Workers' comp claim denied because of a positive drug test?

Every now and then I receive a call from a potential client who asks whether the insurance company could deny their claim based upon a positive drug test, and if so, whether there was anything I could do to help them. In response, I ordinarily explain that a positive drug test doesn't help matters, but that it doesn't mean the insurance company has a valid basis for denying the claim.

You see, Georgia law doesn't say that an insurance company can deny a claim based upon a positive drug test; in general, it says that an insurance company can deny a claim if the injured worker was intoxicated and the accident occurred as a result of the intoxication. In other words, an injured worker can be entitled to workers' comp benefits even if he or she was high as kite when the accident occurred. They simply need to show that their intoxication in no way caused or contributed to their accident.

For example, if the injured worker was a passenger in a delivery truck when the truck was struck by an oncoming driver (who was at fault), then the injured worker would be entitled to workers' comp benefits even if his positive drug test was valid, and even if he admits that he was high as a kite.

There are other cases in which a positive drug test may not be valid or admissible, and in those cases, the injured worker may also be entitled to workers' comp benefits as well. Of course, each case is different and these issues can be complicated. For this reason, we strongly encourage you to seek the help of an experienced workers' compensation attorney who can analyze your case and determine the best way to proceed.

OSHA Cites GA Company Following Amputation Accidents

Following up on in a recent article in which it reported that OSHA is cracking down on businesses with workplace violations, the Atlanta Business Chronicle now reports that OSHA recently fined Crespac, Inc. $266,400 and issued 34 safety and health violations following two workplace accidents that resulted in amputations. 

Director of OSHA's Atlanta-East Area Office, Gei-Thae Breezley, stated:

"In both instances, management knew of deficiencies but acted with plain indifference by failing to correct the problems in a timely manner that could have prevented these amputations."

OSHA cited Crespac for failing to ensure that all machines had proper safety guards and functioning emergency-stop cords. OSHA also cited Crespac for repeat violations related to having slippery and wet floors, allowing employees to operate machines with broken parts, failing to properly train forklift operators, and failing to provide proper fire and training equipment.

In addition, OSHA found that Crespac failed to conduct timely inspections of certain equipment, and that there were deficiencies in its record-keeping of OSHA-incident logs.

Crespac -- which is located in Tucker, Georgia -- designs, develops, and makes custom thermoformed parts and packaging.

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Alabama Company Faces OSHA-Proposed $79,300 in Safety Violation Penalties

Following the death of a Robins Air Force Base worker in March, the Occupational Safety and Health Administration (OSHA) has deemed ASM-Sanders Inc, of Madison, Alabama, responsible for safety violations.  OSHA has proposed a total of $79,300 in penalties to be paid by the company.

In March, a Robins Air Force Base employee died in a chilled water line testing accident, after suffering severe head injuries.  OSHA discovered that ASM-Sanders used compressed air, rather than the manufacturer-recommended hydrostatic testing, to conduct tests for leaks in chemical welds of chloride pipes.  This violation, along with other alleged violations in the workplace led OSHA to propose the approximately $80,000 penalty.

ASM-Sanders has 15 business days from the date of the receipt of the citations to comply or argue the penalities.

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OSHA Issues 'Safety First' Message , Proposes $145,000 in Penalties for Safety Violations

The Occupational Safety and Health Administration (OSHA) is intent on protecting workers and preventing accidents in the workplace.  So intent, that they proposed a total of $145,000 in penalties to be paid by SKAPS Industries, who displayed multiple instances of failing to adhere to U.S. Department of Labor standards. 

SKAPS' three plants, located in Commerce, Ga., Athens, Ga., and Pendergrass, Ga., accumulated 24 serious violations, according to the article.  The Pendergrass and Athens plants will cost SKAPS the majority of the penalties, and each one is responsible for an estimated $44,000 due to- not having conducted annual audiograms for their workers, who are exposed to harmful noise. 

Other violations, exhibited by all three plants, include a variety of safety precautions not being taken.  Omitting necessary OSHA-instituted responsibilities such as developing a "written hazards communication" program, marking emergency exits, instructing operators with lockout and tag-out requirements and providing protection from arc welding rays and electrical hazards will cost SKAPS approximately $51,800.

OSHA's Atlanta-East Area Office Director Gei-Thae Breezley is adamant when it comes to taking all safety precautions possible.

"This company should not wait until a serious injury or death occurs to any of its more than 225 employees before making needed changes in its safety procedures.  When a company persists in ignoring its responsibilities, OSHA will step in to protect workers' safety," remarked Breezley.

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Atlanta Faces $13 Million in ADA Violations

After a thorough auditing of facilities within the city, the Justice Department informed Atlanta City Council members that the city will need to cough up a whopping $13 million due to violations of the Americans with Disabilities Act (ADA).  The ADA, set forth by President George H. W. Bush in 1990, is a civil rights law that prohibits discrimination based on disability.  My FOX Atlanta reports that a variety of Atlanta amenities, from City Hall elevators to Chastain Amphitheater seating, did not properly cater to the disabled.

