State News : Georgia

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NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.  


Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.


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Georgia

LEVY SIBLEY FOREMAN & SPEIR, LLC

  877-284-4034

    The Georgia Legislative Session had no major changes to report for our system in this session.  This should generally be received as great news, considering the trend in recent years to annual increases in our TTD and TPD caps. 

    Although not directly related to Workers’ Compensation HB 451 presents a non WC and private insurance solution to PTSD benefits for first responders, and EMT’s.  This topic has been discussed for the last two sessions and originally was being proposed as an amendment to our WC code but sure and steady work by the Board has this issue positioned to fall into a non-WC coverage insurance program.  To continue with a theme of advancing protections for first -responders, SB 371 would provide additional compensation out of the State Indemnification Fund for public safety/first responders as a gap between workers' compensation benefits and their current wage income. 

    Beyond both of those matters which were near misses from a WC perspective, it remains business as usual with no significant changes to report!

Our Legislative Session for 2024-2025 has kicked off and I am pleased to report that, at this time, there are no proposed changes that currently impact our WC system. In Georgia, our Advisory Council is generally the body that presents any proposed uniform changes to the Legislature but this year there are no changes being presented. Of course, each session presents the possibility for surprises, and we will keep you informed of those. For now, however, it appears that smooth sailing lies ahead from Georgia’s employers regarding Statutory changes.

Several dates have been released by the State Board that would be of interest to claims specialists and employers alike. First, the 2024 Annual Educational Conference will take place August 26-28, 2024, at the Hotel at Avalon in Alpharetta, Georgia. Additional information will soon be available on the Board website at www.sbwc.georgia.gov. Second, Georgia celebrates the 25th anniversary of our CWCP (Certified Worker’s Compensation Specialist) program! The CWCP Certification Program is a comprehensive claims management training course that was developed by the Chairman’s Advisory Council at the Georgia State Board of Workers’ Compensation. The Program is designed to educate participants on the fundamentals of workers’ compensation, and then continue to reinforce and build upon those fundamentals through continued education to ensure that each CWCP Certified Professional has a thorough understanding of Georgia’s Workers’ Compensation system. The CWCP Program consists of a Certification Course and a Re-Certification Course. The CWCP Certification Course is a pre-requisite for a Georgia Workers’ Compensation Adjuster’s License. More information can be found at www.CWCP.net

2023 Legislative Session Overview 

Nathan C. Levy, Partner

Levy, Sibley, Foreman & Speir, LLC 

The Legislative session for 2023 has ended and there are only a few notable changes that we wanted to share with you. Be advised that per the normal course, these changes go into effect on July 1, 2023, and will apply to dates of accident from that date forward. Many of you might recall our newsletter from March 21, 2023, wherein we advised of possible increases in indemnity caps, a change in the language associated with dependency and the increase in the maximum recoverable by a surviving spouse with no dependents. HB 480 was passed and ultimately remained the only impactful legislation for Workers’ Compensation that emerged from the session. 

HB 480 specifically addresses: 

1. A revision to Code Section 34-9-13(e) that formerly allowed for the dependency of a surviving spouse to terminate with remarriage of upon a finding of cohabitation in a meretricious relationship with this latter language removed entirely. Replacing it will be a cessation of dependency benefits upon determination by the board of cohabitation continuously and openly in a relationship similar or akin to marriage that includes support of economic value to the Claimant Dependent. No consideration shall be given to payments made exclusively for board and lodging or to any payment for financial support for a period of less than three months. 

2. A revision to Code Section 34-9-261 increasing the statutory maximum for TTD to $800.00 per week (not less than $50.00 per week) for dates of accident on or after July 1, 2023. This is an increase from $725.00 per week. 

3. A revision to Code Section 34-9-262 increasing the statutory maximum for TPD to $533.00 per week up from $483.00 per week. 

4. A revision to Code Section 34-9-265 increasing the maximum amount paid to a surviving spouse with no dependent from $290,000.00 to $320,000.00. 

Moreover, as we stated in March, with these changes will come some new challenges related to attempts to suspend spousal dependency benefits in circumstances where there is cohabitation but not remarriage and what must be done from an accounting perspective to bear the employer’s burden. At first glance, the evidence appears to require a full forensic accounting to show a true commingling of household dollars in a manner that would be expected to appear with married couples. This new standard is a much greater hurdle to overcome than merely providing evidence that a spouse/dependent is actively living with someone else and holding themselves out as partners. One can expect an increase in litigation in this area until some judicial guidelines are established. 

