City of Poulan v. Hodge

554 S.E.2d 233, 251 Ga. App. 500, 2001 Fulton County D. Rep. 2601, 2001 Ga. App. LEXIS 972
CourtCourt of Appeals of Georgia
DecidedAugust 16, 2001
DocketA01A1189
StatusPublished
Cited by2 cases

This text of 554 S.E.2d 233 (City of Poulan v. Hodge) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
City of Poulan v. Hodge, 554 S.E.2d 233, 251 Ga. App. 500, 2001 Fulton County D. Rep. 2601, 2001 Ga. App. LEXIS 972 (Ga. Ct. App. 2001).

Opinion

Eldridge, Judge.

This workers’ compensation claim involves the tolling of the statute of limitation because the claimant had not reached maximum medical improvement (“MMI”) prior to the termination of benefits by the insurer for a compensable injury of January 9, 1989; the claims for change of condition and permanent partial disability (“PPD”) were not filed until August 12, 1999. Both the administrative law judge (“ALJ”) and the appellate division found that the statute of limitation, OCGA § 34-9-104 (b), had run; the superior court reversed on an error of law as to the application of OCGA § 34-9-105 (c) (5), because the claimant had not been determined to have reached MMI prior to determination of the absence of permanent disability and voluntary termination of benefits. We reverse and remand to the Board of Workers’ Compensation for determination of the facts in light of this opinion correcting errors of law as to the interpretation of the applicable law.

The claimant, who had no pre-existing or subsequent lower back condition or injury, compensably injured his lower back when he fell, hitting his lower back across the edge of a backhoe bucket. The employer-insurer voluntarily paid temporary total disability benefits until March 20,1989, when the claimant returned to light-duty work.

Dr. C. B. Gillespie continued to treat the claimant for a little over [501]*501two months until May 22, 1989, when the doctor released the claimant to return to full-duty work without making a determination of MMI.

From the March 7, 1989 MRI, Dr. Gillespie found “minimally abnormal lumbar MR study demonstrating mild to generative disk changes at L4 through L5 through SI interspaces.” However, this medical report failed to indicate MMI, although there was a labeled box number 7 to indicate this on the form, which was left blank. However, Dr. Gillespie checked “no” as to whether claimant had any permanent disability. The last visit was on April 27, 1989. Section 16, “Date of Final Weekly Payment,” was left blank as was Section 17, addressing permanent injury. Dr. Gillespie never filed a WC-20 “Final Medical Report,” and filed only a WC-18 “Medical Report.” At no time did Dr. Gillespie make a MMI determination prior to making an absence of permanent disability determination.

The claimant returned to work on March 20, 1989, and worked for the employer until November 27, 1989, doing light- and normal-duty work, when he went to work for a different employer for whom claimant worked until December 23, 1989. Claimant contended that he left the employer, because the work was too hard on his back. The employer contended that claimant quit to get more money and an easier job, although the record showed that claimant worked only for three weeks. The claimant claimed that he quit the new job because his back got worse.

The claimant’s back continued to worsen until September 1, 1992. On June 17, 1992, claimant was treated by Dr. William L. Hornback III who diagnosed a condition consistent with a herniated nucleus pulpolsus at L5-S1 on the left. On September 1,1992, claimant experienced a relapse of his prior condition, and on September 15, 1992, Dr. Hornback referred claimant to Dr. Lowery for disc excision at L4-L5. On November 4,1992, claimant underwent surgery for an L4-L5 bulging disc, which was confirmed through surgery. Dr. Hornback reported that the claimant did not reach MMI and PPD status until after surgery, which was the first report of MMI made by any physician.

1. The City of Poulan and Travelers Indemnity Company contend that the superior court erred because OCGA § 34-9-104 (b) barred the claim. We do not agree, because the ALJ and the appellate division erred in their interpretation of OCGA § 34-9-104 (b) and applicable case law applying the statute of limitation.

[502]*502The statute of limitation contained in OCGA § 34-9-104 (b)1 is tolled until “the last payment of income benefits pursuant to Code Section 34-9-261 or 34-9-262 was actually made under this chapter.” Under OCGA §§ 34-9-1 (5)2 and 34-9-263 and case law applicable to the statute at that time,3 there must be a MMI determination prior to a determination of either a permanent total disability or PPD rating, because the legal determination of permanent disability cannot be made prematurely before the claimant has reached MMI. State of Ga. v. Birditt, 181 Ga. App. 356 (352 SE2d 203) (1986). Such MMI determination was not done in this case until after claimant’s operation. Dr. Gillespie never rendered a MMI before rendering his lack of disability opinion; the MMI is the condition precedent to rendering a legal disability rating on the claimant that causes the statute of limitation to commence running. Failure to render a MMI prior to or at the same time before rendering a disability rating prevents the statute of limitation from commencing to run, because there exist potential unpaid claims as to temporary partial disability or PPD, a potential benefit and final benefits potentially owed but not “actually made.” OCGA § 34-9-104 (b). See also MARTA v. Ledbetter, 184 Ga. App. 518, 519 (361 SE2d 878) (1987); State of Ga. v. Bardge, 211 Ga. App. 307, 308 (439 SE2d 1) (1993); State of Ga. v. Birditt, supra at 357-358.

[503]*503As the name implies, permanent partial disability requires a finding of permanency — the loss must be permanent in quality. OCGA § 34-9-263. In the case [before the court], the board found that [the] claimant’s injuries were not permanent in quality since claimant did not reach maximum improvement. . . . But Davis v. Gen. Motors Corp., 166 Ga. App. 401 [(304 SE2d 402) (1983)] cannot be interpreted as eliminating the permanent in quality requirement set forth in OCGA § 34-9-263.

(Punctuation omitted.) State of Ga. v. Birditt, supra at 357-358. The claim in that case was held to be premature, because there was no MMI prior to seeking PPD.

When potential temporary partial disability or PPD payments have not been paid because the employer/insurer stops payment upon the claimant’s return to work, such unilateral act by the employer/insurer tolls the running of the statute of limitation by leaving potential claims unpaid. OCGA § 34-9-104 (b); State of Ga. v. Bardge, supra at 308-309; Wesleyan College v. Mains, 207 Ga. App. 562 (428 SE2d 577) (1993); MARTA v. Ledbetter, supra at 519; Holt’s Bakery v. Hutchinson, 177 Ga. App.

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Related

City of Poulan v. Hodge
554 S.E.2d 233 (Court of Appeals of Georgia, 2002)
City of Poulan v. Hodge
569 S.E.2d 499 (Supreme Court of Georgia, 2002)

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Bluebook (online)
554 S.E.2d 233, 251 Ga. App. 500, 2001 Fulton County D. Rep. 2601, 2001 Ga. App. LEXIS 972, Counsel Stack Legal Research, https://law.counselstack.com/opinion/city-of-poulan-v-hodge-gactapp-2001.