In a recent case, one state’s supreme court clarified the standard for the termination of rehabilitation benefits, an issue that regularly comes up in Georgia workers’ compensation cases. In that case, the employee injured both her knees and her right elbow at work and was awarded workers’ compensation benefits, including rehabilitation services. She eventually obtained part-time employment with another employer.
The original employer then sought to terminate the employee’s rehabilitation services. At a hearing, the workers’ compensation judge found that the claimant returned to suitable gainful employment and thus could no longer receive rehabilitation services. On the worker’s appeal, the court held that the workers’ compensation judge used the wrong legal standard to grant the employer’s petition to terminate the employee’s rehabilitation services.
The workers’ compensation judge determined that since the employee had obtained “suitable gainful employment,” she could no longer receive rehabilitation benefits. However, the state’s supreme court found that if the individual who is receiving rehabilitation benefits is no longer a “qualified employee,” a judge must apply the good-cause standard before terminating benefits. That is, a rehabilitation plan may be suspended, terminated, or altered upon a showing of “good cause,” such as an employee’s refusal to cooperate with a rehabilitation plan or if the employee is not likely to benefit from further rehabilitation services.
Modification of Benefits in Workers’ Compensation Cases
In Georgia workers’ compensation cases, if the State Board of Workers’ Compensation issues a workers’ compensation award, after the appeal period has passed, generally that award is final and cannot be changed. However, if there is a change in condition, the award can be modified later. Under O.C.G.A. 34-9-104, a “change in condition” means “a change in the wage-earning capacity, physical condition, or status of an employee or other beneficiary.” The change has to have occurred after the date on which the employee’s condition was last established by an award or otherwise.
In any change in condition case, the first issue is whether the claimant returned to appropriate employment, since that often determines who bears the burden of proving a change in condition. If a claimant receives disability benefits, returns to work, and later stops working, the claimant generally bears the burden of a proving a change in condition, although there are exceptions. If a claimant receives disability benefits, and the employer seeks to suspend benefits based on the claimant’s ability to return to work, generally the employer has the burden of proving a change in condition. Any party in the case can bring a change in condition claim, and there is no numerical limit on the number of change in condition claims that can be made.
Contact a Workers’ Compensation Attorney
If you have been injured on the job, or if you have already been receiving benefits and have a change in condition claim, a skilled attorney is essential. At the Georgia law office of J. Franklin Burns, P.C., we have decades of experience in Georgia workers’ compensation claims. Our Atlanta workers’ compensation attorneys are former insurance defense attorneys, which means that we understand the other side’s tactics. We provide clients with quality legal representation and responsive client service. For a free consultation, call us at 404-920-4708 or contact us through our online form.