This paper highlights substantive legislative changes made to Title 34 of the O.C.G.A. Please note that this is a very brief summary of the changes.
O.C.G.A. § 34-9-107 is amended to increase the interest payable on a final award of the board, in the event of an appeal, from 7% to 12%.
O.C.G.A. § 34-9-108 is amended to allow for the award of litigation expenses against any party that has brought, prosecuted or defended a case either in whole or in part without reasonable grounds. This is in addition to the award of assessed attorney fees.
O.C.G.A. § 34-9-201 is amended to increase from four to six the number of physicians required on a traditional posted panel. This amendment will not be effective until January 1, 2002 to allow employers time to change their panels. Please remember that a traditional panel must have at least six (was four) physicians or professional associations or corporations of physicians who are reasonably accessible to the employees. At least one of the physicians must be an orthopedic surgeon. No more than two industrial clinics can be on the panel.
Board Rule 200 also provides that one of the listed physicians must be a minority, defined as “a group which has been subjected to prejudice based on race, color, sex, handicap, or national origin, including, but not limited to Black Americans, Hispanic Americans, Native Americans or Asian Americans”.
The Panel must be on the pink poster board and must be posted next to the employee bill of rights. These posters can be obtained from your insurance company or directly from the State Board. All employees must be told of the use and purpose of the panel and they must be posted in a prominent location to which all employees have access. In order to prove that all employees have seen the panels, I suggest that a copy be made of both the panel and bill of rights and each employee sign and date them. A copy of the documents should be kept in the personnel file.
O.C.G.A. § 34-9-202(e) has been amended to allow an employee (in an accepted claim) to have 120 days from the last receipt of income benefits to request a one time independent medical examination. This increases the time from 60 days to 120 days.
O.C.G.A. § 34-9-203 has been amended to change the medical payment provision and the penalties for nonpayment. It still requires all reasonable medical charges be paid within 30 days from the date that the employer or its carrier receives the charges and the report required by the board. But it adds a new provision which requires the employer or its carrier (within the same 30 days) to mail to the provider, requesting payment, a written notice stating the reason(s) that any medical bill will not be paid.
I suggest that if the bill is unauthorized or not related to the claim, then the WC-3 form Notice to Controvert should be sent within the 30 days. If more information is needed before the bill can be considered for payment or denial then a letter or other written notice must be sent within the 30 days informing the requesting provider what information is needed. Please keep in mind that if this is not done within the 30 days, the presumption is that any defense to liability for the bills is waived.
In addition O.C.G.A. § 34-9-203 has been amended to include a penalty provision that if the bills are not paid or if a written reason is not provided within the 30 day time frame then the employer or its carrier may be assessed a penalty:
31 to 60 days = 10% penalty
61 to 90 days = 20% penalty
91 days or more = 20% penalty plus add on interest of 12%.
The penalty is payable to the provider of the medical services.
O.C.G.A. § 34-9-261 has been amended to raise the maximum TTD benefit from $375.00 to $400.00 per week and the minimum from $37.50 to $40.00. Please remember that the date of the accident controls for TTD and TPD benefits, so the maximum of $400.00 will only be for accidents which take place on or after July 1, 2001.
O.C.G.A. § 34-9-262 has been amended to increase the maximum TPD benefit from $250.00 to $268.00 per week.
O.C.G.A. § 34-9-263 (Board Rule 263) has been amended to make PPD ratings based upon the Fifth edition of the AMA guidelines and not the Fourth.
William N. Anderson received his BA in 1990 from the University of North Carolina at Charlotte. He received his Juris Doctor from Mercer University in 1993. While in law school, he was a member of the law review (1991-1993), received the Dean’s Public Service Award, and was the Co-Chair of the 1993 National Conference of Law Reviews.
He is a partner with the law firm of Hamilton, Westby, Antonowich & Anderson, where his primary area of practice is workers’ compensation defense. Mr. Anderson often speaks to employers, insurers, and self-insurers regarding workers’ compensation issues. He is the co-founder of GA WorkersComp, and may be reached at firstname.lastname@example.org or (404)-872-3500.