Ignoring your mail may cost you your workers’ compensation case.

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If you ignore a notice from the Georgia courts, it could cost you your case. Ready Mix USA found this out last month, when the Georgia Court of Appeals upheld earlier decisions by lower courts. Neither Ready Mix or their insurance company, Liberty Mutual, responded to a notice of hearing and failed to appear at a workers’ comp hearing for one of their employees. The employee, Terrell B. Ross, was then awarded full temporary disability benefits at the July 2010 hearing by the administrative law judge (ALJ).

It was afterward that Ready Mix and Liberty Mutual tried to have the hearing vacated, claiming that they didn’t receive adequate notice about it.

This all started when, in December 2009, Ross was swinging a sledgehammer and started feeling pain and tightening in his back. He reported to his supervisor, but was not referred to Ready Mix’s physicians. A week or so later, Ross started feeling pain radiating from his lower back and reminded his supervisor about the previous injury. It was then that Ross was sent for an evaluation and diagnosed with lumbar and thoracic strain as a result of his job. The doctor who saw him put Ross on light duty and prescribed medication and physical therapy. A handful of weeks later, Ross picked the doctor who was authorized to perform treatment; the doctor recommended a cervical MRI. After that MRI, Ross’ doctor referred him to an orthopedic spine specialist to evaluate and treat him further. The specialist recommended facet injections to Ross’ lower back and took him out of work completely as of late May 2010. This resulted in a work status report stating that Ross was totally disabled until his next appointment or the workers’ compensation board approval of facet injections.

Then Ross asked for a hearing with the ALJ in order to ask for authorization for a cervical MRI, lumbar facet injections, temporary total disability benefits, a 15% penalty for nonpayment, and assessment of attorney fees/litigation costs. It was at that time Ross served Ready Mix and Liberty Mutual with written discovery requests. He was seeking Requests for Admissions, Interrogatories, and Requests for Production of Documents.  The hearing was set for July 2010; with Ready Mix and Liberty Mutual absent (and having provided no response to Ross’ discovery requests!), Ross testified and was awarded what he’d asked for.

This brings us to the part where Ready Mix and Liberty Mutual stamped their feet and wanted the hearing vacated. They claimed that they weren’t provided with adequate notice; they also wanted to withdraw or amend their responses (or lack thereof) to the Request for Admissions from Ross. The ALJ issued an order slapping down the motion and cited the inclusion of the notice they were both served in the record.

In short, the court stated that they notified the Defendants by both snail mail and e-mail. The Court of Appeals said, in essence, “Hey, we have a record of mailing and that’s good enough. We even double-checked the addresses for you after the fact and found that there were no clerical errors on our end responsible for your lack of receipt. We can’t help if you didn’t snag your mail for whatever reason.” The attorneys for Ross testified that they had not heard from anyone at Ready Mix or Liberty Mutual beyond the initial authorization for three different doctors from the insurance adjuster.

Ready Mix and Liberty Mutual lost all subsequent appeals. They may have had grounds to dispute Ross’ injury, but since they dropped the ball on reading their mail, we’ll never know!  Don’t do this.

5 TRICKS

INSURANCE ADJUSTERS PLAY ON UNREPRESENTED WORKERS' COMP CLAIMANTS

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