Nathan C. Levy,
Foreman & Speir, LLC
The Legislative session for 2023 has
ended and there are only a few notable changes that we wanted to share with
you. Be advised that per the normal course, these changes go into
effect on July 1, 2023, and will apply to dates of accident from that date
forward. Many of you might recall our newsletter from March 21, 2023,
wherein we advised of possible increases in indemnity caps, a change in the
language associated with dependency and the increase in the maximum recoverable
by a surviving spouse with no dependents. HB 480 was passed and
ultimately remained the only impactful legislation for Workers’
Compensation that emerged from the session.
HB 480 specifically addresses:
A revision to Code Section 34-9-13(e) that formerly allowed for the
dependency of a surviving spouse to terminate with remarriage of upon a
finding of cohabitation in a meretricious relationship with this latter
language removed entirely. Replacing it will be a cessation of dependency
benefits upon determination by the board of cohabitation continuously and
openly in a relationship similar or akin to marriage that includes support
of economic value to the Claimant Dependent. No consideration shall be
given to payments made exclusively for board and lodging or to any payment
for financial support for a period of less than three months.
A revision to Code Section 34-9-261 increasing the statutory maximum for
TTD to $800.00 per week (not less than $50.00 per week) for dates of
accident on or after July 1, 2023. This is an increase from $725.00 per
A revision to Code Section 34-9-262 increasing the statutory maximum for
TPD to $533.00 per week up from $483.00 per week.
A revision to Code Section 34-9-265 increasing the maximum amount paid to a
surviving spouse with no dependent from $290,000.00 to $320,000.00.
Moreover, as we stated in March, with
these changes will come some new challenges related to attempts to suspend
spousal dependency benefits in circumstances where there is cohabitation
but not remarriage and what must be done from an accounting perspective to
bear the employer’s burden. At first glance, the evidence appears to
require a full forensic accounting to show a true commingling of household
dollars in a manner that would be expected to appear with married couples.
This new standard is a much greater hurdle to overcome than merely
providing evidence that a spouse/dependent is actively living with someone
else and holding themselves out as partners. One can expect an increase in
litigation in this area until some judicial guidelines are established.
Certainly, the continued increases in
TTD and TPD should come with little surprise as employers and insurers
are becoming very familiar with cap increases going into effect every July
From a Board Rule perspective, there
are several modifications that also go into effect on July 1st.
The below changes apply to all claims, regardless of the date of accident.
Board Rule 200.2 clarifies the specific Certifications and Licenses
that must be maintained in order to maintain status with the Board as a
“Qualified Case Manager”. The Board rule does clarify that prior to
initially contacting a treating physician, a qualified medical case manager
working without consent of the employee (or counsel) must provide all
parties with written notice of being retained by the
employer/insurer. Qualified medical case managers must also provide
copies of all written documents received from the treating physician to all
parties and attorneys.
Board Rule 100(i) and 102 (E)(1) expand professional conduct
to include a general prohibition by any person in any claim to exhibit
unprofessional, discourteous, or disruptive conduct and that certainly
extends to the courtroom.
Board Rule 203(e) also increases the rate of mileage from .40
to .45 cents per mile, and, finally,
Board Rule 203 in relation to Peer Reviews of medical billing
practices, gives the decision of the “peer review organization” the final
say in ordering a lowering or increasing of any bill submitted for review
and requires/allows the employer to remit payment or take credit based upon
As you can see, the session did bring
about the expected changes and with very little surprise. In the end,
that is the path that Georgia’s employers and insurers certainly
prefer. As always, if you have any questions regarding these issues or
would like clarification on any point, do not hesitate to contact us.