Articles Posted in Workers’ Compensation Case Law

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The Georgia Workers’ Compensation Act can provide many benefits to Georgia claimants. Yet it can also act as a roadblock to certain claims, as one recent case illustrates.

Snowy RoadIn that case, a hospital employee in Missouri was a courier who was responsible for delivering medical supplies. He was supposed to work on a day when there was a severe winter storm. His supervisor asked his superior whether the employee should drive that day, and he was told that he should but that he should drive slowly and carefully. During his shift, the employee’s supervisor called the employee to check on him, and the employee said that his windshield was freezing. The supervisor called his superior again, who said that he should continue to work. Later during his shift, the employee’s vehicle slid off the road, and the employee died as a result. The employee was not delivering any supplies that needed immediate delivery.

The employee’s wife sued the two supervisors for wrongful death, claiming they were negligent in directing the employee to drive his route despite the conditions. The defendants argued the lawsuit was barred by the exclusivity provision in the state’s workers’ compensation act.

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In some Georgia workers’ compensation claims, injured employees may receive benefits for emotional injuries as well as physical injuries. In a recent case, one state’s appeals court considered a psychiatric injury claim after a construction site accident.

BulldozerIn that case, the construction worker was operating a soil compactor on a hill, and the compactor rose up in the air, causing it to fall backwards on top of the worker. The worker filed for workers’ compensation benefits, and the workers’ compensation judge found the worker sustained a back injury and a psychiatric injury.

Under that state’s law, since the worker had worked at his job for less than six months, his psychiatric injury was compensable if it was caused by a “sudden and extraordinary employment condition.” Courts interpreted that standard to mean that the event was not a routine physical injury but instead was an event that would be expected to cause a psychiatric injury, such as an explosion or workplace violence. The worker was required to show by a preponderance of the evidence that the event was “something other than a regular and routine employment event or condition” and that the event “was uncommon, unusual, and occurred unexpectedly.”

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Luckily for employees, they do not have to be in perfect health before an injury in order to qualify for workers’ compensation benefits in Georgia. This means that if an employee is injured on the job, the employee may qualify for benefits if the work injury aggravates a preexisting injury.

Garage TruckCourt Rejects Employee’s Aggravation Claim

In a recent case, one state’s supreme court considered whether an employee’s left knee injury aggravated a preexisting injury to his right knee. In that case, the employee injured his left knee while he was working for the city’s street department, first in 2009 and again in 2012. His injuries were covered under the state’s workers’ compensation act. However, the employee later reported pain in his right knee, and he was diagnosed with severe degenerative joint disease of the right knee.

The employee underwent surgery on his right knee but did not seek workers’ compensation approval for the procedure. After the procedure, the employee filed for workers’ compensation benefits for the injury to his right knee. He argued that his left knee injuries aggravated a preexisting degenerating joint disease in his right knee as well. The workers’ compensation commission rejected his claim, and he appealed.

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Georgia’s Workers’ Compensation Act is meant to give employees a faster and more streamlined way to receive benefits for injuries suffered at work. However, the drawback is that there are limits on what employees can recover under the Act. In some cases, employees attempt to bring claims outside the workers’ compensation system, although in many cases they are barred from doing so.

ContractO.C.G.A. 34-9-11 of Georgia’s Workers’ Compensation Act states that the “rights and remedies” granted to an employee under the Act “shall exclude and be in place of all other rights and remedies of such employee, his or her personal representative, parents, dependents, or next of kin, and all other civil liabilities whatsoever at common law or otherwise, on account of such injury, loss of service, or death.” This means that generally, any claims for injuries incurred at work must be brought under the Workers’ Compensation Act. However, there are exceptions in some cases that may allow employees to bring additional claims.

Court Rejects Breach of Contract Claim, Finding It Barred Under Workers’ Compensation Act

One state’s supreme court found in a recent case that a breach of contract claim was barred by the state’s workers’ compensation act after the man died from a work injury. The man had been injured at work and required multiple surgeries over the next few years as a result. During one hospitalization, he requested an order from the Workers’ Compensation Court that he be treated by a nutritionist, based on a recommendation from his doctors. However, he died before a consultation could be completed. The insurer claimed that it was not required to pay for a nutritional consultation because it argued that his nutritional problems arose prior to his work injury.

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If a worker is injured and files a claim for Georgia workers’ compensation benefits, the employer only has a certain amount of time to investigate the claim and contest compensability. In a recent case, an employer was barred from raising a defense that its employee was intoxicated at the time of his injury because it failed to diligently investigate the claim within the allotted time period.

Tipsy on WineIn that case, the employee fell while emptying garbage from a dumpster while he was working at a fish market. He claimed later that he slipped on a piece of fish. The employer was told about the accident that day, but he did not report the accident to his workers’ compensation insurance carrier. The employee fractured his hip, and due to multiple complications he ended up having five surgeries.

The employee filed a claim for workers’ compensation benefits about nine months after the injury, which was the insurance carrier’s first notice of the injury. The employer paid but continued to investigate the claim during the following 120 days it had to do so. But it was not until almost six months after it was notified of the injury that the employer denied that the injury was compensable. The employer claimed that the injury was not compensable because the injury was due to the employee’s intoxication at the time of the injury.

