Can I sue anyone for my on-the-job injuries?

If someone other than your employer or a co-worker caused your injuries, you may, in addition to having a valid workers' compensation claim, have a basis for filing a civil lawsuit against the party who caused your injuries.  If you prevail against this third party, however, your employer and its workers' compensation insurance company may be entitled to recover some or all of your damages or settlement proceeds as a means of recouping some of all of the workers' compensation benefits they already paid.  This concept is known as subrogation.

Employers are not entitled to subrogation simply because you obtain damages or settlement proceeds from a third party.  Indeed, an employer can recover on a subrogation lien only if they can prove that you have been "fully and completely compensated" for both your economic and non-economic damages.  The law does not prescribe a specific method for proving this, however, and it is difficult, if not impossible, to quantify non-economic damages such as "pain and suffering."  As a result, employers often are not able to recoup all of their losses through subrogation.

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What if I hire a workers' compensation attorney but later become dissatisfied with his or her work?

You may terminate your attorney for any reason; but if you are planning to, keep in mind that he or she likely will be entitled to recover a portion of the proceeds from your case once it is resolved.  Pursuant to Board Rule 108, your attorneys (prior and current) be allowed to recover a combined fee of more than twenty-five percent (25%) of the total award.

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Board Rule 108. Attorney's Fees

The attorney's fee shall not exceed 400 weeks of income benefits and may be terminated or suspended sooner as provided by law or at the Board's discretion. The Board may, in its discretion, approve an attorney’s fee for a period of greater than 400 weeks so long as the attorney fee is not in excess of 25% of the claimant’s weekly benefits.

(a)  Attorney fee contracts.  Immediately upon being employed by an employee or claimant in a matter which is before the Board, the attorney shall file a contract of employment and fees with the Board. This contract shall include the following attorney typed information: (1) name, (2) bar number, (3) firm name, (4) address, (5) phone number, (6) fax number, (7) email address, and (8) Board claim number.  If the Board claim number is not known, this contract shall include the employee's first name, last name, social security number, and date of injury.  Finally, all contracts shall include the employee's name and address.  This contract shall be dated, and shall be signed by both the attorney and the client, and shall include the following statement with respect to an accident occurring on or after July 1, 1992:

This contract is subject to the approval of the State Board of Workers' Compensation, and no fee of more than $100.00 shall be paid under the contract unless approved by the Board. No contract shall be filed with the Board which provides for a fee greater than 25 percent of the recovery of weekly benefits.  Any contract with these terms, absent compelling evidence to the contrary, shall be deemed to represent the reasonable fee of the attorney.

With respect to an accident occurring before July 1, 1992, the contract shall include the following statement:

This contract is subject to the approval of the State Board of Workers' Compensation, and no fee of more than $100.00 shall be paid under the contract unless approved by the Board.  No contract concerning an accident occurring before July 1, 1992, shall be filed with the Board which provides for a fee greater than 25 percent of the recovery of weekly benefits without a hearing, 30 percent of the recovery of weekly benefits with extensive discovery preparatory for a hearing, and 33-1/3 percent of the recovery of weekly benefits after a hearing.  Any contract with these terms, absent compelling evidence to the contrary, shall be deemed to represent the reasonable fee of the attorney.

An attorney who requests approval of his or her fee contract when there is no pending litigation shall file with the Board Form WC-108a.  When an attorney requests approval of his or her fee contract after a hearing notice has been issued and after the dispute has been resolved, that attorney shall file Form WC-108a with the Administrative Law Judge who issued the hearing notice.

(b)

(1) The value of the services of the attorney may be agreed upon by the parties subject to approval of the Board.

(2) Any offer to make payment if the party waives a claim for attorney's fees under paragraph (2) or (3) of subsection (b) of O.C.G.A. § 34-9-108, or any agreement to waive a claim for attorney's fees as a condition to payment of income or medical benefits, where the only consideration for such waiver is the commencement of income or medical benefits, shall be void ab initio.

(3) No party shall be required to pay an attorney for services for which the fee was assessed against the opposing party. The Board, if deemed appropriate, may approve an attorney's fee which combines fees assessed against an opposing party and fees paid pursuant to approval of an attorney fee contract, provided that the claimant receives a credit for the assessed fee.

(4) An attorney advertising to render services to a potential workers' compensation claimant must intend to render said services and shall not divide a fee with another attorney who is not a partner in or associate of his or her law firm unless:

1. The client consents to associating the other attorney after full disclosure that the fee will be divided; and,

2. The fee division is made in direct proportion to the services and responsibility performed and assumed by each attorney; and,

3. The total fee of the attorneys shall not exceed a reasonable fee for the claim.  No party shall be required to pay for the services of an attorney who violates the provisions of O.C.G.A. § 34-9-108(c).

(5)  Upon assessing attorney's fees, costs may be assessed against the offending party which are payable to the Board in an amount not less than $250.00.  The Administrative Law Judge may assess higher costs based on the length of the hearing, time traveled, and time lost from other duties.  In any case where a determination is made that proceedings have been brought, prosecuted, or defended in whole or in part without reasonable grounds, the Administrative Law Judge or the Board may, in addition to assessed attorney's fees, award to the adverse party reasonable litigation expenses, in whole or in part, against the offending party.  Reasonable litigation expenses under this subsection are limited to witness fees and mileage pursuant to O.C.G.A. § 24-10-24; reasonable expert witness fees (subject to the Fee Schedule, where applicable); reasonable deposition costs; and the cost of the hearing transcript.

