Tick Tock Keep Your Eye on the clock: Statute of Limitations Defenses in Georgia Workers' Compensation Claims
A statute of limitations is a law that sets the maximum period under which one can file a claim or lawsuit. Statutes of limitations exist to prevent a party from bringing what is often described as a “stale” claim. This principle applies in several ways under Georgia workers’ compensation law. The general premise is the claimant has a limited amount of time to assert a workers’ compensation claim, and if the claim is not filed timely, it is time-barred. Filing a claim sooner than later allows both parties a better opportunity to develop credible evidence to support or defend the claim.
O.C.G.A. § 34-9-82: Filing a Claim
Generally, the right to compensation is barred unless a workers’ compensation claim is filed within one year after the injury or death of the employee. However, if payment of weekly benefits has been made, or remedial treatment has been furnished by the employer on account of the injury, then the claim may be filed within one year of the date of the last remedial treatment or within two years of the date of the last payment of weekly benefits.
O.C.G.A. § 34-9-82 presents three distinct scenarios which are important to consider. The first scenario is where no income benefits have been paid and no medical treatment has been provided by the employer. For example, if the claimant alleges an injury on Jan. 1, 2021, but does not have any medical treatment furnished by the employer, and does not receive any income benefits, she must file a claim no later than Jan. 1, 2022, for the claim to be viable.
The second scenario involves a circumstance where no formal claim has been filed with the State Board and no income benefits have been paid, but the claimant received remedial medical treatment furnished by the employer. In this circumstance, the clock runs from the date of last medical treatment paid for by the employer. Using our prior example of the claimant with the Jan. 1, 2021 date of injury, if she had emergency room treatment on the date of injury and a follow-up appointment at an urgent care clinic on Jan. 5, 2021, but no further treatment after Jan. 5, 2021, she would have until Jan. 5, 2022, to file a claim for compensation with the State Board.
One of the critical aspects to remember regarding the above two scenarios is that medical treatment must be furnished by the employer. If the claimant seeks unauthorized medical treatment from a non-panel provider which is not paid for by the employer, that treatment will not toll the statute.
In the third scenario under § 34-9-82, the claimant sustains an injury on Jan. 1, 2021. She receives medical treatment and is advised to remain out-of-work for four weeks. Accordingly, the employer/insurer commence payment of temporary total disability (TTD) benefits. The claimant receives a full-duty release and returns to work on Feb. 1, 2021. TTD benefits are properly suspended on Feb. 1, 2021, and no additional income benefits are paid. In this example, if the claimant wishes to file a claim for benefits with the State Board, she must do so by Feb. 1, 2023, in order to avoid the claim being barred by the statute of limitations under § 34-9-82.
O.C.G.A. § 34-9-104: Change of Condition
O.C.G.A. § 34-9-104 outlines the statute of limitations applicable to change of condition claims. A change of condition under O.C.G.A. § 34-9-104 applies where there has been a prior payment of income benefits in the claim. Subsection (b) provides that an application for a change of condition can be made if no more than two years have elapsed since the date of the last payment of income benefits pursuant to O.C.G.A. § 34-9-261 (TTD) or 34-9-262 (TPD).
There is a caveat for claims for benefits under O.C.G.A. § 34-9-263 (PPD benefits). Such a claim must be filed no more than four years from the date the last payment of benefits pursuant to O.C.G.A. § 34-9-261 or 34-9-262.
As a general takeaway, always analyze the date upon which a claim is filed with the Board before accepting the claim as compensable or paying additional benefits. Often there are attempts to file claims after the statute has run with the hope the statute of limitations defense will be overlooked by the employer/insurer. The statute of limitations can be a strong defense that allows employers and insurers to avoid compensability scenarios in stale claims long after the pertinent accidents have occurred, and key witnesses and evidence are difficult to locate. If you need assistance determining whether the “clock has run” in a particular claim, contact a Swift Currie attorney.
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