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Court Finds Employer Cannot Recover Overpayment of Benefits Due to Failure to Follow Procedural Requirements

Procedural requirements can be easily overlooked in Georgia workers’ compensation cases. Yet, understanding each party’s duties and responsibilities is extremely important. In a recent case, one state’s supreme court found a claimant could keep an overpayment of workers’ compensation benefits after the employer failed to follow the procedure outlined in the statute.

Physical TherapyThe claimant in the case worked as a shuttle driver for his employer. One day, the claimant stepped on the frame of a truck and slipped. He fractured his left ankle and had to have several surgeries.

The claimant sought workers’ compensation benefits and received temporary total disability benefits of $67.37 per day. The employer had paid workers’ compensation benefits to the claimant while the claimant was undergoing medical and physical rehabilitation. Almost two-and-a-half years later, the claimant’s doctor reported that the claimant had reached his maximum degree of medical improvement.

The claims examiner then stopped the claimant’s temporary total disability benefits. The employer later realized it had paid the claimant benefits for 156 days beyond what it was required to pay and sought to recover those benefits. That state’s law allowed the payment of temporary total disability benefits only for a period of 104 weeks. The claims examiner decided the claimant should have only been paid for two years, and that he was overpaid by 156 days, or by $10,509.72.

The court explained that under a state statute, once a work injury was found compensable and the claimant was awarded temporary total disability benefits, the claimant would continue to receive benefits until the employer modifies or terminates the award of benefits. However, in order to terminate or modify benefits, an employer is required to follow certain steps.

In this case, the employer did not follow the procedure set out in the statute. It did not try to modify or terminate the benefits until 156 beyond the deadline. Because it did not seek to modify or terminate at the end of the 104 weeks, the claims examiner could not try to recover the overpayments.

Temporary and Permanent Disability Benefits in Georgia

There are three general types of disability benefits available under Georgia’s Workers’ Compensation Act: temporary total disability benefits, temporary partial disability benefits, and permanent partial disability benefits. Each type of benefit provides a claimant with compensation over a certain period of time. Temporary total disability benefits are provided if a claimant is unable to work for more than seven days due to a work injury. Temporary partial disability benefits are provided if a claimant is able to work but earns less than normal due to a work injury. Permanent partial disability benefits are provided if a claimant has a permanent partial impairment. Catastrophic injury benefits are also available for certain injuries, such as total blindness or the amputation of a limb.

Contact a Georgia Workers’ Compensation Attorney

If you have been injured on the job, contact a Georgia workers’ compensation attorney. Having an experienced workers’ compensation attorney who understands both the substantive and procedural requirements is extremely important. At the Georgia law office of J. Franklin Burns, P.C., we have decades of experience in Georgia workers’ compensation claims. Because our Atlanta workers’ compensation attorneys were insurance defense attorneys first, our office has the advantage of understanding the other side’s perspective in order to advance our clients’ cases at trial or through settlement. For a free consultation, call us at 404-303-7770 or contact us through our online form.

More Blog Entries:

Court Finds Employee May Receive Workers’ Compensation Benefits After Car Accident Occurring on the Way to Weekend Training, June 5, 2018, Atlanta Workers’ Compensation Lawyer Blog

Employee Obtains Benefits for Back Injury Despite Similar Previous Injuries, June 20, 2018, Atlanta Workers’ Compensation Lawyer Blog