Unfortunately, not every employer fully complies with the duties and responsibilities placed on them by the Georgia workers' compensation laws. Sometimes, an employer may totally deny a claim, while other times the employer may only deny particular benefits sought by a person hurt at work. For example, an employer might admit that a worker was injured on the job and may be willing to pay for the employee's medical care but deny the employee's request for light duty work or temporary disability benefits.
In such situations, the employee may be without a remedy until his or her case makes it through the appropriate administrative tribunals. However, there may be a chance that he or she can use other benefits at work - short or long term disability insurance, for instance - while the claim proceeds (although there are some risks in doing so). In such cases, there may need to be an adjustment or repayment of these benefits later, if the employee's workers' compensation case is successful.
Facts of the Case
In a recent "published award" issued by the Georgia State Board of Workers' Compensation, the claimant was a woman who worked for a large discount retailer for 27 years. She hurt her back while lifting a cabinet on the sales floor in October 2013. She continued to work for several months, at which point she took family and medical leave time in order to have foot surgery. She had not returned to employment at the time of the hearing, although she indicated that she was (and had been for quite some time) willing to return to her job if her employer would comply with the work restrictions placed upon her by her doctor.
The administrative law judge ordered the employer (which was self-insured) to pay temporary total disability benefits to the claimant from June 9, 2014 until the time of the hearing (and continuing thereafter). The employer was also directed to continue providing the employee with the medical treatment that was reasonably required to affect a cure or give relief to the employee. The employer appealed.
Decision of the Board
The Board adopted in part and amended in part the findings of fact, conclusions of law, and award of the administrative law judge. The board agreed that the employee had suffered a compensable on-the-job injury and that she was entitled to both temporary total disability and medical benefits. However, the board found that the employer was entitled to a credit against some of the amount owed for temporary total disability because of payments it made to the employee through "wages and/or disability plan payments" during part of the time the employee was off work.
It should be noted that, since the employer in this particular case was self-insured, all of the benefits paid to the employee (for both traditional disability and work-related temporary disability) presumably came from the "same pot," so to speak, so a credit/offset was used; in another case involving a separate insurance company for the traditional disability benefits, additional proceedings may have been necessary.
Have You Been Hurt at Work?
The Law Offices of T. Andrew Miller, LLC, helps those who have been injured at work, including those whose claims have been denied by their employer or its workers' compensation insurance carrier. We offer a free, confidential case evaluation so that you can get the advice that you need concerning your claim. Just call us at 678-894-4758 to schedule a time to come in and talk about your Atlanta work injury case. You should not delay in talking to a lawyer about your situation, since there are deadlines and statutes of limitations that, if not followed, can result in the dismissal of your case.