Causation and Notice – Two Issues That Can Complicate a Georgia Workers’ Compensation Claim

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In a Georgia workers’ compensation claim, the plaintiff has the burden of proving that his or her injury is compensable. This requires that the employee show, by a preponderance of the evidence, each and every one of the essential elements of the case: that he or she suffered an accidental injury, that the injury arose out of and in the course of employment with the defendant employer, and that the disability for which the employee seeks compensation resulted from the injury. In addition, the employee must prove that he or she gave timely notice of the work-related injury.

A recent case illustrates what can happen when an employee has a pre-existing, non-work-related medical condition. Her case was further compromised by a lack of timely notice.

Facts of the Case

At the time of her alleged injury, the employee was 54 years old. She had worked for the employer for about 13 years before developing joint pain and stiffness in her neck, back, shoulder, and knee, which she claimed totally disabled her from working as of December 14, 2014. She sought workers’ compensation benefits in the form of temporary total disability and payment of medical expenses, averring that her injuries were work-related. Her employer denied the claim, and the matter proceeded to a hearing in front of an administrative law judge.

The Administrative Law Judge’s Opinion

The judge denied the employee’s claim for workers’ compensation benefits. Although the employee insisted that her injuries were either directly caused by or aggravated by her work with the employer, the employer denied that the employee’s condition arose from her employment. One doctor, who treated the employee on approximately 10 occasions, diagnosed her condition as arthritis, fibromyalgia, and muscle spasms. Another medical provider said that the employee’s complaints were due mostly to osteoarthritis and noted that the employee did not tell him that her job duties had caused her medical problems. Yet another provider’s records indicated that the employee had not suffered from any specific trauma, that she had arthritis, and that she did not mention that her condition was work-related. Given these and other medical opinions that were not favorable to her claim, the judge found that the employee failed to meet her burden of proof.

The administrative law judge further noted that, even if he were to have found that the employee’s claim was otherwise compensable, she had failed to give notice within the time required by Georgia law. When she left her job, she asked for a leave of absence and allegedly told someone in human resources that her condition was not related to her work. Although there was some correspondence between the employer and a third-party administrator (the employer was self-insured), the judge found that these letters were not received within the time required by law and, most likely, were a result of the employee’s claim with the workers’ compensation board. Such claim having not been filed until several months after the alleged injury, the employee’s claim failed for lack of notice.

 

Talk to an Atlanta Workers’ Compensation Lawyer

This case strongly illustrates the importance of talking to an attorney as soon as possible after a work injury so that notice requirements can be met and a medical record establishing causation can be obtained in a timely fashion. If you have questions about your rights under the Georgia Workers’ Compensation Act, we can help. To schedule a free consultation with a knowledgeable Atlanta workers’ compensation attorney, call the Law Offices of T. Andrew Miller, LLC, today at 678-894-4758.

Related Blog Posts:

Work-Related Aggravation of Pre-Existing Injury Can Lead to Suspension of Workers’ Compensation Benefits

State Board of Workers’ Compensation Scrutinizes the Credibility of Injured Workers