As we all know, some of the injured employees we encounter in the workers’ compensation arena are not the most honest or “law”-abiding citizens.
As we all know, some of the injured employees we encounter in the workers’ compensation arena are not the most honest or “law”-abiding citizens. In fact, we have all probably encountered an employee who has sustained a compensable on-the-job injury, begins to receive indemnity benefits, and, low and behold, ends up in jail or worse, in prison. It is at this point that the effects of a claimant’s incarceration on his/her entitlement to workers’ compensation benefits comes into question. Generally, there is a consensus throughout the United States that the mere incarceration of a claimant does not change his/her entitlement to indemnity benefits. However, many states agree that if a claimant is incarcerated and adjudicated guilty of the offense charged, then his/her entitlement to indemnity benefits is suspended. In short, when a claimant is receiving temporary total disability benefits and becomes incarcerated prior to a conviction of a crime, then he/she is clearly entitled to continue receiving temporary total disability benefits despite his/her incarceration. Scott Housing Systems v. Howard, 256 Ga. 675, 353 S.E.2d 2 (1997). On the other hand, where a claimant is receiving workers’ compensation benefits but becomes incarcerated and is convicted of a crime, then such post-conviction incarceration may justify suspension of the claimant’s income benefits from the date of the adjudication of guilt and forward. Scott Housing Systems, supra.
Going one step further – – now that the claimant’s temporary total disability benefits have been suspended based upon his adjudication of guilt and incarceration, his/her entitlement to permanent partial disability benefits comes into question. Georgia courts have long held that permanent partial disability benefits “shall not become payable so long as the employee is entitled to benefits under Code Section 34-9-261 or 34-9-262.” It is not the non-receipt of benefits that triggers payment but entitlement to such benefits. Wet Walls, Inc. v. Ledezema, 266 Ga. App. 685, 598 S.E.2d 60 (2004). However, ordering the employer to commence permanent partial disability benefits when an employee is incarcerated might very well provide a windfall to the employee. Wet Walls, Inc., supra. Therefore, if a claimant is adjudicated guilty and is incarcerated, he/she has no legal right to receive temporary total disability benefits or permanent partial disability benefits. This continues to be clear in the State of Georgia and in many other states.
Now that we have covered “the good” effects of incarceration and adjudication of guilt, let’s tackle “the bad” and “the ugly.”
The Bad And The Ugly
Here, we question the benefit rights of a claimant following his/her release from incarceration. Unfortunately, this is a novel issue in the State of Georgia, and there is no statute or case law on point. However, there is a strong legal argument that a claimant’s incarceration is the ultimate change in condition as he/she has chosen to voluntarily remove himself/herself from the work force by committing a crime. It is clear in the State of Georgia that a claimant bears the burden of proof to show by a preponderance of the competent and credible evidence that his/her inability to secure suitable employment was proximately caused by his/her previous accidental injury. EVCO Plastics v. Burton, 200 Ga. App. 121, 407 S.E.2d 60 (1991). Further, the Georgia Supreme Court has undoubtedly settled the dispute regarding a claimant’s burden of proof to show a change in condition in its Maloney decision. The Court’s decision in Maloney was obvious and unambiguous and explained that in order for a claimant to receive workers’ compensation benefits based upon a change in condition, he/she must establish by a preponderance of the evidence that he/she suffered a loss of earning power as a result of a compensable work-related injury, continues to suffer physical limitations attributable to that injury and has made a diligent, but unsuccessful, effort to secure suitable employment following termination. Maloney v. Gordon County Farms, 265 Ga. 825, 462 S.E.2d 606 (1995). In following the law established in Maloney, it appears obvious that upon a claimant’s release from incarceration, he/she should, upon his/her release, at the very least, have to overcome the Maloney burden and should not be entitled to an automatic recommencement of temporary total disability benefits. Further, allowing a claimant to receive an automatic recommencement of temporary total disability benefits upon his/her release from prison would equate to an assumption that the claimant is totally disabled upon his/her release from prison, without forcing the claimant to legally prove such.
Requiring employers to automatically recommence indemnity benefits to claimants recently released from incarceration allows a claimant to circumvent the burden of proof mandated by the Georgia Supreme Court in Maloney. It appears evident that upon a claimant’s release from incarceration, that claimant should have to prove that his/her present total disability is causally related to his/her previous on-the-job injury. Not requiring a claimant to overcome the Maloney burden upon a release from incarceration gives him/her an unfair presumption that his/her present alleged total disability continues to be related to an on-the-job injury that occurred prior to his/her voluntary removal from the work force. Obviously, this would place the employer at an unfair advantage, as any claimant, upon release from prison, could allege that he/she is totally disabled, and then be entitled to receive temporary total disability benefits without at least proving with sufficient medical evidence that he/she continues to suffer from physical limitations attributable to that injury and has, further, made a diligent, but unsuccessful, effort to secure suitable employment.
Although this continues to be an issue of first impression in the State of Georgia and, undoubtedly, in many other states, the Georgia Supreme Court’s ruling in Maloney is so transparent that it should evidently lead to a ruling on point, establishing that when a claimant is released from incarceration and is alleging a change of condition, he/she must overcome the Maloney burden.
Although there is no clear view as to what is to come in Georgia’s future with regard to whether or not a claimant will bear the burden of proof upon release from incarceration, to show by a preponderance of the competent and credible evidence that his inability to secure suitable employment was proximately caused by his previous accidental injury, we must compel Georgia courts to uphold the clear ruling of the Georgia Supreme Court, that any claimant who seeks recommencement of indemnity benefits, arguing that they have undergone a change in condition, must overcome the Maloney burden prior to recommencement of such benefits.