While insurance companies must always be mindful of actions or statements that may later come back to haunt them by operating as a waiver of certain While insurance companies must always be mindful of actions or statements that may later come back to haunt them by operating as a waiver of certain policy provisions or exclusions, a recent decision from the Northern District of Georgia provides an example of behavior that did not constitute a waiver, and also illustrates the importance of the insured’s residence at the property when a standard homeowners policy is in place. InMahens v. Allstate Ins. Co., 2011 U.S. Dist. LEXIS 36125 (N.D. Ga. 2011), the federal court applied Georgia ... Continue Reading
Has The Claimant Carried His “Maughon” Burden?
You are likely familiar with the Maloney burden, which requires an employee seeking recommencement of disability benefits to establish that he has suffered a loss You are likely familiar with the Maloney burden, which requires an employee seeking recommencement of disability benefits to establish that he has suffered a loss of earning power as a result of an on-the-job injury, has continued physical restrictions as a result of that injury, and has made a diligent but unsuccessful search for suitable light duty employment. Maloney v. Gordon County Farms, 265 Ga. 825, 462 S.E.2d 606 (1995). If you are familiar with ... Continue Reading
Newton’s Law Of…Workers’ Compensation: For Every Defense Ime, There Is An Equal And Opposite Claimant’s Ime
As a fundamental concept in the Georgia Workers' Compensation system, by having a legal obligation to provide lifetime medical treatment for an As a fundamental concept in the Georgia Workers’ Compensation system, by having a legal obligation to provide lifetime medical treatment for an accepted work injury, the employer/insurer, in turn, have the right to maintain a certain element of control over the medical treatment the injured employee receives. The panel of physicians, for example, is typically the first way the employer/insurer can exert its control over medical treatment. However, because in so many cases there are disputes ... Continue Reading
Changes To Handling Of Garnishments In Georgia
For many years, Georgia employers have relied on clerical and administrative staff or employee/payroll services to handle responding to routine garnishments. Executive Summary For many years, Georgia employers have relied on clerical and administrative staff or employee/payroll services to handle responding to routine garnishments. On September 12, 2011, the Georgia Supreme Court issued a decision (the “Decision”) that will require employers to immediately change their practices. The Decision now requires employers to retain counsel when responding to garnishment actions filed in Georgia courts of ... Continue Reading
Is There A Limit To The Medical Records Available To An Employer/Insurer? Recent Rulings About The Scope Of Permissible Discovery
The retrieval and review of medical records is one of the most critical components of litigating a workers' compensation claim. O.C.G.A The retrieval and review of medical records is one of the most critical components of litigating a workers’ compensation claim. O.C.G.A. § 34-9-207 states that: When an employee has submitted a claim for workers’ compensation benefits or is receiving payment of weekly income benefits or the employer has paid any medical expenses, that employee shall be deemed to have waived any privilege confidentiality concerning any communications related to the claim or history or treatment of injury arising from the ... Continue Reading
Workers’ Compensation Subrogation Update
It seems no one today is immune from the rising costs of health care. As a result, more and more insurers are seeking alternative ways in which to curb expenses and reduce It seems no one today is immune from the rising costs of health care. As a result, more and more insurers are seeking alternative ways in which to curb expenses and reduce total exposure per claim. One common example is the increasing prevalence of actions by group health insurers seeking reimbursement for payments made to, or on behalf of, an injured worker, which arguably should have been the primary responsibility of a workers’ compensation insurance carrier or ... Continue Reading
Who Owns The Parking Lot? – Ingress And Egress In Workers’ Compensation Cases
The general rule is that an injury that occurs when an employee is traveling to or from work is not compensable because the injury does not arise out The general rule is that an injury that occurs when an employee is traveling to or from work is not compensable because the injury does not arise out of or in the course of employment. Mayor & Aldermen of Savannah v. Stevens, 278 Ga. App. 166, 598 S.E.2d 166 (2004). However, it is also well established that an injury that occurs during a reasonable period of ingress or egress on the employer’s premises is compensable.Peoples v. Emory University, 206 Ga. App. 213, 424 S.E.2d 874 ... Continue Reading
Spoliation – Innocent Mistakes Can Have Costly Consequences
Spoliation is the "destruction or failure to preserve evidence that is necessary to contemplated or pending litigation." Kitchens v. Brusman, 303 Ga. App. Spoliation is the “destruction or failure to preserve evidence that is necessary to contemplated or pending litigation.” Kitchens v. Brusman, 303 Ga. App. 703, 704, 694 S.E.2d 667, 669 (2010) (internal quotations omitted). Destroying or failing to preserve evidence can wreak havoc on the ability to defend a case. This is not just because evidence is missing or destroyed. A court has the wide discretion to craft sanctions against the party who compromised the evidence, even if ... Continue Reading
When Co-Workers Attack: Interaction Of Violence In The Workplace With The Georgia Workers’ Compensation Act
Violence in the workplace accounts for a large number of workers' compensation claims each year. While at first glance an altercation Violence in the workplace accounts for a large number of workers’ compensation claims each year. While at first glance an altercation between angry co-workers should have little to do with the Workers’ Compensation Act, it is necessary to examine the circumstances and origins of the altercation to determine whether any resulting injuries are compensable. O.C.G.A. §34-9-1(4) provides the fundamental rule that a work injury must arise out of and in the course of the ... Continue Reading
The 411 On Board Rule 205
Few State Board of Workers' Compensation Rules ("the Rules") cause the high level of debate surrounding current Board Rule 205, which addresses preauthorization Few State Board of Workers’ Compensation Rules (“the Rules”) cause the high level of debate surrounding current Board Rule 205, which addresses preauthorization of medical treatment. The Georgia Supreme Court’s February 7, 2011 grant of certiorari in Selective HR Solutions, Inc. v. Mulligan, 305 Ga. App. 147, 699 S.E.2d 119 (2010) has only heightened the buzz surrounding the future of Rule 205 with regard to preauthorization of medical treatment in non-managed care organization (“non-MCO”) ... Continue Reading