Ignore the Comp claim and it will go away - NOT

Much like the Dentist's joke that "if you ignore your teeth, they will go away", there are consequences to treating your workers compensation matters with disregard. Think it can't happen? Think it can only happen with uninsured employers? Consider the case of Ready Mix USA v. Ross, decided by the Court of Appeals on March 14, 2012. Mr. Ross alleged a back injury while working for Ready Mix and requested a hearing by filing form WC14 with the State Board of Workers Compensation. Under current procedures, the Georgia State Board of Workers' Compensation uses an electronic filing and notification system (called the Integrated Claims Management System or "ICMS") issues electronic notifications to those who use the system such as attorneys, self insured employers and Insurance Companies. This system, however, leaves injured workers and employers without access as, for the most part, both are infrequent consumers of the workers compensation system. For such parties, service is made by the State Board mailing of notices via first class mail. Assuming the address is correctly provided by the initiating party (in this case Mr. Ross) the mail is sent an the employer (Ready Mix) is notified by U.S. Postal Service 1st class mail delivery while the insurance carrier (Liberty Mutual) receives electronic notification of the filing of a hearing request and the notice of scheduling for that hearing. One concept is important to know: BY LAW, notice to the Employer is notice to the Insurer just as notice to the Insurer is considered notice to the Employer. The practical effect of this notice issue is that the Court DOES NOT CARE if the Employer and the Insurer never actually talked to each other about a claim, only that they should have talked and made a decision about the claim filed by an employee such as Mr. Ross. When the hearing request was filed in Mr. Ross' claim, not only did the Employer and Insurer apparently not talk, not only did the employer and insurer apparently not make a decision, they failed to do ANYTHING about the claim until after the hearing, about which they had notice, had already taken place. Ready Mix and Liberty did not retain counsel and no one on from Ready Mix or Liberty appeared at the hearing. When the Judge was confronted with a party who presented evidence of service, when the Court itself had evidence that its own notifications (US mail and email) were not returned as undeliverable, the Court entered an order finding in favor of the injured worker and giving him everything that he asked for. The Court of Appeals for some reason accepted the application for discretionary review filed by the Employer even though the Court would be bound to affirm the decision of the State Board if there was ANY evidence to affirm it. One possible explantion for this debacle was the the employer, Ready Mix, was not overly familiar with Workers Compensation, knew that they had insurance to handle such matters and decided to defer to its carrier. Liberty for its part is a large and respected carrier with unimaginable email traffic never realized or took cognizance of the claim. Bottom line: if you want a chance to control your workers compensation experience, show up!
"Skedsvold & White
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