valid Panel of Physicians. As you may know the statute requires

Written by: Lissa F. Klein, Esq. The Court of Appeals chipped further away at the “idiopathic fall” defense and overruled a key case concerning this defense in the recent decision of Cartersville City Schools v. Johnson, A17A1469 (March 16, 2018). By way of background, the claimant in Johnson was a teacher who was instructing her students when she walked

Written by: Michael E. Memberg, Esq.  The individuals who can claim workers’ compensation death benefits under Georgia law are defined by O.C.G.A. § 34-9-13. With respect to a surviving spouse, parent, or child of a deceased employee, the process to establish dependency and entitlement to death benefits is rather straightforward. However, O.C.G.A. § 34-9-13(d) also provides

Written by: Kawania James, Esq. When an injured worker is not forthcoming about his condition, it could lead to an Employer/Insurer unnecessarily paying hundreds or thousands of dollars for a work injury that has resolved or an alleged disability that never existed. Often times Employers and Insurers will utilize investigative methods, such as surveillance and social

By: James G. Smith, Esq. In a decision handed down this week, the Supreme Court of Georgia issued a notable “win” for Employer/Insurers in a case that has made its way through the courts over the past several years (Ocmulgee EMC et. al. v. McDuffie). Specifically, the Court found that an employer need not show the

Written by: Byron K. Lindberg, Esq. Tennessee is one of only a handful of states that does not recognize certification of workers’ compensation adjusters; but that may be about to change. On August 29, 2017, the Bureau of Workers’ Compensation held a Rulemaking Hearing discussing, among other things, a proposed Adjuster and Adjuster Entity Certification Program.

Written by: Rayford Taylor, Esq. The First District Court of Appeal recently considered an appeal in the case of Julio Jiminez v. UPS, Case No. 1D16-4959, involving a challenge to Section 440.12(2) Fla. Stat. (2014). That statute sets the cap on the maximum weekly compensation rate. The merits of the challenge were not addressed by the Appeals

Written by: James G. Smith, Esq. Georgia law provides special rules for determining whether a hernia injury is compensable. I have had a several hernia cases recently, and in each case, the “heavy lifting” of defending the claim undoubtedly takes place in the initial moments or discussions when the alleged hernia is reported to the employer

Written by: Robert J. McCune, Esq. It is of course the plaintiff’s initial burden of proof to establish that their work-related accident caused compensable injuries. What happens when the plaintiff develops different injury claims arising from that same accident? In Parsons v. Pantry, Inc., 126 N. C. App. 540 (1997), our Court of Appeals determined that the

By: Mariel Smith, Esq. On June 20, 2017, in the case of Kendrick v. SRA Track, Inc. the Court of Appeals of Georgia held that in a case where the employee was injured in a motorcycle accident, the employer was not time-barred under OCGA. § 34-9-221(h) from controverting his claim on the ground that the accident

Written by: Brian Mallow, Esq. On Monday, an Alabama Circuit Court Judge issued an order, finding two provisions of the Alabama Workers’ Compensation Act unconstitutional. Judge Pat Ballard held that the state’s $220 per week cap on permanent partial disability benefits (enacted thirty years ago) fails to provide an adequate remedy to injured workers in violation

One of the most experienced and well-respected members of the workers’ compensation community, Dr. J. Carl Sutton, recently passed away. Dr. Sutton and his orthopedic practice, Sutton Orthopaedics & Sports Medicine, served as a panel provider for countless employers on the Southside of Atlanta and across Georgia. He will certainly be missed by employers and

Written by: Dale Slemons, Esq. When an Employee has concurrent employment and it is determined that the concurrent employment is similar, the claimant may be entitled to an increase in average weekly wage and ultimately his workers compensation indemnity benefits based on the combined wages received from both employers. You should be aware of this if

Written by: Dale E. Slemons, Esq. As you know, one of the most important avenues to control the medical costs and overall exposure of your workers’ compensation claims is to utilize the control given to Employers by O.C.G.A. 34-9-201, which requires that the Employer maintain a valid Panel of Physicians. As you may know the statute

