GEORGIA CASELAW UPDATE

1. ANY REASONABLE BASIS

A claimant went to the emergency room with a right lower leg rash and was diagnosed with cellulitis. She initially told her co-workers and her treating physicians she did not know why her leg swelled and she had not been inured. She was later diagnosed with complex regional pain syndrome (“CRPS”) or reflex sympathetic dystrophy (“RSD”).

During the hearing on her claim, she indicated she suffered a torn leg muscle while pushing a tool cart. The medical testimony consisted of depositions of four physicians, only one of which connected her condition to work. The administrative law judge (“ALJ”) denied the claim because the claimant failed to prove by a preponderance of evidence that she sustained a work-related injury.

The ALJ’s decision was affirmed on review by the Georgia State Board, and the claimant appealed to the Superior Court of Bibb County. The trial judge concluded the ALJ had overlooked certain evidence, and remanded case back to the ALJ to reconsider the evidence.

The Court of Appeals reversed the Superior Court’s order because the Board’s decision was supported by some record evidence, and therefore had to be affirmed. The appellate court also stated that even if the case should have been reversed, the case had to go back to the Board and not the ALJ. YKK (USA) Inc. v. Patterson, 2007 Ga. App. LEXIS 1020 (September 13, 2007).

2. NO SUBROGATION RIGHT IF NO BENEFITS PAID UNDER GEORGIA’S WORKERS’ COMPENSATION ACT

In Paschall Truck Lines, Inc. v. Kirkland, 2007 Ga. App. LEXIS 1001 (Sept. 11, 2007), an
employer/carrier was denied the ability to pursue a subrogation claim in a civil suit filed by a claimant in a motor vehicle accident arising out of a workers compensation case.

The claimant was in an auto accident in Georgia, but filed his workers compensation claim in Kentucky where he was a resident and where the employer had its main office. He received workers compensation benefits pursuant to Kentucky law. He also filed a workers compensation claim in Georgia. The parties settled the workers compensation dispute, and the settlement was approved by the Georgia State Board of Workers’ Compensation, and settlement proceeds were paid to the claimant.

The claimant had also filed suit in Georgia against the driver that hit him and the driver’s company. The employer sought to intervene in that action to protect its subrogation claim. The claimant settled the tort case for $100,000 and the claimant sought to have the subrogation claim dismissed. The trial court dismissed the subrogation claim, and was appealed.

The appeals court concluded the employer had no subrogation claim for two reasons. One, no benefits had been paid to the claimant under Georgia’s Workers’ Compensation Act, so the employer had no subrogation right under OCGA §34-9-11.1. However, even if benefits were paid under Georgia law, the statute also requires proof the claimant was fully and completely compensated for his injury in the civil case. The employer did not prove the claimant received full and complete compensation, since he settled his case. As such, the employer had no right to seek subrogation in this case.