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PART I COVERAGE, BENEFITS, AND ORGANIZATION CHAPTER 1 EMPLOYMENT-RELATED ACTIONS: REMEDIES AT COMMON LAW, BY STATE AND FEDERAL STATUTES, AND UNDER THE ACT Development of state and federal remedies against employer Constitutionality of the Act Liberal construction of the Act Principal features of the Act Disability compensation systems in the United States CHAPTER 2 EXCLUSIVENESS OF ACT AS REMEDY Employee's compensation remedy under the Act Employee's negligence action against employer barred Employee's intentional tort action against employer Employee's tort action against co-employee barred Employee's tort action against third parties preserved Employee's tort action against construction design professionals Act's exclusiveness as to persons other than employee Employee's tort action for property damage against employer Employment-related actions that are not barred by the Act CHAPTER 3 EMPLOYMENTS COVERED BY THE ACT Compulsory coverage presumed Coverage and insurance requirements The employer-employee relationship "Employer" defined generally "Employee" defined generally Joint employers Independent contractors distinguished Statutory employers Borrowed servants and loaned employees Illegal employments CHAPTER 4 COVERAGE EXEMPTIONS AND ELECTIONS Employees not in the usual course of business Domestic servants Farm laborers Less than three persons employed Railroad common carrier workers Real estate agents Forestry Commission airplane pilots Corporate officers Partners and sole proprietors Sports officials GEORGIA WORKERS' COMPENSATION CLAIMS CHAPTER 5 EXTRATERRITORIAL APPLICATION Application of Act to out-of-state injuries Effects of similar awards in other states Conflict of laws CHAPTER 6 ACCIDENTS ARISING OUT OF AND IN THE COURSE OF EMPLOYMENT Personal injury, death, or disease generally Personal, neutral, and work-related risks Scope of the risk policy and the meaning of "arising out of' Time, place, and circumstances - the meaning of "in the course of' Meaning of "injury" or "personal injury" Preexisting causes and conditions Subsequent causes and events CHAPTER 7 COMMON PROBLEMS OF COVERAGE UNDER THE ACT AND THE "ARISING OUT OF AND IN THE COURSE OF" FORMULA Acts of God Assaults Emergencies Exposure cases Hearing loss Heart attacks Hernia cases Horseplay Mental injuries Idiopathic falls and mishaps Imported dangers Independent intervening causes Intoxication, alcoholism, and drug addiction Personal comfort and breaks Premises and parking lots Recreational and social activities Superadded injuries Street risks Suicide To and from work Trips of dual or mixed purposes Unexplained accidents and death CHAPTER 8 OCCUPATIONAL DISEASES Occupational diseases generally Responsible employer Independent medical examination Hearing loss Federal black lung benefits TABLE OF CONTENTS CHAPTER 9 DEFENSES AND DEFENSE-RELATED MATTERS Defenses generally Violation of law Willful misconduct Willful intent to injure self Willful failure or refusal to use a safety appliance Willful intent by third person to injure for personal reasons False representation of physical condition Refusal of employment Time limitations on injury and death claims Time limitations on occupational disease claims Time limitations on medical benefits Time limitations on changes in condition Time limitations on overpayment of income benefits Employer conduct tolling limitation periods Removal not permitted Judicial estoppel CHAPTER 10 THIRD-PARTY ACTIONS AND DEFENSES Generally Meaning of "third parties" Third-party claims against negligent employer Defenses of third party Subrogation Claims of creditors CHAPTER 11 MEDICAL AND REHABILITATION EXPENSES AND DISABILITY BENEFITS Generally Notice Waiting period Meaning of "average weekly wage" Temporary total disability and catastrophic injury Temporary partial disability Permanent partial disability Medical benefits generally Change of physicians Refusal of treatment Emergency treatment Private room Lost time not necessary for medicals Surgical procedure Statute of limitations on medicals Physical examination Independent medical examination by employee Disfigurement Malpractice Panel of physicians Medical information not confidential Travel Board approval of medicals Rehabilitation CHAPTER 12 SUBSEQUENT INJURY TRUST FUND Generally CHAPTER 13 DEATH BENEFITS Generally Classes of dependents Compensation for total dependency Compensation during dependency Burial expenses Compensation for partial dependency Conclusive presumption of children's dependency Presumption of spouse's dependency Parent dependent upon child Dependency determined at the time of accident Surviving spouse sole dependent Hernia - death resulting from operation Death of totally dependent spouse Presumptions as to cause of death Death after disability CHAPTER 14 FEDERAL COVERAGES Railroad workers and FELA Seamen and federal maritime laws Longshore workers Federal employees and U. S. military personnel Black lung benefits Energy employees Social Security disability Unemployment PART II ADMINISTRATION, PRACTICE, AND PROCEDURE CHAPTER 15 ADMINISTRATION BY THE BOARD Powers and functions Reports Organization Personnel CHAPTER 16 INSURANCE Insurance generally Penalties Coordination with other insurance TABLE OF CONTENTS CHAPTER 17 INITIAL INTERVIEW Introduction CHAPTER 18 ATTORNEYS FEE CONTRACT Introduction Attorney's fee contract CHAPTER 19 ESSENTIAL ELEMENTS OF PROOF