Table of contents for Georgia workers' compensation claims : with forms / by Jack B. Hood, Benjamin A. Hardy, Jr., Bobby Lee Cook.


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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








Library of Congress subject headings for this publication: Workers' compensation Law and legislation Georgia, Workers' compensation Law and legislation Georgia Forms