I developed a sickness from my job. Is this covered by workers' comp?

Potentially. Georgia law provides that an "occupational disease" is compensable so long as certain statutory requirements are satisfied. Specifically, O.C.G.A. § 34-9-280 states that an "occupational disease" means "those diseases which arise out of and in the course of the particular trade, occupation, process, or employment in which the employee is exposed to such disease." In addition, five requirements must be met: 

1. There must be a direct causal connection between the conditions under which the work is performed and the disease;
2. The disease followed as a natural incident of exposure by reason of the employment;
3. The disease is not of a character to which the employee may have had substantial exposure outside of the employment;
4. The disease is not an ordinary disease of life to which the general public is exposed; and
5. The disease must appear to have had its origin in a risk connected with the employment and to have flowed from that source as a natural consequence.

Because of these strict statutory requirements, it can be difficult to prove an occupational disease claim. If you feel that you've developed an illness because of your job, you should contact an attorney right away to discuss your options. Even if you're not in the Athens, Georgia area, feel free to contact us and we will be glad to assist you with your claim.

I injured my back at work and began receiving benefits. The next month, I injured my back again when I was playing basketball at home. Can the Employer suspend my benefits?

This is a very tricky question and there isn't a very clear cut answer. Chances are, you will be able to continue receiving workers' comp benefits for your back. However, the Employer will likely put up a pretty big fight against it.

Georgia law addresses what are commonly referred to as "independent intervening injuries" in O.C.G.A. 34-9-204(a), which states "No compensation shall be payable for the death or disability of an employee if his or her death is caused by or, insofar as his or her disability, may be aggravated, caused, or continued by a subsequent nonwork related injury which breaks the chain of causation between the compensable injury and the employee's disability."

The case law dealing with this issue in Georgia has been somewhat back and forth, but it appears as though the common theme is that Claimants who are actively receiving benefits/ongoing treatment for the initial work injury will be able to continue receiving the benefits, even if they are subsequently injured in a non-work accident (even if the Claimant was being careless or negligent). However, if a Claimant had been deemed to have fully recovered by his ATP and at some later point re-injures the same body part that was initially injured at work, a reinstatement of benefits would be denied.

Tip: It should be noted that the law requires the Employer to prove that the "chain of causation" has been broken, as opposed to simply unilaterally suspending benefits. In other words, in the example question used in the title of this post, the Employer would have to request an official hearing and have a judge rule on the matter before suspending benefits. If your Employer has cut your benefits off based on this contention, you should absolutely contact an attorney to discuss your options.

Again, this is a highly complicated area of workers' compensation law, so it is always best to consult with an attorney to determine how best to proceed. Even if you're not in the Athens, Georgia area, please contact us and we will do everything we can to fight for your rights.

Quick Definitions: Compensable Injury

This term is used to describe worker's compensation injuries and basically means "covered by workers' compensation insurance." A compensable injury is one that arose "out of and in the course of the Claimant's employment" and for which a Claimant can receive medical care and potentially income benefits.

If I suffer a heart attack or stroke while at work, is that covered by workers' comp?

Generally, no--but there may be situations where this type of injury is compensable. Georgia law specifically provides that an injury or personal injury does not include "heart disease, heart attack, the failure or occlusion of any of the coronary blood vessels, stroke, or thrombosis unless it is shown by a preponderance of competent and credible evidence...that any of such conditions were attributable to the performance of the usual work of employment.”

The reason for the general rule against these kinds of "injuries" being compensable is the principle that, in order to be covered by workers' comp, an injury must arise both "out of and in the course of employment." Thus, a heart attack or stroke is only covered if it can be proven that the work environment or certain aspects of the job led to the "injury." This type of claim can become highly contested due to the fact that these injuries are so factually unique and can be caused by many different factors, such as job stress. 

These injuries can also lead to another complicated area of workers' compensation law--idiopathic injuries. That is, if the Claimant suffers a stroke and falls down and sustains other injuries. If you or a family member has suffered a heart attack or stroke at work, please contact us and we will do everything we can to guide you through the process.  

Quick Definitions: Idiopathic Fall

The term "idiopathic fall" typically comes up as a defense asserted by the Employer.  Strictly defined, idiopathic means "of unknown cause or origin." Thus, an idiopathic fall is a fall caused by an unknown source. Essentially, when this defense to a workers' comp claim is used by an Employer, they are saying that the reason that the Claimant fell down was due to a reason that had absolutely nothing to do with the Claimant's employment, such as an epileptic seizure. An idiopathic fall defense is extremely complicated and very factually dependent, so if your Employer is denying benefits based on this theory, it is highly advised that you contact an attorney to discuss your options and rights.

My back was bothering me before my work accident, but now it's really hurting. Can the employer deny benefits because of the pre-existing condition?

The aggravation of a pre-existing injury IS compensable under Georgia workers' compensation laws. As stated by the Georgia Supreme Court way back in 1940, "Fortunately for the employee, perfect health is not a prerequisite to the enjoyment of the benefits of this statute. There is no standard of health set up or provided in this statute." This rule has since been officially codified in Georgia law under O.C.G.A. ' 34-9-1(4).

Basically, every employer has to "take the employee as it finds him (or her)" and accept the fact that there may be a hidden or pre-existing health condition that could be aggravated by a work accident. Even if a "normal" person wouldn't have been injured by a certain accident, the employer is still responsible for paying medical and indemnity benefits for the injuries arising from the accident.

However, it is important to note that employers will often try to obtain an opinion from the ATP that the employee has "returned to pre-injury status" and that the "aggravation period" of the underlying injury has ended, which would then allow the employer to terminate benefits. In such a case, it is highly advised that the employee should consult with an attorney to defend against an untimely or unjust termination of benefits.

I was injured in my employer's parking lot as I was leaving work. Is this injury covered by workers' comp?

Most likely, yes. Typically, if you're injured in your employer's parking lot, whether you're coming to or leaving work, the injury is compensable under Georgia workers' comp. The language used to determine whether the injury is covered by workers' comp is "reasonable ingress/egress." That is, so long as the employee was was injured during a "reasonable" period of time while coming to or leaving work, it should be covered. The word "reasonable" obviously leaves some room for interpretation, so this is an issue that often gets disputed by employers. Another reason why an employer may controvert such an injury is if the parking lot itself is not under the control or maintenance of of employer. However, as stated above, this kind of injury is almost always compensable, so if your employer tries to deny benefits after you've been injured in their parking lot, you should immediately consult with an attorney to explore your options on how best to proceed.

Quick Definitions: "Catastrophic Injury"

Typically, a cap is placed on an injured worker's receipt of TTD benefits (unlike medical benefits, which are always the responsibility of the employer so long as it relates to the work injury). However, in the event of a "catastrophic injury," the 400 week cap is removed and the injured worker is entitled to TTD benefits for the rest of his or her life. Under Georgia law, there are 5 defined categories of catastrophic injuries--spinal cord, brain, serious burns, amputations, and blindness--and one "catch all" provision, which is factually specific and requires close examination of the true severity of the injury. In short, with regard to the "catch all" provision, if an injured worker is entitled to receive Social Security Disability benefits, he or she may (but not necessarily) be entitled to a "catastrophic" designation.