Introduction County in which accident occurred Employer with three or more employees Claimant's average weekly wage Notice of accident Disability Checklist of essential elements of proof CHAPTER 20 FILING CLAIM FOR INJURY Introduction Checklist prior to filing claim for injury and request for hearing Facts which should be stated on claim for injury and request for hearing form Statute of limitations Occupational disease Against whom should claim be filed? Purpose of hearing CHAPTER 21 APPOINTMENT OF GUARDIANS Introduction Board versus court-appointed guardian Power to settle claim Court-appointed guardian CHAPTER 22 SETTLEMENTS AND AGREEMENTS Introduction Stipulated settlement guides Settlements while case is pending in appellate courts Controverting the right to compensation Suspension of benefits - notice Release to return to work without restrictions Release to return to work with restrictions Late payment of compensation Judgment on award CHAPTER 24 LUMP SUM/ADVANCE PAYMENT AWARDS Introduction Lump sum awards Application for lump sum award Advance payment Payment to trustee Present value table CHAPTER 25 CHANGE IN CONDITION Introduction Change in condition Specific job offer Statute of limitations Application for hearing Hearing before administrative law judge Retroactive operation of award Burden of proof Continuance of hearing Interlocutory orders Change in condition or new accident? CHAPTER 26 PREPARATION FOR HEARING BEFORE ADMINISTRATIVE LAW JUDGE Introduction Where will the hearing be held? Interviewing witnesses Depositions, interrogatories, and notice to produce Procuring medical evidence CHAPTER 27 HEARING BEFORE ADMINISTRATIVE LAW JUDGE Introduction Opening hearing Determination of law and questions of fact Administrative law judge's authority Arguments Pretrial Admissions, interrogatories, and depositions introduced in evidence Settlements Stipulation of facts Copy of transcript Presenting evidence Medical evidence Brief Interlocutory order Award Enforcement of orders Nonresident party Assessment of attorney's fees CHAPTER 28 APPEAL TO APPELLATE DIVISION Introduction Appellate division award De novo hearing Authority to amend awards Deputy directors Contents of appeal to appellate division Time to file appeal Filing of briefs Contents of brief Argument before appellate division Hearing on lump sum award CHAPTER 29 APPEAL TO SUPERIOR COURT Introduction Time limitation Awards appealable Venue Grounds of appeal Briefs Any evidence rule Erroneous legal theory Oral argument Authority of superior court Notice to State Board of Workers' Compensation Supersedeas CHAPTER 30 APPLICATION FOR DISCRETIONARY APPEAL Introduction Nature of appeal Purpose of statute Filing of application Supersedeas Contents of application Brief Response No argument of counsel Disposition of application Court's method of determining application Appeal when application granted Notice to State Board of Workers' Compensation CHAPTER 31 APPEAL TO COURT OF APPEALS Introduction Time of filing notice of appeal Notice of appeal Supersedeas Time of filing of enumeration of errors Contents of enumeration of errors Filing and structure of brief Contents of appellant's brief Contents of appellee's brief Rules in regard to oral argument Method of oral argument Supplemental briefs Motion for reconsideration Notice to State Board of Workers' Compensation CHAPTER 32 APPLICATION FOR CERTIORARI Introduction Motion for reconsideration not prerequisite Standard for granting Notice of intention Time of filing Oral argument Copy of Court of Appeals opinion Number of copies and service Contents of application Motion for reconsideration Responses in opposition to petition Notice to State Board of Workers' Compensation CHAPTER 33 APPEAL TO SUPREME COURT Introduction Brief in Supreme Court Oral argument Motion for reconsideration Remittitur Notice to the State Board of Workers' Compensation CHAPTER 34 FORMS A. STATE BOARD OF WORKERS' COMPENSATION FORMS Employer's first report of injury or occupational disease (WC-1) Notice of payment or suspension of benefits (WC-2) Notice of payment or suspension of death benefits (WC-2a) Notice to controvert (WC-3) Case progress report (WC-4) Wage statement (WC-6) Application for private self-insuring employers and hospital authorities (WC-7) Notice to elect or reject coverage (WC-10) Standard coverage form (WC-11) Request for copy of board records (WC-12) Notice of claim/request for hearing/request for mediation (WC-14) Medical report (WC-20a) Application for lump sum/advance payment (WC-25) Consolidated yearly report of medical only cases (WC-26) Request for rehabilitation (WC-R1) Rehabilitation transmittal form (WC-R2) Individualized rehabilitation plan (WC-R2a) Request for rehabilitation closure (WC-R3) Panel of physicians (WC-P1) Conformed panel of physicians (WC-P2) WC/MCO panel (WC-P3) Request for documents to parties (WC-102) Motion/objection to motion (WC-102g) Notice of representation of any party other than claimant or employee (WC-102i) Attorney leave of absence (WC-102j) Notice to employee of medical release to return to work with restrictions or limitations (WC-104) Attorney fee approval (WC-108a) Attorney withdrawal/attorney fee lien (WC-108b) Notice of use of servicing agent (WC-121) Reserved Change of physician/additional treatment by consent (WC-200a) Request/objection for change of physician/additional treatment (WC-200b) Notice of intent to become a party at interest - group insurance