The Georgia State Board of Workers’ Compensation made a change in 2014 to Board Rule 104 that will help protect injured workers and benefit the workers’ compensation judicial system at the same time.
What Rule 104 does
Rule 104 allows an Employer/Insurer to complete a Form WC-104 giving an injured worker notice that his or her doctor has released the injured worker to modified or restricted duty (commonly referred to as “light duty”) work. Upon serving the form on the injured worker (and his or her attorney if there is one), the Employer has “started the clock ticking” until a reduction in the injured workers’ income benefits from Temporary Total Disability benefits to Temporary Partial Disability benefits.
After this notice, the Employer/Insurer can reduce benefits after 52 consecutive weeks of a light duty status even if the injured worker has not returned to work or been offered any work by his employer. You can read more about the harsh effects of a WC-104 in our blog post on Form WC-104 and our blog post on temporary partial disability.
While this rule has incredibly harsh effects on injured workers, one of the most frustrating aspects was that many injured workers received no warning of their upcoming reduction in income benefits. The law had no requirement that the employer or insurance company file the Form WC-104 with the Board.
Instead, the injured worker and his or her attorney often would see the Form WC-104 for the first time when benefits were reduced. Because the WC-104 was from a full year earlier, it was difficult for an injured worker to prove that the Form WC-104 was never received. Injured workers had nothing to offer a judge as proof other than their own testimony that they did not receive the form.
This used to not be the case. Years ago, Board Rules required a Form WC-104 to be filed with the Board just like other forms related to the payment of benefits (such as WC-1, WC-2, and WC-3). Unfortunately, that filing requirement was eliminated a number of years ago. Without a requirement that the Form WC-104 be filed with the State Board, these disputes were classic “he said, she said” situations over whether the notice had been sent. This resulted in increased litigation, which created more time and expense for everyone involved.
What changes were made to Rule 104
As of January 1, 2014, the Board has reinstated the requirement that WC-104s be filed with the Board at the time of service upon injured workers and their attorneys. Because there is a presumption that filing with the Board is at the same time as service upon a party, Employers who comply with the rule will enjoy a presumption that they fulfilled their obligations before reducing benefits.
At the same time, in those situations where it is not filed with the Board, injured workers should be able to prove that a Form WC-104 was invalid and have their benefits reinstated (or avoid a reduction taking place in the first place). That will mean cost savings for everyone and a more efficient workers’ compensation system.
Questions about Rule 104 or Form WC-104
If you receive a WC-104, there are a number of technical requirements an Employer or insurance company must meet before they can properly reduce your workers’ compensation check. If your benefits have been reduced or you are concerned that they may be reduced, one of our attorneys who specializes in Georgia Workers’ Compensation cases will be happy to speak with you to make sure your rights are protected.
