Retirement Presumption in Georgia Worker's Compensation Claims Addressed in Downing v. Department of Transportation
There are many critical questions to be considered when addressing a Georgia worker's compensation ("WC") claim. Downing v. Department of Transportation ("DOT") shows that it is important to have an experienced Georgia injury attorney as soon as you find you suffer an injury from your work duties.
One of the first questions that arise in a WC claims is, what classification of injury was sustained. There are two types of WC injuries, they are the gradual injury and the incident injury. The incident injury is one that occurs suddenly within the workplace, while gradual injuries are injuries that arise over time because of continuous motions associated with job activities.
Gradual injuries bring up a lot of complications in WC law, which is why the court in Downing goes into such detail regarding this hotly contested WC issues. The court affirms the idea that in a WC claim for gradual injury, the original cause of the injury does not have to be the employee's job duties however the job duties must be a substantial factor in creating the severity of the injury.
The next issue to discuss in a WC claim is whether the employee's injury arose during the course of employment. To prove this, there must be an identifiable and substantial causal connection between the actual injury suffered and the activities performed as part of the injured's employment.
Furthermore, fact finders meet some confusion when identifying the actual date of injury in a WC claim. Because of the nature of gradual injuries, this date of injury can sometimes be disputed. However, the dates that are usually considered in these cases, are the date when a treating medical professional actually diagnosed the employee with the medical condition or when the employee first sought medical attention because of the complaints from this gradual injury.
The court in Downing discusses all of these issues yet it focuses on one main issue in the claim; whether an injured employee can receive WC benefits in addition to their retirement benefits.
This case cites an important legal doctrine that controls this question. This doctrine is called the retirement presumption. Essentially this presumption states that an employee who has retired and is obtaining retirement benefits, cannot also collect WC benefits.
This decision comes because Downing suffered from gradual injuries arising from a pre-existing condition. Downing had spinal stenosis and because of the nature of his work as a laborer, this injury became severely worse. As cited above, in gradual injuries an employee can still collect WC benefits where their injury was pre-existing but aggravated by their work activities.
Subsequently, the pain in Downing's back, leg and hip was so relentless that he was forced to apply for retirement. Downing changed his mind about retirement and upon rescinding his application went back to work for the DOT for another year.
The court reaffirms that the crucial point in the conflict between the rules controlling WC benefit and retirement benefit is the original time of the retirement. This means that when Downing first applied for retirement, this triggered the retirement presumption. It is irrelevant that Downing soon after rescinded that same application.
After another year of working at the DOT, Downing then retired and began working part time for a different employer. After several years, Downing's pain reemerged and he was forced to have spinal fusion surgery. At that time, Downing was receiving benefits associated with his original injury however he applied for additional WC incapacity benefits and was denied.
The court in this case was led to address the issue of whether this man would be eligible to collect both WC benefits and retirement benefits. This determination was contingent on the retirement presumption.
Downing states that where an employee terminates their own employment and receives non-disability benefits from their employer, the employee is not entitled to WC benefits. Hence, when Downing retired from the DOT and accepted the retirement benefits, he barred himself from future WC benefits.
Because Downing was unable to prove that there was a "total physical inability to perform any work that would otherwise be suitable to the employee's qualifications, training and experience," Downing was unable to recover additional benefits through WC. See Costales, 832 A.2d 790.
When you are injured on the job, it is so important to know how your future actions can affect any benefits you are entitled to.