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| Georgia General Assembly |
HBill.html
01 HB497/SCSFA/2
SENATE COMMITTEE SUBSTITUTE
TO HB 497:
AS PASSED
SENATE
A BILL TO BE
ENTITLED
AN ACT
To amend Chapter 9 of Title 34 of the Official Code of
Georgia Annotated, relating to workers´ compensation, so as to change the
rate of interest payable on final awards entered by the board; to provide for
the award of reasonable litigation expenses under certain conditions; to
increase the number of physicians on the posted panel from four to six; to
provide for an exception; to allow an injured employee the right to an
independent medical examination within 120 days of receipt of income benefits,
rather than the current 60 days; to change provisions relating to the penalty
for nonpayment of medical charges by an employer or an insurer; to increase the
maximum temporary total disability benefits from $375.00 per week to $400.00 per
week; to increase the minimum temporary total disability benefits from $37.50
per week to $40.00 per week; to increase the maximum temporary partial
disability benefits from $250.00 per week to $268.00 per week; to provide that
impairment ratings shall be based on the fifth edition of Guides to the
Evaluation of Permanent Impairment; to provide for related matters; to
provide an effective date; to repeal conflicting laws; and for other
purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF
GEORGIA:
SECTION 1.
Chapter 9 of Title 34 of the Official Code of Georgia
Annotated, relating to workers´ compensation, is amended by striking Code
Section 34-9-107, relating to the amount of interest payable on a final award of
the board in the event of an appeal, and inserting in lieu thereof the
following:
"34-9-107.
Any
final award for compensation entered by the board shall bear interest at the
legal rate of 7 12 percent on all accrued amounts and on
all amounts accruing prior to final judgment in the event of an appeal being
taken from the board in the same manner in which it is now provided that
interest shall run on a judgment of the superior court in the event an appeal is
taken therefrom."
SECTION 2.
Said chapter is further amended by striking Code Section
34-9-108, relating to the approval of attorney´s fees by the board, and
inserting in lieu thereof the
following:
"34-9-108.
(a)
The fee of an attorney for service to a claimant in an amount of more than
$100.00 shall be subject to the approval of the board, and no attorney shall be
entitled to collect any fee or gratuity in excess of $100.00 without the
approval of the board. The board shall approve no fee of an attorney for
services to a claimant in excess of 25 percent of the claimant´s award of
weekly benefits or settlement.
(b)(1) Upon a
determination that proceedings have been brought, prosecuted, or defended in
whole or in part without reasonable grounds, the administrative law judge or the
board may assess the adverse attorney´s fee against the offending
party.
(2) If any provision of Code Section 34-9-221,
without reasonable grounds, is not complied with and a claimant engages the
services of an attorney to enforce his or her rights under that Code section and
the claimant prevails, the reasonable quantum meruit fee of the attorney, as
determined by the board, and the costs of the proceedings may be assessed
against the employer.
(3) Any assessment of
attorney´s fees made under this subsection shall be in addition to the
compensation ordered.
(4) Upon a determination that
proceedings have been brought, prosecuted, or defended in whole or in part
without reasonable grounds, the administrative law judge or the board may, in
addition to reasonable attorney´s fees, award to the adverse party in whole
or in part reasonable litigation expenses against the offending party.
Reasonable litigation expenses under this subsection are limited to witness fees
and mileage pursuant to Code Section 24-10-24; reasonable expert witness fees
subject to the fee schedule; reasonable deposition transcript costs; and the
cost of the hearing transcript.
(c) An attorney
shall not advertise to render services to a potential claimant when he or she or
his or her firm does not intend to render said services and shall not divide a
fee for legal services with another attorney who is not a partner in or
associate of his or her law firm or law office,
unless:
(1) The client consents to employment of the
other attorney after a full disclosure that a fee division will be
made;
(2) The division is made in proportion to the
services performed and the responsibility assumed by each;
and
(3) The total fee of the attorneys does not
clearly exceed reasonable compensation for all legal services such attorneys
rendered to the client.
(d) When attorney´s
fees or reasonable litigation expenses are awarded under this Code section, the
administrative law judge or the board shall have the authority to order payment
of such fees or expenses on terms acceptable to the parties or within the
discretion of the
board."
SECTION 3.
Said chapter is further amended by striking paragraph (1) of
subsection (b) of Code Section 34-9-201, relating to the selection of a
physician from a panel of physicians, and inserting in lieu thereof the
following:
"(1)
The employer shall maintain a list of at least four six
physicians or professional associations or corporations of physicians who are
reasonably accessible to the employees; provided, however, that the board may
grant exceptions to the required size of the panel where it is demonstrated that
more than four physicians or groups of physicians are not reasonably accessible.
This list shall be known as the 'Panel of Physicians.' At least one of the
physicians must practice the specialty of orthopedic surgery. Not more than two
industrial clinics shall be included on the panel. An employee may accept the
services of a physician selected by the employer from the panel or may select
another physician from the panel. The physicians selected under this subsection
from the panel may arrange for any consultation, referral, and extraordinary or
other specialized medical services as the nature of the injury shall require
without prior authorization from the board; provided, however, that any medical
practitioner providing services as arranged by a primary authorized treating
physician under this subsection shall not be permitted to arrange for any
additional referrals. The employee may make one change from one physician to
another on the same panel without prior authorization of the
board;"
SECTION 4.
