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Georgia Workers’ Compensation Case Reversed for Second Time for Misapplying Standard of Review

Many Georgia workers’ compensation cases are appealed by one of the parties, meaning that those decisions can be reversed on appeal. Therefore, understanding the standard of review in an appeal is key in any case. In a recent Georgia case, one employee’s favorable decision was reversed on appeal because the reviewing court applied the wrong standard of review.

Rear-End AccidentIn that case, the employee was rear-ended by another car while she was working as a driver, and she injured her back and neck as a result. The employee underwent medical treatments and requested approval for spinal fusion surgery under workers’ compensation. Her employer sent her to be independently evaluated by another doctor. The doctor believed that she was not permanently impaired and that she was able to do regular activities and work without restriction. The parties agreed to forego a hearing and have the administrative law judge (ALJ) decide whether her surgery was reasonable and necessary, based on the briefs and the evidence submitted. The ALJ found the surgery was not reasonable or necessary and denied the employee’s request for benefits.

The employee appealed to the Board of Workers’ Compensation, which found that the ALJ was in the best position to determine credibility and adopted the ALJ’s decision. The case was then appealed to the superior court. The superior court determined the independent doctor was less credible and reversed the decision in favor of the employee. The employer appealed the case again to the court of appeals.

The appeals court reviewed the superior court’s decision and determined the superior court should not have reversed the decision. The superior court was required to defer to the ALJ’s fact findings. It should not have reassessed the independent doctor’s credibility and found him less credible simply because the doctor did not conduct additional objective medical tests on the employee. The court instead should have determined whether there was substantial competent evidence to support the ALJ’s conclusion. Here, the employee’s x-rays, MRIs, and nerve conduction tests were all normal, and several doctors found she did not need joint fusion surgery. Therefore, the appeals court determined there was substantial competent evidence to support the previous decision, and it reversed again in favor of the employer.

Standards of Review in Workers’ Compensation Appeals

The standard of review is the standard under which a court reviews another court’s decision. In Georgia workers’ compensation cases, depending on which court is reviewing the case, a different standard applies.

In most Georgia workers’ compensation cases, a case will first be tried in front of an administrative law judge who judges credibility, finds the facts of the case, and issues a decision in light of the applicable law. If a party appeals the administrative law judge’s decision, the case is heard by the State Board of Workers’ Compensation. Under O.C.G.A. 34-9-103(a), the Board applies the following standard to findings of fact:  it must accept the administrative law judge’s findings of facts if the findings “are supported by a preponderance of competent and credible evidence contained within the records.” Under O.C.G.A. 34-9-f, if the case is appealed again to the superior court, the court applies the following standard:  the superior court must accept the decision of the Board unless there is not “sufficient competent evidence in the record” to support the decision, its legal conclusion was incorrect, or for another reason specified by the statute.

Have You Been Injured at Work?

If you or a loved one was injured on the job, you may be able to pursue a Georgia workers’ compensation claim. Presenting a well-prepared case to the administrative law judge is extremely important because of the standards of review on appeal. However, even if you have already received an unfavorable decision, you may be able to appeal that decision. At the law office of J. Franklin Burns, P.C., we are authorities on Georgia’s workers’ compensation law with decades of experience in workers’ compensation claims. To schedule a free consultation, call us today at 404-303-7770 or through our online form.

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