• bathing
• dressing
• meal preparation
• driving
• cleaning

Given that hospitals often release patients home as soon as possible, I see more and more instances where my clients recover mostly at home, with outpatient visits to rehab.

Under Georgia law (Georgia Code Section 34-9-200(a)), the employer/insurer must provide care that “shall be reasonably required and appear likely to effect a cure, give relief, or restore the employee to suitable employment.”   In the case of Medical Office Management v. Hardee, the Georgia Court of Appeals held that:

There is no express prohibition in the Workers’ Compensation Act against the recovery by an employee of attendant care services provided by a family member, including a spouse. Nor does the employer show that a family member cannot provide attendant home care under the Board’s rules and regulations…

The employer had argued against this “spousal reimbursement” on the grounds that the spouse was performing tasks he/she would do otherwise.   The Georgia Court of Appeals, as you can see, ruled otherwise, and permitted Ms. Hardee’s husband to collect a fee under the State Board fee schedule for attendant services.

What does this mean to you?

• First, do not expect your employer or its insurance company to offer to pay your spouse or significant other for attendant care.   Many insurance adjusters are not aware of the Hardee case and even some who are will tell you (incorrectly) that your spouse cannot collect.
• Second, it helps tremendously to have your authorized treating physician note the need for attendant care.  In my experience it sometimes is necessary to have the doctor write a letter specifically setting out the requirement for attendant care.
• Third, non-medical attendants like spouses or family members can get paid based on the State Board’s fee schedule, which sets a specific hourly rate and other limits
• Fourth, insurance companies will look for ways to avoid paying an injured workers’ spouse.  At a minimum, your spouse must have the physical and mental capacity to care for you.   You should seek legal counsel before submitting a request for spousal reimbursement.

If you would like to know more about spousal attendant care, please call me at 770-351-0801or send me an email.

More recently I have learned of a case where the insurance company’s defense lawyer used a “request for the production of documents” to demand that an injured claimant turn over his personal computer to be examined by the lawyer.  As you may know, when you file a workers’ compensation claim in Georgia, both sides are allowed to demand information from the other per Georgia’ “discovery rules.”

Apparently, in this case, the insurance company believes that the claimant’s hard drive will reveal damaging information – perhaps photos, evidence of work or physical activity, or it may be just a fishing expedition.

Now, this was not my case, and at this point, at least, this demand for the claimant’s computer has not become a regular part of defense counsel’s arsenal, but I think that this type of request sets a very bad precedent.  I learned about this case in a monthly meeting I attend with a few other claimant’s lawyers who get together to discuss current developments in the law and winning strategies.  All of us in last month’s meeting were somewhat taken aback by this discovery request as well as the presiding judge’s approval of the request.  We all agreed that if any of use are involved in a case and the insurance company asks to look at our clients’ computers, we will fight this request vigorously.

However, I would be remiss if I did not let you know about this troubling development.  It is certainly possible that a Georgia appellate court could sanction this type of discovery under certain circumstances.  Therefore, I will be telling my clients to not only be aware that their outside activities could be videotaped by an insurance company private investigator, but that their emails, photographs and other computer activities could be examined by a hostile adversary in a workers’ compensation case.

And for those of you who say “let them look – I have nothing to hide” I would respond by saying that clever defense counsel can take photos, videos and correspondence out of context that will make you look deceitful.

The State Insurance Commissioner’s office has begun a criminal investigation into SEUS, an insurance company that provided workers’ compensation insurance to dozens of Georgia communities.

Suspicions of SEUS, short for Southeastern U.S. Insurance Inc., began when department analysts learned that the company had engaged in questionable business practices with a hunting club it owned in Seminole County. SEUS had invested $10 million in the hunting club when the company was in no financial condition to make such an investment. Upon investigation, the department also discovered that SEUS was inflating company assets while drastically understating liabilities.

In October 2009, Fulton County Superior Court Judge Thomas R. Campbell, Jr., ordered SEUS, which at the time held over 200 workers’ compensation policies and provided coverage to dozens of towns and school boards in Southern Georgia, into liquidation.

Georgia Insurance Commissioner John Oxendine was named as the liquidator. Following investigations into the company’s financial transactions, Oxendine compared the bookkeeping methods of SEUS’s former chief executive, M. Clark Fain III, to those of Enron.

Companies like Enron and SEUS, which are motivated by corporate greed, inexcusably disregard the large negative affect their misconduct will have on innocent citizens. Oxendine’s office has taken over the operation of the workers compensation insurer and is now authorized to sell off its assets to pay claims. SEUS has also been banned from involvement in further business.

[tags] georgia workers compensation, workman’s compensation georgia, jodi ginsberg, georgia workers’ comp information [/tags]