Said chapter is further amended by striking subsection (e)
of Code Section 34-9-202, relating to examination of an injured employee, and
inserting in lieu thereof the
following:
"(e)
Notwithstanding the rights afforded an employee under Code Section 34-9-201, the
employee, after an accepted compensable injury and within 60
120 days of receipt of any income benefits, shall have the right to one
examination at a reasonable time and place, within this state or within 50 miles
of the employee´s residence, by a duly qualified physician or surgeon
designated by the employee and to be paid for by the employer. Such
examination, of which the employer or insurer shall be notified in writing in
advance, shall not repeat any diagnostic procedures which have been performed
since the date of the employee´s injury unless the costs of such diagnostic
procedures which are in excess of $250.00 are paid for by a party other than the
employer or the
insurer."
SECTION 5.
Said chapter is further amended by striking subsection (c)
of Code Section 34-9-203, relating to an employer´s pecuniary liability for
medical charges, and inserting in lieu thereof the
following:
"(c)
The board may, in its discretion, assess a penalty of up to 20 percent
of reasonable medical charges not paid within 30 days from the date that the
employer or the employer´s workers´ compensation insurance carrier
receives the charges and reports required by the board where there has been
compliance with the requirements of law and board rules. Said penalty shall be
payable to the medical provider.
(1) All
reasonable charges for medical, surgical, hospital, and pharmacy goods and
services shall be payable by the employer or its workers´ compensation
insurer within 30 days from the date that the employer or the insurer receives
the charges and reports required by the board. The employer or insurer shall,
within 30 days after receipt of charges for health care goods or services, mail
to the provider of such health care goods or services payment of such charges or
a letter or other written notice that states the reasons the employer or insurer
has for not paying the claim, either in whole or in part, and which also gives
the person so notified a written itemization of any documents or other
information needed to process the claim or any portion
thereof.
(2) The health care goods or services
provider´s failure to include with its submission of charges any reports or
other documents required by the board shall constitute a defense for the
employer´s or insurer´s failure to pay the submitted charges within 30
days of receipt of the charges. However, if the employer or insurer fails to
send the health care goods or services provider the requisite notice indicating
a need for further documentation within 30 days of receipt of the charges, the
employer and insurer will be deemed to have waived the right to defend a claim
for failure to pay such charges in a timely fashion on the grounds that the
charges were not appropriately accompanied by required reports. Such waiver
shall not extend to any other defense the employer and insurer may have with
respect to a claim of untimely payment.
(3) If
any charges for health care goods or services are not paid when due, penalties
shall be added to such charges and paid at the same time as and in addition to
the charges claimed for the health care goods or services. For any payment of
charges paid more than 30 days after their due date, but paid within 60 days of
such date, there shall be added to such charges an amount equal to 10 percent of
the charges. For any payment of charges paid more than 60 days after their due
date, but paid within 90 days of such date, there shall be added to such charges
an amount equal to 20 percent of the charges. For any charges not paid within
90 days of their due date, in addition to the 20 percent add-on penalty, the
employer or insurer shall pay interest on that combined sum in an amount equal
to 12 percent per annum from the ninety-first day after the date the charges
were due until full payment is made. All such penalties and interest shall be
paid to the provider of the health care goods or
services."
SECTION 6.
Said chapter is further amended by striking Code Section
34-9-261, relating to compensation for total disability, and inserting in lieu
thereof the
following:
"34-9-261.
While
the disability to work resulting from an injury is temporarily total, the
employer shall pay or cause to be paid to the employee a weekly benefit equal to
two-thirds of the employee´s average weekly wage but not more than
$375.00 $400.00 per week nor less than
$37.50 $40.00 per week, except that when the weekly wage
is below $37.50 $40.00 the employer shall pay a weekly
benefit equal to the average weekly wage. The weekly benefit under this Code
section shall be payable for a maximum period of 400 weeks from the date of
injury; provided, however, in the event of a catastrophic injury as defined in
subsection (g) of Code Section 34-9-200.1, the weekly benefit under this Code
section shall be paid until such time as the employee undergoes a change in
condition for the better as provided in paragraph (1) of subsection (a) of Code
Section
34-9-104."
SECTION 7.
Said chapter is further amended by striking Code Section
34-9-262, relating to compensation for temporary partial disability, and
inserting in lieu thereof the
following:
"34-9-262.
Except
as otherwise provided in Code Section 34-9-263, where the disability to work
resulting from the injury is partial in character but temporary in quality, the
employer shall pay or cause to be paid to the employee a weekly benefit equal to
two-thirds of the difference between the average weekly wage before the injury
and the average weekly wage the employee is able to earn thereafter, but not
more than $250.00 $268.00 per week for a period not
exceeding 350 weeks from the date of
injury."
SECTION 8.
Said chapter is further amended by striking subsection (d)
of Code Section 34-9-263, relating to compensation for permanent partial
disability, and inserting in lieu thereof the following:
"(d) Impairment
ratings. In all cases arising under this chapter, any percentage of
disability or bodily loss ratings shall be based upon Guides to the
Evaluation of Permanent Impairment, fourth fifth
edition, published by the American Medical
Association."
SECTION 9.
This Act shall become effective on July 1, 2001, except
Section 3, which shall become effective January 1, 2002.
SECTION 10.
All laws and parts of laws in conflict with this Act are
repealed.