Apr 1, 2015

Courts May Not Overturn Georgia Board of Workers’ Compensation Decisions that are Supported by Any Evidence

In ABF Freight System, Inc. v. Presley, a man injured his right knee in a June 2009 workplace accident. According
to the worker, he was employed as a big rig driver and dock worker by
the same company for about 19 years when his injury occurred. Following
his accident, the employee underwent knee surgery.

The hurt worker received temporary total disability benefit payments from
the date of his accident until he returned to work in September 2009.
After the employee returned to work, he apparently resumed his normal
job duties. As a result of his purported ongoing knee pain, the man again
sought medical care for his injury. In March 2010, the employee’s
physician diagnosed the man with arthritis and stated the worker would
need right knee replacement surgery in the future.

In December 2009, the employee injured his left knee while at work. As
a result, he underwent left knee surgery in June 2010. The worker received
temporary total disability workers’ compensation payments from the
date of his surgical procedure until he resumed his normal job duties
in September 2010. After that, the man again resumed his normal job duties
without medical restrictions.

At a hearing before the Georgia Board of Workers’ Compensation, the
hurt employee testified that his doctor discussed replacing the man’s
right knee in July 2010 and again in January 2011. In addition, the man
stated his right knee pain became more severe following the injury to
his left knee. Between September 2011 and December 2011, the worker apparently
received a number of injections in his knee that were prescribed in an
effort to combat his ongoing pain. In February 2012, the worker’s
physician informed him that knee replacement surgery was medically necessary.
Because of this, the employee underwent a knee replacement operation in
June 2012.

Following surgery, the worker’s doctor ordered him to refrain from
working until late October 2012. As a result, the employee sought temporary
total disability benefit payments for the period he was out of work due
to his “fictional new accident.” The man’s employer
disagreed that the surgery resulted from a fictional injury. Instead,
the employer claimed the cause of the man’s temporary disability
was more appropriately characterized as a “change in condition for
the worse.” The distinction was significant because the man’s
workers’ compensation benefits claim was barred by the two-year
statute of limitations included in OCGA
§ 34-9-104(b) if his harm resulted from a change for the worse.

In Georgia, whether an employee sustained a fictional new injury or a condition
change is a question of fact that is decided by an administrative law
judge (“ALJ”). Following a hearing, the ALJ who reviewed the
man’s case found that the worker underwent a change in condition
due to a lack of new circumstances that would merit a fictional injury
ruling. As a result, the ALJ ruled that the employee’s disability
benefits claim was time-barred. After that, the Board adopted the ALJ’s
decision and the worker filed an appeal with the superior court.

On appeal, the superior court reversed the Board’s decision and remanded
the worker’s case for reconsideration. According to the superior
court, the Board failed to consider whether the employee’s left
knee harm constituted new circumstances that aggravated his right
knee injury. After that, the man’s employer asked the Court of Appeals of Georgia
to review the superior court’s holding.

The appellate court stated both the ALJ and the Board considered whether
the injured worker’s subsequent injury caused further harm to his
right knee and rejected the employee’s claim. In fact, the ALJ noted
the evidence offered at the hearing suggested the man’s right knee
failed to return to normal following his initial surgery. Additionally,
the doctor’s diagnosis that the worker would likely need a right
knee replacement in the future supported the ALJ’s conclusion. Because
of this, the Court of Appeals of Georgia held the evidence supported the
Board’s finding that the man suffered a change in condition instead
of a fictional new injury.

Next, the Georgia court stated it was required to construe all evidence
offered in a workers’ compensation case in the light that is most
favorable to the party who prevails before the appellate division. In
addition, the appellate court said the Board’s findings must be
upheld when supported by any evidence. Finally, the Court of Appeals of
Georgia reversed the superior court’s decision in the case.

If you were hurt at work in Georgia, you should discuss your right to recover
financial compensation with an experienced Atlanta workers’ compensation
attorney as soon as you are able. To schedule a confidential consultation
with a hardworking Conyers workers’ compensation lawyer today, do
not hesitate to call Hansford McDaniel LLC at (770)
922-3660 or contact us through our website.

Additional Resources:

ABF Freight System, Inc. v. Presley, Ga: Court of Appeals 2015

Photo credit: clarita, MorgueFile