Articles Posted in Workers’ Compensation Case Law

In a Georgia workers’ compensation case, the ability to present a clear explanation of the facts is just as important as the ability to argue the applicable legal issues. If a judge does not have a clear understanding of the facts, the judge cannot reasonably or reliably make a decision. This was precisely the situation in a recent workers’ compensation case.

The Facts

According to the court’s opinion, the claimant worked as a relief operator and injured his right shoulder in a workplace accident. An MRI later showed that the claimant had a moderate partial rotator cuff tear. The claimant received treatment, and later filed for workers’ compensation benefits. After a trial, the court found the injury compensable and awarded the claimant workers’ compensation benefits. However, the claimant appealed the award in part, arguing that the court should have awarded him for his unpaid out-of-pocket medical expenses.

Not every claimant successfully obtains Georgia workers’ compensation benefits on their first try, but some denials can be reversed on appeal. However, employers and insurance companies can also appeal an award of benefits, as in the situation in a recent workers’ compensation case discussed  below. If you have been injured on the job, a Georgia workers’ compensation attorney could be crucial to obtaining the benefits to which you are entitled.

In that case, an employee who was working at a dairy farm injured his knee while delivering milk to a grocery store. He testified that he was carrying a milk crate and stepped off the truck when his knee “popped” and afterward he could not move it. The employee received workers’ compensation benefits which included surgery and physical therapy.

The following year, the employee’s leg gave out when he was standing up at his house and he fell on his side. He immediately experienced pain in his neck and back. The state’s Workers’ Compensation Commission awarded him benefits for his knee as well as his back. The employer appealed, arguing that there was not substantial credible evidence to support the Commission’s decision.

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Georgia workers’ compensation claimants can encounter problems when requesting certain treatments. In a recent case before one state’s supreme court, the court had to consider whether a worker’s back surgery she had performed in Germany was compensable.

The worker suffered a back injury while working as a driller for a coal company. She underwent surgery and other treatments here in the U.S., but continued to experience pain. One doctor recommended a laminectomy, and the worker went to obtain a second opinion. The second doctor recommended a foraminotomy and transforaminal lumbar interbody fusions. The worker continued to investigate her options online and found an orthopedic surgeon in Germany. The German surgeon recommended two fusions and an implantation of an artificial disc. However, while the artificial disc was approved for use in Europe and several other countries, it was not approved in the U.S. by the Food and Drug Administration.

The worker flew to Germany and had the surgery performed, which appeared to be a success. The worker went back to work and was able to perform her previous duties. She even stopped taking pain medication. Yet, the state’s Workers’ Compensation Division denied compensation for the surgery. The Division found it was “alternative medicine” and was not reasonable and necessary medical treatment.

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Workers’ compensation claimants are not required to show that their employers were at fault in order to succeed in a Georgia workers’ compensation claim. In a recent state appellate decision, the court reversed the decision of a workers’ compensation judge, reiterating that the employee was not required to show that the employer was at fault for the injury.

In that case, the employee was walking down a set of stairs as she was leaving work when she fell and broke her ankle. She was carrying a plant from her desk and was not using the stairs’ handrails. She later testified that her shoe stuck to the tread of the stairs.

The employee filed for workers’ compensation benefits, but her employer argued that the injury did not “arise out of” her employment so the employee was not entitled to benefits. The workers’ compensation judge found that the injury did not arise out of the employee’s employment because she did not show that the stairs were more hazardous than normal stairs or that her work increased her risk of falling on them.

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In a recent case, a Georgia appeals court reinstated a teacher’s claim for Georgia workers’ compensation benefits after it was appealed for the third time. The teacher brought the claim for benefits after she injured herself at work. The teacher was instructing fifth grade at an elementary school and allegedly fell while walking from her desk to the front of the classroom, injuring her knee.Her employer argued the injury did not arise out of her employment. An administrative law judge for the State Board of Workers’ Compensation first granted the claimant’s claim for benefits, finding that she sustained an injury that arose out of and in the course of her employment. The board’s appellate division then reversed the lower court’s decision, denying her benefits. The appellate division found that the claimant’s injury was not compensable because it was not due to the configuration of the classroom, and the act of turning and walking was not unique to her employment. The court found that it was a risk to which she would have been equally exposed outside her employment, and it found it was caused by an idiopathic fall.

The claimant appealed, and the Superior Court then reversed the Board’s decision, reinstating the award. Finally, the employer appealed to the Georgia Court of Appeals.

