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| Georgia General Assembly |
HBill.html
01 LC 19 4952
House Bill
497
By: Representatives Smith of the 12th,
Martin of the 47th, Howard of the 118th, Hammontree of the
4th and Shanahan of the 10th
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 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
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
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. 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 35-9-202, 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 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.
All laws and parts of laws in conflict with this Act are
repealed.