(6)  When requesting payment of attorney's fees at a hearing pursuant to O.C.G.A. § 34-9-108, the party making the request shall be required to demonstrate the reasonableness of the attorney's fees requested by placing into the record expert testimony as to the value of services rendered.  Counsel may testify personally or in affidavit form at the hearing, subject to cross-examination, as to expert status and the reasonable value of the services rendered in order to meet this requirement.  No attorney's fees will be awarded pursuant to O.C.G.A. § 34-9-108 absent this evidence being placed in the record.

(7)  When the parties agree to an assessment of attorney's fees the attorney who is to receive the assessed fee shall file with the Board Form WC-108a, serve a copy on all parties or their counsel, and sign the certificate of service on the form.

(8) An attorney shall not receive an attorney's fee on any medical treatment or expenses obtained for an employee, unless such fee is assessed under O.C.G.A. § 34-9-108(b)(1).

(c) Solicitation of Services. See O.C.G.A. §§ 34-9-22, 34-9-30, 34-9-31 and 34-9-32.

(d) An attorney who has made an appearance by filing Form WC-14 or by filing a fee contract and who wishes to withdraw as counsel for any party therein, shall file a Form WC-108b with the Board.

(e) An attorney of record who chooses to file a lien for services must do so by filing written notice of the contended value of such services with the Board on Form WC-108b within 20 days after (i) withdrawal from the case, or (ii) notice of termination of the contract in writing by the client. The attorney of record filing a lien shall serve a copy of Form WC-108b on all unrepresented parties and counsel. Failure to attach supporting documentation will result in the lien being denied. If the Board includes the issue of approval of the fee lien for determination at a hearing or mediation, and the attorney who filed the lien fails to appear and present evidence in support of the lien, then it shall be void. If all parties agree to resolution of a fee lien request prior to the initiation of litigation, then one of them must file with the Board Form WC-108b. Failure to perfect a lien in this manner will be considered a waiver of further attorneys' fees.

(f) No attorney shall charge to any client as an expense of litigation any portion of any referral fee or membership charged by any lawyer referral service, or nonspecific office costs.

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Board Rule 206. Reimbursement of Group Carrier or Other Healthcare Provider

(a)  Form WC-206, including supporting documentation, shall be submitted to the Board by the party seeking reimbursement during the pendency of the claim.  Copies shall also be sent by the party requesting reimbursement to all counsel and unrepresented parties at interest.

(b)  If a hearing request is pending when the Board receives a request for reimbursement and designation as a party at interest, the Board will provide the requesting party with notice of the hearing.

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Board Rule 61(b)(23). Form WC-108a. Attorney Fee Approval

An attorney shall file this form in order to request approval of a fee contract, an assessed fee by consent, and for resolution of a fee lien dispute by consent, when there is no pending litigation, and shall serve a copy on all counsel and unrepresented parties.

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Board Rule 61(b)(24). Form WC-108b. Attorney Withdrawal/Attorney Fee Lien

An attorney who wishes to withdraw must file this form and follow the procedure set out in Rule 108(b).  An attorney of record who chooses to file a lien for services and/or request for reimbursement of expenses after withdrawal from representation or after services are terminated, in writing, by a client, shall file this form with supporting documentation, and serve a copy on all counsel and unrepresented parties.

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Board Rule 61(b)(31). Form WC-206. Reimbursement Request of Group Health Insurance Carrier/Healthcare Provider

A group health insurance carrier or health care provider which requests reimbursement of medical expenses shall file this form during the pendency of a claim, and serve a copy on all counsel and unrepresented parties.
  • Form WC-206/Reimbursement Request of Group Health Insurance Carrier/Healthcare Provider
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Board Rule 61(b)(39). Form WC-244. Reimbursement Request of Group Insurance Carrier/Disability Benefits Provider

A group insurance carrier or disability benefits provider which requests reimbursement of disability benefits shall file this form during the pendency of a claim, and serve a copy on all counsel and unrepresented parties.

  • Form WC-244/Reimbursement Request of Group Insurance Carrier/Disability Benefits Provider

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O.C.G.A. § 34-9-244. Reimbursement of provider of disability benefits to person who subsequently files claim

(a)  Any party to a claim under this chapter, a group insurance company, or other disability benefits provider who provides disability benefits for a person who subsequently files a claim under this chapter may give notice in writing to the board at any time during the pendency of the claim that such provider is or should be a party at interest as a result of such disability benefits paid to the employer.

(b)  In cases where a group insurance company or other disability benefits provider pays disability benefits to a person pursuant to an employer paid plan who subsequently files a claim and is entitled to benefits under this chapter, the board shall be authorized to order the employer or its workers' compensation insurance carrier to repay the group insurance company or other disability benefits provider the funds it has expended for such disability benefits and take credit for that amount against income benefits due under this chapter, provided that:

(1)  Such employer or its workers' compensation insurance carrier is liable under this chapter for income benefits;

(2)  Such other provider has become or should be a party at interest pursuant to the provisions of subsection (a) of this Code section; and

(3)  The disability benefits paid are pursuant to a plan funded in whole or in part by the employer or workers' compensation carrier.

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