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In a recent case, an appellate court considered whether a woman had presented sufficient evidence to show she was entitled to home renovations after a workplace injury. The woman injured her lower back at work in 1989. In 2014, when the woman was in her 70s, she had a spinal fusion surgery and developed a difficulty in lifting the front part of her foot. She needed to use a cane and had difficulty maintaining her balance. She brought a workers’ compensation claim for the injury she sustained at work to authorize payment for her lawn care, attendant care, and treatment from a podiatrist, as well as home renovations.

Wheelchair BoundTo support her claim for home renovations, the woman hired a nurse to prepare a home assessment. The nurse made recommendations for home renovations, including a ramp, outdoor motion sensor lighting, and widened doors. The judge of compensation claims (JCC) awarded the woman all of the renovations recommended by the nurse, along with all of her other claims. The employer appealed the decision.

The state appellate court considered the award and affirmed the award for all of the services except for the home renovations. The appellate court determined there was not sufficient evidence to show that the home renovations were medically necessary. Under state law, the employer is required to provide compensation for treatment for injured workers, including any “medically necessary apparatus.” Under this statute, the employer may be responsible for providing an accessible living environment.

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Workers’ compensation is designed to help injured workers by allowing them a streamlined way to obtain compensation while they recover from their injuries. The Georgia workers’ compensation program is a no-fault program, meaning an employee will not be required to show that someone other than himself was at fault for his injuries. Of course, an injured worker must be able to prove that the injury occurred while on the job or through the performance of job-related activities.

Construction WorkersDespite the good intentions behind the workers’ compensation program, sometimes obtaining benefits can be difficult. This may be because an employer contests the claim, arguing that the injury did not occur at work or that the specific injury alleged is not a covered type of injury. In fact, earlier this month, a local Georgia news source issued a report outlining the difficulties that Georgians who are injured on the job have in obtaining workers’ compensation benefits.

According to the recent report, approximately one in five Georgians who missed a week or more of work reported having “big problems” in obtaining their benefits. Making matters worse, in many cases, injured workers rely on these benefits to pay for the medical expenses related to the injury. The troubles injured employees have can range from repeated delays on the part of the insurer to contested claims. Roughly half of those reporting “big problems” explained that their employer or the employer’s insurance carrier did not want to provide the necessary level of care in the wake of their injury.

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Earlier this month, the Occupational Safety and Health Administration issued several new citations to a construction company that was remodeling a building when it collapsed, killing one employee and trapping another inside the wreckage for several hours. According to an industry news report, the building collapsed back in December of last year, but OSHA’s investigation has only recently been completed.

Construction SiteEvidently, the company instructed employees to take down two load-bearing walls without specifying how to install a temporary support structure for the rest of the building. As the employees knocked down the walls, the building collapsed. One man was killed in the collapse, and another woman was trapped for several hours before emergency responders were able to free her.

In the most recent citations, OSHA claims that the company “willfully ignored precautions,” which directly resulted in the death of the employee. The OSHA report also indicates that the company failed to take necessary precautions in conducting an engineering survey prior to beginning the work. These citations were in addition to a previous round of citations that was issued earlier this year. The company was fined a total of more than $200,000, and it may face additional liability should the employees and their families file subsequent claims.

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Georgia courts see vast numbers of cases filed each year. In an effort to help courts deal with the volume of cases that are filed, the legislature as well as the court system have developed certain procedural rules that must be followed in order for a case to be properly resolved. These rules come into play early in a case, starting with when, where, and how the case is filed.

Supreme CourtIn Georgia workers’ compensation cases, generally an injured worker will file a claim. If the employer denies the claim, the claim can be submitted to the State Board of Workers’ Compensation for resolution. In some situations, a party that believes the board made an incorrect decision can then appeal the case to a civil court of law. However, Georgia law only allows for a workers’ compensation appeal to be heard when there has been a “final order or judgment” entered in a case. A recent case decided by the Georgia Court of Appeals illustrates how meticulous courts can be when applying procedural rules and laws.

The Facts of the Case

A worker was injured while on the job. The employee filed for medical benefits under the workers’ compensation program, but his employer denied the benefits. Specifically, the employer claimed that the employee’s claim was not filed in a timely manner and that the statute of limitations barred the employee’s claim.

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Earlier this month, a Florida appellate court issued a written opinion in a workers’ compensation case that upheld a lower court’s decision to apply the “firefighter’s presumption” to the plaintiff’s claim that he sustained coronary artery disease as a result of his employment. Ultimately, the court held that, despite some evidence that the firefighter had some risk factors of coronary artery disease, the presumption was proper. Furthermore, since the employer failed to present evidence to dispute the major contributing cause of the coronary artery disease, the employer failed to overcome the presumption.

FirefighterThe Effect of Presumptions in Workers’ Compensation Cases

In some situations, it is difficult or impossible for a party to obtain the evidence they would need to prove their workers’ compensation case, despite that party’s best efforts. However, out of an interest in fairness, state legislatures have enacted statutes that create presumptions that injured workers can use to help establish their case. For example, in both Florida and Georgia, a firefighter who is diagnosed with heart or lung disease is presumed to have gotten that disease through his or her on-the-job exposure.