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Although Georgia workers are generally entitled to recover compensation from their employers for workplace injuries, whether independent contractors are entitled to Georgia workers’ compensation benefits can be tricky. In a recent case, a court considered whether an independent contractor was entitled to bring a premises liability claim against a homeowner after he was injured on the property.

RoofIn that case, the plaintiff was washing windows on a house when he fell off the roof of the defendant’s house. He brought a premises liability claim against the homeowner, arguing that loose rocks and sand on the roof caused him to fall and that they constituted a dangerous condition.

The trial court found that the plaintiff could not bring his claim because he was an independent contractor, and the plaintiff appealed. Under that state’s law, an independent contractor generally cannot sue the hirer of the contractor for injuries suffered in the workplace. However, an independent contractor can sue if the hirer exercises control over the work in a way that contributes to the injury, or if the hirer fails to warn the contractor of a concealed dangerous condition on the property. The plaintiff claimed that the hirer had a dangerous condition on the property, in part because he was forced to walk along a narrow ledge along the roof because piping and mechanical equipment were blocking a safer path. The homeowner provided video and photo evidence taken over three years after the incident that showed individuals walking around the equipment and along a safer path.

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Some Georgia workers’ compensation claimants have difficulty proving a workers’ compensation claim if they have pre-existing conditions. In these cases, employers may argue that the pre-existing condition caused the injury rather than an on-the-job incident.

Wet Floor SignIn a recent case, a court considered whether a woman was entitled to workers’ compensation benefits after she was injured at work. The woman claimed that she sustained a brain injury after she slipped and fell while working at a grocery store. Her employer argued that the brain injury was not related to her employment.

After a hearing before an administrative law judge, the judge found that the woman fell after fainting due to her heart condition, rather than because she slipped. At the hearing, the claimant testified that she told her husband that she passed out. Her husband also testified that the she told him that she had slipped. However, a customer testified that the woman passed out, and a co-worker explained the woman was not acting like herself that day. Her co-worker and manager both testified that she said she did not know how she ended up on the floor.

In addition, the claimant had a history of arrhythmia and had an implantable cardioverter defibrillator device implanted in 2011. Her doctor testified that arrhythmia can cause a person’s blood pressure to drop, causing a person to faint. The woman also told medical personnel that she had fainted a week before the incident at the store. Based on this evidence, the state’s supreme court found that the judge was correct and that the woman failed to show that there was a causal relationship between the fall and her employment.

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Georgia employees often are limited to pursuing compensation from an employee through the Georgia workers’ compensation act. However, in some cases, there are exceptions. In a recent workers’ compensation case, a plaintiff contended that his employer was liable for his injuries because he made an unsafe repair to equipment he used, causing his injuries.

ExcavatorIn that case, the plaintiff claimed that he was injured while he was at work. He was operating an excavator while trying to pull a catch basin out of the ground. The excavator was “running at full throttle,” slipped off the catch basin, and hit the plaintiff.

The plaintiff brought a claim against his employer, alleging that he was injured due to the defendants’ reckless conduct. The plaintiff claimed that the defendant was reckless in not having the excavator properly repaired, even though the employer knew that people operating the excavator would likely sustain serious bodily injuries. He claimed that the defendants made a temporary repair to the excavator that made it run at full throttle, making a jerking action.

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Some Georgia workers’ compensation claims arise from occupational diseases that develop over a period of time, rather than an occupational injury. These claims can be complicated and require claimants to prove certain additional facts. In a recent case, one state’s supreme court considered whether a claimant’s Methicillin-resistant Staphylococcus aureus (MRSA) infection was a compensable occupational disease.

KittenThe claimant was a doctor who worked at a health clinic. He developed an infection in his right hand about eight months after he started working at the clinic. At the time, he told his doctor that the infection was likely caused by a cat scratch from a few weeks earlier. The claimant’s infection later spread throughout his body, causing him two strokes and requiring him to undergo numerous surgeries. The claimant then brought an occupational disease claim against his employer for workers’ compensation benefits. After his claim was denied, he appealed, and his case was eventually heard by the state’s supreme court.

The claimant argued that the previous state’s Commission mistakenly required him to show that he acquired the disease at the health clinic and that it was not present before his employment there. The state’s supreme court agreed. It explained that under the court’s interpretation of its state law, an occupational disease can be “incurred” while working for a series of employers before the disease manifests itself, but only the last employer is liable to the claimant.

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Some Georgia workers’ compensation claims turn out to be more than just a workers’ compensation claim. In a recent case, a court considered whether an employee could bring a fraud claim against his employer after the employer denied his workers’ compensation claim.

GavelIn that case, according to the facts alleged in the complaint, the employee needed to move bags of concrete mix while he was working at a public transportation company. Since he had previously injured his back, and the concrete mix bag weighed 90 pounds, the employee asked his supervisor for permission to break down the bag into lighter bags or to have another employee help him lift the bag. The supervisor refused and ordered him to lift the bag.

The employee picked up the bag, immediately felt pain in his back, and partially collapsed. His supervisor asked him why he dropped the bag, and he told him it was because he injured his back when he lifted the bag. The employee filled out a workers’ compensation claim form the next day. His supervisor later filled out a work report, in which he wrote that he did not witness the employee’s injury. The supervisor was later deposed and testified that the employee did not request an accommodation and that he did not see him injure himself. The employer subsequently denied the employee’s workers’ compensation claim.

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