Administrative Law
| Jurisdiction | Georgia,United States |
| Publication year | 2022 |
| Citation | Vol. 74 No. 1 |
Administrative Law
Moses M. Tincher
Chelsea J. Harris
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This Article surveys cases from the Supreme Court of Georgia and the Georgia Court of Appeals from June 1, 2021 through May 31, 2022, in which principles of administrative law were a central focus of the case.1 Review of decisions by administrative agencies will be the first topic discussed, followed by cases discussing discretionary appeals, followed by cases discussing procedural requirements, with scope of authority to follow. The Article will conclude with cases discussing statutory construction.
In Express Employment Professionals v. Barker,2 the Georgia Court of Appeals discretionarily reviewed an order from the carroll county Superior Court reversing the judgment of the State Board of Workers' Compensation (SBWC) in favor of the claimant, Terry Barker.3 As background, the claimant was an employee of Express Employment Professionals, which operated as a temporary employment agency. On August 14, 2018, the claimant had been assigned to work at a seafood packaging and processing plant where he ultimately fell onto the left side
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of his buttocks and hip, as well as his left wrist, while attempting to move a container of fish parts.4
Later that day, the claimant received treatment from Dr. Leslie Cottrell.5 He complained of pain in his left hip and across his back, but he did not tell Dr. Cottrell of his past history of back pain. Dr. Cottrell diagnosed the claimant with a lumbar sprain and instructed him to start physical therapy. The claimant then began receiving temporary total disability (TTD) workers' compensation benefits.6
On August 21, 2018, the claimant visited Dr. Cottrell again, continuing to complain of back pain, but noting that his hip pain had subsided, and asserted that he began experiencing numbness in his fingers.7 Dr. Cottrell again diagnosed the claimant with a lumbar sprain. That same day, the claimant went to physical therapy, and he informed the physical therapist that his back no longer hurt, but that he was experiencing numbness and tingling in his hands. The physical therapist informed the claimant that his finger numbness was not correlated to the mechanism of his injury. At the next physical therapy appointment, the very next day, the physical therapist again noted that the claimant had no back pain, and that the mechanism of the claimant's injury and the presentation and objective findings related to the injury did not support the claimant's symptoms of numbness. As a result, the physical therapist recommended that the claimant be discharged from physical therapy.8
On September 14, 2018, the claimant visited a different doctor—Dr. Chad Kessler.9 There, the claimant complained of back pain and a radiating bilateral upper extremity pain accompanied by numbness and tingling. Dr. Kessler diagnosed the claimant with a lumbar strain, gave him work restrictions, and told him to start physical therapy.10
The claimant received an MRI in September 2018, which showed a "multilevel mild lumbar facet arthropathy" with a mild curving of the lumbar spine.11 Dr. Kessler believed the MRI showed the claimant suffered from arthritis. Then, on October 26, 2018, Dr. Kessler placed the claimant on maximum medical improvement, provided him a full duty work release, and stated that no follow-up was needed. As a result, Express Employment Professionals and New Hampshire Insurance
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Company c/o Sedgwick CMS (collectively, the Employer) suspended the claimant's wage benefits.12
The claimant filed a motion seeking the recommencement of his TTD benefits, and an administrative law judge (ALJ) denied the motion in April 2019.13 The claimant then visited Dr. David Weiss, who noted that although the claimant had a lot of symptoms, many of the symptoms were insignificant, and that the claimant's present symptoms were a direct result of the job-site injury. The claimant visited another doctor, Dr. Tariq Javid, who diagnosed him with lower back pain, sacroiliac joint pain, and lumbar facet arthropathy. Following these visits, in April 2019, the claimant slipped and fell inside his home, landing on his left hip and buttocks—the same injury site from his work injury. Another doctor then diagnosed the claimant with midline lower back pain and bilateral sciatica with an unspecified chronicity.14
In August 2019, the ALJ held an evidentiary hearing to consider whether the claimant was entitled to the resumption of his TTD benefits.15 After the hearing, the ALJ concluded that the claimant had underwent a change in condition for the better on October 26, 2018, and required no further medical treatment, nor did he have a disability as a result of his work incident and injury. It also concluded that the April 2019 fall inside the claimant's home appeared the same as his work incident, but was nonwork related, and such fall appeared to break the chain of causation between the claimant's work injury and now possible disability. The claimant appealed the ALJ's ruling to the SBWC, which affirmed and adopted the ALJ's decision.16
