Board Rule 104. Suspension/Reinstatement of Benefits

(a)  To unilaterally convert the employee's income benefits from temporary total disability income benefits to temporary partial disability income benefits under O.C.G.A. § 34-9-104(a)(2), the employer/insurer shall serve the employee and the employee's attorney a Form WC-104 no later than 60 days from the date the employee was released to work with restrictions by the employee's authorized treating physician. In addition, the employer/insurer shall attach to the Form WC-104 the medical report demonstrating the employee is capable of performing work with restrictions.

(b)  After serving the employee and the employee's attorney sufficient and timely notice under section (a), if the employee has been released to work with restrictions for 52 consecutive weeks or 78 aggregate weeks, the employer/insurer may unilaterally convert the employee's income benefits from temporary total disability income benefits to temporary partial disability income benefits by filing a Form WC-2 with the Board.  When filing the Form WC-2, the employer/insurer shall attach the Form WC-104 and attached medical report. Copies of all filings shall be served on the employee and the employee's attorney, if represented.

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Board Rule 61(b)(22). Form WC-104. Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations

For non-catastrophic accidents occurring on or after July 1, 1992, the employer/insurer shall send this form to the employee no later than 60 days after the medical release of the employee to return to work with restrictions or limitations.

  • Form WC-104/Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations

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