Written by: Brian Mallow, Esq. In a major victory for employers/insurers, the Georgia Supreme Court today reversed a Court of Appeals decision that significantly limited the application of the “willful misconduct” defense in Georgia workers’ compensation cases. The case involved a cell tower technician, Adrian Burdette, who was seriously injured while attempting a controlled descent (similar

By: Michael Memberg, Esq. The Georgia Workers’ Compensation Act provides that no compensation shall be allowed for an injury caused by an employee’s willful misconduct, including the willful failure or refusal to use a safety appliance or perform a duty required by statute. On paper, the law reads like an employee has to diligently follow every

Written By: Lauren K. Dimitri, Esq. In July of this year, the Appellate Division of the State Board of Workers’ Compensation rendered a decision on surveillance that has created quite the buzz in the Comp community. The Employee in State Board of Appeal #2013024225 appealed the administrative law judge’s order which granted the Employer’s motion for

Written by: David S. Dix, Esq. For many employers in Georgia, Workers’ Compensation is simply fact of life and a cost of doing business.  However, for smaller businesses with fewer employees, Workers’ Compensation may not be a foregone conclusion.  Not all employers are subject to the Workers’ Compensation Act, and not are required to carry workers’

Written by: Brian Mallow, Esq. Last week, in a 7-2 decision, the Oklahoma Supreme Court struck down the Oklahoma Employee Injury Benefit Act, otherwise known as the “Opt-Out Act,” holding that the Act is unconstitutional under the state’s constitution. The case, Vasquez v. Dillard’s, Inc., has been closely watched since the Oklahoma Workers’ Compensation Commission first declared

Written by: Dale Slemons, Esq. Summer is slowly winding down and those fun filled, company sponsored, summer softball teams are gearing up for the playoffs, including our very own HBS “Devil Goats”. Good luck Goats!!! While most company softball teams play for exercise, fun and the occasional adult beverage after the hard fought game, during playoff

Written by: Ashik Jahan, Esq. On May 12, 2016, the Occupational Safety and Health Administration (OSHA) published another final rule regarding the reporting of injuries and illnesses and protecting employees who make complaints. This new OSHA rule, which goes into effect on August 10, 2016, goes after two workplace safety policies that are often involved in

Written by: Dale Slemons, Esq. We were recently notified that Premier Immediate Care will be closing both its local offices this summer. This will be permanent closure for the Lawrenceville office on June 30, 2016 and the Suwanee office on July 15, 2016. The following link: http://www.pic.md/ will lead you to their website and specific directives

Written by: Brian Mallow, Esq. On Monday, the Georgia Supreme Court, in a unanimous opinion, reversed a July 2015 decision of the Court of Appeals that severely restricted the application of both the “change in condition” statute of limitation and the “all issues” statute of limitation. The employee, Willie Barnes, sustained a traumatic work injury in

Written by: Lissa F. Klein, Esq. We often think of O.C.G.A. §34-9-8 as a statute that addresses the liability of principal contractors as “statutory employers” in the context of construction; however, this Code Section is not limited to just such a scenario.  Instead, Georgia courts have addressed claims where O.C.G.A. §34-9-8 works to bar tort claims

Written by: Michael Memberg, Esq. The Georgia Court of Appeals was recently asked to decide if a horrific case of workplace violence constituted an injury as defined by the Georgia Workers’ Compensation Act.  In summary, a convicted felon lied on a job application to get hired by a staffing company.  One day while on a work

Written By: Byron Lindberg, Esq. Texas has always allowed employers to “opt-out” of its workers’ compensation system. Nonetheless, most employers in Texas have traditionally elected to eschew the Wild West uncertainty of liability proceedings for customary workers’ compensation and the shelter of exclusive remedy protection. That approach, however, has seen some defection in recent years among