company/health care provider (WC-206) Authorization and consent to release information (WC-207) Notice to employee of offer of suitable employment (WC-240) Credit/reduction in benefits (WC-243) Notice of intent to become a party of interest - group insurance company/disability benefits provider (WC-244) Subpoena Bill of rights for the injured worker B. SUBSEQUENT INJURY TRUST FUND FORMS Notice of claim (S. I. "A") Reimbursement agreement (S. I. "B") Reimbursement request (S. I. "C") Reserved Reserved Reserved Employer's knowledge affidavit (S. I. "H") Reserved C. FEDERAL COVERAGE FORMS Complaint - death - FELA Complaint - personal injury - FELA Complaint - death - general maritime law and Jones Act (federal court) Complaint - death - Death on the High Seas Act and Jones Act survival (federal court) Complaint - personal injury - Jones Act, unseaworthiness, and maintenance and cure (federal court) Federal employee - notice of traumatic injury and claim for continuation of pay/compensation (CA-1) Federal employee - notice of occupational disease and claim for compensation (CA-2) Federal employee - notice of recurrence of disability (CA-2a) Federal employee - report of termination of disability and/or payment (CA-3) Federal employee - claim for compensation by widow, widower, and/or children (CA-5) Federal employee - claim for compensation by parents, brothers, sisters, grandparents, or grandchildren (CA-5b) Federal employee - official superior's report of employee's death (CA-6) Federal employee - claim for compensation on account of traumatic injury or occupational disease (CA-7) with attending physician's report (CA-20) Federal employee - claim for continuing compensation on account of disability (CA-8) with attending physician's supplemental report (CA-20a) Federal employee - authorization for examination and/or treatment (CA-16) Federal employee - duty status report (CA-17) Federal employee - general information for physicians (CA-21) Federal employee - health insurance claim form (OWCP-1500) Federal employee - uniform health insurance claim form (UB-92) Federal employee - claimant medical reimbursement form (CA-915) Longshore worker - notice of employee's injury or death (LS-201) Longshore worker - employer's first report of injury or occupational illness (LS-202) Longshore worker - employee's claim for compensation (LS-203) Longshore worker - payment of compensation without award (LS-206) Longshore worker - notice of controversion of right to compensation (LS-207) Longshore worker - notice of final payment or suspension of compensation payments (LS-208) Longshore worker - employer's supplementary report of accident or occupational illness (LS-210) Longshore worker - claim for death benefits (LS-262) Longshore worker - memorandum of informal conference (LS-280) Longshore worker - request for examination and/or treatment (LS-1) Longshore worker - pre-hearing statement (LS-18) Longshore worker - report of earnings (LS-200) Longshore worker - attending physician's supplementary report (LS-204) Longshore worker - physician's report on impairment of vision (LS-205) Longshore worker - certification of funeral expenses (LS-265) Longshore worker - application for continuation of death benefit for student (LS-266) Longshore worker - complaint - death Longshore worker - complaint - injury Black lung - miner's claim for benefits (CM-911) Black lung - miner's employment history (CM-911a) Black lung - representative payee report (CM-623 and CM-623S) Black lung - miner's medical development information summary (CM-934) Black lung - miner's authorization for release of medical information (CM-936) Black lung - miner's consent for IRS to release tax information (CM-1087) Reserved Black lung - survivor's claim for benefits or survivor's notification of beneficiary's death (CM-912) Black lung - physician's/medical officer's statement (CM-787) Black lung - request for state or federal workers' compensation information (CM-905) Black lung - report of ventilatory study (CM-907) Black lung - coal mine employment affidavit (CM-918) Black lung - medical travel refund request (CM-957) Black lung - operator response (CM-970a) Black lung - medical history and examination for coal mine workers' pneumoconiosis (CM-988) Black lung - affidavit of deceased miner's condition (CM-1093) Social Security - offset worksheet (SSA-2455) Social Security - request for workers' compensation/public disability benefit information (SSA-1709) D. MISCELLANEOUS FORMS Initial client interview information Attorney's fee contract in workers' compensation case Attorney's fee contract in tort claim Medical authorization Certificate of authentication of medical records Affidavit for judgment and writ of fieri facias Judgment Request for production of documents Notice to produce Request for admission of facts and genuineness of documents Brief in support of claim before administrative law judge Reserved Brief before appellate division Application for appeal to superior court Brief Superior court order Superior court order (another form) Application for discretionary appeal Response opposing application for discretionary appeal Notice of appeal Enumeration of errors Notice of intention to apply for certiorari CHAPTER 35 BOARD RULES Introduction Rules of the State Board of Workers' Compensation CHAPTER 36 SUBSEQUENT INJURY TRUST FUND RULES Trust fund rules Claims procedure and evaluation CHAPTER 37 STATUTES Workers' compensation statutes