Georgia Court of Appeals Sides with Injured Worker in Workers’ Compensation Appeal

Despite the existence of considerable federal and state regulation in the area of workplace safety, workplace injuries remain a commonplace reality. For many injured on the job, workers’ compensation remains the principal, if not exclusive, form of financial recovery. Although many workers’ compensation schemes were designed to provide efficient recovery for injuries, some injured claimants continue to have difficulty obtaining coverage to which they are statutorily entitled. In one recent case, Ward v. Pre-Engineer Systems (PDF download), the Georgia Court of Appeals looked at an interesting question regarding entitlement to new benefits for pre-existing claimants seeking long-term recovery.
In 1973, a construction worker fell more than 40 feet at a worksite and suffered a variety of different severe injuries, including a traumatic brain injury that resulted in persistent cognitive impairment. The workers’ compensation insurer of his employer, Pre-Engineer Systems, paid for various workers’ compensation benefits arising from the fall, including rehabilitation services. Although the insurer had provided rehabilitation services benefits since 1999, it decided to suspend those benefits in 2011. After filing a request for services to be reinstated that was ultimately denied, the worker challenged the insurer’s decision to suspend rehabilitation services.
In administrative proceedings, the worker provided clear evidence of his current, complex medical needs and declining cognitive abilities, which are so severe that his wife has been legally appointed as his permanent guardian. The administrative law judge determined that the worker met the statutory requirements for rehabilitation benefits and rejected the insurer’s argument that the worker should not be entitled to rehabilitation benefits because those benefits did not exist until after 1975, two years following the worker’s injury. Although the Appellate Division of the State Board of Workers’ Compensation later upheld the decision, the insurer sought traditional judicial review and appealed to Georgia Superior Court. Unexpectedly, the Superior Court reversed the Board’s decision and concluded that the worker “[was] not entitled to receive nurse case management services, because this service was not available under the workers’ compensation laws in Georgia on the date of the Claimant’s work related accident in 1973.”

In a unanimous decision, the Georgia Court of Appeals decisively reversed the Superior Court’s erroneous decision. The court looked at earlier precedent regarding whether newly created statutory benefits may be applied in ongoing entitlement cases. In particular, the Court of Appeals cited Chatham County Dept. of Family & Children Svcs. v. Williams, 221 Ga. App. 366, 366-367 (1996), in which the Court of Appeals explicitly held that “workers’ compensation statutes and rules which do not render compensable an injury which would not otherwise be compensable, but which merely affect the scope of treatment required, will be applied to ongoing cases where the injury preceded the effective date of the law.” Accordingly, although new laws may not oblige an employer to pay for injuries that it was not previously obligated to cover, the law may change the scope of benefits for injuries an employer was already required to cover. In this case, the worker suffered an injury that was compensable at the time it occurred. Even if the rehabilitation/nurse care benefits at issue were not available at the time of the injury, retroactive application of those benefits does not render a once un-compensable injury compensable. Instead, the law merely expanded the scope of benefits to which the claimant is entitled, based on the ongoing nature of his pre-existing, compensable injury.
Given that the Court of Appeals referenced several other decisions dealing with not only the same issue but also the same form of contested benefits, it is odd the Superior Court determined that the worker in this case was not entitled. Nonetheless, this case demonstrates the legal complexities that can arise in a workers’ compensation case, especially when there is ongoing entitlement to benefits.
Accordingly, if you’ve been injured in an Atlanta workplace accident, you should consider getting the advice of counsel with experience in workplace liability in order to determine what entitlement you may have to either workers’ compensation or recovery beyond workers’ compensation. The Atlanta injury attorneys and staff at the Law Office of Terrence R. Bethune have considerable experience with workplace liability and are ready to provide the expertise you need. For a free case evaluation, click here or call 1-800-487-8669.
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