Written by: Melanie V. Slaton, Esq. The recent decision of Burdette v. Chandler Telecom, LLC, 335 Ga App 190 (2015), is instructive and explored what constitutes an “employee’s willful misconduct ” in the workers’ compensation  context. The employee was a cell tower technician. On the employee’s initial day of work he was told by his boss

Written by: Michael Memberg, Esq. On January 1, 2016, the Georgia State Board of Workers’ Compensation put into effect Board Rule 200.2 to clarify the rights of Employers/Insurers/TPAs to utilize a nurse case manager. Prior to this Rule, there technically was not a Rule in place defining the role of nurse case managers in workers’ compensation

Written by: Don Benson, Esq. A December 16, 2015, federal court decision found that the pay of telemarketing employees was improperly docked for taking water, bathroom and rest breaks- virtually all time not spent making sales calls was treated as unpaid time. Perez v. American Future Systems, Inc., civ. No. 12-6171 (E.D. Pa. 2015). This unpaid time when

Written by: Sam Crochet, Esq. Recently, Georgia hand surgeon Jim Roderique announced he is retiring from the medical profession. A mainstay on many employer-panels over the years, Dr. Roderique’s retirement brings to light an important issue to consider for defending and managing workers’ compensation claims—regular maintenance of the posted panel of physicians. As we know all

Written by: Lauren Dimitri, Esq. Signs are everywhere! In your office building (“Wet Floor”), on the sidewalk as you walk to lunch (“Sidewalk Closed”) or on the highway as you drive to work (“One Call, That’s All”). Signs are often hard to ignore because they are always in your face. However, what happens if you miss

Written by: James G. Smith, Esq. Recently, I came across an interesting hypothetical scenario in which “horseplay” could have been asserted as a defense. The hypothetical is as follows: An employee arrives at work in the morning and parks his vehicle. As he gets out of the vehicle, a coworker pulls up in a golf cart

The Georgia Court of Appeals recently issued an opinion that could significantly impact indemnity exposure where a claim is (or has been) accepted as catastrophic. In Barnes v. Roseburg Forest Products Co., Case Number A15A0405 decided July 16, 2015, the Court of Appeals considered a claimant’s appeal seeking indemnity benefits under two alternative theories: (1) as

A misunderstood area of workers’ compensation defense exists in the notorious “240 process.” As we often see, an employee’s Facebook pictures, or perhaps his comments to a physical therapist, may be inconsistent with his complaints to the ATP, who has the employee on work restrictions. Given this suspicion, the employer and adjuster then put their

The Georgia Workers’ Compensation Medical Fee Schedule serves to establish maximum fee amounts and uniform payment guidelines for reimbursement to medical providers for their treatment of injured employees. This is not likely to be a surprise, but did you know that compound medications are also covered by the Fee Schedule? Compound medications are created at

As you may know the Georgia Legislature meets during the first quarter of each year. Every couple of years they will make revisions to our laws in an effort to keep up with the times and to react to issues we all face in the actual practice of abiding by and implementing Georgia’s workers compensation

Aside from emergency medical treatment that may be required for a worker injured on the job, states in the southeast (SC, NC, AL, TN, FL, GA, MS and LA) have different rules regarding the initial authorized medical treatment for injured workers. For employers who operate in multiple states, and for insurance adjusters with claims in

Communication is one of the most important aspects of a well-managed, successful workers’ compensation program. It is extremely important to establish good relationships with supervisors, employees, and medical providers both prior to and after a work injury occurs. Injured employees usually are not knowledgeable about the workers’ compensation system and experience fear, doubt, and worry

A recent decision from the Georgia Court of Appeals, ABF Freight Systems v. Presley, 330 Ga. App. 885 (2015), illustrates how difficult it can sometimes be to distinguish between fictional new accidents, changes in condition, and super-added injuries. These types of cases are usually complicated, and it is often a close call as to which category