The claimant then appealed the SBWC's decision to the superior court, which reversed the SBWC's finding that the claimant had experienced a subsequent intervening accident that broke the chain of causation.17 The superior court explained that the decision was judicially inconsistent with the SBWC's conclusion that the claimant had undergone a change in condition for the better on October 26, 2018. As a result, the employer applied for discretionary review, which the Georgia Court of Appeals granted.18
On appeal, the court first concluded that the superior court erred in reversing the SBWC's decision concluding that the claimant had
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undergone a change in condition for the better in October 2018 and required no further medical treatment nor suffered from a disability as a result of the work incident and injury.19 It explained that the superior court did not review the SBWC's decision with the appropriate deference, noting that evidence must be construed in favor of the prevailing party—here, the employer.20 Under such deference, the superior court would have seen that, although there was competing evidence on the issue, there was nevertheless "some evidence" supporting the SBWC's decision.21 Thus, the superior court erred in reversing the SBWC's decision.22
Next, the court concluded that the superior court erred in reversing the SBWC's finding that the claimant experienced a subsequent intervening accident that broke the chain of causation.23 It noted the record contained evidence which clearly demonstrated that the claimant had been released back to work in October 2018 but had experienced another nonwork-related injury in April 2019.24 As such, the "any evidence" standard was satisfied in support of the SBWC's finding, and the superior court erred in reversing such finding.25
Finally, the court held that the superior court erred in ruling that the SBWC's finding that the claimant had a subsequent intervening event and underwent a change in condition for the better were judicially inconsistent.26 It explained that the evidence showed that the claimant did have a change in condition for the better in October 2018, but that he subsequently suffered a nonwork-related injury in April 2019.27 Thus, the SBWC's findings were not inconsistent because they indicated that the claimant had healed from his work-related injury, but was subsequently injured in a nonwork-related incident.28 Ultimately, the court reversed the superior court's findings.29
In Sunbelt Plastic Extrusions, Inc. v. Paguia,30 the appellate court considered whether Sunbelt Plastic Extrusions, Inc. and its insurer (collectively, Sunbelt) proved its statute of limitations defense against a
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former employee's claim for a designation that her work-related injury was catastrophic.31 As background, on March 31, 2009, Julie Paguia (claimant) injured her left hand during "the course and scope of her employment with Sunbelt and sought workers' compensation benefits."32 She was eligible for 400 weeks of temporary total disability benefits (TTD), which lasted through November 29, 2016.33
On November 20, 2018, the claimant "filed a form with the State Board of Workers' Compensation [(SBWC)] requesting that her injury be deemed catastrophic," entitling her to continued payments.34 Sunbelt opposed the designation, arguing that the claimant's request was barred by the two-year statute of limitation set out in Official Code of Georgia Annotated section 34-9-104(b).35 Sunbelt presented testimony from its claims adjuster, who stated that she completed a claims payment authorization form, and it was her opinion that the claimant's final check was mailed on November 15, 2016, based on the typical mail schedule. However, Sunbelt presented no concrete evidence of how much time passed between the claims adjuster filling out the claims payment authorization form and when the mail was actually picked up by the post office.36
An administrative law judge (ALJ) conducted a hearing and rejected Sunbelt's argument while finding that the claimant's injury could be deemed catastrophic.37 As to the statute of limitations defense, the SBWC concluded that although Sunbelt established that it filled out the authorization form on November 14, 2016, it did not present sufficient evidence of when the payment was actually mailed to the claimant, other than it was on a date after November 14. The SBWC adopted the ALJ's decision, and the Houston County Superior Court affirmed. Sunbelt subsequently moved the appellate court for discretionary review, which the court granted.38
On appeal, the court first addressed the statute of limitations issue, concluding that neither the ALJ nor the SBWC erred in concluding that Sunbelt's statute-of-limitation...
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