O.C.G.A. §34-9-200(a): 400 week cap on medical benefits

  • Effective for claims 7-1-13 forward
  • Does not apply to catastrophic claims under O.C.G.A.§34-9-200(g)
  • Most claims will be unaffected due to settlement or CAT status
  • Consequences of new law unknown, but several possibilities
    • Decrease in medical costs for employers/insurers
    • Increase in number of claimants seeking CAT designation
    • Possible reduction in MSA values, though CMS may challenge as impermissible shifting of burden to Medicare

O.C.G.A. §34-9-203(c): payment of mileage expenses

  • Effective for mileage reimbursements made on or after 7-1-13
  • Payment/reimbursement of mileage now due 15 days from employer/ insurer’s receipt of charges and reports…not 30 days
  • If employer/insurer object to all or part of the mileage reimbursement request must notify claimant within 15 days and explain why and/or request additional information

O.C.G.A. §34-9-222: lump sum advances

  • Effective for advance requests 7-1-13 forward
  • Repayment now made with interest at 5% per annum, not 7%
  • A claimant must receive TTD for at least 26 weeks/show hardship
  • State Board has wide discretion; repayment made by reducing number of weeks of benefits (PPD) or payment amount (TTD)

O.C.G.A. §34-9-240: return to work

  • Effective for 240 return to work offers 7-1-13 forward
  • If a light duty job is offered under 240 process the claimant is required to attempt the job for 8 hours or 1 scheduled workday, whichever is greater
  • The failure of the claimant to do so can result in TTD suspension

O.C.G.A. §34-9-261 and §34-9-262: increase to max TTD and TPD rates

  • Applies to claims for injuries 7-1-13 forward
  • New maximum TTD rate is $525 per week
  • New maximum TPD rate is $350 per week

O.C.G.A. §34-9-104: notification of release to light duty work

  • Effective January 1, 2014
  • “Back to the old days”…file the 104 on the front end
  • Remember to serve a copy upon the claimant/opposing counsel
  • Must still be within 60 days of a light duty release from the ATP