The Georgia Court of Appeals recently decided a statute of limitations case involving an injured worker who needed knee replacement surgery. Unfortunately, the Court concluded that the injured worker could not receive temporary total disability benefits while his doctor disabled him from work as a result of the knee replacement surgery.
What are the underlying facts of this case
This case is ABF Freight System, Inc. v. Presley. Mr. Presley injured his knee at work in 2009. He had surgery on his knee and missed a couple of months from work after the surgery. He returned to work at his regular job, but his knee kept getting worse. A few months after returning to work, he was told that he would eventually have to have a total right knee replacement.
Mr. Presley also sustained an injury to his left knee in 2009. This injury also required surgery an caused him to miss some work before he returned to his regular job. He kept working and put off his knee replacement until June 2012.
Everyone agreed that the knee replacement surgery was due to Mr. Presley’s work injuries. The workers’ compensation insurance company even paid for the surgery. However, the insurance company refused to pay Mr. Presley temporary total disability benefits while he was out of work following the surgery. They based their refusal on the O.C.G.A. 34-9-104 statute of limitations.
The Court of Appeals agreed that the insurance company was not required to pay benefits while Mr. Presley was out of work. The court ruled this way because it had been more than two years since Mr. Presley last received temporary total disability benefits.
Of course, the reason that it had been more than two years was that Mr. Presley did the right thing. He tried to keep working and put off his knee replacement surgery as long as possible. If he would have had the surgery sooner, he would have been paid for his time off work.
Why should we penalize injured workers for trying to do the right thing?
It seems wrong to penalize an injured worker for continuing to work, but we often see this unfair result with the O.C.G.A. 34-9-104 statute of limitations. One of the supposed purposes of statute of limitations in workers’ compensation is to give some “peace of mind” to employers and insurance companies in workers’ compensation cases. In other words, if an insurance company had not heard about a case and had not paid any money for more than two years, the insurance company would claim that it should be able to have some peace of mind.
The O.C.G.A. 34-9-104 statute of limitations rarely serves this stated purpose. More often, it allows the insurance company to avoid its responsibility while penalizing injured workers. In Mr. Presley’s case, the insurance company knew for years that he was going to have to have a knee replacement and miss work.
There was no reason for them to have peace of mind. They knew his case was ongoing. There is no reason that they should not have to pay him benefits. Nevertheless, because of the way that O.C.G.A. 34-9-104(b) has been interpreted, Mr. Presley can never receive temporary total disability benefits again for his knee injuries.
What can you do to avoid this problem?
There are two possible solutions to this problem. If you are injured at work and need surgery, you may need to go ahead and have the surgery sooner. Having the surgery sooner may prevent the insurance company from avoiding its responsibility of paying you benefits.
The second way to avoid the problem is even better – change the law. Georgia and many other states have made it increasingly difficult for injured workers to get benefits in recent years. Changing the law is certainly not easy, but it is necessary. You can help change that by letting your elected representatives know that you want a fair workers’ compensation system in Georgia that protects the rights of injured workers.