Certainly, the continued increases in TTD and TPD should come with little surprise as employers and insurers are becoming very familiar with cap increases going into effect every July 1.  

From a Board Rule perspective, there are several modifications that also go into effect on July 1st. The below changes apply to all claims, regardless of the date of accident. 

·     Board Rule 200.2 clarifies the specific Certifications and Licenses that must be maintained in order to maintain status with the Board as a “Qualified Case Manager”. The Board rule does clarify that prior to initially contacting a treating physician, a qualified medical case manager working without consent of the employee (or counsel) must provide all parties with written notice of being retained by the employer/insurer. Qualified medical case managers must also provide copies of all written documents received from the treating physician to all parties and attorneys. 

·     Board Rule 100(i) and 102 (E)(1) expand professional conduct to include a general prohibition by any person in any claim to exhibit unprofessional, discourteous, or disruptive conduct and that certainly extends to the courtroom. 

·     Board Rule 203(e) also increases the rate of mileage from .40 to .45 cents per mile, and, finally, 

·     Board Rule 203 in relation to Peer Reviews of medical billing practices, gives the decision of the “peer review organization” the final say in ordering a lowering or increasing of any bill submitted for review and requires/allows the employer to remit payment or take credit based upon that outcome.  

As you can see, the session did bring about the expected changes and with very little surprise. In the end, that is the path that Georgia’s employers and insurers certainly prefer. As always, if you have any questions regarding these issues or would like clarification on any point, do not hesitate to contact us.

 

2023 Georgia Legislative Session Starting to Take Shape

 Nathan Levy

Partner, Levy, Sibley, Foreman & Speir, LLC

As you know, workers’ compensation is always in a state of change and it is incumbent on employers and insurers to keep apprised of shifts in new caselaw, Board Rules and Statutes.  In varying degrees, our Legislature seems to bring about some modifications to 34-9 annually and 2023 looks to be no exception. Essentially, there are two Bills; HB 480 and SB 91, that will likely impact Workers’ Compensation.

 

SB 91 essentially extends the ongoing life of the Subsequent Injury Trust Fund for another two years. This is an event that will continue until the open claims dwindle to an acceptable level of handling. Beyond that, SB 91 has no further effect.

 

HB 480 does have some material changes that should impact all of us. The Bill proposes;

 

1. A revision to Code Section 34-9-13(e) that formerly allowed for the dependency of a surviving spouse to terminate with remarriage of upon a finding of cohabitation in a meretricious relationship with this latter language removed entirely. Replacing it will be a cessation of dependency benefits upon determination by the board of cohabitation continuously and openly in a relationship similar or akin to marriage that includes support of economic value to the Claimant Dependent. No consideration shall be given to payments made exclusively for board and lodging or to any payment for financial support for a period of less than three months.

2. A revision to Code Section 34-9-261 increasing the statutory maximum for TTD to $800.00 per week (nor less than $50.00 per week) for dates of accident on or after July 1, 2023. This is an increase from $725.00 per week.

3. A revision to Code Section 34-9-262 increasing the statutory maximum for TPD to $533.00 per week up from $483.00 per week.

4. A revision to Code Section 34-9-265 increasing the maximum amount paid to a surviving spouse with no dependent from $290,000.00 to $320,000.00.

       

The most thought provoking changes reference the new thresholds for suspending spousal dependency benefits in circumstances where there is cohabitation but not remarriage and what must be done from an accounting perspective to bear the employer’s burden. At first glance, the evidence appears to require a full forensic accounting to show a true commingling of household dollars in a manner that would be expected to appear with married couples. This new standard is a much greater hurdle to overcome than merely providing evidence that a spouse/dependent is actively living with someone else and holding themselves out as partners. One can expect an increase in litigation along this area until some judicial guidelines are established. 

 

Beyond that, these legislative changes bring about little effect or impact on our system. Certainly the continued increases in TTD and TPD in their regularity make those changes almost expected and with inflation and cost of living issues, come with little surprise. Be advised that Sine die is set for March 29th and change is always a possibility. As always, we will attempt to keep you informed of these proposed changes and any new information that impacts Georgia’s employers and insurers in the area of workers’ compensation.