When a presumption applies in a workers’ compensation case, the burden to disprove the presumption shifts to the employer. The employer must then submit some evidence to overcome the presumption, or the presumption will stand, and the worker’s injuries will be determined to be work-related for the purpose of a workers’ compensation claim.

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For those whose profession requires that they occasionally work on the side of Georgia highways, it will come as no surprise to hear that the shoulder of a road is a dangerous place to be. In fact, it is estimated that upwards of 400 deaths per year are caused by accidents occurring on road shoulders across the country.

Construction SiteOver the past several years, every state has enacted its own version of a “Move Over Law,” which requires motorists to slow down or give room to emergency vehicles and workers on the road’s shoulder. While each state’s law is slightly different, most laws require motorists to accommodate police, firefighters, emergency responders, tow-truck drivers, accident clean-up crews, and other state transportation workers.

Georgia’s move over law was enacted in 2003 and requires drivers to move over when emergency vehicles are present. If it would be illegal or impossible to change lanes, the driver must slow down to a “reasonable and proper speed,” given the current road conditions.

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Earlier this month, the Court of Appeals of Georgia issued a written opinion in a workers’ compensation case brought by a man who was injured while he was grocery shopping on his personal time. The injured employee claimed that he was a “continuous employee” because his job required that he stay in a hotel away from his home. Ultimately, the court affirmed the lower court’s decision that the injured worker was not a continuous employee.

Wet Floor SignThe Facts of the Case

The injured worker was employed by a plumbing company based in Augusta, Georgia. Since the employee did not have a residence in Augusta, the employer provided the employee with a hotel room. While the employee only worked Monday through Friday, the employer allowed the employee to stay in the room over the weekend because the employee was having car trouble and found it financially burdensome to travel back home over the weekends.

One Sunday, the employee was grocery shopping when he tripped and fell, injuring his ankle. The employee was not working that day, and he was not on call. The employee filed a claim for workers’ compensation, claiming that he was a continuous employee.

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Earlier this month, one state’s supreme court issued a written opinion in a workers’ compensation case involving a man who was seriously injured while working at a national hardware store chain. The employer argued that since a doctor had determined that the employee could return to work, although the worker’s back was found to have a 75% impairment rating, permanent benefits should be denied. The court ultimately rejected the defendant’s argument and found that the injured employee should have been eligible for permanent workers’ compensation benefits.

X-RayThe Facts of the Case

In September 2010, the employee slipped and fell while he was helping a customer load merchandise into their vehicle. As a result of the fall, the employee seriously injured his back. Specifically, he suffered from a herniated disc and spinal-cord compression. He had surgery performed to fuse two of his discs together. However, even after the surgery, he suffered from neck and back pain and had difficulty with balance.

The injured worker was seen by several doctors, each of whom had different opinions about his level of impairment. However, all of the medical opinions suggested that the level of impairment to the worker’s spine was over 50%. Some opinions placed the level of impairment at around 90%. However, one of the doctors opined that the employee could return to work with significant restrictions.

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Earlier this month, the Supreme Court of Georgia issued a written opinion in a workers’ compensation case brought by a man who was injured on the job while descending from a cell phone tower. The court was tasked with determining whether the employee was prevented from obtaining workers’ compensation benefits because his injury allegedly was caused when he disregarded a known safety rule. Ultimately, the court determined that “willful misconduct” can, but does not necessarily, prevent workers’ compensation eligibility, and it remanded the case for further fact-finding.

Power LinesThe Facts of the Case

The worker in the case was an employee of a telecom company. The worker’s job required that he climb cell phone towers. It was company policy for workers to climb down the towers when their job was complete. However, the worker decided to use a controlled descent instead, against company policy and his co-worker’s advice.

During the controlled descent, the plaintiff fell and was seriously injured. He filed for workers’ compensation benefits for the period of time while he was recovering. However, the employer contested the worker’s eligibility, and an administrative law judge determined that his “willful misconduct” prevented him from obtaining benefits.

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The Georgia workers’ compensation program is designed to allow for injured workers to obtain temporary benefits while they recover from their injuries. However, in some cases, an injured worker’s employer contests that the injury either occurred at work, was related to the employee’s employment, or fit under the definition of a “compensable” injury. In these cases, an injured worker’s application for workers’ compensation can be significantly delayed and may even be denied.

StairwellA skilled workers’ compensation attorney can assist any injured worker in the preparation of their claim in hopes of reducing resistance from an employer. Additionally, a workers’ compensation attorney is prepared to litigate on behalf of their client, and appeal an adverse result if necessary.

Employer Denies Employee’s Workers’ Compensation Claim Based on Slip-and-Fall Accident

Earlier this month, a state appellate court issued a written opinion in a workers’ compensation case brought by an employee whose claim was initially denied by his employer and then by an administrative law judge.

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