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Georgia workers’ compensation claimants must be cognizant of the state’s procedural rules and requirements in order to bring a successful claim. In a recent workers’ compensation case, a claim for benefits was denied on appeal after the claimant raised an issue for the first time on appeal.The claimant was employed at Walmart as an overnight support manager. One night during his shift, he felt lightheaded and exhausted, and he told coworkers he was going to leave early that night. Soon afterward, he fell in an aisle and had a seizure that lasted for at least 30 seconds. The claimant suffered sinus fractures, a facial laceration, and a potential traumatic brain injury. The claimant requested workers’ compensation benefits, claiming that his injury was a result of his tripping over a pallet at work.

Evidence showed that when he was 12 years old, the claimant became sick with a virus and had several surgeries to remove a cyst and implant a shunt. He was prescribed anti-seizure medicine after experiencing a seizure during a surgery, but he stopped taking the seizure medication after high school, and he did not have any seizures until the fall at work, when he was 44 years old.

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As states continue to legalize medical marijuana, courts handling workers’ compensation cases have to consider whether it can be covered as medical treatment. As Georgia expanded its medical marijuana program last year, this issue could soon arise in Georgia workers’ compensation cases.

In a recent case, the claimant sustained a back injury while he was working at a paper mill in the 1980s. His employer agreed to place the claimant on total disability. He continued to suffer from chronic pain, and in January 2012 the claimant was issued a certification to use medical marijuana for his back pain. He subsequently filed a petition seeking payment from his employer for the cost of the medical marijuana. The employer argued that an order requiring it to pay for the medical marijuana was barred by the federal Controlled Substances Act.

Maine’s Supreme Court considered the issue for the first time in the state. The majority decided that there was a conflict between federal and state law, and that in the circumstances presented in that case, the federal Controlled Substances Act preempted the state law. Maine’s Medical Use of Marijuana Act allows qualifying patient to possess a certain amount of marijuana for personal use.

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Generally speaking, Georgia workers’ compensation claimants may be entitled to benefits if they are injured while working at an out-of-town job site. However, in a recent case a court rejected a claimant’s request for benefits after he was hit by a drunk driver while working out-of-town.

The claimant had been working as a laborer on a roofing job in another town. The claimant and other employees working on the project were staying at the hotel during the week. Every day, the claimant and the other employees would leave around 6 or 7 am in company trucks and return around 6 or 7 pm. The workers were paid from the time they left the hotel until the time they arrived back. After they arrived back at the hotel, the workers were free to do what they wanted. The workers were allowed to use a company truck to run errands if they obtained permission, but were not allowed to take a company truck to a bar.

The night of the injury, the claimant was walking from a bar across the street to his hotel in the early morning when he was hit by a drunk driver. He suffered serious injuries, including having to have his right leg, a finger, and a toe amputated. He applied for workers’ compensation benefits, claiming that his injuries were the result of a hazard created by the requirement that he travel to the roofing project. The administrative law judge granted him benefits, but the Workers Compensation Board denied the claim.

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In a recent case, an appeals court considered whether a positive drug test could be used against a claimant who was denied Georgia workers’ compensation benefits.

The Facts of the Case

The claimant was employed at a cotton gin company. He was working at the loading dock one day when a truck backed up and hit him from behind. He was crushed between the truck and the loading dock and suffered multiple injuries, including pelvic, chest, and rib fractures.

The company requested a drug test, and a lab technician obtained a urine sample while the claimant was at the hospital. The test came back positive for the presence of cannabinoid metabolites. One of the claimant’s coworkers testified that they had smoked marijuana at work together on the morning of the injury. The claimant testified that he only smoked marijuana when he was not working. The claimant also presented an expert witness who testified that marijuana metabolites can be present in urine for days or even weeks after marijuana is smoked. The employer asserted that the worker was impaired and, as a result, did not hear the truck backing up before he was struck.

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The Georgia’s Workers’ Compensation Act and its State Board of Workers’ Compensation provide parties with specific laws and procedures to follow in Georgia workers’ compensation claims. In a recent Georgia case, an appeals court considered the impact of an employer’s challenge to an employee’s claim on her ability to choose her own treating physician.

In that case, the claimant had been working as a banquet server at a hotel when she slipped and fell, seriously injuring her elbow. She suffered a right elbow fracture and sought treatment through an approved orthopedic specialist. Her condition improved and the doctor authorized her return to work. After she returned to work, however, she experienced severe pain and she subsequently stopped working. Before she left her job, she sought treatment with two other doctors who were not approved by her employer.

After she left her job, the claimant tried to have her workers’ compensation benefits reinstated, claiming that her condition had worsened. Her employer requested a hearing to determine whether she was still entitled to benefits. After the hearing, the judge found her condition had worsened and awarded her temporary total disability benefits. The judge also found the employer’s request for a hearing constituted a controvert of the claim, which allowed the claimant to choose her own treating physician.

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