Why Do I Need A Restricted Duty Job Program? Best Practices 1. Return injured employees to meaningful employment. 2. Utilize employees’ work skills during their period of partial disability. 3. Maintain a good employee attitude by providing meaningful employment. 4. Maintain communication with employees. Benefits 1. Helps the injured employee maintain income levels. 2. Eliminates

Georgia law is clear that in the event that an injury is deemed compensable, the employer must provide the injured worker with medical treatment which is prescribed by a licensed physician, and which “shall be reasonably required and appear likely to effect a cure, give relief, or restore the employee to suitable employment.” Less clear,

About the program The Georgia State Board of Workers’ Compensation certifies employers as a drug-free workplace. Those certified receive a 7.5% reduction of their workers’ compensation premiums. Employer must submit a copy of their certificate each year to their carrier in order to receive the discount. (O.C.G.A. §33-9-40.2) (O.C.G.A. §34-9-412) Self-insured employers who qualify for

Drugs and alcohol certainly have no place in a safe work environment. In fact, Georgia provides a discount on workers’ compensation insurance premiums for employers who participate in the Drug-Free Workplace program established by the Georgia Workers’ Compensation Act. However, despite the obvious dangers of employees working while under the influence of drugs or alcohol,

The Red Flags of Workers’ Compensation: 25 Warning Signs 1. News of layoffs/termination/transfer. 2. Unwitnessed accident. 3. Accident reported after a holiday, weekend or vacation. 4. Short-term employee. 5. Lack of cooperation with medical suppliers. 6. Instant lawyer retention. 7. Disciplined shortly before the accident. 8. Employee is not a “happy camper.” 9. Family owned

The general rule is that an injury that occurs when an employee is traveling to or from work is not compensable because the injury does not arise out of or in the course of employment. Mayor & Aldermen of Savannah v. Stevens, 278 Ga. App. 166, 598 S.E.2d 166 (2004). However, the ingress/egress rule is a

An employee reports to his supervisor that he has a swollen, round skin lesion on his knee. It must be a spider bite, right? Not so fast. An increasing body of research has revealed in recent years that spider bites are often misdiagnosed, especially with respect to brown recluse spiders. In Georgia, for example, a

A South Carolina case recently made national headlines when the S.C. Supreme Court ruled that an employee who was injured in a company kickball game was entitled to workers’ compensation benefits. Stephen Whigham, an employee at a public relations firm, was encouraged by his boss to organize the kickball game as a team-building event. Whigham

The Court of Appeals has recently issued its decision in Chambers v. Monroe County Board of Commissioners, 2014 Ga. App. LEXIS 551 (2014), providing some clarity in the murky area surrounding idiopathic injuries. The claimant in Chamberswas a firefighter/EMT for Monroe County. The claimant was asked by a supervisor to stand from her chair when she heard

While employers and insurers are quite familiar with the impact of Medicare in the context of a workers’ compensation claim, Medicaid can also greatly affect the handling of a workers’ compensation claim as well.  Medicaid is a federal entitlement program which provides healthcare to the poorest population of the United States.  Many groups of people

For starters, looking to the relevant code section, O.C.G.A. §34-9-1(4) recognizes “strokes” as being potentially compensable.  Specifically, in relevant part, this code section states: “”Injury” or “personal injury” means only injury by accident arising out of and in the course of the employment … “Injury” and “personal injury” shall not include… heart disease, heart attack,

Although the Workers’ Compensation Act requires an injured employee to give his employer timely notice of his injury, mounting a successful defense based on the lack of notice is usually more difficult than it sounds. The courts typically construe the notice provisions in the employee’s favor, liberally defining what qualifies as notice and sometimes excusing

I recently evaluated a claim with facts somewhat similar to the following: The claimant sustained a right knee injury in January of 2003, which was accepted as compensable. The claimant received medical benefits and was paid income benefits for a period of time until being released back to regular duty work in October of 2003.

