Change of Condition

Few phrases seem so clear and yet are so confusing as "change of condition." Part of the problem is that the phrase seems self-evident and yet, as used in the workers compensation context, means something that is certainly less than crystal clear. You see, in the workers compensation context, "change of condition" is a term of art. The definition is found within O.C.G.A. § 34-9-104.  In subsection (a) of that statute, the change of condition is defined as “A change in the wage earning capacity, physical condition, or status of an employee or other beneficiary covered by the Act which change of condition must have occurred after the date on which the wage earning capacity, physical condition, or status of the employee or other beneficiary was last established by Award or otherwise.”

The statutory definition contains a lot to consider so let’s break it down.  The change of condition is referred to as a change in the wage earning capacity of the employee, in other words the employee is seeking temporary total or temporary partial disability benefits.  If the change in condition is referring to the change in the physical condition, and the employee is seeking income benefits, then the the employee will seek to show that there is a physical worsening of his condition.  That physical worsening should be proven by the medical evidence.  The next change of condition refers to the status of the employee or beneficiary.  In this context, we are usually referring to the employment status of the injured worker such as a layoff or termination.  It is for this reason that an employee who is terminated from his employment may have an entitlement to income benefits.  Another type of change of condition in which the employee’s benefits are suspended is the WC-104 conversion.  It is in this example, the employee’s physical condition has not changed, his employment status has not changed but his income benefits are being converted from temporary total to temporary partial benefits based upon the legislative policy judgment that determines that this employee would be deemed to have undergone a change in his condition for the better after the expiration of the 52 consecutive or 78 aggregate weeks of benefits while on temporary total disability.

​The next and crucial portion of the change of condition statute refers to the previous determination of a wage earning capacity, physical condition or status established by Award or otherwise.  In other words, change of condition refers only to those cases in which an employee’s claim has been accepted as compensable and for which income benefits have been paid.  If no income benefits have been previously paid, then the claim by definition cannot constitute a change of condition.  The payment of medical benefits for any claim does not establish the employee’s condition by Award or otherwise and does not, therefore, provide the basis for a change of condition claim.  It is after the payment of income benefits that the employer admits that a compensable injury has occurred.  This is no small distinction and will determine the applicability of the various statutes of limitations that must be considered. After this decision on compensability the employee has the right to lifetime medical for that condition for so long as it relates to the original injury. Once income benefits have been paid, an employee can seek to have those income benefits restarted if he has had a physical or economic or economic change in his condition if the employee has restrictions related to the injury and if the request is filed within 2 years of the last payment of income benefits. We will cover this statute of limitations on change of condition claims in a subsequent post.



"Skedsvold & White
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