Despite the ADA's nineteen-year existence, this was Atlanta's very first Justice Department-auditing.  Now, at a time when its financial future and security is in serious question, the city must find a speedy solution to the hefty costs.  Council members will vote today on a proposed 6-year, $2-million-a-year plan. 

City Council Finance Chair Howard Shook is trying to address both the seriousness of the defects and the financial burden with which he is confronted.

"We have to remedy this lists of defects.  Period.  Some of these defects go back before this current administration," remarked Shook. 

He went on to say that "It could not come at a worse time. We're scraping for nickels and dimes under the sofa cushion to make sure we have cops on the streets and the lights are turned on."

 

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Ascension Inc. Acquires Haas &Dodd

Ascension Insurance, Inc., a Kansas City-based company, announced its recent acquisition of Atlanta-headquartered Haas & Dodd Insurance, Inc.  Ascension's gaining of Haas & Dodd, effective July 1, 2009, marks the second strategic purchase from the Atlanta market in the company's recent history, following the January 2008 acquisition of Bryant Wharton. 

Interested in expanding business in Atlanta and throughout the southeast, Ascension will look to utilize Haas & Dodd's history of reputable service in a collective effort to broaden its high-level brokerage and risk management services to customers. 

Haas & Dodd president Charles Meriwether is eager and excited to join Ascension, intent on continuing a long-standing history of helpful expertise for its clients. 

 

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2009 Workers' Comp Conference Agenda Recently Released

The State Board of Workers' Compensation recently published its agenda for its Annual Educational Conference, which is scheduled to take place in Atlanta from August 30th to September 2nd. In addition to the annual case law update, speakers will, among other things, be discussing:

  • The AMA Guidelines to Permanent Impairment;
  • Permissible Uses of the Form WC-207/Authorization for Release of Medical Information;
  • Management of Catastrophic Events in the Workplace;
  • Ethical Challenges in Medical Case Management of Work-Related Injuries; and
  • The "Never Ending Change in Condition vs. New Injury Saga."

Personally, I'm looking forward to the sounds of Vince Vance and the Valients at the Tuesday Night Dinner and Dance.

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City of Atlanta Continues to Ignore Injured Policemen's Workers' Compensation Concerns

Imagine risking your life day-in and day-out in an effort to improve and uphold the safety of Atlanta, only to have that same city renege on its promise to medically compensate your on-the-job injuries. Debilitated policemen and women across Atlanta have been facing this dilemma for years and are continuing to fight it.

Atlanta Mayor Shirley Franklin has recently diverted the media's focus to a comment directed toward her by a frustrated officer named Scott Kreher, who expressed his aggravation by saying he wanted to "beat Franklin with a baseball bat." Kreher was suspended from protecting the streets for this ill-perceived "threat."

The injured policemen and women, many of whom are wheelchair-ridden, have had their medical bill concerns fall on deaf ears, according to the article.  Earning a salary that hardly speaks for the bravery and dedication that they maintain, the cops have a legitimate worry when facing financially steep, weekly trips to the doctor.

Franklin, who reportedly claims she does not "know a person who wants anyone to say, 'I want to beat you in the head,'" went so far as to have the feds investigate the comment made by Sgt. Kreher. Clearly, Franklin is not entirely in touch with the hostility in her own city, as such "objects of violence" are exhibited and directed toward her own policemen on a daily basis.

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Gracias Abogado Bader; Valio La Pena!!

El abogado Bader me ayudo, y aunque el proceso fue un poco largo, VALIO LA PENA! Gracias abogado Bader por toda su ayuda!!

Juan M.

Lawrenceville, GA

Notable Changes to Medical Fee Schedule (2009)

The State Board of Workers' Compensation (SBWC) recently posted a list of notable changes to the 2009 Medical Fee Schedule. Some of these changes include:

  1. CPT Codes - CPT Codes were updated with code additions, deletions, and revisions in accordance with the AMA.
  2. IME Rates - Rates for Independent Medical Examinations have increased to $600.00 for the first hour, and $150.00 for each additional 15 minutes.
  3. Physician Testimony - Rates for physicians giving testimony have increased to $600.00 for the first hour and $150.00 for each additional 15 minutes.
  4. Emergency Transportation - Ambulance and Air Services have been added to the Fee Schedule.
  5. Non-Emergency Transportation - Reimbursements for non-emergency transportation have increased by 1.7%.
  6. Home Health Services - Hourly rates for home health services have increased by 1.7%.
  7. Medical Records Charges - Reimbursement for copies of medical records remains unchanged from 2008.
  8. Pharmaceutical Charges - Reimbursement for pharmaceuticals remain unchanged from 2008.

You can see other notable changes that have been made to the Medical Fee Schedule by visiting the SBWC's website.