The Claimant filed a WC-RICATEE requesting a catastrophic designation. What should I do next? First and foremost, an objection/response should be prepared and filed with the State Board. Under the current law, once a claimant has filed a request for a catastrophic designation, the Employer/Insurer has twenty (20) days to file a response, or else

There are several instances when a Georgia workers’ compensation claimant may receive authorized medical treatment from an out-of-state provider in non-emergency scenarios.  For example, an authorized treating physician may make a referral to a specialist in another state, which is not uncommon in metro areas near the state line.  It is also possible an out-of-state

Teleworking or telecommuting, allows employees to perform their work remotely, either from home or other locations outside of the traditional office.  While telecommuting has become a popular option for employers and employees alike, there are many issues to be aware of regarding work-related injuries involving employees working from home. Workers’ compensation laws typically do not

For many years, O.C.G.A. § 34-9-240 has provided a tool for compelling injured employees to return to light duty work, but this mechanism was often ineffective.  Although it allowed an employer to unilaterally suspend income benefits if the injured employee refused the light duty job, the employee could simply show up for work and “attempt”

As we all know, employers are required to provide reasonable medical treatment for work injuries.  In exchange, employers can limit who the injured employee is allowed to see by posting a valid Panel of Physicians.  A valid panel will have at least six unaffiliated doctors, at least one orthopedic surgeon, and no more than two

Who is considered a “supervisor” can often determine liability in both workers’ compensation claims and in sexual harassment cases, although the standard of who is a “supervisor” is different. In sexual harassment situations, any sexual harassment claims defense lawyer understands that there are different liability standards depending on whether the accused harasser is a co-worker

Come on down! You just committed workers’ compensation fraud for being on the Price is Right! A news story emerged out of Greenville, North Carolina this month about a postal worker who was convicted of workers’ compensation fraud in a claim she filed in 2011. According to the story, the worker represented that she was

   Many times situations arise in cases that create a suspicion of symptom magnification or malingering.  When this issue is present, there are concerns that the claimant may be exaggerating pain behaviors for financial incentive or to avoid returning to work.  Some of the identified risk factors for malingering include ongoing litigation, significant discrepancy between

With almost 50% of the adult population of North America on Facebook, your Claimant more likely than not has a substantial Facebook trail. Not lagging far behind on the social media bandwagon are, to name a few: Twitter, LinkedIn, Instagram, Tumblr, and Pinterest. And, with the penchant for these websites to revamp their privacy settings

On Tuesday, March 12, 2013, the Georgia Senate voted 45-0 to pass legislation developed by the Advisory Council to the State Board of Workers’ Compensation.  HB 154 now awaits the Governor’s signature before becoming law.  According to GSIA, HB 154 passed through four legislative committees and both chambers without a single dissenting vote, primarily because

As one of only two states remaining where workers’ compensation matters are still hashed out in the courts, Tennessee may be sticking out like a sore thumb. Back in the Fall of 2012, we highlighted the Krohm/Bryant Report as being the shot across the bow for workers’ compensation reform in Tennessee. In his State of

The end of 2012 brought with it important decisions in Georgia appellate courts affecting key issues in workers’ compensation claims.  Below is a brief summary of three of the most recent decisions that addressed workers’ compensation issues. Arby’s Restaurant Group, Inc. v. McRae (Decided November 5, 2012): Many people are familiar with the Court of

We wanted to update you on a recent decision by the Georgia Court of Appeals regarding the proper role of the superior courts on review and the difference between a fictional new injury and a cumulative trauma. In JMJ Plumbing, et. al. vs. Cudihy, A12A1348, the Court of Appeals was called upon to review the

Almost as difficult as repealing a tax is wresting workers’ compensation from the trial courts in Tennessee.  Undaunted, business groups have relentlessly chipped away at this gargantuan task over the past several years. In response to a 2012 Request for Proposals issued by the Tennessee Department of Labor and Workforce Development, consultants Gregory Krohm and

On November 5, 2012, the Supreme Court of Georgia reversed the Court of Appeals holding in Arby’s Restaurant Group, Inc. et al. v. McRae.At the trial level, McRae had been directly ordered by the State Board to sign a medical release “expressly authorizing [her treating physician] to meet privately with a representative (or representatives) of

