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Proving Entitlement to Income and Medical Benefits in Front of the Georgia State Board of Workers’ Compensation is All About the Evidence

Workers who are hurt during the course and scope of their employment may be entitled to substantial compensation in the form of temporary or permanent disability payments, medical treatment, and other benefits. Although the injured employee is not required to prove that the employer was “at fault,” the worker does have certain obligations and must meet the statutory requirements in order to receive certain benefits.

Facts of the Case

A recent decision from the Georgia Board of Workers’ Compensation resolved a claim for temporary total disability (TTD) filed by a 41-year-old concrete trucker who was allegedly hurt in an accident on the job in June 2015. The defendant employer did not begin paying TTD benefits to the employee until March 2016, and he sought payment of benefits from the date of his injury up until the time the employer began paying him TTD benefits. The employee also asked the Board to require the employer to pay certain medical expenses for which it had denied responsibility.

The Board’s Decision

The administrative law judge denied both the employee’s request for TTD benefits from June 2015 to March 2016 and his request for payment of the medical expenses in controversy. With regard to the TTD benefits, the judge found that the employee was treated by a doctor on the day of the accident but that the doctor authorized him to return to work on regular duty. The employee made several trips to the emergency room thereafter, but none of the doctors who saw him suggested that he should be off work or on light duty due to his alleged injuries from the accident.

When an employee seeks payment of TTD, he or she has the burden of proving, by the preponderance of the competent and credible evidence, that he or she is entitled to such benefits. Since the employee did not provide any medical evidence suggesting that he was taken off work by any of his treating physicians during the period at issue, the judge found that the worker was not entitled to TTD for this time period.

With respect to payment of the medical expenses submitted by the employee, the judge found that all of the bills were from trips to the emergency room and that none of these were reasonable or necessary under the circumstances. In so holding, the judge noted that the employee could have – but apparently chose not to – see his panel physician instead of presenting himself to the ER. In the opinion of the judge, these visits were more for the purpose of seeking narcotic pain medication than for a true emergency.

Experienced Atlanta Workers’ Compensation Attorney

If you have been hurt at work but are not receiving the benefits to which you are entitled, the Law Offices of T. Andrew Miller, LLC, can help you fight for what you are due. We regularly assist workers whose Atlanta workers’ compensation claims have been denied, working hard to make sure each client receives what he or she is due. For a free consultation regarding your work-related accident, call us now at 678-605-9109. Timeliness is important in workers’ compensation cases, so you should not delay in talking to a lawyer about your situation.