Occasionally, an Employer/Insurer’s satisfaction of their obligation to provide an employee with appropriate medical care can create an increased risk of additional accidents.  For example, an employee will likely have to brave the freeways and roads in order to travel to and from his medical appointments.  If the employee is involved in a car accident while traveling

As is well established in workers’ compensation law, in order for an injury to be compensable, it must have been sustained in the course and scope of the worker’s employment. However, there can sometimes be a very hazy line between activities that fall within the scope of employment and those that do not, especially when

Two concepts that are often misunderstood and frequently the subject of litigation in Georgia are “fictional new injury” and “change in condition.”  A recent case that made its way through the Georgia appellate system, Scott v. Shaw Industries, Inc., illustrates how these concepts sometimes overlap and exposes the difficulty that courts often have in distinguishing

dil·i·gent [dil-i-juhnt]  adjective 1.  constant in effort to accomplish something; attentive and persistent in doing anything:  a diligent student. 2. done or pursued with persevering attention; painstaking:  a diligent search of the files. The Georgia Court of Appeals has recently reaffirmed the Maloney v. Gordon Farms decision from 1995, which requires a “diligent, but unsuccessful

When most people think of the Racketeer Influenced and Corrupt Organizations Act (RICO), theyimmediately think of the mafia and organized crime.  However, a recent decision by the Sixth Circuit Court of Appeals may open the door for future RICO claims in a workers’ compensation setting. In Brown v. Cassens Transport Company, Sixth Circuit, No. 10-2334,

“Privacy is no longer grounded in reasonable expectations, but rather in some theoretical protocol better known as wishful thinking.” Pretty harsh-but also pretty accurate. This is the language from the judge in a ruling in the 2010 New York case, Romano v. Steelcase Inc., 2010 WL 3703242 (N.Y.Sup. September 21, 2010) regarding a Plaintiff’s expectation of

Recently, a Claimant attorney and two orthopedic surgeons have published “IME Prep,” an instructional DVD series created by Atlanta Claimant’s attorney Rob Hendrix. IME Prep is designed to educate claimants and their counsel about what goes on at an IME. This development has caused great concern within the Workers’ Compensation community, and with good reason.

Today, the Georgia Supreme Court granted a writ of certiorari for the case of Arby’s Restaurant Group, Inc., et. al. v. Laura S. McCrae, Court of Appeals Case No. A11A1021.  Since the Court of Appeals issued their ruling last December, claimant attorneys have tried to argue that the McCrae case limits the ability of employers and insurers to

The Center for Immigration Studies estimates about five percent of workers in the U.S. are illegal immigrants. In some industries, such as food service and construction, it’s much higher – 18 percent for construction. While IRCA, the Immigration Reform and Control Act, does not prohibit an illegal immigrant from seeking employment, it does prohibit an

With the rapid rise of social networking through internet sites such as Facebook and Myspace, more and more people are placing personal and private information on the web. At Hall Booth Smith & Slover, we perform internet inquiries of popular social networking sites and public records databases on every claimant upon receipt of a new

In Georgia, it is well established that an employee is generally not acting in the course of his employment when traveling to and from work. However, one of the exceptions to this rule is the “special task” rule. This exception allows for an accident to be deemed compensable when the employee is engaged in a

In the event of a catastrophic injury, the Georgia Workers’ Compensation Act requires an employer/insurer to provide the injured employee with reasonable and necessary rehabilitation services. This often requires the employer/insurer to make structural modifications to an employee’s home. In extreme cases, an employer/insurer can be required to provide the employee with new housing, which

Most workers’ compensation claims begin and end with the handling of a claimant’s physical injury.  However, many also deal with the handling of a claimant’s psychic injury. The Georgia Workers’ Compensation Act recognizes psychic injuries as compensable under O.C.G.A. §34-9-1. Like a physical injury, a psychic injury must meet certain criteria in order to be